Changing the disability poverty paradigm(1)

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  • But… We know its possible. Individual providers and states do much better A substantial number of providers only support community employment now, including several who will speak

Transcript

  • 1. CHANGING THE DISABILITY-POVERTY PARADIGM CHALLENGING THE DEPENDENCY PARADOX IN POLICY, MONEY & HUMAN SERVICES
  • 2. VALUE STATEMENTS
    • Poverty is a war whose battlefields are local communities, led by either complacent or transformational leaders.
    • Poverty is fueled by weapons of unemployment, paternalism, vulnerability and opportunity gaps.
    • Poverty can only be overcome by a commitment of every individual in a community to work together in a solutions-oriented process (ie. Looking Inwardly instead of Pointing Outwardly) .
    • POVERTY IS ABOUT PEOPLE
  • 3. THUS FAR, WE HAVE MADE THE SHIFT FROM THIS…… To……..
  • 4. WORK PLAY FAMILY & FRIENDS
  • 5. POVERTY BY THE NUMBERS U.S. Census Bureau (13 September 2011) 46.2 million Americans were living in poverty in 2010. Persons with Disabilities experienced the highest rates of poverty of any other subcategory of Americans for the tenth year in a row. SUBPOPULATION 2009 Poverty Rate 2010 Poverty Rate Children 20.7% 22.0% African-American 25.8% 27.4% Hispanic 25.3% 26.6% Disability 25.0% 27.9% Total U.S. Population 14.3% 15.1%
  • 6. POVERTY AND DISABILITY: MONEY IS THE NOT ALWAYS THE PROBLEM; SOMETIMES IT’S AN ISSUE OF PRIORITY Figure 1. Percentage of Estimated Federal and State Expenditures for Working-Age People with Disabilities by Major Expenditure Category, Fiscal Year 2008 [1] [1] Adapted from Livermore, Stapleton and O’Toole (2011, Health Affairs) $357 Billion in FY2008
  • 7. WHAT DOES $357 BILLION BUY US IN TERMS OF OUTCOMES?
  • 8. WE HAVE PROOF THAT PEOPLE CAN WORK WHEN SERVICES FOCUS ON EMPLOYMENT 2009 – UMASS Boston ICI ID/DD Agency Survey Success in employment varies widely 2009 Washington State (88 %) Oklahoma (60%) Connecticut (54%) Louisiana (47%) New Hampshire (46%)
  • 9. MEDICAID IS THE FOUNDATION OF STABILITY FOR PWD
    • There is no private insurance product to cover life long supports for people with significant disabilities
    • No one individual or family can bear the costs of supports for a life time
    • Until Medicaid HCBS, institutions were the only alternative for many PWD
  • 10. TODAY’S FISCAL CRISES IS NOT JUST A MATTER OF NUMBERS, IT IS A MATTER OF PEOPLE. THE DIALOGUE WE MUST ENGAGE IN IS ONE OF EQUITY, ETHICS, AND ENGAGEMENT.
  • 11. EQUITY
    • THROWING MONEY AT THE WRONG THINGS IS NOT IN THE BEST INTERESTS OF INDIVIDUALS WITH DISABILITIES
  • 12. This Model results in Chronic Impoverishment, Cyclical Dependency, and Loss of Human Dignity throughout Lifespan. The Cyclical Dependency Model
  • 13. This Model represents Optimal Self-Sufficiency, Independent Living, Economic Empowerment and Full Community Participation The Self-Sufficiency Investment Model
  • 14. COMMUNITY SUPPORTS ENABLE INDIVIDUALS TO….
    • Live in their own home and enjoy the support of family and friends
    • Get a job
    • Enjoy good health
    • Be part of and contribute to their community
    • Achieve their personal potential for independence and self sufficiency
  • 15. SELF-SUFFICIENCY IS NOT ONLY BETTER FOR PWD, IT ALSO MAKES ECONOMICAL SENSE SERVICE AREA CYCLICAL DEPENDENCY SELF-SUFFICIENCY MODEL Education Segregated: $25-45K/student/year Full Inclusion: $12-26K/student/year Employment Average annual costs of SW/individual: $19,388 SW is less cost-efficient to taxpayers : 0.83 SW is less cost-efficient to workers : 0.24 Ave annual costs of SE/individual: $6,619 SE is more cost-efficient to taxpayers : 1.21 SE is more cost-efficient to workers : 4.20
  • 16. COMMUNITY SERVICES MAKE FINANCIAL SENSE Data Source: Lakin, K.C. MSIS and NCI data from 4 states (1,240 Individuals), 2009   Type of Service Cost per Person People Served with $5 M ICF/MR $128,275 39 HCBS Residential $70,133 71 Host/Foster Family $44,122 113 Own Family $25,072 200
  • 17. ETHICS
    • REFORM REQUIRES BOLD AND COURAGEOUS LEADERSHIP BY THOSE WORKING DIRECTLY WITH PWD
  • 18. CHANGED THINKING LEADS TO CHANGED PUBLIC POLICY
    • From:
    • Assuming that PWD
      • Need to be taken care of
      • Can’t work
      • Need constant supervision
      • Are a burden to families
    • To:
    • Discovering that PWD
      • Can be self sufficient
      • Can work and pay taxes
      • Don’t need constant supervision
      • Are valued family members
      • Key Point:
      • People need
      • support that matches
      • their needs .
  • 19. THEORETICAL FRAMEWORK : DIMENSIONS OF THE SOCIAL GUARANTEE APPROACH
    • Social guarantees are defined as legal and administrative mechanisms that determine entitlements and obligations related to certain rights and ensure the fulfillment of these obligations on the part of the state. While the social guarantee approach is still in its infancy, the social guarantees framework can be of benefit to the monitoring of public policy and progressive realization of social and economic rights in a range of contexts.
  • 20. ENGAGEMENT
    • SITTING ON THE SIDELINES, BURIED IN A SANDBOX SOMEWHERE IS NOT A PATH TO TRANSFORMATIONAL LEADERSHIP.
  • 21. TRANSFORMATIONAL LEADERSHIP: REFORM IS IMMINENT
    • REFORM IS INEVITABLE…..
  • 22. TRANSFORMATIONAL LEADERSHIP: WHAT ROAD WILL YOU TAKE?
    • BE MINDFUL WHAT WE ASK FOR…..USE THE CRISIS AS AN OPPORTUNITY FOR TRANSFORMATION
  • 23. HOW TO LEAD TOWARD CHANGE IN TIMES OF UNCERTAINTY
    • Innovative Collaboration with Traditional and Non-Traditional Partners
    • Continue to Look Inwardly
    • Engage in the Advocacy Wave – at all Levels of the Public Policy Dialogue
  • 24. THANK YOU!!! Serena Lowe President, AnereS Strategies, LLC Executive Director, Collaboration to Promote Self-Determination Federal Government Affairs Consultant, National Disability Institute 202-548-2502 (Office) 202-907-8369 (Cell) [email_address]