Well, its been too long since my last post but so much has happened. I have been very busy assisting an Independent Living Center develop a Strategic Plan. The project was just finished in late October so now I am looking for another project to keep me busy.
The original purpose of the blog was to express my opinions on the state of disability policy in the US but so much has changed or is at risk I find it hard to know where to start. The most important issue that needs to be addresses immediately is the threat to Medicaid and the community based services the program funds. Congress is considering serious cuts to the program which in the long run would actually cost Medicaid more money because reducing community based options through waivers would actually send more people into institutions.
This short sighted strategy is based on the simple fact that Congress has never looked long term at the way it budgets. The kick the can down the road mentality is alive and well in Washington so if the cuts occur then we will be back at it in a few years trying to fix the problems it creates with the proposed changes it is now contemplating.
The present system of creating community options is through the waiver process. It seems to me that the opposite should be the case. That is, a waiver should be written if a person has to be placed in an institution! The present system is so disjointed and many states have little community based options in place. This is happening in spite of the Olmstead decision of the Supreme Court handed down over 12 years ago. The decision states in simple terms that "an individual who can handle and benefit from community based options" must have that option instead of being placed in a institutional setting. The decision does require that a plan for implementation be developed but this plan is non existent in many states. If the plan does exist it has little if any time lines to ensure that all persons with disabilities have equal access to community options.
Massachusetts for example still does not have a system that provides equal access to all individuals with disabilities. There are small waivers for individuals with acquired brain injuries and those with traumatic brain injuries. The Commonwealth also recently instituted a money follows the person program but these approaches still do not address many individuals who will not be eligible due to the caps on the programs.
Next time I will dig deeper into the complex situation of community options and the significant unemployment problem affecting people with disabilities. Let me know what you think about this post. Feedback is good and dialog solves problems!
http://jchappelldisabilitysolutions.blogspot.com/
