Popularly elected, to self-govern, federal, state and local governments
('big guvmint' to social liberal & fiscal conservative neoliberals
R, D and 'Independent,' to reduce email and phone clutter of money ask
contact, voters) combine to define a 'system' or 'civil society.' Posts
on this blog have stated support for 'rebuilding the system' is better
than a 'one person at a time' individual change approach that leaves
hidden savage inequalities in life outcomes for people with
disabilities.
Cuts to the PMHS (public mental health system) in Maryland since 2003,
as a representative case for what happened in other states as well, were
laundered with rhetoric about 'systems transformation' to 'consumer-led
and-directed services,' 'respect for individuals' and 'individual
empowerment' have led to the outcome, by 2017, of long-term budget cuts
for public mental health services.
One question of participants in the recovery coach training (second
image above) asks if one has license in counseling, social work or
psychology who are usually paid more for their work than 'recovery
coaches." People with intellectual disabilities would never be trained
as inclusion coaches or aides to help their peers with intellectual
disabilities even under the 'meme' of 'presumed competence' demanding
equal treatment in policy development as 'self-advocates.'
The Keep the Door Open Acts in the 2016 and 2017 (keepthedooropenmd.org)
Md General Assembly sessions were both attempts to raise Medicaid
reimbursement rates to community based IL (Independent Living) services
providers to prevent more providers from being lost as many have been
since 2003. Individual confidentiality prevents long term outcome
studies of what happened to Chestnut Lodge consumers/patients when CPC
health closed it by 2002. The same confidentiality prevents long-term
outcome studies of consumers/patients who 'fell through the cracks' when
Saint Luke's House and Threshold Services merged into Cornerstone
Montgomery and the contraction of Sante Group/Rock Creek Foundation
after they sold their 700 Roeder Rd Silver Spring building to the local
Catholic diocese and downsized their day program into the SSWRC (Silver
Spring Wellness and Recovery Center).
Section H of a 2007 report (first 3 screen grabs below) from the
Primary Care Coalition lists language capabilities at various private
nonprofit IL (independent living) services providers. Several of the
services mentioned are in Washington DC and may deny MoCo residents
access based on non-residency. If a person feels that they are a 'good
match' for the services they can move to Washington DC from MoCo, Md and
relieve the county government of one resident who may have received
more money in services than they paid in local taxes (gentrification at a
'one person at a time' level).
Section G Consumer Services (fourth screen shot or screen grab down) of
the 2 listed consumer services as of 2007. The one listed at 700
Roeder Rd Silver Spring has moved twice and changed management once and
mission to focus mostly on mental health and substance addiction
recovery services.
The exceptional few people living with mental illness and/or substance
addiction who had attained better recovery outcomes 'pushed back' by the
end of 2015 in the survey (2 images below) for a livable level of pay
and input into the mission of their employers or grant-funders for
'self-employment.' Needing to advocate for better pay and working
conditions exemplifies the long-term budget cuts to the Maryland PMHS on
the labor cost portion of the community services budget of the MHA
(Mental Hygiene Administration), now called the BHA (Behavioral Health
Administration), of the DHMH. The cuts were achieved by shifting the
work from licensed counselors, psychologists and social workers to
people with lived experience of mental illness whose lack of academic
and licensure credentials was exploited to cut pay.
Services for people with physical and intellectual-developmental disabilities have not been cut by the same amount long-term. If they have been cut by the same amount long-term the cuts haven't affected the delivery in community-based settings as much as public mental health services have been affected.
Funding for Independent Living (IL) services for people with physical and intellectual-developmental disabilities (as well as people with other types of disabilities) even increased by 2011 with the enactment of the Lorraine Sheehan
'dime a drink' alcohol tax increase earmarked for funding independent living (IL) services.
(dead link copy and paste of Lorraine Sheehan's obituary that no longer loads content follows to help readers learn what Lorraine Sheehan's role in disability rights advocacy was that deserved naming of legislation for her)
http://www.thearc.org/NetCommunity/Page.aspx?pid=1910
The Arc Mourns the Loss of Lorraine Sheehan
12/23/2009
The Arc Mourns the Loss of Lorraine Sheehan
It is with great sadness that The Arc of the United States announces the passing of Lorraine Sheehan. Lorraine died on Saturday, December 19 [2009] after a long struggle against pneumonia, compromised by cystic fibrosis. Lorraine was an indefatigable disability rights advocate and a treasured member of The Arc family. She has been an active member of The Arc for many years—serving as a member of The Arc of Prince George's County, and as Past President of The Arc of the United States. As President of The Arc at the time the Disability Policy Collaboration was established, she personally signed the agreement with UCP.
In her leadership role as President and previously as the Chair of The Arc’s Governmental Affairs Committee, she provided the strongest pro collaboration push from The Arc’s volunteer leadership. In addition, Lorraine was President of The Arc of Anne Arundel County, and Government Affairs Chair and President for The Arc of Maryland. She had been currently serving as the Co-Chair of the DPC Steering Committee.
Lorraine Sheehan grew up in New Hampshire and moved to Maryland with her husband and family in 1965. She has four children and six grandchildren. At an early age, her third child, John, was diagnosed as deaf and “mentally retarded.” Later, he was diagnosed with autism and determined not to be deaf. John has significant disabilities and lived at home with Lorraine in Edgewater, MD.
Because of John and his special needs – especially related to his schooling – Lorraine became involved in the disability movement. She focused her attention on independent living opportunities for individuals with disabilities and later on advocacy on behalf of individuals with disabilities and their families. It was her passion for advocacy that led to her emerging as one of Maryland’s leading advocates for individuals with disabilities.
Indeed, she became one of the nation’s most powerful voices for our constituency, due in no small part to her profound commitment, keen intelligence and charismatic presence.
In 1974, Lorraine was elected to the MD House of Delegates, where she served for nine years. In the General Assembly, she introduced bills on transportation for students with disabilities and the first bill ever addressing the Developmental Disabilities Administration's waiting list. In 1983, Governor Harry Hughes appointed her Secretary of State of Maryland for one four-year term.
Because of her expertise in the area of disabilities, Lorraine was appointed a Commissioner to the Anne Arundel County Housing Authority. She continued to focus much of her work on independent housing for people with disabilities, ensuring that even individuals with the most significant disabilities have an opportunity to choose where they live.
As a public official, she educated other policymakers and the public at large while helping to transform communities into places of inclusion. As a parent, she waged a tireless fight for the rights of people with disabilities and their families. Lorraine mentored many family members and professionals.
Professionally, Lorraine went on to be named the Public Policy Director for the Maryland Disability Law Center; she also worked with the Public Sector Consulting Group. She continued to volunteer her time and expertise, by serving on boards and committees charged with improving the lives of individuals with disabilities. Lorraine will be greatly missed – she was a true force in advancing the rights of people with intellectual and developmental disabilities.
Peter V. Berns
Chief Executive Officer
HB1283 of the 2017 General Assembly Session, which passed the House unanimously by 'crossover day,' was opposed by State Comptroller Peter Franchot. In his arguments Franchot leaves out that more craft (small batch) beer breweries distributing more beer to taprooms for 'on premises' consumption, without a requirement for buyback of beer produced over the increased annual production cap, will generate more tax revenue under the Lorraine Sheehan Health and Community Services Act of 2011 'dime a drink' alcohol tax increase.
“What’s more, these strong partnerships between our brewers directly help our retailers and wholesalers, by increasing variety and interest in Maryland beer. A beer enthusiast from Western Maryland who visits a Baltimore-based tasting room and becomes a fan of their products will most likely purchase those products at a local independent retailer. Simply put, a rising tide lifts all boats – and we need to continue to support, not hinder, the relationships that have been built and fortified by our brewers.
Among the 'boats' lifted by a 'rising tide' of a good craft beer industry are the 'boats' (actually lives lived in communities of ones' own choosing) of people with all types of disabilities (physical, intellectual-developmental, and behavioral/mental health/psychiatric/substance addiction) whose independent living services will have a more sustainable funding basis. A more sustainable funding basis will prevent crises of 2001-2003 and 2009-2011 where service providers close or tighten eligibility criteria (cut population served) after national and global 'recessions' that have worse 'economic depression-like' impacts on working poor and people with disabilities. In the image below listing the PRP programs and Supported Employment Programs, functioning in 2007 while defunct by 2017, exemplify the severe economic harm done to people with disabilities by the long-term Maryland state budget cuts to programs designed to help people with disabilities find and keep jobs.
[Update April 9 2017 to correct sentence fragment and hold past and current Republican state administrations accountable for the harm of their fiscal policy decisions.]
The Md. Medicaid cut in 2003, and 2009 demands to restore the cut, (2 images below) that restricted eligibility criteria to incomes above 116% of poverty after it had been at 300% of poverty, proposed by then-Republican Governor Robert Ehrlich devastated, to the point of closure and leaving people with disabilities unserved including the author of this blog post, by 2017 is shown in the images below.
2017 incumbent Governor Larry Hogan worked as appointments secretary in the Robert Ehrlich administration. The job of appointments secretary is vet executive appointees to prevent politically embarrassing and electorally-losing 'scandals' and to avoid the appearance of political corruption. 2017 incumbent Governor Larry Hogan may have vetted the DHMH Secretary (Nelson Sabatini) or MHA Secretary (Brian Hepburn) or MDOD Secretary (Kristen Cox) or Insurance Commissioner (Alfred Redmer) who recommended the 2003 Medicaid cut, making 2017 Governor Larry Hogan complicit in the economic harm to people with disabilities who lost eligibility for services and could not pay the costs of replacing the services in money or time.
The cut disrupted, to the point of closure leaving the people with disabilities unserved, many of the Independent Living (IL) services providers listed in the 2007 report images above. Rebuilding a personal support system after a crisis is difficult enough for people without disabilities it's even harder for people with disabilities dealing with poverty and rising costs of living. Shifting the role of providers to the exceptional few peers working as recovery coaches is grossly inadequate. The cuts should be fully reversed with 2003-17 inflation adjustments or the recovery coaches should be paid commensurately with the work they are asked to do as the 2015 survey suggested a need for.
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