Newport Accessibility Games

A friend informed me some people are supporting the new traffic plan on Spring St. on Americans with Disabilities Act grounds.  They say that closing off the street altogether makes it safer for persons with disabilities in that area.  They don’t realize that it creates the necessity to travel further by wheelchair to get places and it makes access to the courthouse even more difficult than it already is.

Let me explain my lack of enthusiasm for this “support”.

First, who is making this an ADA issue?  Everybody whose business is totally accessible (no excuses acceptable here), please step forward.  Nobody?  Everybody whose nonprofit organizations hold fundraisers only at accessible locations, show yourselves.  Hmmm.  Still no one.    Well then, surely, these are people who supported the Accessibility Advisory Committee when there was one and routinely support ADA issues.  Anyone?  Still no response.

So, the only other group I know consists of people who have no real ADA knowledge or commitment but who have other goals and hope that creating an ADA issue will help achieve them.  Ahhhh!  There you are!  We’ve met before. 

Some of you didn’t like the designer of Queen Anne’s Square, so tried to make it an ADA issue.  You yourselves owned businesses that were not then – and are not now – accessible.  Some of you objected to sidewalk seating at some restaurants but needed assistance in making that happen.  Call on the ADA!  Some of you wanted help with ordinances that enhance biking or wanted tree removal.  Make it an ADA problem to ensure success.

To those of you making the traffic pattern an accessibility issue, where were you when the Washington Square redesign demolished half the accessibility that existed before?  If you were concerned about access, why did it take fifteen years of fighting to get an elevator in City Hall?  And why did the lower Broadway project make the entire area inaccessible? 

I could go on, but you get the idea.

I know that whenever and however the traffic pattern issue is resolved, you will all go away.  Since the same people who designed Washington Square and lower Broadway oversee the Spring Street project, it will involve more bricks and cobblestones and other elements that make access dangerous or even impossible for persons with any mobility impairment and persons who are blind.  None of you talking about the traffic pattern will be there to object. 

So, call me a cynic.  I’ve earned the right. 

Every time I try to access a Newport business, I hear excuses about why it just cannot be accessible.  I’ve seen announcements of fundraisers held in restaurants and other inaccessible facilities.  I worked with the now defunct Accessibility Advisory Committee to educate city officials and city residents to change the city’s accessibility and attitude toward it.  I regularly get calls to make problems go away by turning them into ADA issues.

You can’t just play a single card in this game.  You need to sit in for the entire hand.

Raising Expectations Through Sports

Sports have often led the way to elevating the expectations of persons with disabilities and two recent events continued to validate that leadership:  The Clagett Regatta and the U.S. Olympic and Paralympic Committee.

The Clagett Regatta, the premier regatta for persons with disabilities in North America, was held in Newport, RI, its home base, June 18 to June 23, 2019.   Since its inception, this regatta has provided sailors with disabilities the opportunity to compete on an elite level with other sailors around the U.S. and the world.  Many of the Clagett sailors gain the skills and confidence to compete in national and international events not identified as being adaptive.  Sailing is a great equalizer.  This year, the results were published in a story in Scuttlebutt Sailing News, a daily electronic newsletter about all things sailing in North America.  A great example of inclusivity!

On June 20, 2019, the U.S. Olympic Committee and the U.S. Paralympic Committee confirmed their merger with the name change to U.S. Olympic and Paralympic Committee (USOPC).  The commitment to this change began nearly a year ago and the merger includes raising the awards for Paralympic medalists to the same level as that for Olympic medalists.  The USOPC is the first organization in the world that includes both Olympic and Paralympic in its name and one of only four national organizations in the world to manage both Olympic and Paralympic sports.

Paralympic sports don’t get the same television and news coverage in the US as other Olympic sports or as Paralympic sports do in other countries.  Their inclusion in the USOPC and their parity in awards should lead to more awareness of this level of sport and this writer hopes that leads to more and better coverage.  If anyone has ever seen Paralympic competition, wheelchair tennis or regattas in adaptive boats, they know that the level of athleticism and intensity of competition is worthy of attention.

If the expectation of persons with disabilities can be raised in sports, that raise should be translatable to employment and accessibility as well.  That would bring parity to persons with disabilities in all areas of life.  What a great idea!

Stop Making Excuses

How often have you heard:  “I didn’t know I couldn’t park there.  I’m so sorry.”  I’m willing to bet you hear it more than once a week if you have a disability and use accessible parking.

Not only do people not seem to recognize the meaning of the little blue sign with the international symbol for accessibility but they also seem to suddenly not know that the diagonal lines in the access aisle mean no parking.  So, let’s review the use of diagonal lines in all areas.

Diagonal lines in front of a fire hydrant mean:  No Parking.

Diagonal lines in and near a crosswalk mean:  No Parking.

Diagonal lines in a fire lane mean:  No Parking.

Diagonal lines near a corner mean:  No Parking.

Diagonal lines between accessible parking spaces mean:  No Parking.

See?  There is consistency.  In every single case, diagonal lines mean No Parking.  So, how can a person claim to not know the meaning of the lines when they are in the access aisles of accessible parking?  Seriously, if they don’t know, they should have their license suspended until they go to driving school for a refresher.  Or, are they just making an excuse?

That’s one of the main reasons I no longer accept their apologies.  They don’t mean anything.   They are not sorry that I had to sit out in the rain for an hour and miss an important appointment because they were too lazy to walk a few steps. It’s just another way of trying to say they thought they could get away with it and they are sorry they got caught. 

It seems that people pick and choose which laws they will obey.  Most of the time, accessible parking and anything under the Americans with Disabilities Act fall on the side of laws that won’t be obeyed.  Sadly, they also fall on the side of laws that are rarely enforced.

If someone parks in a fire lane, a parking ticket will be issued.  If someone parks in a crosswalk, a parking ticket will be issued.  If someone parks in the access aisle – with the same diagonal lines – it becomes “a teachable moment”.  Frankly, I feel I have been the teacher for far too many teachable moments.  Graduate them or fail them, but stop asking me to allow this to happen again and again and again, etc.

If accessibility laws were enforced across the board, I sincerely believe they would have the effect they were meant to have – to level the playing field so that persons with disabilities can live, go about their business, recreate and otherwise live full and independent lives. 

These laws have been in effect long enough for people to know about them unless they have been living under a rock.  Who really doesn’t know about parking under the little blue sign?  Who really doesn’t know what the diagonal lines mean?  Who really doesn’t know that the Americans with Disabilities Act exists for the purpose of allowing persons with disabilities to live full and productive lives on an equal basis with other citizens? 

Stop saying you’re sorry when you really mean you don’t care.  I know you will do it again first chance you get.  And this sorry state of affairs will continue until the laws are enforced and you feel the pinch. 

Police please take notice.  

We Need Another Martin Luther King Jr.

This week, we’ve been celebrating Martin Luther King Jr.’s birthday.  He was a committed advocate and leader and his work greatly advanced the Civil Rights Movement.  In my never-to-be-considered-humble opinion, his greatest strength was the ability to mobilize so many to peacefully support the rights of all to live as fully integrated citizens of this country. 

I would love to see such a leader support the rights of persons with disabilities.  We are so very far behind when it comes to civil rights.

Persons with disabilities are black, white, brown, male, female, transgendered, gay, straight, rich, poor, young, old, Christian, Jewish, Muslim, Buddhist, atheist, and speak every language that exists on this planet.  We are part of every segment of society.  There are even some who refer to those without disabilities as temporarily able, since we have an open enrollment all year long.  While some are born with a disability, membership in this society is not closed at birth.  An illness or accident can open the door to anyone at any time.  All told, persons with disabilities, both visible and not visible, comprise approximately 20% of the population.

We have the federal Americans with Disabilities Act and the Americans with Disabilities Act Amendments Act of 2008, but we don’t have the strong leader needed to support our taking our rightful place in society. 

I can hear some of the arguments against our achieving this goal now: 

·      It’s too expensive.

·         What do those people want now?  They’re out of institutions and nursing homes.  What more could they want?
·         We support (or help) the handicapped.  (How many insults can you see in such a short sentence?)
·         And more.

Perceptions and expectations are big barriers to full inclusion into society.  We are acceptable if we are a charitable cause.  But, there are many who do not imagine we can be customers, employees, employers, colleagues, etc.  One question that was posed to me during a training has stuck with me as an example of this:  We are a healthcare facility, what could we hire people with disabilities to do here?  While this was a healthcare facility, this question shows the doubt that we face every single day.

We need a national leader of the caliber of Martin Luther King Jr. to change this perception, show our abilities in as strong a light as our disabilities, and lead us to the place that we have a right to be as fully integrated members of society.

Any volunteers?

To Be Treated As Equal, Take Equal Responsibility

We recently celebrated the 25^th anniversary of the Americans with Disabilities Act.  The Governor’s Commission on Disabilities organized an informal celebration where persons with disabilities, advocates and agencies that support our efforts could mingle and talk about the progress or lack of progress resulting from the ADA.

The celebration was held at the Eisenhower House in Fort Adams State Park.  This location was selected because it had recently been made accessible with a grant from the Governor’s Commission on Disabilities.

In order to complete this story, it’s important to know that public transportation in Rhode Island leaves a lot to be desired.  Since public bus routes are limited, paratransit operations which run within three-quarters of a mile from fixed bus routes are also limited.  So, that particular option, either public transport or paratransit, were not on the list of available options.

The celebration was pretty well attended so it was a surprise to later hear so much mumbling, grumbling and outright complaining about the perceived inaccessibility of an event to celebrate the ADA.

I am all about supporting the rights of persons with disabilities to have opportunities equal to those of our counterparts in the able-bodied world, but I have to admit I was miffed about this criticism.  A number of people did attend, including people in wheelchairs, so where did this fall apart?

The average person, when faced with a transportation barrier, will start calling friends (“Are you going?  How are you getting there?’), looking to carpool or share rides.  Alternatively, more telephone calls and using the internet can help locate alternative means of getting from point A to point B.  There were a number of alternatives that would have gotten people with or without disabilities to the Eisenhower House, some of them really fun.

Besides finding someone who was driving and offering to help pay gas or tolls, the possibility of putting together three or four people and renting a town car could work.  In a state the size of Rhode Island, four people sharing a town car can be quite affordable.  Another alternative would be to take the public transportation or paratransit to the Gateway Center and take a cab from there.  There are accessible taxis in Newport and they do not require reservations.  Even more fun, and probably more affordable, would be to get to the Gateway Center and take Old Port Marine’s accessible launch across the harbor to Fort Adams.  I sometimes take this launch to avoid driving and dealing with traffic.  Sometimes I take it just because it is a fun way to get there.  A similar option would be to just get to Jamestown and take the Jamestown Ferry from there. 

So, persons with disabilities, if you want equal rights – and it’s good to fight for them – you need to take equal responsibility for yourself.  Don’t limit yourself to one option and complain because it doesn’t work.  You’ll have a lot more fun and a much better life by taking some initiative.  Focus more on what you want to do than on the limits.  I know this because I’m there with you.

Excuses for Lack of Access

People don’t always recognize how inaccessible their businesses can be and how that discriminates against persons with disabilities. I know they don’t understand when they give excuses that don’t make sense.  Some of these excuses make me laugh until it hurts and others just make me shake my head.   Here are some examples:

During a survey of business owners, the question of accessibility was posed.  One business owner actually said that his business was accessible since the building only had one step to get into it!  Talk about no clue.  For someone in a wheelchair, that one step was as good as a steep cliff.  Access is denied. 

Another business owner said he wasn’t concerned since no one had come in to say he couldn’t get in.  Yes, that’s right.  (Read it again if you don’t get it.)  He somehow felt that if people could not get into the building, they would come in and tell him.  How?  Do people even think about what they say?

Another interesting response from a business owner was that he was not required to be accessible since he never said he was accessible.  How about if we apply that to other laws?  Suppose a policeman stops you for speeding.  Do you think that excuse would fly?  Try telling the officer that you were not required to obey speed limits since you never said you would.  While the officer may have difficulty writing that ticket at first because he would be laughing so hard, you can be sure there would be a ticket with a fine attached.  The same goes for any other law you break.  This is not a response that will benefit you.

When I recently complained to a business owner that I couldn’t attend several events that were held at his facility, he replied that two out of three of their facilities were accessible.  He then invited me to visit the accessible ones.  Somehow the fact that two facilities are accessible does not help when the event is at the inaccessible one got lost on the business owner.  Access to the events I was trying to attend was denied. 

When you fail to comply with the Americans with Disabilities Act, you are effectively putting up a “Keep Out” sign.  Actually, a sign can be ignored when the barrier cannot be.  Is keeping people out of your business what you really want to do?  Persons with disabilities make up the third largest market segment in the U.S.  I think that’s a lot of business to turn away.

Annette Bourbonniere

www.accessing-ability.com

Twitter:  @AccessInclude

Federal judge rules in favor of more accessible taxis

Hurray!  Advocates for persons with disabilities have been fighting with the city of New York regarding accessible taxis.  Now, a federal judge has ruled in their favor.  http://www.nytimes.com/2011/12/24/nyregion/taxi-fleet-in-new-york-is-inadequate-for-wheelchair-users-judge-rules.html

The resistance on the part of the city and its Mayor, Michael Bloomberg, has been both puzzling and annoying.  With the population of persons with disabilities growing, and a new fleet of taxis being commissioned, the city administration, led by Mayor Bloomberg, fought against making the new taxis accessible.  The new taxis were to have all sorts of amenities, including televisions, but it was deemed that they should not be accessible.

Advocates did not give up the fight and this decision was recently handed down.  Additionally, Governor Cuomo signed a bill that asks for a plan for more taxis to be accessible. 

Persons with disabilities comprise the third largest market segment in the United States.  Additionally, accommodations for persons with disabilities are frequently adopted by the general population as innovations.  So, it’s time to retire the argument regarding costs.  It’s an investment, people!

Annette Bourbonniere

www.accessing-ability.com

Twitter:  @AccessInclude

Reviewing the System Is Only Part of the Answer

Reviewing the system for awarding disability benefits is necessary but it will not solve the real problem.http://online.wsj.com/article/SB10001424052970204844504577098810070396878.html?mod=rss_Health

It is true that the trust fund for Social Security Disability benefits is running out of money and will not survive another decade.  It is important that this system get reviewed.  However, just reviewing this aspect of the system will not even come close to resolving the issues both the government systems and persons with disabilities face.

One problem we have is that we keep trying to fix pieces of the system.  Our disability policy has more Band-Aids than substance at this time.  But, it appears that we will keep on adding more.  It is a system that is based on the fact that, in the past, persons with disabilities were totally incapable of substantial gainful employment and were likely to die in a few short years.  That is no longer true, but the policy has not changed.

If we had a disability policy and system that reflected today’s reality, we could save the government a great deal of money and, at the same time, make life better for persons with disabilities. 

As things stand now, most people who receive disability benefits live in poverty and are forced to remain in that state in order to receive critical services.  At the same time, persons with disabilities are viewed as lazy (just check the comments at the end of the article) and unwilling to work.  This perception is perpetuated by the lawyers who advertise that people are entitled to these benefits, as though a life of poverty were something to strive for.

It is really time to look at the big picture.

Annette Bourbonniere

www.accessing-ability.com

Twitter:  @AccessInclude

Are Charter Schools Discriminating Against Persons with Disabilities?

Charter schools in Florida and elsewhere are not admitting students with disabilities.  http://www.npr.org/2011/12/14/143659449/florida-charter-schools-failing-disabled-students.

While they claim they do not turn away students because of their disabilities, they do say they are not equipped to meet their needs.  Of course, then, one has to ask why they are not so equipped.  They are publicly supported.  Of course, not every public school is equipped for every student either, but students are more likely to have their needs met at most public schools. 

Part of the problem is that students with disabilities most often have Individualized Education Plans (IEP’s) and those IEP’s will not send a child to a school that cannot meet their needs. 

Some charter schools specialize in children with disabilities, but that is just another form of segregation and, unless it is really impossible to meet the needs of these students elsewhere, special schools are a giant step backwards. 

How widespread is this problem?  What are the solutions?

Annette Bourbonniere

www.accessing-ability.com

access-ability.verizon.net

Twitter:  @AccessInclude

Is Managed Care the Answer for Dual Eligibles?

Is managed care the answer for dual eligibles?

More and more persons with disabilities are among the growing number of dual eligibles, i.e. people eligible for both Medicare and Medicaid coverage.  Persons with disabilities are eligible for Medicare either because of age or their disability and are eligible for Medicaid because of the poverty that has been forced upon them. 

There are good arguments both for and against managed care for this population, as can be seen from this article in the LA Times:  http://www.latimes.com/news/local/la-me-healthcare-duals-20111114,0,3197520.story.

Whatever we do to make healthcare better for this population now, we need to be realistic about how this problem came about and decide how to prevent this in the future.  What we do now is focus on one aspect of policy at a time and try to put a bandaid on it.  What we end up with is an unwieldy and unworkable system. 

A disability policy that is based on current reality, that does not force persons with disabilities to live in poverty in order to obtain critical services is needed soon.  Current policy is so expensive the system is about to implode.  It is possible to have a policy that saves government many dollars and still improve the lives of persons with disabilities. 

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

Using iPads for Voting

Oregon has begun implementing the use of iPads to assist voters with disabilities. http://www.nytimes.com/2011/11/17/us/oregon-tries-out-voting-by-ipad-for-disabled.html?_r=1 Election workers bring the iPads to the voters’ homes or nursing homes, along with a portable printer.  Because there is the ability to enlarge the view for persons with visual impairments and because there is no need to be able to grasp a pen for marking the ballot, this use of technology has the potential to solve a number of problems for voters with disabilities.  Once the ballot is completed, it can be printed out and approved by the voter before mailing or being brought to election stations.  Screen readers can read back the ballot before printing for those who cannot see it to review it.

As more counties and states try this out, it is likely they will look at it as a way for other voters to cast their ballots as well.  Once again, an accommodation will become an innovation.

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

Proposed New Rules for Federal Contractors

The Obama Administration has proposed new guidelines for hiring workers with disabilities that would require all federal contractors to set goals of having 7% of their workforce composed of persons with disabilities.

Certainly, this will add some muscle to the Americans with Disabilities Act, since it requires action which is stronger than the passive of not discriminating.  Of course, there will be the ever-present paperwork needed to document this effort and businesses will object to that, as they have objected to paperwork requirements of Affirmative Action and the ADA. 

Some other concerns include how to document this 7% since the ADA does not allow you to ask about disability.  That’s not quite true, though, is it?  AFTER a person is hired, it is allowed to ask disability related questions and, if the response is voluntary, this documentation can be accomplished. 

What I find exciting about these new guidelines is that federal contractors will have to document their efforts to recruit individuals with disabilities.  This outreach is crucial to all successful employment programs and needing to document it will ultimately lead to workforces that are more inclusive of persons with disabilities.

This will not resolve all the employment issues of persons with disabilities, but it is a giant step in the right direction.

You can read the notice of proposed rule-making or submit a comment at http://www.regulations.gov.  Comments will be accepted until February 7, 2012.

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

Why Disability Policy Needs to Change

We talk about the need for disability policy to change, and people wonder how big the problem is.  Consider this scenario.  It is only one person, but it is a realistic reflection of how disability policy works now.

A woman with a disability makes the decision that working is better than not working, even though she is not able to get health insurance because of her disability.  Of course, since she has no insurance, she never really gets ahead.  However, she considers work to be therapeutic and continues. 

As time goes on, the aging process catches up with her and she is diagnosed with a chronic disease on top of her original disability.  Now there is a significant cost added and she just plain cannot keep up.  Since she is working, she is not eligible for any assistance.  Over time, she loses all that she owns and even becomes homeless.  Ahh!  Now she is eligible for assistance.  She gets disability benefits (since she cannot work during this process), medical assistance (what she most needs) and subsidized housing.  Now she can begin putting her life back together and get back to work.  Right?

Of course, there is the need to continually report and qualify for her benefits.  Every program requires its own reporting, even though they all use the same information.  Some programs even require reports two or three times a year.  This really does nothing to motivate or improve self-esteem.  It is a real downer.  It also forces her to keep her income to a level that does not put her over limits required for receiving assistance.  No way to get ahead.

But, she manages this and is at least grateful that her medical expenses are covered.  She gets the adaptive equipment she needs and takes care of herself medically.  Then it happens.  She turns 65 and it all changes.  Her $700 a month in Social Security benefits gets cut by $115 to pay for Medicare.  Then she finds that her medications are not longer completely covered.   With the extra help available, her plan D provides for a lower copay.  She needs only to pay $1.10 for generic medications and $3.30 for name brand medications, for covered drugs.  And that’s the catch.  “Covered drugs” does not cover all her medications.  Other medical supplies are also cut, mostly in half.  Medicare only covers adaptive equipment that allows her to function in her home.  What is needed to go outside and have any kind of life is not covered.  Added up, her medical expenses again eat up most of her income.  The prospect of again becoming homeless looms.  There is really no way out.

At what point does any of this make sense? 

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

Primary Care and Healthcare Access

Another healthcare issue for persons with disabilities is physical access. 

Physical access goes beyond ramps and elevators.  It includes restrooms, exam rooms and any other room or space that is ordinarily accessed by patients.

There are standards for all accessible bathrooms put out by the Federal Access Board.

More recently, this same Federal Access Board has published guidelines for accessible healthcare facilities.  These guidelines include adequate space between and in exam rooms, accessible exam tables, lifts, scales and other equipment.  Almost no healthcare facilities meet these guidelines.

Primary care providers are the ones who see persons with disabilities the most, since they are in charge of coordinating all the other care.  Yet, these very same providers are paid the least and so are least able to afford the equipment needed by persons with disabilities.  This puts all of us who need this type of equipment at a disadvantage.

This is one more reason that this country needs to address the issues related to primary care.  No healthcare system, managed care, fee-for-service, or any other configuration, will work until we can provide stable, quality, accessible primary care.

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

High Cost of Low Pay for Primary Care

Something for insurers to consider when setting reimbursement rates is that the shortage of primary care physicians plays a role in raising the cost of healthcare.

When there is no primary care physician available, people tend to go to the more expensive provider – emergency rooms.  While walk-in centers fill the gap for some, many walk-in centers do not take Medicaid, so persons with disabilities usually have to opt for the most expensive service available, simply because it is available.  This should be a real cause for concern since it means that people who use healthcare services the most are using the most expensive services.

This problem is not resolved by health centers and health systems if they have do not retain the same primary care providers.  This is because coverage and continuity of care are not interchangeable.  Coverage may be provided by new primary care physicians, but the time needed to develop the relationship that assures continuity of care is not there.  So, even with new good primary care physicians, the default option for some people will still be the emergency room.

Consider this – a person with a disability feels ill.  This person has not yet really connected with a  new primary care physician after his or her previous one has left a practice.  This person then faces the choice of calling a stranger (new but not yet established primary care doctor), and wait for a call back, with no certainty of whether or when that stranger will be available, or going to an emergency room where he or she will certainly be seen, even by a stranger.  For some disabilities, a minor problem can escalate to a major one quickly so the certainty of care will be the choice in almost every case.  This problem does not get resolved by the instant transfer of medical records either, since that transfer does not establish the relationship that is necessary for true continuity of care.

So, if paying primary care physicians less causes poorer healthcare delivery at a higher price it seems logical that Medicare, Medicaid and all other insurers should re-evaluate the reimbursement structure, looking at the bigger picture.

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

Shortage of Primary Care Doctors

The United States Department of Health and Human Services Health Resources and Services Administration has designated more than half the states in the U.S. as Primary Care Health Professional Shortage Areas.  Does this scare you?

While the reasons for this shortage are many and complex, one reason for this shortage is that health care providers in this group are paid significantly less than specialists.  The low pay leads to fewer physicians going into primary and the need for some primary care providers to move to other practices more frequently in order to earn more money.

This is a problem for all healthcare consumers, but it puts persons with disabilities in a particularly difficult position. 

Optimal healthcare is usually achieved through a partnership between the patient and healthcare provider.  This partnership takes time to establish.  This partnership then directs the tone and direction of other services.  Then, of course, it is left up to the primary care provider to write referrals and prescriptions and letters of necessity for these other services.  When a person cannot connect with a primary care physician or when primary care physicians come and go, this relationship is disrupted, sometimes for several years at a time, leaving a significant gap in needed continuity of care. 

Persons with disabilities often have to manage several some complex healthcare needs.  With a primary healthcare provider that has become a trusted partner in this management, it’s possible to stay ahead of these needs to set up contingency plans for dealing with them before they get out of hand.  Losing a trusted partner in this management can lead to problems that would be otherwise preventable.  This gets even more complicated when a person with a disability needs a referral to a specialist in order to satisfy some insurance requirement and getting a referral from a stranger who has not had the chance to understand the need is delayed. 

This shortage then sets up a bad relationship since the person with a disability needs to push to get needs met before problems get worse.  Nobody wins.

I will comment on the cost implications of this shortage in another post.

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

. 

Placing Blame Doesn't Work

Don’t you just love it when you find out that gaining your own civil rights puts everyone else’s in jeopardy?  The if-we-give-you-this-it-will-ruin-it-for-everyone-else attitude is alive and well.

I cannot count how many times this excuse is given when dealing with access issues.  How many times do we get told that, if accommodations are provided, the costs will be so high that everyone else will suffer?

A recent example is in New York City, where there is a civil suit filed by the U.S. Attorney’s office against the city because of the lack of accessible taxis.   Mayor Bloomberg claims that the suspension of accessible taxis is bad so other riders will be uncomfortable.  Shame on us for making others uncomfortable so that we can be included.

Another claim that the mayor has made is that it will raise costs because of the cost of the modifications and the increased gas costs.  There we go again, making costs higher for everyone else.  He insists that the drivers won’t like them because the larger size makes it more difficult for the driver to communicate with the rider, leading to lower tips.  We really kill the economy with that one. 

Bloomberg also stated that it is too difficult for wheelchair users to hail taxis and that drivers don’t want to pick them up.  Well, it’s good to know that he’s looking out for us.  Right.

If were not enough, Governor Cuomo also got on the bandwagon, stating that having accessible taxis could jeopardize allowing street hails in the burroughs and upper Manhattan. 

So, it’s really clear that we wheelchair users are a royal pain and will cause the collapse of the New York transportation system. 

Their solution is that residents use designated transportation.  Of course, that will not work for tourists visiting New York.  Separate but equal?  Go to the back of the bus?  Does anyone recognize this rhetoric as blatant discrimination? 

It’s time for people to recognize that persons with disabilities are real people, living real lives, contributing to the economy like everyone else.  This is not charity or compassion, but thinking like a smart businessperson.  Include us and you will benefit.  In this case, it would mean that those of us who use wheelchairs, whether as residents and employees or as tourists, add much more than we take.

In the meantime, it’s just great to know that we are to blame for all the troubles of the world. 

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

The problems with disability policy based on medical model

When disability policy was developed, disability was viewed in the medical model.  The understanding was that the person had a medical problem that was in need of fixing and that, until that medical problem could be fixed, that person was unable to work.  If the medical problem could not be fixed, the person would be considered totally and permanently disabled. 

We put physicians and other medical providers in charge of whether or not a person could work, whether or not a person receives various disability benefits and what services and accommodations a person with a disability needs. 

While we are inundating medical providers with paperwork to attest to these things, no one seems to take into consideration that they are not the ones with all the answers. 

While most disabilities have a physiological beginning, that doesn’t necessarily mean they need or will respond to medical interventions.  For example, if a person is in an accident and incurs a brain injury, the disability can be permanent.  However, the time for effective medical therapy is only for a short period after the injury.  If the person still has the disability after 20 years, what do we expect a physician to do? 

Some disabilities are the result of medical conditions that need ongoing treatment, but many do not need medical intervention.  Yet, we put them all in the same category and require that there be medical documentation of all kinds of things related to disability. 

In the meantime, since most medical providers have the same view of disability as the average population, they are responding with the viewpoint that they are supposed to be able to decide major life issues for these people.  Should the person work?  What are the person’s transportation needs?  Does a person need a roll-in shower?  What about a parking pass?  Should the person be in a nursing home?  If so, can we keep the person out with appropriate services?  What services?  (Read the last three again to note the irony.)

Removing disability issues from the medical establishment could benefit persons with disabilities, ease the burden on medical providers and reduce costs for society.  Since the medical model is now recognized as not appropriate for determining disability, let’s next consider what the basis for disability needs to be.

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

The Roles of Design, Attitude and Quality Control

Comments from Niall 3

This is the third of a series of Comments from Niall. It is designed as part of a series that will hopefully raise awareness of the contribution that people with disabilities can make to the community

Design

This is the starting point to achieve accessibility and therefore inclusivity. Architects, interior designers, construction engineers etc.... These are the people that will create our future environments. Yet, how many of them are fully informed of the needs of people with disabilities?

I am certain that the vast majority of them want to get the best result that they could but lack of awareness about accessibility is the main barrier to their achieving a fully inclusive environment.

Attitude

To physically create a fully inclusive environment means little if the people that work in it, or the people that buy or live in it, are not committed to the belief that everybody is welcome. This need for a positive and indeed, creative attitude also extends to people with disabilities. Their awareness of the possible limitations to achieving a fully inclusive environment is vital if a truly harmonious outcome is to be reached.

Quality Control

This may seem obvious but there are many examples, that I have actually seen, where the best intentions of people trying to achieve inclusivity, have failed. The initial design was good, the building appeared to be broadly accessible but the actual building work was altered (due to perceived construction necessities) so as to render the final result of little use to people with disabilities. When the builders move in they are focussed on the main issues: will it stay up, are all the electrics and plumbing in the right place and will it pass the inspections to allow it to open. The needs of people with disabilities are sometimes not their first priority. And, yet, if the concept of a fully inclusive working, selling or living environment were accepted then accessibility would become automatic. Rather than be treated as an additional worry, the building would meet the needs of as wide a range of people as possible. Inclusivity would be part of the Mainstream.

How to Maintain that Inclusivity

Having achieved an inclusive environment it is then all too easy to lose it. For example, extra desks and display stands for products etc. spread onto clear routes and accessibility is then lost.

The next Comment from Niall will cover the ways to maintain Inclusivity and then promote it to all potential users.

Niall can be contacted at tarrell@btinternet.com

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

Who Benefits from Inclusivity

Comment from Niall 2

This is the second of a series of Comments from Niall. It is designed as part of a series that will hopefully raise awareness of the contribution that people with disabilities can make to the community

Who benefits from Inclusivity?

First, who are these people who will benefit? The immediate answer is people with disabilities. And yet there are so many more people involved in every interaction in our modern society. What about all the family, the friends, even the representatives (such as lawyers) of those people with disabilities? All of them will also hope and indeed, expect to be able to enjoy life or work together in a fully inclusive environment.

And yet, there are also the owners and people that work in every business. In an inclusive environment everybody benefits. The service or workplace environment is available to all and then everybody is happy, or at least they all share the same experience.  This allows people with disabilities to be an expected and valuable part of the community.

Meeting the needs of people with disabilities

This is often easier than it may at first appear. Most people with disabilities are very aware of what they need to be part of the community and are therefore a main source of information. There is also a wide range of design guides available to assist when building or renovating a building. But the most important thing is common sense. Speak and listen to people that have experience in this area. Best practice and good examples are so much more effective than trying to just achieve compliance with the law.

How to achieve inclusivity – an introduction

This will be covered in more detail in the next Comment from Niall but broadly includes: Design (of a building or a space), Attitude (of builders, managers, staff and users) and Quality Control (are access elements in an environment effective and truly meet the needs of people with disabilities).

The next Comment from Niall will expand on the various ways to achieve as much inclusivity as possible. Followed by an introduction on how to maintain that inclusivity.

Niall can be contacted at niall@btinternet.com

 www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude