By Gary Blumenthal

Federal Judge Joseph Tauro's recent decision to bar Massachusetts from closing the Fernald Development Center affects far more than the 187 people with mental retardation living at the Waltham institution. His ruling opened a complex legal, human and social issue with the potential to impact tens of thousands of lives across Massachusetts and the nation.

The prohibition on closing Fernald sets back the clock more than 30 years, when families, citizens and politicians first learned of the horrors that had occurred in the back wards of America's state hospitals. Secluded from their families and their home communities, patients suffered widespread abuse and neglect.

The furor that erupted led to community-based programs for the developmentally disabled. Thousands were welcomed back into families and neighborhoods, improving their quality of life and that of their families.

In Massachusetts, the five development centers now serve only a few hundred each, while more than 30,000 people with developmental disabilities live and work in community programs, or remain at home with the help of family support programs. These community-based services cost half of what the state institutions cost.

This fiscal disparity has long been the source of great tension in the human service field as the advocates have watched the commonwealth continue to invest its limited tax dollars into an outdated system, while forcing community programs to struggle.

Making this issue even more complex has been the reaction of a small but vocal group of parents of state institution residents who oppose institutional closure for various reasons, including, but not limited to, fear of change.

I understand the fear. My brother, Steve, was institutionalized at the age of 9 in 1966, when there were few other options. My widowed mother, Blanche, made a gut-wrenching decision that no parent should have to face.

Seeing the rise and success of community programs over three decades actually has proven to be both comforting and frightening for families. They are largely thrilled with the level of care and service their relative receives, but it has prompted many to question their choosing to institutionalize so many years ago. My mom knew that feeling. She chose to move Steve into a community setting 12 years ago, just days before she died.

Choice for families is paramount, and is mandated in Medicaid law. However, Tauro's decision dictates that institutionalization at that particular locale remain a choice that, ironically, could limit the choices of others seeking community-based settings.

Simply put, the decision is also bad public policy. Massachusetts must now continue financing an institutional program that drains millions of dollars for a few hundred.

Some leaders understand this dilemma. In 1995, as executive director of President Clinton's Committee on Mental Retardation, I heard then-Assistant Attorney General Deval Patrick address this very issue at the Conference of the American Association on Mental Retardation.

Patrick said the goal of community inclusion ended the day when people with disabilities were "treated as objects of charity." He called for disability policy to be "based on inclusion, not exclusion; independence, not dependence; empowerment, not paternalism."