1960 began a new decade with a new president, Massachusetts’ own John Fitzgerald Kennedy. The family of Rosemary was committed to improving services to people then described as the retarded.  In his first year in office, President Kennedy called for “A National Plan to Combat Mental Retardation.”

 

This lay the foundation for the Maternal and Child Health and Mental Retardation Planning Act of 1963.  A White House Panel on Retardation was established which, among other recommendations, stimulated a grant program of $265 million that was allocated and distributed to states for planning.

In Massachusetts, the Department of Mental Health (DMH), then the official state agency for both retardation and mental health, contracted with the Medical Foundation, Inc., a voluntary not-for-profit human service agency, to manage the planning process (The Medical Foundation had been awarded a similar contract to develop a comprehensive plan for mental health covering the years 1963-1965).  At the time, I was Executive Director of the Medical Foundation, and became the director of both planning projects.  The retardation project ran from 1964 - 1966. The Medical Foundation wrote the grant  proposals, the procedure for planning, recruited both staff and the many participants.

It is to be noted that in the 1960’s, Massachusetts and most other states managed the major public mental retardation (MR) efforts under the oversight of mental health (DMH). Their fate was largely tied together. DMH, at that time, was largely an umbrella organization under whose aegis ran a large number of institutions for MR and MH clients/patients. The occasional child guidance clinic, mental health clinic, court clinics and MR preschool nursery were lost in the institutional culture.

These two planning projects ran through two Massachusetts executive branch administrations, one Democrat (Governor Endicott Peabody) and one Republican (Governor John Volpe).  Both Governors gave the projects their full support.  Project staff wrote the MH and MR sections for both Governors’ state of the state messages and for both political party platforms.  For MR, a 23 member Planning Board and 10 Task Forces were ultimately responsible for the 154 page final report.  The two reports led Governor Volpe to ask the projects’ legal council, William J. Curran and myself (as project director) to draft enabling legislation to implement the findings.

Passing the legislation was another story. The year was an election year. The Governor wanted to serve a second two-year term.  The President of the State Senate was nominated to run against him.  Both candidates for Governor wanted to be the sole sponsor of the legislation.  Since the projects were the responsibility of the executive branch, the authors felt compelled to report to Governor Volpe first.  Neither Curran nor I endorsed a candidate, and we struggled to keep the legislation alive as it became one of the two major issues in the campaign.  Volpe was reelected and, as promised, called for a special Session of the Legislature between Christmas and New Year's Day.  After two nearly all-night sessions, the Legislature passed the bill on December 28, 1966 and the Governor signed it later the same day.  In a book that Curran and I later authored, we described this partisan struggle and noted “In the later stages of the Legislative fight, the Associations for the Mentally Retarded, particularly the State Association, were extremely valuable allies.”

Forty years later in hindsight, did all of this matter? The planners did not recommend closing of all these dysfunctional institutions.  They did realize they were a mess.  Phasing down was recommended.  They hoped that size reduction might help. Combined with much smaller settings, they urged the development of community-based programs. They established the statewide regions and areas that largely exist to this day.  It required citizen participation at every level.  It made clear that contracting by the public sector with the private sector was a both legal and a useful tool.  For the first time,  MR was not only given equal status within the Department of Mental Health, the necessary structural changes were including in the new legislation.  When it was decided later to establish a free standing DMR, the structure and enabling legislation was in place. The law also focused on programs, not physical centers (state schools).  The legislation contained only one reference to “Centers” and that was to assure the Commonwealth’s ability to receive Federal funds tied to a “Center.” 

Independent of the legislation, the first recommendation of the MR Planning Board was to establish a statewide office reporting to the Governor to coordinate state action to combat retardation.  It was implemented almost immediately, later becoming the model for the nation, and is still operative under a different structure.

Enacting legislation and implementing it is not always congruent, but every effort was made to see that implementation actually occurred, continuing efforts into the late 1960s.  Typical here was developing tables of organization, designing  procedures to recruit and appoint citizen members of the new committees, writing their responsibilities, writing staff  job descriptions and developing a needs/resource’s budget priority system.