Life on Wheels (112 page)

Track the status of the ADA and the ADA Restoration Act at www.aapd.com or adarestoration.blogspot.com.

When Hurricane Katrina struck the Gulf Coast and decimated the city of New Orleans, the woeful state of emergency preparedness for people with disabilities was revealed. People with disabilities were trapped in their homes; some died. Those evacuated were not allowed to bring service animals or prescription medicines and arrived in locations that had no provisions for access. Some were simply turned away from emergency shelters, finding themselves suddenly imprisoned in nursing homes.

Federal programs are being established as emergency preparedness rises higher on the priority list in disability advocacy. You are encouraged to inquire about emergency planning for people with disabilities in your own community; chances are you will find that little thought has been given the topic.

As goes Medicare, so goes the insurance industry. The Centers for Medicare & Medicaid Services (CMS) is a branch of the US Department of Health and Human Services. In an effort to control the substantial money it spends on mobility equipment (durable medical equipment), CMS has been pursuing a policy of competitive bidding, in which the lowest-price provider gains large contracts for wheelchairs and scooters.

This raises huge concerns for disability advocates. A low-price provider is not going to provide the up-front consultation and follow-up services that are necessary for a person to get the right wheels and for the wheels to be properly configured. Manufacturers are also concerned because their profit margins will go down as large providers pressure them to cut prices. This will cut into research and development funding and very likely force production offshore—resulting in lower-quality chairs overall.

Follow this issue at Advancing Independence: Modernizing Medicare and Medicaid (www.aimeee.com/aimmm).

Originally known as MiCASA—the Medicaid Community Assistance and Supports Act—the Community Choice Act is the newest incarnation of federal legislation geared to ensure that people with disabilities get the option to live in their own communities rather than be forced into, and essentially imprisoned in, skilled nursing facilities.

The Supreme Court did the right thing in this instance, supporting the Olmstead case on the ADA’s provision that services be provided in the “least restrictive setting.” The government has a long way to go to implement all of the regulations that are potentially affected by the decision, and the Community Choice Act would go a long way toward achieving that end.

It is well demonstrated that providing services in the community costs less than providing institutionalized care—often dramatically less. There is also frightening evidence of the poor level of care in some of these settings where, at best, people must live according to the institutions’ schedule and boundaries, limiting the people’s life quality and options. Yet, a very strong nursing home industry lobby resists this reform for obvious reasons: the more than $63 billion spent annually on these services. Follow its progress at www.adapt.org.

This three-pronged piece of legislation was introduced in March 2007 and was designed to

Expand research at the National Institutes of Health to foster collaboration among scientists.

Support rehabilitation research to measure the effectiveness of certain rehabilitation to optimize mobility, reduce secondary complications, and further develop assistive technologies.

Develop unique programs with the Centers for Disease Control and Prevention to improve the quality of life and longterm health for people with disabilities.

AAA (Triple A),

409

AAN (American Academy of Neurology),

333–334

AAPD (American Association of People with Disabilities),

425

Abdomen

muscles of,

25

,

34

,

85

,

104

,

109

,

293

pain,

66–67

surgery and,

317–318

Abilities Expo,

409

Ablebodied partners,

263–266

Abortions,

285

,

287

Abstinence, sexual,

250

,

285

Abuse, physical/sexual,

43

,

120

,

250

,

290

.

substance abuse

Acceptance

options and,

132

,

174

,

273

,

276

others, by,

153

self,

151

,

152

sexuality and,

269

,

271

,

273

Accessibility,

442

,

444

.

building features; homes

Accessibility codes,

344–345

,

352–353

Accessible Designs, Inc.,

211

Acorda Therapeutics,

321–322

,

330

,

332

Activism,

143

,

323

,

340

,

392

.

advocacy; rights of people with disabilities

Activities of daily living (ADLs),

29

,

30–31

.

occupational therapy (OT)

Activity-based rehabilitation,

32

,

312

Acupressure/acupuncture,

69

,

106

,

108

Adaptability (adjustment) to disability,

4–5

,

7

,

137–138

,

155–157

,

223

ADAPT (American Disabled for Attendant Programs Today),

425

Adaptive technology,

9–11

.

computers

AD (autonomic dysreflexia),

18

,

54

,

55–57

Addiction,

69

.

substance abuse

Adjustment (adaptability) to disability,

4–5

,

7

,

137–138

,

223

Adjustments, wheelchair,

194–196

,

352

ADLs (activities of daily living),

24

,

27

,

29

,

30–31

,

84

.

occupational therapy (OT)

Adoption,

294

Advancing Independence: Modernizing Medicare,

452

Advocacy.

activism; rights of people with disabilities

employment and,

425–426

equipment and services, for,

7

,

190

funding,

191

groups,

10

,

438–439

history of,

449–453

importance of,

339–340

local,

370

Reeve foundation and,

300

,

324

rehab and,

3

,

28

self,

6

,

21

,

45

,

54

,

156

,

188–189

suicide and,

148–149

training,

50

,

421

Aesthetics, wheelchair,

185

,

194

Age of injury,

326

Aggression,

173

,

174

Aging,

60

,

84

,

112–114

,

156–157

,

239

,

342–343

,

371

Aguayo, Albert,

306

Aides, nursing,

18

AIDS,

322–323

Air.

ventilation of homes

Air flotation cushions,

75

,

217

Airlines,

400–404

,

409

,

451

Alarms,

35

,

374–375

Alcohol,

60

,

68

,

83

,

86

,

90

.

substance abuse

Alexander, Craig,

245

,

252

Alexander Technique,

108–109

Alfred E. Mann Foundation,

328

ALS (amyotrophic lateral sclerosis),

10–11

,

41

,

62

,

76

,

79

,

155

,

342

,

437

Alternating pressure,

219

Alternative healthcare,

106–111

American Academy of Neurology (AAN),

333–334

American Association of People with Disabilities (AAPD),

425

American Disabled for Attendant Programs Today (ADAPT),

425

American Medical Association,

333

American Paralysis Association,

323

Americans with Disabilities Act,

122

,

346

,