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In early 1967, we were spending at a rate of $600 million a year for about 200,000 institution residents. However, merely to maintain the standards and rate of current institution services will require a rapid rise in institutional costs. By 1975, we could be spending $2 billion a year on our institutions, and they could still be most inadequate. That this is a strong possibility is underlined by the fact that some public institutions with the highest per diem expenditures in this country are grossly dehumanizing.

The point is that money alone is not the answer, not to the problem of institutions or to many other problems. What is ultimately more important than money is philosophies, ideologies, and concepts, and a system of priorities based on these.

Manpower and Staffing Considerations

Several sections of this chapter have referred to personnel problems in the development of an adequate service system for the mentally retarded, and in particular have emphasized the effects to be expected from programs oriented toward specialization and dispersal of residential services. The following observations and propositions will highlight additional aspects of the manpower situation.

While state government invariably has set unreasonably high standards for the construction of residences, it has shown the greatest resistance toward making adequate allowance for even minimal standards when it comes to the staffing of these residences.

Throughout this book, references have been made to administrative arrangements and conditions, now prevailing in institutions, which create very unfavorable working conditions. It should be reiterated in this context that particularly in residential settings, careful thought needs to be given to the dignity and comfort of care personnel as well as residents.

Application of the principle of normalization to the personnel field requires that personnel on any level, working with the mentally retarded, should meet at least the same personal and technical standards as equivalent workers in other settings dealing with nondeviant groups.

Training and Recruitment

The relative newness of mental retardation as a field of professional study and the unusually rapid development of new knowledge and approaches in the field make it imperative that residential and other service agencies place strong emphasis on the development of their professional staff. Means would include adequate and accessible professional libraries; regularly scheduled staff development seminars which include persons from related disciplines, services, and agencies; and attendance at state, regional, and national professional meetings. Necessary arrangements must be made with civil service or other relevant authorities for a period of induction training of professional personnel lacking prior training and experience in the field of mental retardation.

By means of incentive grants, universities should be encouraged to develop training programs for leadership at the predoctoral level, e.g., a 2-year master's degree in retardation administration and program development. Graduates of such programs should be able to step into a wide range of leadership positions, including state planning, program administration, workshop direction, executive positions in the parent movement, etc.

To attact -sic- young people to mental retardation careers early in their academic-professional development, the SWEAT program should be strengthened and expanded. (6) However, SWEAT awards should be made very discriminatively and only to those agencies which are ready to invest a high degree of interest and guidance in the students.

A promising innovation aimed at development of intermediate level personnel has been initiated in several states through collaboration between state agencies and junior colleges in training persons in retardation. Encouragement of such programs through financial participation of state and federal government appears desirable.

Service systems should make major efforts to utilize part-time workers, especially those who have some skill and experience in retardation but who cannot or will not work full time. This is increasingly being done in the fields of education and nursing. Administrative flexibility in scheduling would enable more housewives and students to work in the field, and would be likely to attract more students to retardation-related careers. Part-time work should be particularly easy to arrange in special-purpose hostels where residents are out working or studying during the day, so that peak coverage is required for weekends and for relatively short periods in the mornings and evenings. Finally, some hostels could permit part-time working students to live in, offering them free room and board in return for some work, and again attracting them to eventual careers in the field. The establishment of small, specialized, and dispersed hostels makes such practices much more feasible than in the past.