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Patrick Monahan has come home to his mother, Laura Acosta, after five years at a residential facility for brain-injury victims in Carbondale, IL, because his 22nd birthday disqualified him from further state aid. This leaves Acosta with the nearly impossible choice of paying hundreds of dollars a day out of pocket or turning her household inside-out in an attempt to give him constant care.

From the Chicago Tribune:
Eleven years ago, an aneurysm left Acosta's son, Patrick Monahan, with a wounded brain and a dangerous lack of impulse control. He's friendly, funny, a devoted Bears fan, but his behavior is wildly unpredictable. He has heightened sexual urges, the result of a rare syndrome that developed after the brain injury, and cannot be left unattended.

After more than five years at a residential facility for brain-injury victims in Carbondale, Monahan returned to his mother's Chicago Ridge home last week, facing an uncertain future. Though he has the intellectual capacity of a 13-year-old, the state does not classify him as either developmentally disabled or mentally ill, so he has dropped through a crack in Illinois' social services network, losing all the state aid that covered his care for the past decade.

"I'm at my wits' end," said his mother, who along with his stepfather works full time. "I've done everything I can, but the state of Illinois will not help us, and I don't know what we're going to do."

Monahan was seated next to Acosta as she spoke, shaking his head in frustration. He looked up at his mother through wire-rimmed glasses and said, "It's my fault."

Once a jovial kid with aspirations to become a dentist, Monahan was robbed of his future by the aneurysm and several strokes that followed. He is now a grown man, often confused and guilt-ridden by his own actions, most of which he is unable to control.

His mother said her son has never been charged with a crime, though she described several minor acts of vandalism he has committed over the years.

More troubling, Monahan's brain injury led him to develop Kluver-Bucy Syndrome, which causes hypersexuality. Acosta said he has made impulsive attempts to act on his sexual desires, all of which have been stopped before harm could come to anyone. He also receives a monthly shot to help control sexual behavior.

"He can't be left alone," Acosta said. "He's my son, and I want him safe, but I also worry about other people. If he hurt someone I could never live with myself. But I don't know how we're supposed to take care of him."

John Schornagel, executive director of the Community and Residential Services Authority, which helps advise the state on the residential needs of children with severe emotional and behavioral disorders, said that, unlike many other states, Illinois has no lead agency to deal with people who have suffered brain injuries.

And, he said, once people with brain injuries reach age 22 — making them adults in the eyes of the state and not qualified for special education or other youth-focused funding — they are essentially out of luck.

"Some states have shoehorned (patients with traumatic and acquired brain injuries) into their mental health systems," he said. "Other states have shoehorned them in with people with developmental disabilities. What's at the heart of the problem here is that Illinois simply hasn't made a decision about adults with brain injuries that have residential needs. Which agency should have lead responsibility for this? Which agency should fund this?"

Read the entire article.

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