If you were under the impression that the North Carolina Department of Health and Human Services (NCDHHS) was only focused on COVID-19 right now, you would be mistaken.
On Thursday, Jan. 13, the department published its “Olmstead Plan” – “designed to assist people with disabilities who receive or are eligible for publicly-funded services to reside in and experience the full benefit of being part of day-to-day life in communities alongside those without disabilities.”
The plan, which was put together with the help of organizations from across the state, has a goal of helping those with disabilities stay out of institutions – and of supporting those now in institutions and wish to leave.
The Olmstead Plan provides ways those with disabilities can get easier access to housing, jobs, home and community-based services in the places where they live.
NCDHHS Secretary Kody H. Kinsley said in a prepared statement that the plan comes at the issue from a lot of angles.
“The Olmstead Plan captures our Department’s total commitment to build towards the vision in which every North Carolinian can live, work, and thrive in their communities. The plan supports building capacity in our community-based health care services and supports and furthering the infrastructure that enables health such as transportation, employment, and housing. I look forward to working with all of our stakeholders to implement this plan.”
The plan, which took years to put together, gets its name from the US Supreme Court’s imperative in the case of Olmstead v. L.C., which found that unjustified segregation of those with disabilities is, in essence, a form of discrimination.
In the first phase, the plan will attempt to:
- Strengthen alternatives for community inclusion for individuals and families through increased access to home and community-based services and supports.
- Use various strategies to “recruit, train and retain” staff that provide daily services that allow those with disabilities to “live, work and thrive” in their communities.
- Move some people away from institutions to more independent living situations and provide needed supports in the community for those who need it.
- Enhance opportunities for education and pre-employment transition services for younger clients – as well as finding “competitive integrated employment opportunities for adults with disabilities.”
- Address disparities when it comes to access to services.
- Get more input into public policymaking from families and individuals who’ve lived with disabilities.
NCDHHS hopes to use the data gained from implementing the first phase to improve services going forward.
It’s one thing to plan a vision and another thing to provide the funding and personnel that actually provides the consistent and reliable services people who need them require.
In 2002 my mom was injured and suddenly as a quadriplegic needed 24-hour intensive help with everything. She lived in CA and we only for a brief time considered moving her here to NC. CA had much more generous Medicaid (MediCal) rules allowing for future in-home aid and services when their long-term care insurance ran out. There were also better local and state services for people with her level of need for in-home care.
After meeting a young man who was living in a local CA nursing facility soon after mom’s injury I found that even their MediCal services weren’t optimal for people who wanted in-home or independent living options. He was in his 20s with a brain stem injury, a non-speaking quadriplegic who was confined to a nursing facility because there was no option for an aide at an independent facility. Additionally, MediCal and the facility wouldn’t allow a power chair since all facilities provided a manual chair, and wouldn’t provide an assistive speaking device. A charitable organization provided him with the speech device he needed but he and his speech therapist had to haggle with the nursing facility over allowing him to use it. It took the young man and me two years to get him permission to have his power wheelchair, arguing with MediCal, and the nursing facility regarding his need and the safety of his having one.
Over the last 20 years I’ve found the government likes to plan a vision, design programs, then fails to fund them adequately for the population that needs the services. They have administrative staffing that gets paid to do studies and make lists but the real program never materializes. It’s frustrating and makes me angry. This young man has now lived in a nursing home populated by elderly people with dementia and stroke for over 15 years instead of living with young people his age being able to go out and socialize, get a job, and provide for himself which has been his desire. The saving grace has been his ability to participate in one of the most important medical studies done by UCSF in recent history for which we are grateful which may finally allow him the housing independence he’s wanted.
Here in NC, there are several programs that claim to help people with needs “stay at home” but when a person looks into the program they find the funding or services seriously lacking. The financial requirements to qualify are limited, the geographical locations are limited, the waiting lists are too long, the time allowed for help is not adequate, the duration of the program isn’t long enough. In the long run, people realize their choice is having a family member or friend quit work giving them total care, or being in a nursing facility. It makes you angry and depressed when you think you’ve been offered a solution only to find it’s a lie.
I do hope these proposed programs materialize. History causes me to doubt it.
I know a disability when I see it. She follows me around all day.