So it's no wonder most people today recoil from the idea of placing our grown autistic children in such places. And that much of current policy is aimed at "de-institutionalization," including new Medicare regulations.
But given the autism explosion — the skyrocketing numbers of young adults unable to care for themselves, and often exhibiting challenging behaviors — what we need today are in fact, more and more and more institutions.
How dare I say such a thing? Am I cruel, evil, heartless and nuts? No, here's the rub: the word "institution" has multiple meanings, encompassing both the asylums of the past, where we shunted disabled people to keep them out of sight and out of mind, as well as the nonprofit stalwarts of today, which provide ongoing support and programs for people who need it most.
In its more beneficent guise, an institution is the latter, an "organization founded for a social purpose," including serving people with special needs. Here are some examples of Bay Area "institutions" serving adults with autism and other developmental disabilities:
—Pacific Autism Center for Education
—Morgan Autism Center
—Cedars of Marin
—Arc of San Francisco
These are all vital and cherished organizations providing core and necessary social services, including day programs, employment, residential support, and housing. But when we closed the capital-I "Institutions," we seemed to forget that we needed to develop small-i "institutions" to replace them. California's budget has not expanded to provide reasonable rates to allow established nonprofits to grow, or new ones to take root. These organizations run at constant deficit, in some cases losing tens of thousands of dollars per year per client.
With thousands of dependent autistic young adults aging out of the school system and into an underfunded, overburdened adult system each year, we need to let hundreds of stable, mission-driven, autism-serving "institutions" bloom in California. These "institutions" need to be steeped in autism programming, provide strong supervision and training, be expert in abuse prevention, and provide in loco parentis services with caring, warm hearts. Without funds, how can such institutions proliferate, as they must? Let's support the establishment of more stable, high-quality, lifespan-serving autism "institutions," aware of the profound difference between Institutions and institutions.