The MDCH vision of the future

Lansing is a place I do not pretend to understand. Emanations from the Michigan Department of Community Health (MDCH) about its "vision" for people with developmental disabilities seem especially murky and at times far removed from reality.

On December 16, 2009, Michael Head, a Deputy Director at MDCH, met with the directors of the state's Prepaid Inpatient Health Plans (PIHPs). PIHPs are regional affiliations of Community Mental Health agencies. (Our PIHP is the CMH Partnership of Southeastern Michigan that includes the CMH agencies from Washtenaw, Lenawee, Livingston, and Monroe Counties.)

According the PowerPoint presentation of Mr. Head's talk, Michigan's "vision" for adults with developmental disabilities is for them to have the supports and services necessary to be healthy and safe and to successfully:

• contribute to their communities
• earn an income in a non-segregated community setting
• live in their own homes
• have full community inclusion with meaningful participation and membership
• have friendships and relationships
• have fulfilling lives

According to the MDCH, people who do not conform to the state's vision of success (people who live in group homes or are unable to earn an income in non-segregated settings, for example) are now being deprived of a new-found right, "the right to live in the world".

The state's vision dovetails nicely with the MDCH proposals to deal with the state's economic crisis: eliminate the bad old "legacy" programs such as day programs, sheltered workshops, group homes, and other programs in settings designed especially for people with the most severe and complex disabilities. A principle underlying the planning process for the future is that consumers need to get used to making do with less than adequate services, but rest assured: the state is more than willing to give them ample opportunity to participate in the fight over what to do with the remaining resources.

There are many well-defined rights for people with disabilities, including the right to treatment and services suitable to the person's condition and the right to participate in determining those services through the Person-Centered planning process. State and local mental health agencies have the obligation to assure that rights are protected and services available to meet the needs of a diverse population. There is nothing wrong or illegal with the existence of programs such as day programs, licensed group homes, and sheltered workshops that provide for the needs of many people with developmental disabilities. No one can deny a person participation in benefits that are generally available to everyone in a community, based solely on a person's disability, but neither can a person be forced to participate in a program or service they do not need or desire. And rights do not disappear in a bad economy.

"Living in the world" is not a right, but an often unpleasant reality that we all have to cope with. Everyone, unless one happens to be a hermit, lives in a community. "The" community, however, is an ill-defined abstract notion that is open to interpretation. Attempting to eliminate an infrastructure of services that many people with developmental disabilities depend on by choice and necessity does nothing to protect rights and very likely will not save money.

There is no getting around the seriousness of Michigan's economic crisis, but placing the burden of the crisis on vulnerable people and their families who have few resources with which to fight back is not a reasonable or humane approach.