Monday, January 5, 2015

Least Restrictive?


Olmstead requires that people live in the least restrictive environment.  For those with profound disabilities, is a community program truly the least restrictive environment?  What are the limitations of community living?

Just as all persons with developmental or intellectual disabilities are different and have different needs, community programs differ across the country.  Communities differ.  Some bureaucrats and advocacy groups are quick to put persons with disabilities and communities into one neat box.  One size does not fit all. 

In Wyoming, the Life Resource Center offers many services in one place.  Residents receive day services, physical therapy, aquatic therapy, equine therapy, behavioral services, medical and dental services, pre-vocational services, medical services, and dental services all on the same campus. These services are provided by professionals who have experience and expertise with developmental and intellectual disabilities.

The community programs don’t provide medical, dental, physical therapy, aquatic therapy, or behavioral health services and are limited to what is available in the community.  Our smaller communities have limited resources; including medical, dental, and mental health services. At times, providers are not familiar with the complexities involved with the developmentally disabled; especially the profoundly disabled with complex medical needs.  In many Wyoming communities, people travel to receive medical, dental, or mental health services.  These limitations affect those living at home with family as well.

Community integration is one of the larger arguments for deinstitutionalization.  In fact, new rules require persons in adult day services (formerly day habilitation) spend a certain amount of time in the community.  For residents of Wyoming, this rule is far-fetched; especially considering the lack of cultural venues in smaller communities and seasonal weather. In addition, not all programs have the staffing or equipment necessary to take their clients out into the community.

Policy changes are made by bureaucrats without input from those who are working directly with community program participants and without considering the impact of those policies.  Despite the intention to fully integrate persons with disabilities into their communities, true integration is not always possible. 

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