Thursday, February 12, 2009

Agenda part 3: Disabilities

Here, we continue my ongoing series on the "Agenda" section of the new White House website.

This section was formatted a bit differently. We have a four-part plan, to start, follow by one of the familiar subheadings. That subheading also has four parts. I'll divy up this response into two sections of four parts each, then.

The plan:

First, provide Americans with disabilities with the educational opportunities they need to succeed by funding the Individuals with Disabilities Education Act, supporting early intervention for children with disabilities and universal screening, improving college opportunities for high school graduates with disabilities, and making college more affordable. Obama and Biden will also authorize a comprehensive study of students with disabilities and issues relating to transition to work and higher education.

The IDEA act has existed for some time, and is occasionally updated, the last time being in 2004. I've seen both good and bad results of it's provisions, such as abuse of Individual Education Plans (by both schools and parents), but this point seems to be focused on the 40% of IDEA programs that the federal government is supposed to fund. They have yet to do so, and this plan seems to say that the commitment will be met. I'm all for that -- I despise unfunded mandates. They put an untenable burden on lower-level constituencies. As much as IDEA is an imperfect law, meeting the funding commitment may mitigate some of the issues.

Second, end discrimination and promote equal opportunity by restoring the Americans with Disabilities Act, increasing funding for enforcement, supporting the Genetic Information Nondiscrimination Act, ensuring affordable, accessible health care for all and improving mental health care.

Decent goals here. I worry about some places when it comes to ADA enforcement, though. Reasonable accommodation is difficult when you're dealing with older structures, such as might be found at a college. My own alma mater was a beast -- my fraternity's charity occasionally put administartors and professors in a wheelchair and challenged them to move about campus. It wasn't easy, by any means, and given that the school was perched at the top of a mountain, it occasionally resulted in near-injurious comedy. Watching the school president roll a hundred yards downhill in one of our parking areas, out-of-control, was a priceless, if later sobering, vision. Aside from that, though, a point was made when the only way to access the cafeteria was through an elevator in the kitchen. I had to assist a grown man through a narrow space filled with hot food, stoves, people, and dishes, just so he could get a meal. It could not have been managed alone. Making it into half the dorms is no easier. From my last visit, which nearly a decade after the incident described, access is no better. The school is wide-open to ADA suits. The funds to modernize often just aren't there. However, on the side of discrimination in employment, housing, or other areas, I don't think there can be enough (reasonable) enforcement. One can always be overzealous, of course, but applying the law in an evenhanded and fair manner is simply a means for social justice.

Third, increase the employment rate of workers with disabilities by effectively implementing regulations that require the federal government and its contractors to employ people with disabilities, providing private-sector employers with resources to accommodate employees with disabilities, and encouraging those employers to use existing tax benefits to hire more workers with disabilities and supporting small businesses owned by people with disabilities.

I have few issues with this. The only concern I have would be an abuse of hiring regulations; if they are so worded that you are likely to see someone in a job which their disability would reasonably prevent them from performing, then things will have gone too far. If we stop short of that, it's a good move to help empower a class of people that are often left out in the cold through no fault of their own.

And fourth, support independent, community-based living for Americans with disabilities by enforcing the Community Choice Act, which would allow Americans with significant disabilities the choice of living in their community rather than having to live in a nursing home or other institution, creating a voluntary, budget-neutral national insurance program to help adults who have or develop functional disabilities to remain independent and in their communities, and streamline the Social Security approval process .

I've got no problems here. Home- and community-based care tend to have better outcomes, with more dignity that institutional care. As far as streamlining the SS process, any reduction in a bureaucracy that size is usually a big cost-saver, though changing byzantine systems without letting them collapse is a hell of a challenge. I wonder about that budget-neutrality, too. This looks like a first step toward nationalized or single-payer care on a general level. If they can manage a good program here, I think it would be a good showpiece.

Heading: Autism

Now, before we get into this one, I have a couple of points to make. First, it's likely the only reason that this is in here is because of the antivaccine militia. However, given the structure of the points below, I think it is a repudiation of the points raised by antivaxxers. Coupled with the failure of the test cases before the vaccine compensation program court, and the continued exposure of Andrew Wakefield (who help drive the initial manufactured controversy, apparently with falsified data),I hope that the public start getting some better reporting on the matter. Now, on to the agenda statements:

  • First, President Obama and Vice President Biden support increased funding for autism research, treatment, screenings, public awareness, and support services. There must be research of the treatments for, and the causes of, ASD.
  • Thumbs up, no problem here. This may be the only sop to the antivaxxers, actually, because they always cry for "more research". Of course, that's mainly because the research, when well-done, never shows what they want it to.

  • Second, President Obama and Vice President Biden support improving life-long services for people with ASD for treatments, interventions and services for both children and adults with ASD.

  • Frankly, I figure this would be covered by the items listed in the non-autism segment. Doesn't hurt to restate things, though.

  • Third, President Obama and Vice President Biden support funding the Combating Autism Act and working with Congress, parents and ASD experts to determine how to further improve federal and state programs for ASD.

  • Looking at this act, I think the best money spent is on improved screenings. Disorders on the spectrum are far easier to mitigate (note that I didn't say "cure"; there is no "cure") when caught early. Research on early markers is good, too. However, it looks like the bill originally contained provisions looking at "environmental" factors, like mercury and vaccines. In a move that gives me some hope for Congressional intelligence, someone with sense stripped them out prior to passage. The law looks good, and is money well spent, in my opinion.

  • Fourth, President Obama and Vice President Biden support universal screening of all infants and re-screening for all two-year-olds, the age at which some conditions, including ASD, begin to appear. These screenings will be safe and secure, and available for every American that wants them. Screening is essential so that disabilities can be identified early enough for those children and families to get the supports and services they need.

  • Thumbs up on this. Screening is probably already at a point that it needs to be moved even earlier, though.

    All in all, this is a short section on the agenda that mostly involves funding or enforcing laws already in place. I think most everything here will see an easy implementation, but nothing is going to be a high priority.


    Other posts in this series can be found at the Agenda Index.

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