By Debra Jasper
Enquirer Columbus Bureau

Light therapy is used by a Lake County school that caters to the needs of school age children. (Photo by Michael E. Keating)

In a run-down trailer in the back woods in Vinton County, Frances Malone takes care of a sister, two sons, a daughter and a grandson — all five of them mentally retarded.

The 78-year-old grandmother, who's still recovering from her own heart surgery, asks the Lord each morning just to get her through the day.

"There's no activities for them here, no jobs, no nothing," she says. "I'm all they've got."

When it comes to getting mental retardation services, the Malones couldn't live in a worse Ohio county.

Taxpayers spend just $2,800 a year on each mentally retarded person in Vinton. The Appalachian county has just one county caseworker, no medical specialists and a workshop that sits mostly empty.

Haves and have-nots
Tax dollars spent each year on mentally retarded Ohioans varies wildly — from $43,800 in Wood County to $2,800 in Vinton County.
County	Amount per mentally retarded person	Mentally retarded people
Wood	$43,798	358
Lake	$38,730	951
Clinton	$27,624	127
Clark	$26,764	773
Richland	$24,915	682
Franklin	$24,276	6,460
Portage	$23,007	634
Columbiana	$22,731	398
Trumbull	$22,384	1,004
Cuyahoga	$22,205	6,210
Hancock	$21,791	319
Athens	$21,021	269
Summit	$20,431	2,166
Jefferson	$20,303	390
Geauga	$20,269	467
Madison	$20,208	204
Montgomery	$20,012	2,017
Marion	$19,722	295
Fairfield	$19,698	380
Wayne	$18,457	463
Mahoning	$18,276	924
Hamilton	$18,184	3,346
Clermont	$17,541	657
Fayette	$17,372	142
Tuscarawas	$17,187	420
Holmes	$17,142	236
Guernsey	$16,744	193
Lucas	$16,530	2,226
Ashtabula	$16,415	510
Muskingum	$16,388	335
Meigs	$16,365	110
Auglaize	$16,217	215
Union	$16,156	282
Highland	$15,714	184
Stark	$15,662	1,843
Henry	$15,645	329
Butler	$15,574	1,333
Medina	$15,418	664
Erie	$15,258	362
Ross	$15,020	403
Defiance	$15,001	201
Brown	$14,800	118
Warren	$14,741	706
Allen	$14,560	604
Washington	$14,410	415
Ottawa	$14,332	300
Morrow	$14,331	237
Shelby	$14,155	265
Scioto	$14,127	433
Miami	$14,057	584
Monroe	$14,008	97
Ashland	$13,742	276
Fulton	$13,719	226
Pickaway	$13,649	230
Delaware	$13,628	586
Hardin	$13,544	166
Huron	$13,493	221
Coshocton	$13,492	283
Adams	$13,149	122
Seneca	$13,025	407
Greene	$12,805	474
Jackson	$12,406	114
Lorain	$12,079	1,624
Van Wert	$12,079	176
Belmont	$12,067	418
Gallia	$11,775	160
Perry	$11,733	255
Licking	$11,508	743
Morgan	$11,494	81
Wyandot	$11,328	141
Pike	$11,327	213
Champaign	$11,306	334
Carroll	$11,281	194
Knox	$11,142	280
Crawford	$10,721	255
Logan	$10,583	377
Putnam	$10,279	173
Paulding	$10,247	173
Sandusky	$10,164	344
Harrison	$9,875	134
Lawrence	$9,772	394
Darke	$9,753	339
Mercer	$8,500	295
Preble	$7,948	262
Hocking	$6,653	175
Noble	$6,624	67
Williams	$6,162	297
Vinton	$2,795	159
Source: Ohio Association of County Boards of Mental Retardation and Developmental Disabilities, 1999 Revenue and Expenditure Report for county mental retardation boards.

Yet across the state in Lake County, on the banks of Lake Erie, taxpayers spend $39,000 a year — nearly 14 times more — on each mentally retarded resident.

Lake County operates a sprawling, 65-acre complex with soccer fields, wooded hiking trails, medical specialists and even a greenhouse where people can earn money by raising plants.

All of which illustrates a harsh reality: In Ohio, the kind of care mentally retarded people get depends largely on where they live.

Disparities are stunning in a system that depends on local tax dollars more heavily than any state in the nation.

Local tax levies raise 40 percent of the $1.4 billion in non-Medicaid funds spent each year. In most states, local dollars account for just 5 percent of the money spent.

The results are predictable. Poor counties go begging for state help while rich counties pass tax levies to upgrade even more. Residents of poor counties go without such basics as medical care, while those in richer counties work in state-of-the-art facilities, take trips and have access to psychologists, speech therapists and other medical specialists.

It's a funding system that's significantly flawed, says Tom Nerney, director of the Center for Self-Determination, a national group based in Ann Arbor, Mich., which provides training to disability groups.

"There is a simple issue here of justice," he says. "People of equal need ought to have access to equal resources."

Despite the drawbacks, officials say Ohio has a long history of local control and will always lean heavily on county tax dollars. The funding system mirrors the public school-funding formula, which relies so much on local property taxes that the Ohio Supreme Court has ruled it's unfair and unconstitutional.

As with schools, lawmakers are starting to focus on inequities in the mental retardation system. They voted last year to spend $20 million over the next two years to help poorer counties begin to catch up, although advocates say far more is needed.

That new money provides little comfort to Chris Layh, superintendent of the Vinton County Board of Mental Retardation in rural McArthur, 130 miles east of Cincinnati. To get the new money, counties must show they are raising local funds, and his board has failed 14 times in the past decade to pass a tax levy.

It's the only county in the state without one.

"I look around the state and see what other counties are able to do, and I just sit here and burn," Mr. Layh says.

Down the hall from his office Mr. Layh gives a tour of a small warehouse, which is supposed to provide piecemeal factory work and other jobs. Since there's no work, the few mentally retarded people who bother to show up host a regular, but sparsely attended, garage sale. Others just sit around with nothing to do.

"Down here, no one thinks the squeaky wheel gets the grease because everyone knows there is no grease," Mr. Layh says. "It gets really depressing after a while."

The best of care

The difference between services offered in Vinton County and those in Ohio's more prosperous counties couldn't be more apparent.

Lake County, a wealthy suburb of Cleveland, runs a special school, childhood and recreational programs and two busy workshops, which offer people everything from factory work to computer training.

The workshop also provides special adaptive equipment for severely mentally retarded or medically fragile people. It has chairs that swing from the ceiling and vibrating mats that help stimulate people.

The county takes an unconventional approach to "time-out" rooms, too. County workshops often put aggressive or agitated mentally retarded people in bare, concrete rooms where they're supposed to cool off or calm down.

Lake County provides dimly lit, carpeted quarters featuring soft music, colorful lava lamps, waterbeds and other features designed to soothe fragile nerves.

"It's uplifting. It has a calming effect," says Gary Metelko, who directs adult activities at one of the county's workshops.

In addition to services for adults, Lake County operates Broadmoor School, attended by 96 mentally retarded children. They have access to a huge gymnasium, a variety of special-needs devices and a swimming pool.

While the trend in Ohio and nationally is for mentally retarded students to go to public schools with other kids, that's not always the best choice, Broadmoor Superintendent Elfriede Roman says.

"Some parents try the public schools and bring their children back here," she says. "They think their children do better with special attention."

Cari Dorchock is one of those parents. Her daughter, Ashlee, attended a public elementary school but moved to Broadmoor when she turned 13. Ms. Dorchock says Ashlee — who has a seizure disorder and operates on the level of a 2 1/2-year-old — received little stimulation in the public middle school and ended up sitting in a bean bag chair most of the day.

"I'm a social worker, and I've been to lots of seminars on inclusion and it sounds great," Ms. Dorchock says. "But I don't know that they are ready for some of our kids in a regular school system. I can't even imagine what happens to kids in wheelchairs or kids who use feeding tubes."

At Broadmoor, which has a teacher and an aide for every four students, teachers have more time to work with Ashlee. "It's changed her life for the better 100 percent," her mother says.

Linda Creviston, who has been teaching swimming classes for 25 years, says mentally retarded students like Ashlee benefit from an opportunity to socialize and an activity that provides wonderful physical therapy.

"We have a very nurturing approach to teaching in the water," she says, laughing as she helps two squealing little girls down a twisting slide. "Everyone's learning from each other."

Ms. Roman says the county receives tremendous community support. Lake County voters have approved not one but two levies to support the mentally retarded since 1984. Local business groups such as the Rotary Club raise about $100,000 each year to help pay for extras: field trips for kids, a new gazebo for mentally retarded senior citizens.

The county's recreational specialists take residents to karate and horse-back riding classes. They even helped one man try out his dream of virtual-reality parachuting.

'Life's not fair'

Karate classes and parachuting are beyond even the imagination of Ms. Malone's family.

The mentally retarded members of her family range in age from her sister, Bertha, who's 73, to a grandson, Don, who's 35. A 49-year-old son, Joe, has had three strokes, a heart attack, is diabetic and needs frequent kidney dialysis.

"First thing I do every morning is test Joe's sugar," she says. "Then I give him his shot and his medicine. Then I fix breakfast and do laundry. Then it's time to fix lunch. Then it's nap time for everybody, and I try to clean house. Then I test his sugar again. Then I get supper, clean up after supper and then it's time for bed."

Things were easier for the Malones when a son, daughter and grandson attended the Vinton County workshop during the day. But with no work to do and no trained staff to help fill their time, the three eventually just quit.

Her grandson, Don, hated it there: "I was treated awful. I wasn't allowed to look out the window. They were always yelling at me."

As bad as things are, Ms. Malone has an even deeper fear: That when she dies, another daughter, Sharon, will be left alone to care for everyone. Sitting at her cluttered kitchen table, Ms. Malone rests her head in her hands, exhaustion etching the lines in her face.

"I was born and raised in this county and so was my husband. It makes me really angry to think I'd have to move to another county to get them the services they deserve," she finally says.

Sharon, too, has learned not to rely on anyone else for help.

"They say they don't have any money so maybe that's just how it is," she says. "I've survived chemotherapy, a biopsy and a mastectomy. Life's not fair. I've found that out. But God's spared my life so I can take care of them. And that's what my life will be."