Laura Hershey: Writer, Poet, Activist, Consultant Rotating Header Image

nursing homes

Five personal reasons why I want our lawmakers to vote FOR the health care reform bill, imperfect though it is…

Five personal reasons why I want our lawmakers to vote FOR the health care reform bill, imperfect though it is:

1. I hope that some of my disabled sisters and brothers currently in nursing facilities will be able to leave the institutions, and receive the support they need under the bill’s plan to improve Medicaid. Among other provisions, states would be offered a 6% increase in the federal Medicaid match, to encourage them to provide community-based personal attendant services.

2. I hope that some future people with disabilities — which could include any of our aging parents, our returning veterans, or anyone else among us — will be able to get the assistance they need in their own homes, without impoverishing themselves to qualify for Medicaid, through the bill’s long term care insurance services program.

3. I hope that some of my attendants who are currently unable to afford health insurance, or unable to obtain it due to pre-existing conditions, will finally have access to health care. They work incredibly hard supporting my and other people’s health, independence, and quality of life, yet this important job does not provide them with employer-sponsored health insurance. I sincerely hope there will soon be affordable, meaningful, portable coverage available to them.

4. I believe, deeply, that health care is a human right. This bill takes an incremental step toward fulfilling that right, for some people. It’s not enough, but it may be a start.

5. I want to defeat these assholes.

Disability Rights Resolutions for the March 16 Democratic Caucuses

If you live in Colorado and you are registered as a Democrat, I hope you’ll help support disability rights becoming part of the Party platform. You can do this by introducing disability rights resolutions at your neighborhood caucus tomorrow night, March 16. I have drafted two resolutions — one about health care reform and community choice, the other about ratification of the Convention on the Rights of Persons with Disabilities.

The text of both of these resolutions is pasted below. Click on these two links to download printable, PDF copies of both —





WHEREAS Americans with disabilities and chronic health conditions rely heavily on public health programs, primarily Medicaid and Medicare, not only for primary health care but also for long-term care needs; and

WHEREAS Medicaid and Medicare contain a strong institutional bias, with funding policies favoring placement in nursing homes and other facilities, thus draining resources away from home and community based care; and

WHEREAS every state participating in the federal Medicaid program is required to provide nursing home services, but home and community based services are optional, and are thereby unavailable in many states; and

WHEREAS sixty-seven percent of Medicaid long-term care dollars pay for institutional services, while the remaining thirty-three percent must pay for all community based services; and

WHEREAS the vast majority of people disabled by age, injury, or illness would prefer to receive services in their own homes rather than in institutions, yet many are forced by current policies to enter facilities in order to get the assistance they need; and

WHEREAS the institutional bias not only deprives people of choice, home, and independence, but also costs taxpayers far more than would a comprehensive nationwide system of home and community based services; and

WHEREAS as the population ages and more people require long-term care, the current institutionally-biased health care system will become more expensive and unsustainable; and

WHEREAS the Community Choice Act (CCA), introduced in the U.S. House and the U.S. Senate, would allow individuals to choose home and community based services as an alternative to placement in a nursing facility; and

WHEREAS the CCA would provide states with financial assistance and incentives to reform their long-term care service systems to provide services in the most integrated setting;

THEREFORE, be it resolved that

THE COLORADO DEMOCRATIC PARTY supports the concept of community choice in long-term care programs; and that

THE COLORADO DEMOCRATIC PARTY pledges to ensure that health care reform legislation and policy proposals emphasize choice and independence rather than institutionalization.



WHEREAS at least ten percent of the world’s population, more than 650 million people, have physical or mental disabilities; and

WHEREAS throughout the world, many people with disabilities are denied their human rights and kept on the margins of society; and

WHEREAS the United Nations adopted the Convention on the Rights of Persons with Disabilities (“the Convention”) on December 13, 2006; and

WHEREAS the Convention establishes the legal obligations of governments to recognize and respect the rights of persons with disabilities; and

WHEREAS the purpose of the Convention is to promote, protect, and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity; and

WHEREAS the Convention sets forth general principles including individual autonomy, independence, nondiscrimination, full participation and inclusion in society, respect for difference and acceptance of persons with disabilities as part of human diversity, equality of opportunity, accessibility, equality between women and men, and respect for the evolving capacities of children with disabilities; and

WHEREAS the Convention is crucial for the social and economic development of societies worldwide, including in developing countries where eighty percent of people with disabilities live;

WHEREAS eighty-two nations have already ratified the Convention; and

WHEREAS at President Obama’s direction Susan Rice, U.S. Ambassador to the United Nations, signed the Convention on July 30, 2009; and

WHEREAS adoption of the Convention by the United States requires ratification by two-thirds of the U.S. Senate;

THEREFORE, be it resolved that

THE COLORADO DEMOCRATIC PARTY calls on all Democratic senators to actively support ratification of the Convention on the Rights of Persons with Disabilities; and that

THE COLORADO DEMOCRATIC PARTY urges the U.S. Senate to ratify the Convention on the Rights of Persons with Disabilities as soon as possible.

Debating Advocacy Priorities: Free the Oppressed, or Promote Employment?

Always willing to challenge the disability rights movement with provocative ideas, my friend Josie Byzek has now written a column calling on our advocacy movement to make employment a top priority. It hasn’t been, says Josie, and “this has got to change.” She questions the wisdom of expending so much of the movement’s energy and resources on the nursing home issue. She argues that we should shift attention to employment advocacy, so that improved job opportunities will help keep people from getting so poor that they end up institutionalized.

I have a couple of quibbles with Josie’s column. (I don’t think she’ll mind me airing my critique. I know Josie well to know that she enjoys a healthy, respectful debate.)

First of all, Josie’s article attributes the lack of focus on employment, in part, to “a community organizing model that erroneously teaches change can only come from the very bottom up.” She goes on to make this questionable claim: “I can’t think of a single successful social change movement that was initiated and propagated primarily by the poorest of the poor, the most oppressed of the oppressed. Social change, in actuality, typically begins in the middle class.”

When I read this statement, Cesar Chavez and the farmworkers movement leapt immediately to mind: Poor, disenfranchised, marginalized by class, race, and language, these laborers organized a massive and ultimately successful grape boycott to protest their exploitation by the agricultural industry.

Then I thought of those drag queens rioting at the Stonewall Inn, fighting back against police harassment and other forms of discrimination. These unsung heroes in high heels, mostly low-income people of color, sparked the modern lesbian/gay/bisexual/transgender (LGBT) movement. (If anything, that movement’s takeover by the middle class has threatened to derail it. Instead of demanding real justice, and the right to be ourselves in any environment, the LGBT movement’s loudest current demands are to be allowed to assimilate into two of our society’s most oppressive institutions: marriage and the military.)

So I disagree that a grassroots, bottom-up advocacy model is wrong for the disability rights community. Having said that, I agree with Josie about the importance of job opportunities. Our community should be outraged by the fact that only around 37 percent of disabled Americans are employed. Like Josie, I would like to see a more aggressive “push for policies that truly can shift that unemployment rate.”

This is more than a civil rights issue, it’s a human rights issue. The International Convention on the Rights of Persons with Disabilities — which took effect in 2008, and which has been ratified by 78 countries (though not yet by the United States) — recognizes “the right of persons with disabilities to work, on an equal basis with others; this includes the right to the opportunity to gain a living by work freely chosen or accepted in a labour market and work environment that is open, inclusive and accessible to persons with disabilities. (Article 27).” It goes on to call for nondiscrimination, reasonable accommodation, affirmative action, training and placement services, self-employment opportunities, and more.

And just as important, I think, is Article 28 of the Convention, which recognizes “the right of persons with disabilities to an adequate standard of living for themselves and their families, including adequate food, clothing and housing, and to the continuous improvement of living conditions…”

Our disability advocacy movement needs to prioritize economic issues, including but not limited to employment. Certainly, everyone should have access to opportunities to use their skills and talents for financial reward, for this increases our choices in life, and improves our own and our families’ well-being. Most disabled people are denied those opportunities. In the U.S., disabled people’s lives tend to enrich other people, while leaving us relatively poor. Many of us aren’t allowed to earn a living; if we do, we can lose the very supports that keep us alive and out of nursing homes. There are a few loopholes, called work incentive programs, but these are quite complex, and people who use them frequently face bureaucrats’ suspicion and mistreatment.

Furthermore, workplaces can be very unfriendly to people with significant disabilities. I’m not just talking about blatant prejudice. I’m talking about corporate structures that barely tolerate any human needs or differences on the part of workers. Schedules and duties can be rigid, office politics can be baffling, and organizational cultures can be downright brutal. Even non-disabled workers have difficulty with these aspects of many job environments; for workers with chronic physical conditions, or mental health issues, they can become insurmountable barriers. Yet the rehabilitation industry, and even employment advocates, focus mostly on getting disabled people “ready for the job market.” I think we need to advocate for fundamental changes in the U.S. workplace, beyond just a reasonable accommodation to an individual’s disability. We need to reconfigure corporate America, to make it serve workers and consumers — indeed, to make it serve the public good — rather than to funnel resources upward into an ever-growing concentration of wealth.

And while I agree with Josie that we “ought to be delinking disability from poverty,” I also think we ought to be delinking poverty from suffering. No human being should endure deprivation of basic material needs such as housing, food, and clean water. In the spirit of Article 28, we must advocate for “an adequate standard of living… and… continuous improvement of living conditions.”

Which brings us back to the nursing home issue. We should demand job opportunities, for anyone with a disability who can and wants to work. But as long as so many of us live with the fear of losing our right to live in the community, we must focus on freedom instead.