Public Policy

Help-Your-Self advocates in favor of and helps implement programs and legislation that increase people's ability to live on their own and avoid institutionalization. Individuals with disabilities desperately seek to integrate into society and escape the medical model of care they have been kept on.

Providing for one's own healthcare needs and securing employment are integral parts of independent living. However, this is easier said than done. Everyday activities such as getting to a bathroom, cooking, feeding oneself, and accessing transportation are not simple tasks for people with disabilities. Many individuals require assistance and rely on government programs to provide personal care help; this type of government assistance is not always easily attainable. Additionally, individuals who wish to obtain gainful employment are often frustrated for the following reasons: the inability to find Personal Care Assistants, the unwillingness on the part of nursing agencies to accept D.C. Medicaid Waiver cases, lack of control over one's own personal care schedule, and dependency on agency care.

Personal Care Policy

Consumer Directed Care, also known as Self-Directed Care and Directed-Care, is an essential part of an individual's ability to feel independent. Being able to make decisions about one's own care empowers people. In 2001, because of the President's New Freedom Initiative (NFI), the Center for Medicare and Medicaid Services (CMS) established new programs to assist in implementing changes that would give people with disabilities the option to make choices about where and how they live. CMS has recently started to allow individual states to establish programs for self-directed care under their Elderly and Physically Disabled Waiver (EPD) program. The District of Columbia, through the Office of Disability and Aging (ODA), offers several programsthat support people with disabilities, but not all are designed to optimize people's independence. ODA is currently writing new regulations to provide a 'Directed-Care Services' program under their EPD Waiver. Medicaid-eligible individuals with disabilities, and people over the age of 65, will be able to receive personal care assistance in accordance to their own individual needs. The program will give people with disabilities the authority to make decisions about the type of support that is best for them, allow people to hire their own staff, manage their own care, and control the budget that supports them.

The beauty of this new program is that it affords consumers a choice, maximizes people's independence, and grants a greater number of government paid care-giving hours than traditional Home and Community Based Services (HCBS). Help-Your-Self assists with the development of these programs to insure that the needs of people with disabilities in our community are met.

Work Incentive Policy

The ability to work and sustain employment is key to an individual's independence: it provides income, a sense of purpose, identity, self-worth, and a sense of contribution to society.

When providing work opportunities for individuals with disabilities it is important to acknowledge people's abilities and also understand their limitations. Joining or rejoining the workforce is sometimes a scary proposition for individuals with disabilities; Help-Your-Self tries to alleviate this type of pressure, improve people's ability to sustain their health needs, and help people achieve their employment goals by bridging the communication gap between the community, businesses and government agencies.

Businesses and government agencies need guidance on how to enhance people's potential, outreach to the community, and meet people's needs. Barriers can often be reduced by providing simple solutions that people are unaware of simply because they have not been exposed to the world of individuals with disabilities. There are ways to eliminate physical barriers through the use of technology; there are ways to reduce program barriers by improving communication techniques, and there are ways to enhance productivity as well as worker satisfaction. Sometimes the solution is as easy as implementing a program that offers people a choice of working onsite or remotely. The key to success is mutual understanding and increasing tolerance.

Creating work incentives, however, seems to be the most difficult public policy to coordinate. Due to government regulations, people with disabilities often find themselves having to choose between working or having health insurance. The types of medical services that people with disabilities require are generally not included under typical employer-provided medical insurance policies. This is a major obstacle which discourages people with disabilities from engaging in work. Increases in people's earned income or assets cause them to lose their Social Security cash benefits and Medicaid services that sustain their life. Why are government regulations designed to discourage people from working to their full potential?

The federal government is implementing policies that would allow people with disabilities to earn an income that exceeds Medicaid eligibility requirements yet still retain their Medicaid benefits. The 'Medicaid Infrastructure Grant' (MIG) and the 'Real Choice Systems Change' (RCSC) grant offered by CMS, and the 'Ticket to Work and Work Incentives Improvement Act' offered by the Department of Human Services, are government efforts to enhance employment options and motivate people to reenter the workforce. These state-customizable services are intended to secure sustainable competitive employment. A key component of this endeavor is the responsibility to modify the healthcare delivery system to meet the needs of people with disabilities who want to work.

What We Believe In

We encourage policies in the District of Columbia that require implementing services that help people with disabilities to live a truly independent living lifestyle - as defined by those individuals. We support programs that allow individuals to work yet retain their medical insurance coverage. We speak formally and informally to government agencies, businesses and community audiences throughout the District of Columbia to promote and educate about programs such as a Medicaid Buy-In for Workers with Disabilities, Money Follows the Person (MFP) grant, self-directed care services, and other work incentive programs. We advise the Medical Assistance Administration how best to implement their EPD Waiver program, Personal Care Assistant services, their Directed-Care Services program, and their MIG and RCSC grants. We are members of the Mayor's Committee on Persons with Disabilities and advise the D.C. Office of Disability Rights in an effort to coordinate their services to match the needs of the community.

Resources

• Centers for Medicare and Medicaid Services
• D.C. Department of Human Services
• Elderly and Physically Disabled Waiver (EPD)
• Home and Community Based Services (HCBS)
• Money Follows the Person (MFP)
• New Freedom Initiative (NFI)
• Real Choice Systems Change Grant (RCSC)
• Ticket to Work and Work Incentives Improvement Act