My name is Adam Ballard, and as a wheelchair user and as a member of ADAPT, the national grassroots direct action disability rights group that fights to end Medicaid’s institutional bias.1 I have seen firsthand the enormous need for housing that is accessible, affordable, and integrated into the community. Without it, folks with disabilities are being warehoused and commodified in nursing homes and other institutions, where our limited Social Security incomes and Medicaid benefits are taken and used to line the pockets of congregate care operators.
I experienced this reality firsthand myself when I became injured. Although I had access to home-based care for my recovery, I was forced to “rehab” in a nursing home because I couldn’t return to my own home due to inadequate physical access. This injustice propelled me further on my journey toward radical disability activism, and not long afterward, I joined ADAPT.
At ADAPT, we recognize that true freedom from institutions for people with disabilities can’t be achieved until real housing choice and a range of options for community living are available for our people. Ending the institutional bias will only be effective if affordable, accessible, integrated housing for all is available. One way to make progress on this front is to advocate for institutionalized people to be considered homeless under federal law. This would increase access to various housing and rental subsidy programs under the homeless prevention umbrella. Our case for making this change is as follows.
We recognize that institutions such as nursing homes are not “homes” at all, no more than any non-disabled person would consider a shelter or hospital bed a home.
Just as homeless shelters and “doubled up” housing are not real housing options for people who do not have a home, institutions are not a real housing option for people with disabilities. All these groups face similar crisis conditions that are perpetuated, not solved, by the current “service” system. Just like people in shelters, people in institutions do not have control over their own lives. Staff members in institutions dictate every aspect of the lives of people with disabilities who are trapped in institutions: when people wake up, when and what they eat, and where they must spend their time during the day. Like people in doubled-up housing, people in institutions have little or no privacy. Just as people on the street experience abuse and neglect, people with disabilities experience abuse and neglect by the same people who are supposed to care for them. All of these conditions conspire to keep people who are homeless and people in institutions victims of the same institutional and systemic violence. A lack of support for and control over our own lives perpetuates social and economic injustice.
The basic solution for all these groups is similar: a permanent, affordable residence that is fully integrated into the community. The current service system must be reformed to provide people with disabilities accessible, affordable, integrated housing with services that are controlled by the people who use them and follow them to the individual or collective setting of their choice. Defining people in institutions as homeless is a crucial part of making this goal a reality on the local, state, and national level. It will help ensure that government agencies and other service providers for people with disabilities meet their moral and legal obligation to provide community-based housing and support services.
We realize that in the contemporary political landscape, dominated as it is by austerity and deficit reduction, it may be difficult for our friends in the homeless advocacy community to hear of our desire to tap into the already limited resources at their disposal. But we must reject false choices and attempts to divide and conquer by those in power. Instead, let’s stand together and fight for new and increased resources for all our communities together. Together, we’re beautiful; together, we’re powerful. Let’s free all who are incarcerated or warehoused or abandoned by failed policies and corporate collaboration. Free Our Sisters, Free Our Brothers, Free Our People Now! ◊
1. For more information about Medicaid’s institutional bias, please visit www.adapt.org. CURE. Photo