Wednesday, February 24, 2010

Ann Arbor CIL: Computer Lab Available for Public Use

From the Ann Arbor Center for Independent Living:

The Ann Arbor CIL’s computer lab contains four computers for public use. The computers can be used to connect to the Internet and have the Microsoft Office Suite and other software for your use.

A range
of assistive technologies such as voice recognition, screen readers, and alternative keyboards are also available on some of the computers. The computer lab is available for drop-in use between the hours of 9am and 4pm Monday through Friday. (Occasionally, it may be closed for classes or other activities.)

Ann Arbor Center for Independent Living
3941 Research Park Drive
Ann Arbor, MI 48108
(734) 971-0277 phone

Wednesday, February 17, 2010

The WCHO, the Governor's budget, and DD services

The Washtenaw Community Health Organization (WCHO) board met last night. The Executive Director Patrick Barrie summarized the Governor's proposed budget for the Department of Community Health for fiscal year 2011. It shows an increase in Medicaid funding for MDCH of about 3% and a small decrease in General Fund allocations. This sounds much better than the dire predictions of up to 20% cuts in DCH programs, but the proposals are based on some shaky assumptions:

  • that the tax system will be restructured to lower the sales tax and imposes a tax on services;
  • that large numbers of teachers and state employees will retire and be replaced with new hires at a lower pay rate and decreased benefits;
  • that physicians and hospitals will be taxed to generate more federal funds that will go back to physicians and hospitals;
  • and that federal Medicaid stimulus funds will be extended for another six months.

The largest reductions proposed are in funds for people with substance abuse problems. These are often the same people who end up in emergency rooms and hospitals at greater cost to the health care system and the community than if they had received treatment before they reached a crisis situation. There has been much discussion at the WCHO board and committee meetings of plans to provide better access to services for people with mental illness and substance abuse problems. Early access saves money in the long run and generally improves the quality of life for these consumers.

So far in this budget crisis, there has been almost no discussion by the WCHO board of services for people with developmental disabilities other than to say that most people with developmental disabilities qualify for Medicaid and are therefore entitled to services. It helps that Medicaid funding is available and will probably increase.

We know, however, that the Michigan Department of Community Health is targeting for elimination programs for people with the most severe disabilties - group homes, sheltered workshops, and day programs. One might logically think that the state is motivated by a desire not only to save money, but to shift more of the responsibility from serving people with severe and complex disabilities from the state to local mental health agencies. But the state claims to have a higher moral purpose: specialized programs that serve only people with disabilities discriminate against them by isolating and segregating them from people who are not disabled. By eliminating these programs the state serves the noble purpose of rescuing people with disabilities from discrimination.

The mental health system fully supports people with mental illness and substance abuse problems in joining together in clubhouse programs and recovery and support groups. Other parts of the system encourage a full array of options for senior citizens, including group living in independent and assisted living facilities. But when it comes to people with severe developmental disabilities, the state is set on saving them from the horrible fate of having to associate with people like themselves. Now that's discrimination!

Monday, February 8, 2010

Michigan Medicaid cuts: foolhardy or fiscally responsible?

According to an article in the Traverse City Record-Eagle, the Michigan Health & Hospital Association, the Michigan State Medical Society, and the Health Care Association of Michigan are some of the groups concerned about further cuts in Medicaid reimbursement rates for the 2011 fiscal year. The Michigan Senate Majority Leader Mike Bishop, R-Rochester, wants to reduce Medicaid spending by $160 million to $500 million by dropping so-called optional Medicaid services or the number of people eligible for Medicaid.

As people have lost jobs and health care benefits, the state has come to rely more and more on Medicaid: 1.7 million people or 1 in six are now enrolled in the program. As reimbursement rates decline, the number of doctors accepting Medicaid has also decreased, making access to health care more difficult for some Medicaid recipients.

Medicaid funding is a confusing and complex subject. As budget proposals are offered by the Governor and the legislature, I hope there will be some wise people who know a lot more than I do, who will help us understand the comparative wisdom of the choices our legislators will have to make.

Medicaid is a shared state and federal program where the federal government matches state money according to a formula that varies from state-to-state and year-to-year, depending on the state's economic condition and need. Michigan is a very needy state indeed. For every dollar that the state spends on Medicaid, the state gets three dollars from the federal government. While this is not free money, in many respects, Medicaid services are a real bargain. I assume that by maintaining or increasing Medicaid spending, the money could go a long way toward maintaining and increasing jobs in health care and specialty services in the community mental health system and would have a positive effect on the economy.

That the Senate Majority Leader is considering dropping optional Medicaid services, could be a scary proposition. Don't let the word "optional" fool you. These services are lifelines for people with developmental disabilities and their families, as well as for the other populations that Medicaid serves. Here is partial list of optional Medicaid services that people with developmental disabilities have come to rely on:

  • Prescribed drugs
  • Medical care or remedial care furnished by licensed practitioners under state law
  • Diagnostic, screening, preventative, and rehabilitative services
  • Clinic services
  • Dental services
  • Prosthetic devices
  • Eyeglasses
  • Physical therapy and related services
  • Intermediate care facility for the MR
  • Home health care
  • Case management
  • Respiratory care services for ventilator-dependent individuals
  • Personal care services
  • Private duty nursing services
  • Hospice care
  • Home and community-based waiver services

Reducing spending on Medicaid and the services covered, looks more like folly than fiscal responsibility to me.

For more information on Medicaid services, including a more complete chart of mandated and optional services, see the VOR Website.

Thursday, February 4, 2010

High school for students with autism and Asperger's to open in Ann Arbor

A new private high school for students with high-functioning autism and Asperger's Syndrome will be opening in Ann Arbor, Michigan, in September 2010, according to a recent article in Veritas Christi High School, a non-denominational faith-based private school, will be located at 410 S. Maple on the west side of Ann Arbor. The school will offer a college-prep curriculum specially designed for students with autism and Asperger's Syndrome.

The school's founder, Richard Nye, says this population needs a small school with very small classes and expert faculty. They need stimulation in an environment where they won't feel different or stigmatized. He also says that he wants the school to be "inclusive" and not limit it to just students with autism and Asperger's Syndrome. I am guessing that what he means by "inclusive" is that the school will not exclude students out-of-hand just because they don't carry the right label. If they can benefit from the small classes, extra attention, and specialized curriculum, and their parents can pay the tuition, then who cares what their diagnosis is or whether they have one?

Surprisingly, the school wins high praise from an advocate for the kind of inclusion that would seem to preclude a school specially designed for students with particular types of disabilities. Sally Burton-Hoyle, a professor of special education at Eastern Michigan University and director of the Autism Society of Michigan from 1994 - 2006, has, in the past, said that inclusion of disabled students in regular public schools in classrooms with their non-disabled peers is a right and not a privilege.

Featured in the 2002/2003 Winter newsletter of the West Michigan Inclusion Network, Burton-Hoyle is quoted as saying “I think that people are as disabled as their setting is” and that the educational system must have a strong commitment to include students with autism in general education classes in the public schools. “It is best practice for persons with autism to be included and involved with typical and age-appropriate peers.”

According to the article, Sally Burton-Hoyle has apparently changed her mind. She says about the new school in Ann Arbor, that it will fill an educational void:

“We’ve not been able to ever point to a (place and say) go here, go there, and have it be the kind of place that would support people with Asperger’s...It’s particularly important for teens, who in a typical school setting may not be accepted for their strengths - like focusing very intensely on certain topics or talking a lot about them...Hopefully, kids will walk in and know it’s a place where they can feel accepted...If not, their anxiety goes up and their ability to perform at where they should be goes way down."

In the "Inclusion Wars" that started in the 1990's and continue to the present day, many mainstream, government-funded advocacy groups have actively tried (and often succeeded) to close specialized schools that are necessary for kids like mine. Rather than fighting the advocates, it would have been refreshing, to say the least, to hear an advocate defend a parent's right to advocate for a school setting that offers expertise in the particular disability the child has in a non-stigmatizing and accepting environment or for any setting that works for a particular child.

Instead we have an "educational void", created in large part by the proponents of an inclusion ideology based on false generalizations about a group as diverse as any in our society: students with disabilities.

A private school for students with high-functioning autism and Asperger's Syndrome, especially one that will help them through a college-prep curriculum, is a worthy undertaking. Schools, public or private, that provide students and parents with choices (including regular classrooms with appropriate supports) and alternatives that fulfill the educational needs of disabled students deserve our support. An inclusion ideology that is fraught with contradictions, false assumptions, and harmful generalizations about children with disabilities is hardly worth defending.