A month ago, Jessica Gridley did something her parents thought they'd never see: She stood up at a conference in State College and addressed a room full of strangers.
She talked too fast, and for only a couple of minutes. But her bravery floored Mark and Melanie Gridley.
Three years ago, Jessica couldn't walk into a Fashion Bug without anxiety overwhelming her.
She is 25, and has a form of schizophrenia as well as bipolar disorder. She was asked to tell her story to a statewide conference for the Clubhouse Coalition, a psychiatric rehabilitation program that helps mentally ill people learn social and workplace skills that can help them find success in their communities.
For the last three years, Jessica has traveled by Paratransit each day to the Cornerstone Clubhouse in Phoenixville, where her favorite activity is answering the phone.
That's going to end July 15.
The state Medical Assistance Transportation Program has determined that although it is proper for Medicaid to reimburse the cost of Jessica's daily services at Clubhouse, it will no longer pay the cost of her traveling there.
She is one of thousands of mentally ill people who are trying to understand why their routines must change.
Advocates across the state are deeply troubled. I'm with them.
"They're funding the program, but cutting off the transportation. We are floored," said Lu Mauro, a director of a Clubhouse in Sellersville, and an advisory board member of the state Association of Psychiatric Rehabilitation Services.
She and others I spoke to predict the decision will save money in the short term and cost more in the end - and that doesn't even begin to account for the human toll.
"You're going to find them in hospitals," Mauro predicted. "You're going to find them in prisons."
The Phoenixville Clubhouse learned in a June 13 letter from Chester County that rides will no longer be reimbursed. Patrick Bokovitz, the county's community-development director, said last week that during the year that ended June 30, 124 mentally ill people rode Rover Community Transportation to day programs such as Clubhouse, making 1,700 round trips.
The county didn't have much warning of the state's decision and cannot offer the rides itself. "It's something we are not in a position to do," he said.
The state doesn't make it easy to figure out just how many people the decision will affect. Mike Race, a spokesman for the Department of Human Services, couldn't provide numbers of those who are transported for psychiatric rehab.
He said the June 8 announcement not to reimburse travel expenses for psychiatric rehab was merely a clarification of existing policy.
Medicaid "was never supposed to be used for that," he said.
But it had been, for about a decade, Mauro said. She said the state stands to save between $2.5 million and $3 million a year, and the clarification of the rules will strand as many as 2,000 mentally ill people.
Melanie Gridley isn't sure how her daughter will cope.
Jessica has lived in Phoenixville for the last year at Liberty House, which is equipped to support the mentally ill. She travels four miles by van to and from the day program. Her parents say they can't drive her - they live 20 miles away in Coatesville.
At the Clubhouse Coalition last month, Jessica told how she liked being considered a member of a team, not a patient. She liked how each day was highly structured.
Diagnosed at 17 when growing up in Syracuse, she has come into her own at the Clubhouse, her mother says, after years of painful struggle.
"She is without question the hardest-working, most persevering young woman I've ever known," her mother said.
"Baby steps are huge successes when someone is struggling with mental illness."
And Pennsylvania has just cut her off at the legs.