Restrict Choice? You Bet!

Numerous recent comments sent to the US Administration on Developmental Disabilities from the “Voice of the Retarded” have centered on maintaining a range of choice as the main argument against the desegregation of institutions into the community. See (http://www.envision2010.net/others.php) Institutional and sheltered work advocates have long relied on the “choice” argument to support their views. They say ending segregation removes an option for them about how they want their family member’s life to be. They go on to say community-based services can be unsafe and inadequate. 

They have set up a false choice.

It is false because we should never use taxpayer funds to segregate people who have done nothing wrong, whatever disability challenges they pose. Government sets priorities all the time about what choices it will provide its citizens and what it will pay for. There is no inherent right to be housed in an institution at taxpayer cost. If an option has been shown to be ineffective, morally objectionable, and comes at a higher cost than other community-based alternatives, it need not be an available choice. Most everyone agrees that we have a moral obligation to support our citizens with disabilities, but there is nothing implicit in that belief about doing so through an expensive, taxpayer-funded model that takes people out of society and puts them in a simulated society “for their own good” when we have more cost-effective, integrated solutions available.

As important, people don’t need institutions because some community settings offer inadequate support. People don’t need workshops because sometimes a job doesn’t work out. The solution to this is to improve community support to the quality level we know that works from research, not build substitute, artificial communities. 

Society absolutely knows how to properly support people with medical, learning and behavioral challenges without resorting to institutional or segregated placement. It also is time that institutions, an obsolete service model, are finally removed from the menu of choice. A number of states have done so with good evidence to support the improvement in quality of life for people with disabilities. With what we know today about how to support people in community settings, where all of us belong, it is simply wrong to offer segregated options, as the Supreme Court Olmstead decision implies. 
February 25, 2011
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