As if there weren’t enough problems and obstacles already for programs that are trying to house the homeless, or at least trying not to let things get any worse, things are still getting worse. Really, it’s one of those news stories where you think, “Hey, is this from The Onion?” We’re all in favor of parody and satire, and The Onion is a great publication, but when an Onion-like story is slipped in amongst the “real” news, as if we’re supposed to believe it, well, that takes a joke a little bit too far.
Except… the Associated Press is not generally known for its sense of humor, and Ken Kusmer is their man in Indianapolis for coverage of social services and diversity issues. Somehow, we don’t think he’s kidding. This is actual reportage from the great state of Indiana.
“Ind. parents told drop disabled kids at shelters,” the story is titled. Kusmer says social workers are telling parents to drop off their disabled children at homeless shelters. This is not a one-shot deal. He mentions several instances.
First, it’s important to understand what a Medicaid waiver is, and a four-minute video from an organization called Arc explains it. The program allows Medicaid to fund home-based and community-based services for children and adults with disabilities, in their own homes or neighborhoods.
This is a wonderfully humane alternative to sending people to facilities. Which don’t exist anyway. The program was developed so the state could close all state-funded institutions for people with developmental disabilities, and although we’re just looking at Indiana here, we’re betting the overall situation is pretty much the same throughout America.
Medicaid waivers are concerned with two types of need: primarily medical need, and need motivated by the developmental disabilities, including autism. Ideally, when this program is up and running, and has funding, the services available would include 24-hour residential support, employment services, adult day services, respite care, support to participate in the community, family and caregiver training, behavior supports, transportation, and various modalities of therapy.
So, forget everything you’ve just learned, because the darn thing is broken anyhow. With very few exceptions, the waiting lists have always been long, sometimes reportedly as long as 10 years, which would take us just about back to when the program was initiated. Now, the waiting lists stretch into infinity.
What happens when aging parents can no longer care for a disabled adult child, because the parents need care themselves? Institutionalization? Not an option. Independent living? If the person could live independently, she or he probably would be doing so already. What happens when both parents work, and even with both parents working, there’s no way they can afford to hire help because they just barely make a living wage? What happens when there is only one parent? When there is only one parent and more than one disabled child? When there is only one parent and more than one disabled child, and the parent has to go into the hospital for surgery? What happens is, in most cases, nothing.
Except that a state social worker, overburdened with unfillable requests, burned out from having to say “no” over and over again, might suggest dropping off the disabled family member at a homeless shelter. Of course, giving this kind of advice is not official policy, and a bureaucrat interviewed by the journalist said any employee who made such a suggestion would be disciplined. And nobody has actually done it… yet. Kusmer says,
There have been no confirmed cases of families dumping severely disabled people at homeless shelters because Indiana wouldn’t provide the care needed. But some families have been on waiting lists for waivers for 10 years. The lists contained more than 20,000 names last month…
Kusmer also spoke with Kim Dodson of The Arc of Indiana, the group responsible for making the YouTube video mentioned above. She says,
It is something we are hearing from all over the state, that families are being told this is an alternative for them. A homeless shelter would never be able to serve these people.
Truer words were never spoken. “Emergency housing shelters are consistently full,” says Richard R. Troxell, whose familiarity with homeless shelters is matched by few people in the entire nation. For instance, assessing the situation at the time when Austin, Texas, decided to ban outdoor living, which is pretty much the only kind of living available to people experiencing homelessness, Troxell wrote,
The number of homeless in Austin was estimated to be several thousand, which far out-numbered the few hundred beds at the Salvation Army, the only shelter in town at that time.
And now there is even more need, everywhere, and fewer resources. Shelters are just hanging on by the thread, trying desperately to help people who possess the ability to make it through the door on their own, and wait in a line. Even when made in jest — and not a very funny jest, at that — the idea that homeless shelters could take on another whole population is the least humorous idea of the decade.
Source: “Ind. parents told drop disabled kids at shelters,” Yahoo News, 10/27/10
Source: “Indiana’s Medicaid Waiver Program,” YouTube
Source: “Looking Up at the Bottom Line,” Amazon.com
Image by Alan Stanton, used under its Creative Commons license.