Common Sense, the Federal Budget and Disabilities

On June 22, 1999 the Supreme Court upheld the Olmstead Decision.  Advocates for individuals with disabilities compare this to the historic Brown vs. Board of Education ruling that declared separate public schools for black and white students unconstitutional.  Are you familiar with the Olmstead Decision?  I will admit that before Rachel, I knew little about disabilities and I did nothing to advocate for the rights of these individuals. Of course the birth of Rachel changed all of that.  Even so, I have had to educate myself and be educated on the multi-faceted world of disability advocacy. For me, it is personal and I appreciate the many people who have joined these advocacy efforts because of their love for one Rachel Mast.

This is a very simplistic summary.  The Olmstead Decision (Title II of the Americans with Disabilities Act) prohibits the institutionalization of individuals with disabilities.  To quote the Pacer Center, “in the Supreme Court’s words, services to individuals with disabilities should be provided in the most integrated setting possible.”  In other words, if possible individuals with disabilities should live in the community, live in homes. These individuals are afforded the same rights as all American’s under the constitution, and we must offer more choices than the historic institutions where many individuals with disabilities have been forced to live with no input into their living situation.

Many if not most of these “historic” institutions have been closed now but the nursing home industry thrives.  It is my understanding that the nursing home industry has a very effective lobby and in the words of a friend “there are so many jobs tied to the industry”.  Often, families of individuals with disabilities aren’t even totally aware of the fact that they have an option besides nursing homes.  Many individuals with disabilities are forced into nursing homes with no say in the decision. One key reason I hear from families is that the family doesn’t think they have another option. Please do not misinterpret my thinking here: when used appropriately, I am not anti-nursing homes.

Why should this matter to you?  This is where that Common Sense part comes in. Medicaid provides the funds for many of the supports for individuals with disabilities in our country. In 2009 the average national Medicaid cost to serve a person with an intellectual disability in an institution including nursing homes was approximately $137,000.  Comparatively, the average to serve that same person in the community was $44,000. Yet states continue to spend a large portion of Medicaid dollars on these institutional settings.  I direct you to an article (Modernize Medicaid) by Democratic Representative Tom Harkin (IA) and Republican Representative Cathy McMorris Rodgers (WA). It is an enlightening article and illustrates just one aspect of how applying common sense to this one part of our budget crisis could yield positive results.

Individuals with disabilities are one of the most vulnerable populations in our country. Unfortunately, they are usually more dependent on the government for basic living.  They also need people like you and me to use our common sense and our voice to advocate for them – especially in a time when our country has many tough choices in the face of a “bad” economy.  For me it is about more than just the money though. It is that dignity and respect thing again.  I believe that individuals with intellectual disabilities have more ability than disability. I believe they have the right to live fulfilling lives and to have input into decisions about their lives.  I believe they should be afforded the opportunity to live “Real Lives”.  That’s it.

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kb responded:
I really appreciate today’s post. I was unaware of the specifics, albeit not surprised, by the costs associated with paying for nursing home care/assistance versus that of being in the community. Were these annual or lifetime? Communicating these options to individuals with disabilities and their families (along with our legislators) definitely appears to be key in this process.
Thanks again for continuously educating me, I have so much more to learn…
Jawanda Mast responded:
Jawanda Mast
Good question kb. The quoted numbers are cost for one year. Whether you have any connection to disability or not, you might want to lean how your tax dollars are being spent and why. And if this is happening in this arena, how many other areas have the same kinds of issues?Education is always key.

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