Shameful Seattle – CENSORED

Seattle Commission for PwD - please be accountableToday, Mayor Durkan, signed into law that Seattle has eliminated special certificates for disabled people to work for less than minimum wage.  Sounds like a great idea to encourage people to hire those with disabilities – that is, until you know the truth behind this legislation and the misinformation that was used to push it forward and make others believe it was the right thing to do.

While I fully support equal wages for equal work – regardless if one is disabled or not – I have great concerns about the lack of understanding of the complex issues involved in this legislation.  For the people affected by this legislation, community integration is as important, if not more important, than the wage they earn.

The Seattle Commission for People with Disabilities has so far been only mendacious in their replies to questions.  Also, as I was in the process of writing this post, I have again been blocked from the public Facebook Page for Seattle Commission for People with Disabilities.  Again, they refused to answer the questions and censored discussions.  Seattle PWD Censorship

 

Seattle Commission for PWD needs to be accountable and answer the questions.  Threats and accusations do not show accountability for decisions you have made.

Mayor Durkan was totally unable to answer the questions asked at the end of the press conference – either she knows the answer and is too embarrassed to say or she has no clue and bases her information on the lies she has been told by the commission.

 

 

Seattle has rapid elimination of sub-minimum wage

Councilmember Teresa Mosqueda – thank you for the concern you have for our community members with disabilities. While I understand this has just passed into law, I believe there was some very critical information that was left out, not addressed and misrepresented by members of the Seattle Commission for People with disAbilities .

The first issue is that these certificates are not “general purpose” to allow any employer to pay a person less than the minimum wage just because that person has a disability. They were for specific employers for specific employees for specific jobs. Generally, they are used for people with complex and often intellectual disabilities. It is an fact that those with intellectual disabilities, just be definition of the disability itself, may not be as productive as a person with a different type of disability – such as autism. Autism is NOT an intellectual disability but it is a developmental disability. This issue is one that the Seattle Commission for People with disAbilities has failed to acknowledge and understand.  (Particularly co-chair Shaun Bickley)

The second thing is that for people working in these job, they tend to work 10 hours or less a week and most often have a job coach to assist them in their job. The job coach may be 1:1 or only check in occasionally – depending on the support needs of the disabled person. The funding for the job coach is typically paid for through the Developmental Disabilities Administration through the counties. Without a job coach, many of these people would not be able to get and maintain employment.

One example of this is the issue of my son. He does work in a supported integrated employment setting within Seattle. He does earn a bit more than the minimum wage and works 9 hours a week with a 1:1 job coach. The vocational vendor agency is paid $2700 per month to provide the job coach for his 9 hours of work a week. If for some reason a job coach is sick or on vacation and they cannot get a sub, my son is not able to go to work that day.

For people like my son, they are not working at these jobs for their sole income and they all tend to live in poverty. They most likely receive SSI which will be reduced from the $750.00 to something less based on their earned income. Due to the earned wages my son makes, his SSI is reduced to $532.00. He then needs to pay rent, utilities, food, household necessities, clothes, healthcare supplies not covered by insurance, and other necessities of daily life out of his SSI and earned wages.

People like my son (who needs to have 1:1 supervision during all waking hours) are generally linked with several agencies, family members, friends (natural supports) a healthcare team, community members and paid support staff to navigate daily life. It is collaborative web that can work very well – until someone tweaks one part without working with the rest of the team and it can then all fall apart.

For instance, my son lives in supported living with 3 other disabled young adults. Luckily, their agency does provide a reliable van for them to use but they need to coordinate transportation based on the residents schedules. They are the ones who transport my son back and forth to work each morning since my son needs 1:1 hand off from his support staff to his job coach – Access bus is not an option – nor is any type of public transportation.

It’s extremely unfortunate that the Seattle Commission for People with disAbilities did little research on this issue and how it impacts the lives of those how work in these jobs. I have asked repeatedly for the research and Mr. Bickley has refused to provide it – but continues to refer to this non-existent research. I did provide the Seattle Commission for People with disAbilities with links to a report from the National Council on Disabilities which had clear outlines for a transition from sub-minimum wage to integrated employment and their timeline was from 2-10 years. Not a rapid, sudden elimination of certificates.

I also provided another very useful resource from the Journal of Vocational Rehabilitation which had very useful discussions and resources on how to encourage and create integrated work for those with significant intellectual disabilities. Again, this looked at a period of transition and planning for funding to be stable and sustainable for the required job skill building and training of job coaches.

I do not believe that either of these extremely useful and national resources were even discussed at a commission meeting because their decision had been made and any information from a person who did not agree totally with the proposed agenda by Mr. Bickley was not brought to the table.  Mr. Bickley has stated many times that there was unanimous opinions regarding the elimination plan by disabled people and advocates denying the fact that there were many who had a different opinion.
Regarding other states who do not use certificates:

New Hampshire did not have any businesses using the certificates but updated their policies to officially end the practice if they were used. The minimum wage in New Hampshire just $7.25 an hour and disabled people can be paid less if part of an approved work training program.

According to the NH Developmental Services Employment Data Report – the average number of hours worked a week is 11 and the average weekly pay is $92.73. More than 50% of the jobs are 2-9 hours per week.

A case study of the transition from sheltered workshops to integrated employment of disabled people in Maine done by the George Washington University Milken Institute School of Public Health, Department of Health Policy and Management highlighted the fact that when people leave the sheltered workshop, many work fewer hours per week and make less money than if they remained in the sheltered workshop.

Alaska recently banned the subminimum wage. Robert Dinerstein, a law professor at American University and director of the schools’ Disability Rights Law Clinic believes that Alaska will be able to accomplish an integrated work force by giving workers a job coach who goes to work with the person for the first month to help them “learn the ropes.” Evidently this professor does not understand the fact that some people may need the 1:1 support to remain employed – it’s not a “learn the ropes” and then on their merry, independent way.

Maryland has a 4 year phase out of “sheltered workshops” which they hope to have completed by 2020. The plan involves moving people from sheltered workshops to competitive integrated employment. Each individual making less than minimum wage will receive an individual plan for the phase out.

According to the United States Department of Labor “Subminimum wages must be commensurate wage rates – based on the worker’s individual productivity, no matter how limited, in proportion to the wage and productivity of experienced workers who do not have disabilities performing essentially the same type, quality, and quantity of work in the geographic area from which the labor force of the community is drawn. ”

The documentary “Bottom Dollars” by Disability Rights Washington and Rooted in Rights states “If people are given the proper services and supports and proper assistive technology, the sky is the limit for many, many individuals.” This I believe to be true but there is a big IF and that included funding needs to provide supports and sustain them. Did the Commission for PwD look at these issues?

Please ask the Seattle Commission for People with disAbilities  about the research they have done and the transition plan they have developed for our citizens in Seattle.

Seattle Outlaws Subminimum Wage

Council votes to eliminate sub-minimum wage

Seattle bans lower wages

DD Ombudsman – Washington State

I have had contact with the new Office of the Developmental Disabilities Ombudsman in Washington State.  This is a critical organization for those with intellectual and developmental disabilities to be aware of regarding any concerns pertaining to their care and services received.  It is especially important for those who live in the State Operated Intermediate Care Facilities (ICFs) since these residents have no other objective advocate to review their concerns or complaints.

DD Ombuds logo

With that being said, I do have some reservations about reporting concerns to the DD Ombudsman.  The Protection & Advocacy Agency (Disability Rights Washington) which has been very vocal with their agenda of closing the ICFs, is the independent non-profit agency that was awarded the contract to administer the DD Ombudsman Program.  The Region 3 Ombudsman (Noah Sidel) was the previous Self-Advocacy Coordinator with The Arc of Washington working with Self Advocates in Leadership (SAIL) and has testified many times to legislative committees with the position that the ICFs need to be closed.

Given the history, it is very difficult to trust that the above biased agendas will not be pushed forward by the DD Ombuds office if concerns of those residing in the ICFs are reported.  I know that ICF residents and families have been reluctant to make any complaints regarding concerns out of fear their complaints will be used as “proof” that the ICF needs to be closed.   The history is that rather than looking at the problem and fixing it, the problem is used as a reason to close the ICF.

The problem is that when residents of state operated facilities make allegations the investigations are done by non-objective, state employees.  Many times these investigators are not healthcare providers and are not able to assess if the care provided met the community standard of care (medical and nursing care to be specific).  Once the Residential Care Services (under the Department of Health and Human Services) the facility administration or the State Investigative Unit have “investigated” and made their report, there is no ability to appeal or have an outside, non-DSHS employee review the allegations.

If state law were followed with regards to medical and nursing care of these residents, the oversight of the care would be provided by the Department of Health.  The management of nursing care and practice would be done by Registered Nurses – not non-nurse administrators.  Complaints regarding nursing or medical care would be reviewed by healthcare professionals not investigators who are not licensed healthcare providers.

These are systemic problems that need to be addressed.  My hope is that by bringing these critical problems to the attention of the DD Ombudsman, appropriate legislation will be written which will bring the oversight of the healthcare of residents in the ICF in compliance with the Washington State Law.

Below are some letters that describe the allegations and specific State Laws which were allegedly violated.  My intention regarding this information is so that these systemic problems are identified and corrected.  I support a full continuum of care and the ICF is a critical part of that continuum.  This information is not to be used in the agenda of closure but to address the issue of quality care and appropriate oversight of healthcare.
document for DD Ombuds

letter to Mr. Hakim regarding systemic issues of healthcare neglect at Fircrest

Letter to Senator Keiser regarding issues at Fircrest and DD Ombudsman 2017

Systemic Errors in Medication Administration at Fircrest

ODDO-Advisory-Committee-Meeting-Minutes-9.16.17

DD-Ombuds-Annual-Report-2017-Final

DD Stakeholder Survey for DD Ombudsman

We need to provide choices – not restrictions

Please view the video which highlights the need for choices and options in our efforts to provide services and appropriate care and homes for those who live with intellectual and developmental disabilities.  This is one example of many that need to be options allowed and promoted.

 

 

The last of the Institutions – Part 5

Unfortunately, once again, Susannah Frame has mislead people in this “investigation” series on King 5 in Seattle.  There is much to clarify in this recent segment which aired December 8, 2015.

Myth 1

“Only a handful of states operate more institutions for people with developmental disabilities than Washington. And in Washington, more people live in these segregated settings than most of the rest of the country”

Fact of the matter:ICF ID Table 2013

The above table is only the STATE Operated ICF/ID’s

26 states have fewer State operated ICF/ID s for a total of 25 facilities which are home to 11, 294 people (Average per facility – 451 people)

24 state have more State operated ICF/IDs  for a total of  828 facilities which are home to 42,553 people (Average per facility – 51 people) –

Hardly what I would call a handful of state (or facilities for that matter!)

 ICF ID Chart by state 2013

Myth 2

“Since the 1970s when the deinstitutionalization trend started, 16 states have closed all of their institutions that once housed the developmentally disabled, including Oregon, Alaska, and Hawaii. And 21 states, including Idaho, have fewer than 100 residents total living in these types of public facilities”

Nursing Facility and over 16 residents 2013

CMS cost reported by states 2013

The above table is taken from the CMS-64 report.  Again, Susannah Frame is incorrect with her “facts”.  There are only 8 states that have not reported funds for a STATE OPERATED ICF/ID.

It is interesting to note of those states with no costs for a state operated ICF/ID,  6 of those reports costs for private ICF/IDs.  Some of these are quite pricey to the states that have them.

Interesting that only 12 states do not have a large State operated Facility and only 7 states have less than 100 people in these state operated ICF/IDs and Nursing Facilities.

More to come about the private facilities in each state and the funding for both the ICF/IDs and the Home and Community Based Waivers (HCBS).

I believe Ms. Frame and King 5 have some additional investigative work to do.  This is a very sloppy example of research which they are promoting.

Myth 3

According to Mr. Bagenstos, supposedly a “top Department of Justice attorney in the Civil Rights Division” Washington state “remains kind of stubbornly, an outlier”

Look at the tables above and see for yourself.  By the definition that I understand, Washington is CERTAINLY NOT an “outlier.” 

That’s all for today – more myths to be examined from this episode withing the next few days.

Data Retrieved from the following resources:

Medicaid Expenditures for Long-Term. (n.d.). Retrieved from http://www.medicaid.gov/medicaid-chip-program-information/by-topics/long-term-services-and-supports/downloads/ltss-expenditures-fy2013.pdf

(2013). Residential Services for Persons with Intellectual or Developmental Disabilities: Status and Trends through Fiscal Year 2011 (2013). National Association of State Directors of Developmental Disabilities Services (NASDDDS), Human Services Research Institute (HSRI), Association of Professional Developmental Disabilities Administrators (APPDA). University of Minnesota.

United States Census Bureau – Population Estimates – National Totals 2014. (2014). Retrieved from https://www.census.gov/popest/data/national/totals/2014/index.html

Univesity of Colorado Department of Psychiatry. (2015). The State of the States in Developmental Disabilities. Retrieved from http://www.stateofthestates.org/index.php/intellectualdevelopmental-disabilities/state-profiles

 

The Olmstead Decisions is Misinterpreted

 

 

Seattle Times “Opinion”

I want to be hopeful but am afraid that nothing will change.  Even though The Seattle Times published an article by Maureen O’Hagan entitled ” State ignoring abuse at group homes “ and The Seattle Times published the editorial “DSHS must investigate alleged abuse at group homes for the disabled” my hopes of reform fade.  We hear that The Arc – Washington State will be advocating with legislators on this.  The Arc-Washington writes “The basis of the problem lies with DSHS. It takes weeks or months for them to respond to reports of abuse and often nothing happens. The Governor proposes to add funding for more investigators.”

This is just “talk” and will amount to “no action” from The Arc, Disability Rights Washington, Washington State Developmental Disabilities Council and other agencies which receive public funds to advocate for this population.  The history is that they use these funds to discriminate our most vulnerable.   In the name of deinstitutionalization these groups have advocated for community inclusion.  What these groups do not understand is that many of these same people already lived in a community – it may have been a different type of community than what the people who run these organizations may choose to live in,  but it is a community for the people who find it supportive, safe and stable.

The mis-placed and misguided advocacy of these groups is also the basis of this problem.  I know that I am not the only one who has attempted to educate these advocacy groups on the issues of unsafe conditions in these group homes or issues of safety and stability.  These groups have not wanted to hear or acknowledge that there were problems.  They wanted to see that moving people from stable and safe supportive communities to individual homes scattered far from their friends and families to be “included” in community was an experiment that was succeeding. They wanted to see “inclusion” and “integration” work.  I do too – the difference is that I see inclusion as being part of the community – community meaning participating, contributing and belonging.  I believe each person can define what that community is to them and they can make a choice.  The misguided advocates do not allow people to make this choice and have defined “community” to mean something else.  Many times the “community” these misguided advocates force upon people does not lead to “inclusion” but to  ISOLATION and IMPRISONMENT.

This experiment failed – many have been harmed or killed.  It’s time to stop this experiment on unsuspecting people. How many of these people provided “informed consent” to this social experiment?

Where is the advocacy for improved oversight, better staffing levels, better pay for caregivers?  These are critical to improving care, safety and stability for all.  Yes, we need investigations but investigations without action will do nothing except waste more money and cause more harm.

 

 

Autistic Man walks away from drunk caretaker

This story exemplifies some of my worst fears.

Answers sought after autistic man walks away from drunk caretaker.

I hate to take advantage of situations which have caused harm to others but in this case, I must point out that this is the very issue which I am trying to advocate against.  I have been trying to have the so-called DD Advocates (The Arc, Disability Rights Washington, the Washington State Developmental Disabilities Council, the Community Residential Service Associates and others) look at the facts more accurately.  They refuse.  Maybe more stories such as this will help open their eyes to what they are really advocating for with regards to our most vulnerable citizens with the highest support needs.  They are not advocating for safe, quality, cost effective care but for substandard and negligent care.  Rather than advocating for the vendors, it is time they really advocated for our citizens in need.

Here is my post to the KOMO News story:

As a healthcare provider, parent of a child with intense support needs and advocate for our most vulnerable citizens, this story more than sickens me. I am appalled at the care, lack of oversight and more that is reported in this story and am so thankful that this man was found and will hopefully now be cared for in a caring, safe, healthy and humane environment for him.

I’m so afraid that we will hear more and more about abuses such as this one. The Arc, Disability Rights Washington and even the Washington State Developmental Disabilities Council all oppose any type of congregate care for our most vulnerable citizens – stating that all citizens can be safely cared for in community settings for less cost. The only way to have it cost less than a congregate care community is to endorse negligent care such as this type of care.

With staffing turnover rates of up to 45% in these community settings, there is no stability or sustainability and I wonder about the level of training and lack of back up support for the staff and residents. To me, this situation is a time bomb ready to go off at any moment.

This is so unfortunate since the so-called DD advocates will not address the facts about support care levels and safe care. They support the vendors, such as Service Alternatives rather than our loved ones.

I support a continuum of care model – a model which is based on the assessed needs and choices of the person and their family/guardian. This model includes the Residential Habilitation Center (Fircrest, Yakima Valley School, Rainier School and Lakeland Village) through independent homes. It is the safest and most cost effective model to best serve ALL our citizens with intellectual disabilities.

Much of the factual information has been shared with these so-called DD advocates and legislators – but they do not want to address the facts. I do hope that publicizing these tragedies will serve some good in knocking some sense into those who make the policies. Much of the research regarding the facts of the issues can be found at www.becausewecare1.com.

It is our duty as a society to safely care for our most vulnerable. Yes, this is a hard job, I know, I’ve been there and I am SO thankful for the care that our son is finally able to have at Fircrest. He loves his home there, he loves his school (Shorecrest) and he is active in his community. Yes, it’s not perfect but it’s the best we can do and it is the safest and least restrictive environment for him and many others.

I do know there are some excellent community homes with excellent caregivers.  We need to support our caregivers – they are the backbone which provide stability and sustainability.