Caring Across All Divides
By Samuel Nelson, National Student Labor Action Project Intern on Caring Across Generations
When the Supreme Court ruled on Olmstead v. L.C. in 1999, thus allowing those who have the approval of a state treatment professional to live on their own, it was a major victory for disability rights advocates. Today’s hearing, called by Senator Harkin of Iowa, shows that while the progress of implementation has been slow, it is going forward with increasing fervor, particularly now as healthcare and fiscal policy are center stage in contemporary politics.
There was a resounding sense that this issue of care needed to be addressed by the whole government, not by one particular agency or department. Henry Claypool, Director of the Department of Health and Human Service’s Office on Disability, emphasized that the new HHS Administration on Community Living work with other departments on this vital issue of the disabled living in their own homes and communities. Director Claypool and other state and federal government officials have called for a broad strategy to fully implement Olmstead using not only HHS, but the Departments of Housing and Urban Development, Transportation, and Veterans Affairs. Delaware Secretary of Health Rita Landgraf hoped that Delaware’s strategy of housing vouchers and shifting care from institutions to communities can be used as a prototype for the nation as a whole. Mr. Perez stressed the VA’s role in implementing Olmstead, noting that many returning veterans and those already home have disabilities requiring care.
Reiterating the importance of the states in implementing Olmstead, Alabama Commissioner of the Department of Mental Health Zelia Baugh explained how the state has been shifting resources in a cost effective manner to eliminate the institutional bias. Commissioner Baugh stated that the cost of one patient in an Alabama mental institution was upwards of $150,000 a year and paid for by the state; however, it costs the state only $60,000 a year to have a person stay in their home and community to receive care. Finally, Ricardo Thorton, a gentleman who spent many years in DC mental health institutions, testified that he was an example of the potential of people in the institutions. He said, “In the institution, the staff thought for me. I wasn’t allowed to think on my own”. Since he was able to leave the institution, he has married, had a son, and has been working at the Martin Luther King Jr. Library for 35 years.
Mr. Thorton’s story, and the testimony from the government officials, shows how a community based system of care is not only better for those who need it, but ultimately more affordable as well. There have emerged problems not considered when Olmstead was enacted. Both Secretary Landgraf and Commissioner Baugh said that housing and transportation have been serious issues. HUD requires a criminal background check for Section 8 affordable housing, and the nature of our society’s stance toward the disabled and mentally ill in particular means that many have some prior offense. Another issue brought up was that some people are afraid to get jobs because that means losing their Medicaid benefits-such as an in home assistant, which often is not covered under private insurance. Secretary Landgraf suggested a Medicaid buy-in could be an effective tool to offset this.
Olmstead, and by extension the Caring Across Generations agenda, is moving forward. Senator Harkin has introduced the Sense of the Senate Resolution, Senator Franken from Minnesota is about to introduce a Federal Home Care Bill of Rights, and Governor Markell is to be the next chair of the National Governors Association and has vowed to focus on home care. These three developments are great for us as the campaign moves forward. Because this is an expansive campaign, it is reassuring to hear that the government is trying for an expansive strategy- incorporating the local, state, and federal levels, as well as across governmental departments. It leaves CAG in a position where Care Councils can really push for the care agenda at the local and state levels and know they will have some level of influence since this issue is now a priority for legislatures.
This more local and state focus also means that students now have a huge window of opportunity to be involved with the movement. Students must take advantage of this shift in governmental strategy to have their voices heard in the forums and legislatures where home care policies are being discussed. Mr. Thorton credits his success and life in large part to education that he received at a special education school. Those of us who are privileged enough to have an education or are currently receiving one must be involved in the movement for home care so that those who have traditionally been on the fringes of society have the opportunity to receive an education and become self-sufficient. Because education is such a large part of self-sufficiency and because the shift is to self-sufficiency, students can be an invaluable part of CAG going into this new stage of Olmstead implementation.
