Where is the choice? Where is the person-centered care?

The historic Olmstead Decision  “affirmed that the ADA requires states to provide services for people with disabilities in the “”most integrative setting appropriate” and that states are obligated to place people with disabilities in community settings when treatment professionals determine such settings are appropriate, the individuals themselves do not oppose such placement, and the state can reasonable accommodate community placement given its available resources” (Lakin & Stancliffe, 2007) (OLMSTEAD V. L. C. (98-536) 527 U.S. 581 (1999), 1999)

Washington State is practicing way outside these boundaries by passing laws prohibiting supportive community services to those under 21 regardless of the person’s assessed needs which may require intensive supports available ONLY in the supportive community.

Where is the choice?  Where is person centered care?  It is certainly not being practiced in the case before an Administrative Law Judge this week.  Read the case below, read the choices of the family, read the recommendations of the professional experts – all which indicate this 19 year old young man is stable, safe and has adapted well to his home in a supportive community.  Developmental Disabilities Administration (DDA) is continuing to deny long term admission to the chosen community where this 19 year old has lived for over one year.  DDA is using Roads to Community Living and a recent Washington State Law denying him permission to stay in his home while attempting to “build a home around him” in the community.

 

He already has a community where he is safe, stable and one which his family/guardian and care professionals agree is the best option for him in the least restrictive environment for him and one in which he is happy.  Where is the Person-Centered Care in the actions that DDA is taking?

Jack was admitted on “short term stay” in June 2012.  Jack transitioned very well, his medications were adjusted, he has 1:1 support, he has freedom to move about, he attends a local public school, his family is nearby and engaged, and Jack is happy.   Jack’s family has looked at over 10 “community” homes in the area, none of which would provide a safe environment for him.  Administrators in several Supported Living Agencies have told the mother that they would not be able to manage Jack with his needs.  The local Medical Expert in Autism who had managed Jack’s care prior to the short term stay for stabilization wrote that he had “run out of treatment options” for Jack.

When the short term stay was nearing 90 days, Jack’s mother was informed that Jack needed to leave this community.  Jacks mother had already seen there were no safe alternatives for Jack elsewhere and having already run out of treatment options by the experts in the community and fearing for Jack’s safety, she requested that Jack be allowed to be admitted on a long term basis to the supportive community which had served him very well.

Jack was denied.  An “exception to rule” was requested – this was denied.  Jack’s mother requested an administrative hearing.  After the hearing, the Administrative Law Judge stated that she did not know enough about the law to make a decision at that point.  She requested DDA to submit a proposal for supported living for Jack, share with the mother who would then write her comments, concerns and her proposal, which would then all be submitted to the judge.

The Administrative Hearing Manager wrote she objects the submission by Jack’ mother and has requested a post-hearing conference to discuss the Mother’s submissions.

It must be emphasized that Jack’s mother‘s concern is Jack’s SAFETY.  She has made this perfectly clear.  The Administrative Hearing Manager asked Jack’s mother “don’t you think you are asking for too much?’ to which Jack’s mother replied “Is Jack’s safety too much?”

Again, where is the choice?  Where is the Person-Centered Planning?  Where is the common sense? Where is the compassion?

 

To be continued. . .

 

Bibliography

OLMSTEAD V. L. C. (98-536) 527 U.S. 581 (1999), No. 98-536 (Supreme Court of The United States June 22, 1999).

Lakin, K. C., & Stancliffe, R. J. (2007). Residential Supports for Persons with Intellctual and Developmental Disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 151-159.

 

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