WHAT ARE ATTENDANT SERVICES?

Almost eight million Americans need assistance with daily living tasks like dressing, eating, toileting, house keeping, as well as things like remembering to take medications, balancing a checkbook, etc.. This assistance is called attendant services. A 1993 Families USA study found that 64% of people needing such assistance were not able to get it last year.

WHY IS THIS A NATIONAL CONCERN?

Our defacto national long-term services policy opts for institutionalizing people who need assistance, rather than helping folks in their own homes and/or communities. Two glaring examples of the institutional bias in our current system are: 

     *  Every state that gets Medicaid funding is required to have
        nursing homes.  There is no requirement for home and
        community-based services, which (when provided) are
        completely optional services or small, discretionary waiver
        programs.


     *  In 1993 we spent 82% of our federal long term funds on
        nursing homes ($28.4 Billion), six (6) times as much as on
        home and community-based services ($4.6 Billion).

Funding, policies and regulations all contribute to this institutional bias. And the system is driven from the federal level down.

Outdated attitudes, that can not conceive of people with disabilities living in the community with attendant services, foster the current system. Even greater encouragement comes from the lobbying of the powerful nursing home industry (now worth over $60 Billion), whose goal is to keep the dollars flowing to their programs without regard to the needs of the individual, or our society in general. We have become the crop of an industry making profits off of our lives.

WHY DOES THIS ISSUE NEED TO BE ADDRESSED NOW?

Long term care must be reformed if it is to truly meet the needs of our society. As our society ages, as people with disabilities are able to live, the pressures will only grow. Good, community-based attendant services, part of long term care, can prevent many health complications, and help people maintain themselves at greater levels of independence and productivity. Every day we wait, more lives are being wasted.

WHO IS EFFECTED AND HOW?

You do not go into a nursing home because of your age. People are not admitted because they turn 65, 80 or even 101 years old. You go in because you acquire a disability. (It may be acquired at birth, or through to the aging process, by accident, or illness). Lack of community-based resources also contribute to forcing people into institutions. NO ONE, regardless of age, WANTS to go to a nursing home. Yet we keep sending people to them. In 1992 1.6 Million people, old and young, were trapped in nursing homes.

It is not just the individual who is effected. The current bias is anti-family. Families are split apart because government policies will not help even children live at home. The bias is bad economically for us all. Attendant services mean jobs. Without these services, family members -- mostly women -- are forced to give up jobs in order to provide this assistance. On average it is cheaper to help people in their own homes.

This bias is inhumane. More and more people choose to die rather than exist in a nursing home. A 1993 Wall Street Journal article outlined this phenomenon among older Americans. ADAPT members have known this for years from personal experiences.

WHERE IS THE NEED MOST URGENT?

This national issue calls out for a nationwide solution. People who need attendant services in Massachusetts have the same needs as people in Southern California, Kansas, Washington and Utah. There is nothing unique about taking a bath in Kentucky, or eating dinner in Georgia that warrants a "states' rights" approach to service delivery. As each state faces fiscal crises, community-based services are being devastated; people are being compelled to fight for even the most basic assistance. Then we see more and more people coerced into institutions or fleeing to another state where cuts have not yet started.

WHAT IS ADAPT?

ADAPT, American Disabled for Attendant Programs Today, is a grassroots, disability organization. ADAPT's first issue was access to public transit. We fought this civil rights battle for almost a decade, going to jail at times in order to achieve equality. Once we won this, it was obvious freedom was our next issue. Most of our members are users of attendant services and many had to fight to free themselves from nursing homes and similar institutions. We can not use hard won rights guaranteed under the Americans with Disabilities Act if we are stuck in bed, let alone in an institution.