Older Americans and People with Disabilities - Bridging the Disconnect. Information Bulletin # 320 (8/2010)
This Information Bulletin is an attempt to bridge and solidify advocates from two communities - older Americans and people with disabilities. For many reasons, there has been a disconnect between them.
More than two years ago, we wrote “The Older Americans Act: Consumer Choice and Control over Long Term Care,” (see February 9, 2007 Information Bulletin). We reviewed how Congress’ amendments to the Older Americans Act and its “Choices for Independence” began to provide services for people to remain in their homes, instead of going into nursing homes. The Older Americans Act was for the first time really focused on community!
The OAA provided grants for States to develop a “single point of entry” for long-term care, so people would know what community-based services were available in order to avoid institutionalization. This single point was through the “Aging and Disability Resource Centers” (ADRC). It also adopted the “consumer model” so people could self-direct care and services.
The Older Americans Act is up for reauthorization in 2011. Yes folks, Congress will have to face whether or not the “Aging and Disability” centers will be refunded. This reauthorization will provide a forum and opportunity for these two communities to discuss how well they have worked together, how well the ADRCs are functioning, if they are serving both older Americans with disabilities and younger Americans with disabilities and what changes should occur.
There are a number of issues which we hope both communities understand and address:
1. Medicaid is the same funding stream for long-term community care and nursing homes for all people with disabilities, regardless of age. Cut-backs and reductions of Medicaid services impact every disabled person, and State legislatures’ common attacks on services will hurt people regardless of age.
2. Yes, these two communities do not agree on everything (e.g., assisted living, identifying oneself as having a disability), but there are unequivocally common interests. In an era of reductions and attacks by States on community-based services, it is critical to put aside differences and join to fight what the two communities have in common.
3. There really is power in numbers! Can you imagine a State legislative hearing with twenty-five year old wheelchair uses holding hands with seventy-five year old wheelchair uses demanding their right to live in the community and not being dumped into nursing homes.
4. How about next year, during the Congressional reauthorization hearings, joining forces? Tell Congress that all people with disabilities, regardless of age, want the right to receive services in their own homes.
5. The increased Medicaid funds for Money Follows the Person grants must focus on getting anyone out of nursing homes who wants to live in the community - not just people with disabilities under 60 years old. Older Americans do not enter nursing homes because they want to; they do not have community-based services offered to them. If both communities combined their efforts, they could have a significant impact of enhancing waivers - especially in those 20 States that have not yet received MFP grants but probably will be applying for them very soon.
6. The Independent Living Centers serve many older Americans with disabilities. Yet, the AAAs and ILCs in most states keep each other at some distance. As the under 60s younger Americans with disabilities become the over 60s older Americans with disabilities, yes it really happens, the disability issues and culture will cross the age barrier. Let’s hope that the people take the lead and make these organization really work together.
To not take the 2011 reauthorization as an opportunity to address these issues and to jointly work out strategies is perilous.
POWER concedes nothing without a struggle.
Steve Gold, The Disability Odyssey continues
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