News from the September 2003 Mouth.

GAO REPORT CRITICIZES HOME CARE

Two U.S. senators who get heavy campaign contributions from nursing homes ordered a General Accounting Office audit of Medicaid waiver programs. The July report found that states did not do enough “monitoring” of people who get services at home.

Thomas A Scully, administrator of the federal waivers for the Centers for Medicare and Medicaid Services, responded that federal inspectors should not be marching through private homes to evaluate care. We second that.

Since 1992, the number of Medicaid beneficiaries on waivers has tripled. 800,000 people, more than half over the age of 65, now take part in waiver programs.

The GAO found “medical and physical neglect” in some cases, and blamed it on the lack of basic safety and hygiene standards in homes. Its report waved a particular red flag over state programs where people direct their own care, hiring and training their attendants. Perhaps the GAO sees that as “unprofessional”—exactly the point of such programs.

DO YOU WANT CONTROL?

In related news, Bob Williams, once Donna Shalala’s top disability adviser, testified in June before the House Committee on Energy and Commerce about Cash and Counseling demonstration programs. The demonstrations, he said, “set out to provide an obvious answer to a common sense question. Do people with disabilities want to have a great deal of control over the quite intimate forms of help and supports possible?”

As the overwhelmingly successful demonstration programs showed, the answer is yes. Williams warned, however, that without federal safeguards, states would cut care to cut costs. He also warned that managing one’s own care works best when you have a whole network of support.

IF THE BUS WON'T STOP FOR YOU, STOP THE BUS

Anthony Trocchia calls himself “a reasonable person,” but even reasonable people can lose patience when, count ’em, four public buses pass by because, drivers say, their lifts are broken. Trocchia, president of Disabled in Action of New York City, rolled out in front of that fourth lame bus and refused to move.

Soon he was joined by several workers from the nearby Queens Independent Living Center. When Green Lines, operators of the bus, volunteered to send a “special” bus with a working lift, Trocchia said no thanks and maintained the blockade. Soon journalists arrived.

Green Lines, transit operators on contract, may see that contract taken over by the MTA. “This would never have happened in Manhattan,” Trocchia said. But wherever in the U.S. it happens, “we should do this every day until they remedy the situation.”

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