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Wednesday, February 6, 2008 By JAMES FLANIGAN In the past 30 years, New York has seen a "quiet revolution" in the way we treat our citizens with disabilities. Unfortunately, much of that good work is being threatened by a lame-duck administration in Washington. As recently as the early 1970s, New York operated the nation's largest institutional system for people with disabilities. Thousands of people were housed in institutions like Willowbrook, Rome and Letchworth, that were isolated, poorly administered and lacking in individual attention. Finally, television exposes and a major class-action lawsuit brought the conditions to the public's attention. Gradually, the system changed through the use of Medicaid waivers and added categories of optional Medicaid services. People were moved from institutions into smaller residences in the community. Parents, who in the past might have been told to place their son or daughter in an institution, were provided with supports like respite and service coordination to help them keep their family members at home. Schools, churches, places of employment, recreation facilities and public transportation became part of the natural support system for individuals across the state. The Medicaid dollars that once paid for those failed institutions were redirected to support many more people in much more humane community settings. New York went from being infamous for one of the country's worst institutional systems to being known for one of the finest systems of community supports for people with disabilities. This transformation was accomplished with strong support from Republicans and Democrats in Albany and Washington. For a little over a year, the Bush administration has been campaigning to dismantle this system by making drastic cuts in the Medicaid funding that holds it together. Knowing that Congress would never approve such cuts in the normal budget process, the administration has used a series of proposed regulations issued through the Center for Medicaid and Medicare Services to make technical changes that would result in the loss of hundreds of millions of dollars in funding to the state Office of Mental Retardation and Developmental Disabilities. These changes were released when Congress was not in session. It appears the Bush Administration hoped its cuts would go unnoticed, underreported or misunderstood by the public and the press. It was only partially right. While the proposed changes have received little attention from the national media, people with disabilities, their families and advocacy groups became aware of the draft regulations. They have been working closely with congressional staff to analyze and counter the potential negative impact. With strong leadership from Sens. Charles Schumer and Hillary Clinton and New York's delegation in the House, moratoriums were placed on the first two sets of proposed regulations. These moratoriums were attached to bills the President was sure to sign. Unfortunately, a third set of regulations is scheduled to go into effect in March. And the moratoriums on the first two sets of regulations, which would result in a loss of more than $500 million in Medicaid funds to New York, are scheduled to expire in May and June. We are working closely with Congress to extend the first two moratoriums and place an additional moratorium placed on the third set of regulations. The clear intent of the Bush administration is to dramatically cut funding for community-based services for people with disabilities in New York and other states that have followed our lead. These cuts are being proposed without any apparent concern for the impact on the people who depend on Medicaid waiver services. In recent months, the Times Union's opinion pages have seen a growing volume of letters, op-ed columns and editorials expressing varying views on the legacy of the Bush years. Hopefully, the final listing of Bush "accomplishments" will not include destruction of community-based services for people with disabilities. James Flanigan is executive director of the Rensselaer ARC.
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