Pennhurst & subsidiarity

I had a short-term job some years ago working at a home for dual-diagnosis adults. The best thing about that job was each night, on my way home, heading out of the driveway past some of the men’s group homes where, in all but the harshest weather, the guys would all be gathered on the porch. So the last thing I would see and hear each night before leaving was a half-dozen beaming faces and waving hands as they wished me good night and told me they’d see me tomorrow. Best perk I’ve ever had.

The worst thing about that job was the paperwork, especially the paperwork for the dozen or so individuals in our care who were former residents of the Pennhurst State School. That paperwork was a difficult chore, but a worthy one.

19bedroomYou may have heard of Pennhurst. If not, picture the hospital in One Flew Over the Cuckoo’s Nest, only worse. More than 2,500 mentally retarded Pennsylvanians were warehoused and neglected there in 1968 when WCAU reporter Bill Baldini arrived with a camera crew. Philadelphia’s Channel 10 News is still proud of this Pennhurst Special Report, calling it “perhaps the most important news report” in the station’s history. That pride is well deserved. This is what good journalism can do — speaking up on behalf of people with no voice, shining a light into dark corners and provoking change.

That report helped to prompt a class-action lawsuit on behalf of the residents of Pennhurst — a case that wound up going all the way to the Supreme Court of the U.S. three times, where it became a landmark decision regarding the care of the mentally ill. Eventually, nearly 20 years later, Pennhurst was closed and the Commonwealth of Pennsylvania promised that its residents would never again suffer from the kind of conditions they suffered there. That promise involved, as I said, a great deal of paperwork to ensure that it was being kept, but we were glad to be keeping that promise and glad, even, of the burden of documenting it.

I’ve been thinking about the Pennhurst case lately due to a series of reports in the paper by Lee Williams documenting “Trouble at Delaware Psychiatric Center.” The scope of this trouble is nowhere near the scale of the Pennhurst scandal, but it arises from many of the same underlying dynamics. Caring for those suffering from mental illness is not easy and it is not cheap and it never stops. This is even more true for dual diagnosis individuals (those with some combination of mental illness and mental retardation).

Deciding what our obligation is for such care and how we should go about providing it is a challenge made all the more confusing by the many different and undifferentiated competing notions of what we mean by “we” and “our.”

Here is another instance in which the principle of subsidiarity is not only helpful, but necessary.

We are poorly served by the widespread belief that our society involves two, and only two, kinds of political actors: individuals and the state. Subsidiarity, by contrast, recognizes the existence of a host of other actors and agents: families, neighborhoods, civic groups, schools, universities, businesses, churches, religious congregations, nonprofits, etc. Refusing to acknowledge the existence of such actors means refusing to acknowledge the relationships and responsibilities that individuals and the state have to them, which leads in turn to a distorted, Hobbesian, understanding of both individuals and the state. Individuals become viewed as detached, solipsistic atoms engaged in a war of all against all. The state becomes viewed as a monolithic, gargantuan Leviathan — a threat to, rather than the created servant of, the individuals. They are viewed as binary opposites, a view that allows in turn only the binary possibilities of socialism/totalitarianism or anarcho-libertarian/social Darwinism.

(It’s worth noting that the American Constitution rejects this binary view with its distorted understanding both of individuals and of the state, and it does so in its first three words.)

This binary outlook cannot accommodate the mentally disabled. They are, like all children, dependent, and thus incapable of surviving in a Hobbesian jungle. They are dependent, first and foremost, on their families. Acknowledging the reality of such dependence, and of the reality of the existence and obligations of families, shatters the illusions of the binary outlook and forces us to consider the wide world that exists beyond its artificial walls.

The mentally disabled are like all children, only more so. They will never grow out of it. Raising a 4-year-old is a challenge. Caring for a 4-year-old who will always be a 4-year-old, even as his body becomes the body of a 24-year-old, and a 34-year-old, can be overwhelming. Families facing such overwhelming dependence tend to become, themselves, dependent on outside help.

Those who can’t imagine any actors other than individuals or the (federal) state cannot imagine any sources for such outside help other than some kind of federal response — whether institutional or a cash transfer, paid for with tax revenue that they view, by definition, as confiscatory. Here in the real world, however, that help can come in a variety of forms from a variety of different sources: from extended family, neighbors, community groups, schools, businesses and charities (faith-based or otherwise), and from multiple levels of government — municipal, county and state as well as federal.

The idea of subsidiarity is that all of these different actors have different and complementary responsibilities in society. Each has a particular role to play, and the most just and most efficient scenario is one in which each plays its appropriate role and meets its appropriate responsibilities. The presence in our society of intensely dependent mentally disabled people is similar to the the presence in our society of orphans — the situation we looked at earlier as an illustration of the importance of subsidiarity. These individuals’ families hold the primary responsibility for caring for them, but when the family is unable to do so all of these other actors have a role to play.

Ideally, these other actors will be able to support the family, strengthening its ability to care for its members in need. Such support may be financial, or in kind, or in assistance with providing care. But the individuals may still require more specialized, professional care. We could walk through numerous best-case, and next-best-case, and next-to-next-best-case scenarios here, as we did in looking at the foster care system, seeing how in each scenario the failure of any of the various actors to play its appropriate role will result in slightly worse, slightly less effective care. Ultimately, if all the actors from the family on down the line fail to fulfill their responsibilities, then all that will be left is the state — the actor furthest removed and therefore least likely to provide efficient, quality care. Again, this does not result from nefarious government seeking to amass power to itself by usurping the role of these other actors, but rather from these other actors abdicating their responsibilities so that only the state remains as the provider of last resort. The end result of such a situation tends to look like the Pennhurst State School.

Judge Broderick’s decision to close down Pennhurst and to recommit to the mentally disabled, whenever possible, living in the community was a reaffirmation of subsidiarity. It requires a vigorous, but appropriate, role for all levels of government. The state’s role in all this is, foremost, to empower and enable all the other actors to meet their appropriate responsibilities as well. That involves both incentives and regulations, both tax deductions and funding that comes from tax revenue.

The taxes that provide such revenue are legitimate because they arise from the decision by “we, the people” that we do not wish to live in a society in which our most vulnerable and dependent are locked away in houses of horror like Pennhurst, because we have decided that these perpetual children ought not to have to fend for themselves on the street and that their families ought not to be crushed by the responsibilities they may not be financially or technically capable of fulfilling.

You anarcho-libertarians are free, of course, to disagree with this decision. You can complain that any taxation, even the negligible amounts required here, constitutes the theft of money that belongs to solipsistic, atomistic, individual you. But please recognize that in doing so — in abdicating your membership in “we, the people,” and refusing to participate in meeting any responsibilities that entails — you are contributing to the growth of the very government you supposedly dread, forcing it to expand to fill the vacuum left by your refusal to be a citizen, neighbor, parent, cousin, parishioner, executive, volunteer or taxpayer.

But in any case, don’t complain to me about it. I really had nothing to do with making humans social animals who live in differentiated, mutually dependent societies far more complex than your cramped, binary scheme. That just happens to be the way it is, whether you like it or not.

(Pennhurst photo from this site.)

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  • hapax

    @Mabus: “As for churches and tax-exemption…the church is not subordinate to the state in principle and shouldn’t be in practice. Therefore the state has no business taxing it, any more than churches have demanding tithes from the state.”
    I’m fine with that, as long as the churches/synagogues/Temples of Set/etc. also do not expect clean water from their pipes, fire protection when they start to burn, police investigation when they are robbed, access to the roads, and so forth.
    The whole point of Fred’s post, as I understood it, as that NOBODY can opt out of society as a whole, whether they claim they want to or not. If you benefit from the organization, you should help support it. If you don’t, work to change it. You don’t get to just pick up your ball and go home.

  • Mabus

    Jeff: I believe in the “umbrella” theory of government, with the funds being collected at the center (of power), then spread to the local level, with some “ribs” to ensure that localities don’t go totally off the rails. This, if done right (the problem with all theories, right?), would see that the places that need the most aid would get it, where they could spend it on programs that make sense to that locality.
    I tend to agree…at least in theory. As you say, it may or may not work in practice. The obvious way of manipulating such a system is for the small number of people at the center of power to make inappropriate rules about what the localities have to do to get the money. I don’t say that’s guaranteed to happen, you understand, just that it can happen and has to be watched out for.
    Jeff: Churches are, at root, a place where like-minded people come to celebrate their beliefs and act upon those beliefs. As such, they are no more sacrosanct (pun intended? I’ll let you guess.) than, say, the local chapter of “Drinking Liberally” or a similar conservative gathering, neither of which can shield profit from taxation and neither of which demands fees from the government. The First Amendment refers to “freedom of religion”, not “freedom of churches”. The Disestablishmentarians won, right?
    hapax: The whole point of Fred’s post, as I understood it, as that NOBODY can opt out of society as a whole, whether they claim they want to or not. If you benefit from the organization, you should help support it. If you don’t, work to change it. You don’t get to just pick up your ball and go home.
    Religions exist in various states of organization. Some have governments that resemble those of states, while others are not much more than a common philosophy. The RCC might be compared to a constitutional monarchy, for instance (I say that as a suggestion; any Catholics here are free to offer alternative splainy). The Churches of Christ are more like a hodgepodge of city-states, each run by minarchists. Ideally, those different forms of government ought to involve different amounts of state involvement, but doing so would undoubtedly be perceived as religioius discrimination.
    I pay my taxes, although I prefer them fairly low, and I don’t complain overmuch about it, at least not between elections. But I don’t pay taxes as a member of every group I belong to, formal or otherwise. Imagine having to pay taxes via your extended family, your LiveJournal community, or the buddies you hang with at the bar! Many of my church’s congregations are not much more formal than those groupings, unless state regulations require it of them. It’s not clear to me that this is “opting out of society”.
    Maybe I’m failing to understand because of those differences. Perhaps churches that demand tithes from their members turn tidy profits; I don’t know. We usually have trouble just covering operating expenses.

  • MichaelR

    Mabus, I don’t think the post (or at least its tone) is directed at folks like you, since the core of your objection seems to be “this is not the best way to do things.” It’s aimed more at the “OPPRESSIVE COMMUNIST TYRANT HOW DARE YOU TAKE WHAT’S MINE TO MAKE SURE PEOPLE DON’T STARVE/FREEZE/GET ABUSED IN SHITTY STATE HOMES YOU JUST WANT MORE POWER” type. (I’m sure you can think of some prime examples of this sort.)

  • hapax

    Religious organizations that own property should pay property taxes. Religious personnel that receive salaries should pay income taxes. Religious organizations that receive income (tithes, collections, red heifers, etc.) from their members above a certain nominal level should report that income. If they wish to avoid paying taxes on that income, they can fill out the paperwork like any other non-profit. It really isn’t that hard.
    My extended family, LJ community, or bar buddies do not own joint property, hire staff, or collect dues. They do, however, all pay sales taxes on their purchases, which many non-profits and religious organizations do not (it depends on jurisdiction).
    If your church groupins are so informal that they meet in your living room, have volunteer clergy, and only pass around the hat to cover coffee afterwards, I assure you that the IRS will have no more interest in you than it will in your family reunion barbecue. When you start erecting million dollar buildings that require government services, however, you shouldn’t complain if they take a look.

  • Jeff

    Perhaps churches that demand tithes from their members turn tidy profits; I don’t know. We usually have trouble just covering operating expenses.
    Think of a church as a business with a philanthropic arm (Ford and its Foundation, frex). The property the church owns should be taxed as much as any other building. Any income the church makes (and here think Falwell and Robertson, not the Mayberry First Church of Making Do) should be taxed, offset by charitable donations.
    Your MySpace friends don’t own any property, don’t make any income, don’t sell anything. There’s nothing for them to pay tax on. If your church is like that (“where-ever three or more come together in My name”), there’d be nothing for them to pay tax on, either.
    But Crystal Cathedral, Liberty Baptist, etc? C’mon!

  • Jeff

    Dang, hapax, that was SPOOOOOOOOKY!

  • cjmr

    Depending on locality, churches that own property may or may not pay property tax. Churches in our county have to pay property tax on any land not occupied by the church building itself. Clergy pay income tax on their salary–in fact, the IRS counts them as being self-employed, so they pay self-employment tax, too, as well as social security and medicare. Churches also have to pay all those stupid add-on taxes on utilities, phone service, etc. that we all find so annoying. They are exempt from paying sales tax on things they purchase (as are scads of other charitable organizations, and all schools) and business income taxes, but are not exempt from payroll tax on non-clergy employees. I don’t know if churches that have gift shops have to charge (and hence pay) sales tax on items they sell. That might be a locality thing as well.
    One thing churches definitely do not have is profits. I’ve spent nearly half my life working with church financials (either helping my Dad or as an adult as auditor or on church council) and in my experience churches are lucky to break even over a 12-month period–and almost never do over shorter periods.

  • Jeff

    One thing churches definitely do not have is profits. I’ve spent nearly half my life working with church financials (either helping my Dad or as an adult as auditor or on church council) and in my experience churches are lucky to break even over a 12-month period–and almost never do over shorter periods.
    Riiiiiiiiiiiiiiiiiiiiiiiight. The Los Angeles dioceses has $3 million in EXCESS property it can sell, but it’s a poor widdle non-profit. Jimmy Swaggart and Jerry Falwell never made a dime off their church. Pull the other one, it’s got bells on.
    Maybe some, maybe most, churches don’t make a profit, but many obviously do.

  • cjmr

    The LA archdiocese has lots of property that it bought and held (or was bequeathed and held) over the course of the last, roughly, 480 years, and due to value appreciation it is now worth $3 million dollars. (Actually, I think the figures I’ve been seeing have more a couple more decimal places on them than you put in–given the land prices in LA a single piece of property could easily be worth $3 mil.) Technically, that’s profit, but it’s the same sort of ‘profit’ we’ve made on our house–it doesn’t physically exist until the asset is liquidated.
    The 15 acres owned by my previous (Lutheran) church is worth at least $1 million to a developer, who could build 30 ‘luxury’ homes on it and sell them for $500K each–and that is in one of the ‘affordable’ suburbs of DC. The first 10 acres was purchased in 1958 for something like $5K, the 5 acres that the daycare playground is on for $150K, ten years ago. So the profit on that sale would be $845K. And that’s a church entity that’s only owned property for 50 years–you’re surprised that the Catholic church has property with an accumulated value 10 times that high in 480 years???
    Side note, what do you suppose the value of all the real estate owned by the Blue Cross/Blue Shield ‘non-profit’ insurance agencies is? Non-profits aren’t forbidden from owning real property, and real property (generally) appreciates in value.

  • hapax

    @cjmr: “in my experience churches are lucky to break even over a 12-month period.”
    Oddly enough, you could say the same thing about me. Somehow, I don’t think the IRS would be amused if I explained that I don’t owe taxes because I spend every dime I take in.
    Nobody here is saying that churches (or any other religious organization) must pay taxes. All I have heard (or said) is that IF a church wishes to claim a non-profit/charitable tax exemption, THEN they should have to jump through exactly the same paperwork hoops as the Ford Foundation or the Battered Woman’s Shelter or the Unicorn Defense League, instead of waving a magic “render unto Caesar” religious card.

  • Jeff

    As hapax poins out, and as I’ve been trying to say, is that all we want is for churches to have no special tax breaks. Let them file the same as Blue Cross — if they’re a true non-profit, they might even get money back.
    BTW, the “render unto Caesar” is, to me, a statement that The Church does owe The State.

  • Pat Greene

    At the federal level, a church or religious organization is a 501(c)(3) organization. 501 (c) (3) covers a wide range of organizations, including scientific, literary, charitable, or educational non-profits, among others. The USOC is a 501(c)(3). Churches are subject to losing their tax exempt status for political activity.
    Churches are not different from any other 501(c)(3) nonprofit, at least at the federal level.
    Please check your facts before ranting.

  • Fishbone McGonigle

    Churches are subject to losing their tax exempt status for political activity.
    Of course, under the Bush regime it’s only churches espousing liberal politics that actually have to worry about this.

  • Drak Pope

    Prove it, Fishbone!

  • hapax

    @Pat Greene “Churches are not different from any other 501(c)(3) nonprofit, at least at the federal level.
    Please check your facts before ranting.”
    Pat Green, are you a tax lawyer or accountant? I am not, but I’ve had to fill out my fair share of 501(c)(3) applications, so I have a fair notion what’s involved.
    To wit: The objection to religous tax exemptions is that word: “religious”. If churches etc. wish to apply for 501(c)(3) status as educational, charitable, literary, scientific, or public safety organizations, I’m all for that. The question is why “religious” status should be included in the sufficient qualifications of a 501(c)(3), any more than “political”, “recreational”, or “social” organizations.
    Please read the posts you are responding to before insulting the posters.