Years of hard struggles to inch forward and provide a few basic
supports to our elderly and disabled citizens are wiped out by one
stroke of a pen. "So sorry" say the Legislators, "No room in the
budget."
Isn't it time we faced up to the fact that we can't keep fighting for
little gains, and hold them against the crushing financial hammer of
the Corporations? Until we change the System, we will always be
hustling, trying to hold the line. As long as Profit is ahead of
People, we lose. As long as the Rich and Powerful remain the Rich and
Powerful, we will lose.
Carl Jarvis
On 12/20/17, Miriam Vieni <miriamvieni@xxxxxxxxxxxxx> wrote:
Oklahoma Poised to Cut Off 20,000 Disabled and Elderly People From
Life-Sustaining Home Care
Wednesday, December 20, 2017
By Rebecca Anger, In These Times | News Analysis
In early November, the Department of Human Services (DHS) in Oklahoma sent
letters to more than 20,000 disabled and elderly residents informing them
that the in-home care services they were currently receiving as part of the
ADvantage Waiver and In-Home Supports Waiver for Adults programs could be
cut in one month. The full consequences of eliminating such vital programs
are unimaginable but include reduced quality of life, poor health outcomes,
extensive job loss and increased care costs.
I know firsthand that these cuts pose an existential threat to disabled
people in Oklahoma, because I am a disability rights advocate and concerned
waiver program recipient in Illinois. Medicaid waiver programs allow the
disabled and elderly to receive long-term care services -- such as bathing,
dressing, toileting, feeding, cooking and cleaning -- in their own homes,
instead of institutionalized settings. These services are critical for
protecting the rights and freedoms of the disabled and elderly -- and
allowing people to contribute to society as productive members. The
programs
ensure a higher quality of life for all recipients and are fiscally
responsible for states, when compared with higher costs of
institutionalized
care.
So why would a state decide to eliminate these programs?
DHS says they have no choice. The state is facing a $215 million deficit in
2018. The agency needs $69 million to fund all the programs it is cutting,
including the Medicaid waiver programs, for the 2018 fiscal year. Earlier
this year, the legislature tried to increase the tax on cigarettes by $1.50
a box, but then lobbyists from Philip Morris USA and R.J. Reynolds
challenged the increase and won at the state Supreme Court level.
Frustrated
lawmakers then attempted to impose a six-cent increase on fuel, which also
failed, despite Oklahoma having one of the lowest taxes on fuel in the
country.
Cutting vital waiver programs that provide life-sustaining care to disabled
and elderly residents is not the answer to a budget shortfall. People who
are unable to afford assistance on their own could see a dramatic erosion
in
the quality of their lives, or could even lose their lives. Thousands of
workers will likely lose their jobs, and those who are lucky enough to go
to
a nursing home will cost the state at least three and a half times more. We
cannot let Oklahoma get away with these cuts, nor can we accept this action
as a dangerous precedent.
During the first part of November, the Oklahoma legislature did manage to
agree on a stopgap budget, which dipped into the state's rainy-day fund to
finance the waiver programs through March 1, 2018. Beginning in February 1,
2018, DHS intends to send another round of letters explaining that the
waiver programs will be eliminated.
This delay buys people like Richard Anderson an extra three months to find
alternative care. Anderson is a founding member of the Oklahoma chapter of
ADAPT, a national grassroots organization that advocates for community
living. Thanks to the ADvantage waiver, he lives independently with
cerebral
palsy. "You'll see people go into nursing homes, which ironically would
cost
the State of Oklahoma three and half times more," he tells In These Times.
"[The state] is leaving transitioning up to the individuals and their
families, if they even have family."
Anderson says that there are not enough beds available in nursing homes
throughout the state to accommodate the influx of new people needing care
--
and that people will die without services.
The elimination of the waiver programs will also have a major impact on
Oklahoma's workers. More than 450 provider agencies will lose their main
source of income, and it has been estimated that at least 10,000 nurses,
home care workers and caseworkers will lose their jobs.
Many people with disabilities who are served by the program work or
volunteer in their communities. Without the home care workers who get them
ready for the day, they will be forced to stop participating in all aspects
of society. The elimination will also impact the economic capabilities of
family members who will have to leave the workforce to take care of their
loved ones.
These cuts are poised to roll back decades of gains that were hard-fought
by
disabled communities. For the last 40 years, disability activists and
organizations like ADAPT have tirelessly worked to gain the right to live
in
the community. Eliminating waiver programs will erase this work, and people
with disabilities will again be shut out of the community.
We have seen this before. Until 2010, in Tennessee roughly 97 percent of
people with disabilities lived in nursing homes. Residents in the 1990s and
early 2000s were so desperate for freedom that a center for independent
living in Memphis arranged for people to leave nursing homes in the middle
of the night and flew them to Colorado, where in-home services were
provided.
With the help of the ACLU of Oklahoma and the Oklahoma Disability Law
Center, Anderson and others have filed a class action lawsuit challenging
the state's elimination of the waiver programs. In doing so, Anderson hopes
"to save the waiver programs in Oklahoma and send a message to other states
that this is inhumane."
Activists say the law is on their side. Title II of the Americans with
Disabilities Act (ADA) requires that, "A public entity shall administer
services, programs, and activities in the most integrated setting
appropriate to the needs of qualified individuals with disabilities." The
Supreme Court in their 1999 Olmstead decision stated that the ADA protected
people from a segregated setting, such as a nursing home.
However, the US Department of Justice has provided guidance that explains
states can violate the ADA and Olmstead decision because of budget cuts,
but
public entities have "a duty to take all reasonable steps to avoid placing
individuals at risk of institutionalization."
The lawsuit argues Oklahoma has not taken reasonable steps to avoid the
institutionalization risk, and Oklahoma still has options before lawmakers
cut these vital services. The legislature could make cuts to other
non-vital
services that would not have blood on their hands. Slashing a program that
saves money in the long run does not make sense when there is a budget
deficit.
In the meantime, Anderson and other activists from the Oklahoma chapter of
ADAPT will be engaging with lawmakers and protesting their rights to live
in
the community. He encourages others to get involved and call state
legislatures to educate them on the importance of the waiver programs. "I'd
like to think," he said, "it would rally more persons with disabilities to
speak up and fight for their lives and rights."
Originally published at InTheseTimes.com.
Rebecca Anger
Rebecca Anger is a disabled social activist and an aspiring attorney in
Chicago, focusing on health and civil rights law.
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