Chapter 4: Nancy becomes PA Deputy Secretary for MR
06:06:25:13 - 06:12:21:25 Lisa: In 1993 you served as Pennsylvania's Deputy Secretary of Mental Retardation, a role you served in until 2003?
Lisa: You were in charge of overseeing institutional and community services for more than 80,000 individuals. Um, during your time there as Deputy Secretary there was a 50 percent reduction in institutional residency, which is pretty remarkable. Um, how are you able to accomplish all of that in this relatively short period of time?
Nancy: Um, the first reason we could accomplish it, the first, as with all achievements there are many fathers and mothers. Um, one reason, let me step back. I was the Deputy Secretary for ten years, two at the end of one administration and then eight with a new administration so most of my time I worked for Governor Ridge, um and the Governor and his cabinet officer Feather Houston created an environment that enabled lots of good things to happen um the Governor was well educated on disability issues by the disability community by the Centers for Independent Living who had established a relationship with him when he was in congress so by the time, and end he and his wife both sat on the board of the Barber Center in Eerie so they knew a lot. He knew a lot and in fact in his campaign had a disability expert and so he came into office sort of getting a lot of it, understanding the issues um and hired a cabinet officer who was a really good manager who didn't know anything about disability but who could generalize from just a little bit of information very effectively and get it, as we say. Um, the fact that I had been there for eight years already was very helpful, um I had relationships with a lot of people um, I knew the system, I knew the budget, I just knew a lot. So I was ready for a new Governor more than a new appointee is who has never worked in state government which is usually what happens. And so um, I was ramped up and they were open um, and the advocates were extraordinary. The advocates were extraordinary. Um, very early on they made the misstep of suggesting litigation and the secretary um there were lots and lots of conversations to make this happen but in the end there was a big meeting with the secretary and Kevin Casey who was the head of PNA at the time and um, Ron Rucker, who was a provider at the time and chair of our planning advisory committee and she said to them 'You bring me a plan that's doable, that's credible, I promise you I'll support it.' And so we spend a year and a half doing something called a Multi-Year plan and it was data based, we hired somebody to get a lot of data about everything in Pennsylvania; who was being served, what it cost, blah blah blah blah blah blah. And we spent months with the planning advisory committee and the consultants laying it all out for them, here is where everybody is and here is what it costs and it exposed the disproportionate investment in the institutions at the expense of services in the community and the waiting list and it galvanized the stake holders to compromise. On one extreme, people wanted a plan that would close all the institutions within five years. On the other extreme, the institutional families on the planning advising committee wanted no institutions to close. And in the end, we compromised that over a five year period, 1500 people who leave the facilities and the money would be reinvested in the community. But the plan was just not about that. It was also about building infrastructure, and it was about developing certain service models, building an information infrastructure for credibility and accountability. And so, because everybody came together, literally signed on the dotted line, around the room on the multi year plan. We published about 100,000 copies, it was everywhere, and every group on the planning advisory committee, the providers, the advocates, the self-advocates, of which there were many, all stood by it and supported it. And so for a good, I would say that was probably the second year of the Ridge administration it became the foundation for the rest of that administration. Every year we got money. And then the next issue was the waiting list, and we did the same process for the waiting list initiative and began to get money for the waiting list. And so, it's just, the stars were aligned. A good governor, a good secretary, the advocates were very mature, enough trust built up, and we I think - everybody took advantage of that opportunity, and that was a collaborative that was really very successful. And I have to say the other factor was, for most of that time we were not in a recession but the Commonwealth budget was healthy, which really allowed the administration to make good on its commitment, which then engendered trust and confidence, and it just grew from there.
06:12:22:06 - 06:13:38:06 Lisa: You know, it says in the Multi Year plan, they address the sort of different places where everyone came. They said they agreed to get past absolute positions and agree on responsible action.
Nancy: Yes. It really was an extraordinary experience to watch it happen. When we began, the people on the PAC, of which there were maybe about 25, would not even sit at the same table together. And we tried to hold a retreat and they wouldn't agree on two or three consecutive dates, so we had to hold the retreat one day at a time. And actually that was the retreat that produced the concept of everyday lives, which preceded the Multi Year plan. But this was a group of people who were not on the same page. It was great disparity in the advocacy community, but over time they really came together. And I think Bill West at the time, Kevin Casey, deserve a lot of credit. I think PAR, PCPA, all those associations that are named in the planning advisory committee, to an organization and to a person behaved in the best way they could to compromise and come up with a good solution. It was really great.
About Nancy Thaler
Born: 1949, Kingston, PA
Executive Director, NASDDDS; formerly Director of Quality Improvement, Centers for Medicare and Medicaid Services Disabled and Elderly Health Program Group (2003-2006); past Pennsylvania Deputy Secretary for Mental Retardation (1993-2003)
Community Collaborative, Pennhurst, Self-Advocacy, Everyday Lives, Self-Determination