Workforce Wednesday
Shielding the Light from the Increasing Winds of Segregation
Lois Curtis. Picture provided by John Poole of NPR.
Trump really has flooded the zone. Yesterday’s news was that Ukraine started the war against Russia. In weeks past it was the very temporary, but terrifying freeze on Congressionally authorized funds and the blatant bluff of 25% tariffs against our North American trading partners. It is really hard to respond to this much stupid shit on a regular basis.
Thus, it is all the more important to focus on the vital shit, which, for my community is Medicaid funding. Medicaid provides so much more than health insurance for the poor. It also provides vital community living support for people with disabilities. Almost all of the employment and community support that is provided for people with intellectual and developmental disabilities in this country is funded by Medicaid. Historically, this funding simply covered long-term services in institutional facilities like nursing homes. But for over 40 years[1] the recipients of Medicaid funding have been able to choose community based instead of institutional settings. Lois Curtis, one of the two ladies who fought to get out of a Georgia nursing home and whose Supreme Court case, Olmstead v LC, established the right for people’s Medicaid dollars to support their lives in community instead of institutional settings, just died two years ago. She is rightfully considered a hero in the disability community.
Medicaid funds are provided to states on a matching basis. This means that states like Massachusetts, which chooses to provide robust services for Medicaid recipients, the cost to the Federal government is high. In contrast, some states like Texas severely limit their expenditures on Medicaid funded support for people working and living in the community. According to some reports, the wait list for receiving services like employment supports that are fairly easy to access in Massachusetts, is seven or eight years in Texas. In these states, the proportional Medicaid cost to the Federal government is lower.
In the first Trump administration there was a significant push to cap Medicaid expenditures to states. That would have devastated states with robust services like Massachusetts. For this reason, advocates fought fiercely against this initiative. I had several friends who I have worked with for years who were cuffed and their wheelchairs dragged or carried out of Congressional hearing rooms and hallways simply because they wanted to witness Congressional committee meetings and ensure that the voice of the disability community to be heard.
Now the fight to protect Medicaid is on again. As a leader in my community, I have to stand up and advocate, but I also have to prepare for the possibility that Trump and his minions will win. It is exhausting to think about. It would significantly damage revenue streams that fund disability housing, community, and employment services. But we have to be prepared. Scanning the horizon and planning for contingencies is what leaders do. Even when sick to their stomach.
I’m tempted to write a long update here, because just last week I learned that 17 states are suing the Federal government and seeking the elimination of section 504 of the Rehabilitation Act of 1973. Section 504 is the law that bans the federal government or institutions that receive funding from the federal government - think elementary schools where many students have 504 plans that provide reasonable accommodations that support their learning or hospitals who have to have examination tables that can be accessed by people with physical disabilities - from discriminating against people with disabilities. These anti-discrimination laws were later expanded to the private sector, covering businesses that employ over 15 people in a little piece of legislation called the Americans with Disabilities Act. If the federal government and, by extension, the myriads of local resources that are funded by the federal government are set free to discriminate against people with disabilities, how quickly do you think that the petrochemical company and major insurer that we refer to as our federal government will eliminate protections in the private sector?
That was last week’s fresh horror that I had to rearrange my schedule to attend a national policy briefing about. See what I’m saying? Exhausting. I’m not even going to write about the call that I had with the international disability nonprofit I support last week where we worried about whether the students we support in west Africa will have access to food resources that are provided by U.S. Aid and often distributed by Christian nonprofits like World Vision.
At our best, the core promise of this country is that all people were created equal and endowed with the inalienable rights of life, liberty, and the pursuit of happiness. The current administration appears dead set on violating that core promises for our fellow citizens with disabilities and other populations that does not meet their hetero, white, male, eugenically approved ideals. And a majority of the country, though probably not a preponderance of my readers, voted for these violations. If I believed in souls mine would be sick.
Cliche to say, but the disability community has survived worse. Infanticide, eugenics, state institutions, barred access to buses and education. I have no doubt that the community will find a way to thrive again. What are the survival strategies we need to employ?
They are many in number and not a few exceed the bounds of my imagination. It is to a consideration of those strategies that I will turn next.
[1] Starting with the 1915c waivers that were introduced in 1981.