One-size-fits-all approach doesn’t suit state’s disabled

The following op-ed appears in shorter form in editions of the Prosser Record-Bulletin and the Dayton Chronicle published during the week of Feb. 22.

By Sen. Maureen Walsh

In the Legislature, we pride ourselves on listening to the people. But what happens when those people have no voice?

Where the state’s developmentally disabled are concerned, it is an enormous problem – really a classic story of governmental indifference. A one-size-fits-all program that suits the less-disabled individual is expected to serve everyone, even those for whom it is completely inappropriate.

We call this policy “employment first.” It has the best of intentions. The idea is that disabled adults, age 21 and older, can achieve the greatest degree of independence and fulfillment by working at a job. Using Medicaid funds, the state contracts with employment provider agencies around the state to place the disabled in jobs around their communities.

On paper, it appears a smashing success. Washington touts itself as a national leader in job placement for the disabled – about 7,000 of them working at any given time, for a cumulative average of about 10 hours a week.

Yet those figures don’t tell the whole story. Many who have been placed are working as few as two hours a week. Many who are employable cannot be placed for lack of local job opportunities – a particular problem in my southeast Washington district and in rural communities around the state.

The truth is that not all clients are employable. Many are so severely disabled that a job is not an option. The way this policy works, these high-acuity clients spend nine months waiting for job placements that will never come, before they finally become eligible for community-based day programs better suited to their needs – supervised care, day training, skill development and similar offerings. More than 10,000 disabled adults go entirely unserved.

That’s why I have sponsored Senate Bill 5510, which would require the state Developmental Disabilities Administration to restructure the way it delivers programs. Clients, parents and guardians would be allowed to choose the type of program that suits them best.

Simple enough, right? Yet the idea seems to have many spooked. At this point, it’s not clear whether the bill will even get a hearing.

You might think of it as a lesson in the way government really works. The bureaucracy is none too keen on an overhaul. The employment providers want to protect their funding, and they have learned to lobby effectively.

But perhaps the biggest stumbling block is that the most severely disabled cannot speak for themselves – and I mean this in a most literal way. Two years ago, the Legislature attempted to address this problem with a somewhat different approach. We got a full-court press from parents and the disabled themselves, defending the state’s current system. Yet those we heard from were the least disabled, whose needs were being met. The severely disabled didn’t speak up at our hearings, because they could not.

We need to find a solution. Federal rules require us to serve everyone eligible for Medicaid. Under Medicaid rules, the developmentally disabled are entitled to be housed at residential habilitation centers – a far-more-costly option that separates these individuals from their families. The state’s employment and day programs offer a more-humane alternative at much lower cost to taxpayers. But when these programs are administered so poorly that the majority of the state’s disabled are left unserved, it is only a matter of time before someone files a lawsuit and forces the state to act. If our current struggle to revamp our mental health system is any indication, the Legislature’s inattention to this issue could spell even bigger trouble in the future.

Our programs should be designed for the people they serve, not those who administer them. Choice is a powerful concept that empowers the disabled and their families to select the programs that suit them best. Not to mention the fact that fixing our DD system is the right thing to do. That should count for something.

Sen. Maureen Walsh, R-Walla Walla, represents the 16th Legislative District.