Medicaid... and independent living

Many of Missouri's seniors and people with disabilities are steaming over recent events in Jefferson City. After years of fighting for rights and services that allow them to remain in their homes living independently rather than being confined to institutions, these groups now face an uncertain future. Medicaid cuts proposed by Gov. Matt Blunt would slash benefits to many of the states disabled and elderly poor.

Not-for-profit independent living centers across the state, including SEMO Alliance for Disability Independence serving five counties in Southeast Missouri, are working with legislators to try and preserve programs vital to our most vulnerable citizens.

Independent living centers such as SADI provide services to over 31,000 disabled Missourians annually.

Among the services funded by Medicaid that would be affected is the Personal Assistance Service program, an in-home care program that allows disabled people to direct their own care at home.

The program offers many advantages not included in other in home programs and already provides for screening of applicants to help prevent the kind of abuse the governor seeks to eliminate. Monitoring of PAS consumers is conducted monthly to ensure continued compliance with Medicaid standards. Fifty-one percent of the SADI personnel who administer the program must be disabled themselves, giving them special insight into the needs of disabled consumers.

SADI personnel are experts on disability issues and have a personal stake in cutting waste and abuse. Fully 60 percent of PAS consumers in Southeast Missouri are people over 50 years old. The remainder are carefully screened individuals with serious physical disabilities, hardly the stereotypical able-bodied young couple with children so often cited as abusers.

Some PAS consumers are able to work part time with the assistance of the program, contributing something back to society.

The governor's proposal to lower the Medicaid eligibility level threatens the independence of many disabled and could result in some leaving the work force in order to continue benefits. The broad use of the budget knife as proposed could actually gut a program that is the most economical of its kind, costing 61 percent less than confinement to nursing homes. The program already achieves the governor's stated goal of eliminating abuse.

Also threatened by the budget ax is the assistive technology program that allows many disabled Missourians to obtain hearing aids, wheelchairs, walkers and a variety of other devices that allow them to remain independent. Many cannot afford these items without assistance, and some cannot continue to work part-time jobs without them.

Under the proposal, prosthetics such as artificial limbs would be considered optional and not covered. Frankly, we believe mobility, the ability to work and the ability to take care of oneself constitute rights, not options.

Some pundits lament that we are becoming a socialist society by providing services such as Medicaid and that we should do things as they were done in the good old days. Sure, let's do that. Let's go back to a time when whole families became infected with mumps, measles or even more horrible contagious diseases due to lack of inoculation; to the times when for every 1,000 live births, nine women died; to the times when the elderly and physically disabled were locked away in institutions out of sight and out of mind; to the days when teenagers lost most of their teeth before adulthood; to the days when we did not need to worry about retirement, because few lived long enough to enjoy it.

During his election campaign, Governor Blunt promised to contain Medicaid costs by uncovering instances of abuse and verification of Medicaid eligibility. He did not suggest the draconian cuts now on the table. We believe his first approach was the correct one.

The independent living centers have proposed a number of remedies that would go a long way toward achieving the governor's goals without punishing those who Tom Brokaw called "the greatest generation" and the disabled who stand to lose the right to independence that they have fought so long to earn.

SADI understands the need for fiscal responsibility and supports efforts to clean up abuse and make Medicaid more efficient. However, if this is done in a fashion that degrades the lives of thousands of our citizens without actually fixing anything, Missourians will have serious questions of our lawmakers.

We invite the governor and all other lawmakers to accompany one of our independent living specialists on a regular visit to the home of a consumer who relies on the PAS program. We believe that such a visit would greatly increase their appreciation of the critical need for these services.

Will Richardson is the outreach specialist for the SEMO Alliance for Disability Independence in Cape Girardeau.