Florida Court Ruling: Community-based Services, Not Institutionalisation
Forced institutionalisation is not the only denial of rights and autonomy to people with disabilities that people think of as a thing of the past and believe doesn’t need to be addressed, countered, or fought any more. As a result, when we attempt to have conversations about these very real, very structural, and very present issues, we meet rhetoric like ‘oh, well, that doesn’t happen anymore, right? It sure was sad when it did, though.’
(Related: So, When Will You Have the Money?)
They Call it ‘Reverse Discrimination’
People say this is ‘unequal treatment’ and that ‘if you want to be treated like everyone else, you need to be held to the same standard.’ What they miss is that the standard is inherently discriminatory and biased. Holding everyone to the same standard is effectively an act of discrimination, because it demands that people fit into a mold they can never fit into, reach goals they can never attain, because the deck is stacked against them from the start.
Crude Violations: BP Is Dumping Toxic Waste In Low Income Communities of Colour
Given that this waste is supposedly ‘nontoxic,’ why were cleanup workers wearing protective suits? Given that this waste is supposedly ‘nontoxic,’ why are people who have been exposed to it getting sick? Given that this waste is supposedly ‘nontoxic,’ why is care being taken to ensure it doesn’t end up in privileged communities?
California Judge Says State of California Is Still Providing Inadequate Health Services to Inmates
The findings of the report on California’s prisons recommend that the most effective way to improve access to health care for California inmates is to reduce the prison population by releasing inmates. Early release has already been promoted to deal with overcrowding as well as budget problems. However, we also need to approach this from the other side; it’s important not just to reduce the prison population, but to put fewer people in prison in the first place. This requires a major overhaul of California’s mandatory sentencing laws and approach to law enforcement, both of which are long overdue.
Why SF’s Proposed Sit/Lie Laws are a Terrible Idea
The intersections with disability here are rather clear. For one thing, there are some intersections between homelessness and disability, because some homeless people are, for example, mentally ill or have disabling physical problems. Do either of these things make them unworthy of compassion, or not human? Of course not, but from the way this proposed ordinance is designed, it is, on a very basic level, criminalizing homelessness even more than it is already criminalized (not to mention socially stigmatized), while taking extra “common sense” steps to avoid citing non-homeless people for an offense.
It’s Always More Complicated: The “Justified” Abortion (I have snuck this in under policy even though it doesn’t really fit.)
I deeply resent the way anti-choice advocates point at people with disabilities and talk about how they’ll all be eliminated if we allow abortion-on-demand. The sheer amount of hate directed at Don when he goes to pro-choice rallies by the anti-choice contingent, because they see him as a traitor to their cause, is amazing to me.
And yet, many pro-choice advocates also use people with disabilities as pawns in these so-called debates. They hold up stories of fetal abnormalities as “justified abortion”, as the acceptable test-case, the one they know the general public is likely to agree with. I see no analysis, no discussion, of the ableist nature of this narrative. It’s an acceptable justified abortion because the fetus was abnormal, and who wants a broken child that’s going to ruin everyone’s life?
The Canadian Government Is Going To Court So They Don’t Have To Make Web Content Accessible To Screen Readers
Now, I Am Not A Lawyer, and it’s been about 10 years since I studied the Charter, so I’m going to leave that out there and not discuss my personal interpretations because they don’t matter. What matters is two things: 1) What the court says and 2) That the Federal Government is arguing that they shouldn’t have to be accessible to screen readers in court.
The latter is, of course, being read as Jodhan wasting tax payers money in a frivolous lawsuit, not the Federal Government for refusing to have accessible content.
Follow-up: WIN!: Federal Court Orders Canadian Government To Make Websites Accessible To Screen Readers!
Backscatter X-ray scanners, security theatre, and marginalised bodies
If anyone believes airline security operators for a second when it comes to future commitments to respect the privacy of airline travellers? I’ve a harbour bridge I’d like to sell you. […] I give it 24 hours before clandestine mobile phone images of travellers with marginalised bodies show up on the Internet.
Barriers to justice when rapists attack women with disabilities: Australian report
Caroline uses a communication book to communicate, but her communication book did not have the vocabulary she needed to describe what had happened to her.
Where About Us But Without Us Leads
Make no mistake, the assistance provided in assisted outpatient treatment is the armed force of the state ensuring that persons who fall under the purview of this law and those like it comply with any and all aspects of the court-ordered treatment plan. Assisted outpatient treatment is strictly from Minority Report — the person needs have no actual history of violence and need not be judged to be in immanent danger of harming ouself or others.
We Need to Consider More than Universities
Because predators aren’t just at universities and colleges. All those uni students will leave school eventually. Not all predators even go to uni. They will all be looking for targets. Not only will they choose targets that are vulnerable and have a low risk of incurring negative consequences, they will seek out environments where there are large concentrations of their preferred targets. They will search for jobs where they will be in positions of authority over those targets. Predators that prefer children try to get jobs in schools or in religious settings. Predators that prefer disabled people, mentally ill people, or elderly people look for work in hospitals and supportive care facilities. Predators that prefer sex workers become pimps or police.
I Love Policy
At the end of the day, though, policy is literally life and death. Whether a mentally ill teenager gets tased or shot by a police officer depends on law enforcement policy, training, and management. Whether a PWD can afford and access the medications and equipment they require to live. Policy determines how and why and for how long and under what circumstances people are institutionalized. Whether and how they are protected from abuse and neglect from caretakers and family. Whether and when and how they have children.
Institutional Research Boards, Syphilis, and You!
So have we created the right policy? The best policy? A good policy? I don’t know. Our review of the policy gave us only a little bit of answer and a whole lot of questions. It turns out that’s often how policy works, and the kinds of problems with this policy are the same kinds of problems we see in a lot of policies. There’s the problem of specificity – how do you write a policy that says exactly what you want? There’s the problem of implementation – how do you get people to do what the policy says? And then there’s the problem of enforcement – how do you make sure that people are really following the policy? It’s easy to make sure that the rules apply to the most extreme examples – the Guatemalas, and Tuskegees, theMilgrams and the Stanford Prison Experiments – but it’s harder to address the cases nearer the line between ok and not ok.
Vulnerability Indexes, Homelessness, and Disability
I strongly support these programs and have been very excited to see them gaining traction in LA. (we have project 50 in downtown LA, project 30 in the San Fernando Valley, and others pending right now.) I also think these programs are of special interest from a disability perspective because of the extremely high prevalence rates of mental and physical disabilities among the long-term chronic homeless, and the way these disabilities make it difficult, if not impossible, for this group of homeless people to move towards stable permanent housing.
Predatory Lending and Health Services
Nothing like being billed $15,000 at 13.9% interest for a medical procedure you did not sign up for and for which you had no actual medical need!
“COPAA cannot support the current legislation because S.3895 permits restraint and locked seclusion as planned interventions in students’ education plans, including behavior plans and individualized education programs,” wrote the group’s executive director Denise Marshall. “By allowing restraint and locked seclusion as planned interventions, S.3895 weakens protections under the Individuals with Disabilities Education Act (IDEA) and legitimizes practices that the bill seeks to prevent.” (source)
If you are a USian with the time, please write your Senators and ask them to remove this portion of the bill. Restraint and locked seclusion are never appropriate for students and they most certainly do not belong in individualised education programmes. It’s time to take abuse off the table when it comes to options for disciplining students!]]>
Less than half of NHS professionals believe they or their team have had sufficient training to undertake assessments of people who self-harm, according to research by the Royal College of Psychiatrists. The College asked more than 1,500 of its members whether they felt they had adequate training and less than half of respondents felt their training was insufficient to carry out assessments… 26% of staff felt that they did not know about self-harm to communicate effectively (59% of staff in the emergency department).
As one of the members of the working group involved in the survey and report points out, this is a serious problem: “When a person turns up to hospital having harmed themselves, this may well be the first time they have had contact with the health service. Failure to deal effectively with a person at this stage can have major repercussions. It may discourage them from returning in a later crisis and stop them getting the care they need.” It’s also a problem because the general stigma against people who self harm goes unchecked: “large numbers of healthcare staff have a profoundly negative reaction to patients who harm themselves, compared with those with physical illness, and … this is likely to be reflected in the quality of clinical care.”
Not only is this problem serious, it’s also pervasive, as the report estimates that 4 in 1,000 people in the UK self harm, resulting in 170,000 people presenting themselves at hospitals for help with self harm every year. And of course, members of some groups are more vulnerable than others, including asylum seekers, minority ethnic groups, prisoners, QUILTBAG people, and veterans. Young people are also more likely to engage in self harm. And these people are not getting the help they need, the help they deserve.
(You can download the full report here.)]]>
Consider this statistic, from Peter Orszag at an event in DC called The Future of American Jobs Part II: The number of applications for the Social Security Disability Insurance has increased from an average of 500,000 per quarter in 2006 to 750,000 in 2010. Why? Well, it’s unlikely that American disabilities themselves have increased by 50 percent in the last four years. It is more likely that healthy Americans discouraged from the awful job market have sought out disability insurance and collected Social Security money even though they’re not actually disabled.
SSDI requires that its recipients be unable to work. Unemployment insurance, on the other hand, requires that its recipients look for work. Like any government program, UI can be gamed, and sometimes it surely is. But the fundamental point holds: If we stop supporting unemployed people with cash, there is a risk that we kick them out of the labor force onto disability insurance, where we pick up the tab by paying for them through SSDI not to work and not to look for work.
WHERE TO EVEN BEGIN, amirite? Let’s start with identifying the huge, glaring factual error in the argument – the assumption that all SSDI requires for eligibility is “that its recipients be unable to work.” You may not be surprised to learn that the long term disability insurance program through the federal government actually requires that the individual’s inability to work be due to a disability, rather than due to a lack of jobs at their skill level, or a lack of jobs that pay living wages, or any number of other reasons that a person would be unable to work. Yes, this disability benefits program actually has requirements about having a disability! And the Social Security Administration requires quite a lot of verification from medical professionals (who it considers more objective and reliable than people themselves) that it independently reviews and assesses before determining whether a person has a disability that qualifies them for SSDI. You cannot just walk into a Social Security office and demand SSDI benefits, no matter how long you’ve been out of work.
Now let’s look at the statistic he is using to lend legitimacy to his argument: “The number of applications for the Social Security Disability Insurance has increased from an average of 500,000 per quarter in 2006 to 750,000 in 2010.” What does this statistic tell us? It does not tell us anything about the trends, if any, of people receiving SSDI – just the number applying for it. Granted there is some cost to Social Security to review and assess these applications, but the main cost Thompson is raising is the amount of money spent on SSDI benefits – about which this statistic tells us absolutely nothing. Even the knowledge that there are 250,000 more SSDI applications per quarter this year than in 2006 tells us nothing about whether the application (or approval) rates are anywhere near the actual underlying prevalence rates. Even if disability rates have remained perfectly stable, we have no idea whether the 500,000 applications per quarter in 2006 was undercapturing the number of people who were actually eligible for SSDI.
(This built-in, unstated assumption that the starting point in increasing disability benefit rates was the “correct” or desired rate and that any increases are dirty lying cheating fraudulent people is extremely common. You see it in discussions about changes in special education enrollment, rates at which students are identified with learning disabilities, and more. And the assumption that the lower rate correctly reflects the actual prevalence in the population is so ingrained that people, including Thompson, do not even state that they are making such an assumption. It should be obvious to the reader, they imagine, that lower disability benefit rates are right!)
But Thompsons’ main point – that people currently in the workforce may shift to disability benefits if they are unable to find work – gets to the conflation of “disabled” and “unemployable” that I’ve discussed before. There are certainly people who would meet the criteria for SSDI who are employed right now, influenced by any number of factors including the stigma against not working, the difficulty of verifying eligibility for SSDI, and the likely higher income available through work. Unemployment may motivate those people towards SSDI, but so could a bunch of other things, like failure to provide reasonable accommodations at work and employment discrimination against people with disabilities. But a whole lot of people who are unemployed are simply ineligible for SSDI, because they’re unemployed for economic reasons and do not have a disability that would qualify them for SSDI.
A potential takeaway from this kind of thinking is that for reasons including saving money on disability benefits, we should mitigate and eliminate barriers to employment for people with disabilities. But this post concludes that because everyone on unemployment could pull down the higher SSDI benefits if they got the notion, we should support the unemployed. That’s not relevant either to people with disabilities or without them and is fundamentally nonsense.]]>
1. Ableism has a dictionary definition.
The Oxford English Dictionary traces the world ableism back to 1981; likely the word was in use amongst activists before then.
[< ABLE adj. + -ISM suffix, after RACISM n., SEXISM n.2, etc. Compare ABLEIST adj., and also earlier ABLED adj. 2, ABLED n.]
Discrimination in favour of able-bodied people; prejudice against or disregard of the needs of disabled people.
1981 Off our Backs May 39/1 ‘Ableism’that is, the systemic oppression of a group of people because of what they can or can not do with their bodies or mindsis the result of..ignorance. 1993 R. HUGHES Culture of Complaint iii. 162 But certainly clause (3) made it clear that he was against racism, sexism, ableism, lookism and any of the other offences against social etiquette whose proscription by PC was already causing such mirth and laughter among the neo-conservatives. 1994 Canad. Woman Stud. Fall 92/2 Just as there is racism in the feminist movement, there is also ‘ablism’. Able-bodied women have not fully accepted women with disabilities. 2006 C. OYLER & B. HAMRE in C. Oyler Learning to teach Inclusively viii. 145 Although racism and sexism..are recognized as serious challenges to fairness, equity, and democracy,..ableism is often not even acknowledged.
It defines ableist as “Characterized by or exhibiting ableism.”
I mention the dictionary definition because people often claim that ableism is a made-up word that internet activists created just to annoy them, as opposed to a word with history that people with disabilities ihave been using to define their experiences for at least 30 years.
2. Ableism can be deliberate.
A. The Canadian Government went to court so they could continue to make their web content inaccessible to screen readers.
B. Clint Eastwood argued vehemently that 10 years was far too short a period of time to expect that businesses would follow the Americans with Disabilities Act (ADA) and painted himself as a little guy fighting back against the “sleazy lawyers” preying on “the disabled”, rather than as someone who had been breaking the law for 10 years and was now choosing to fight for his right in court to continue to do so. John Stossel argued earlier this year that the ADA might require businesses to be accessible, and this was unacceptable 20 years after the ADA had been passed. [Content warning: John Stossel]
C. Where’s the Benefit has spent the last few months detailing out how cuts in spending will affect people with disabilities. It’s hard to pick just a few examples. How about the Member of Parliament who declared that anyone who was on Twitter too much wasn’t really disabled. Or what Disability Living Allowance (DLA) actually does being misrepresented by both the government and the press?
D. Dave Hingsburger: Service Interupted:
‘Purposeful exclusion,’ I said, ‘there is no way anyone could design this, approve this and build this, without knowing that people with disabilities will never be able to use it. That makes it purposeful. The fact that only certain people can now use it make it exclusion.’
‘I’m sorry,’ she said but I interrupted.
‘This is bigotry in concrete, this is prejudice made of steel and glass, this is how builders and designers and hotel managers spit in the face of those with disabilities. They knew, they didn’t care, they did it anyways.’
E. Politicians across Canada, who make 30 second advertisements that are carefully scripted to make the best impact, don’t use the subtitling option when they upload those same 30-second scripted videos to YouTube. But I guess some politicians are okay with their videos looking like this (image description below):
Image description: Michael Ignatieff (older white dude in a sensible blue shirt and tie, his hair a bit windblown) with the caption “Don’t let anybody into Medicare”.
Actual quote: “Don’t let anybody intimidate you”.
3. Ableism has an academic definition.
Here’s a good example:
Ableism is a form of discrimination or prejudice against individuals with physical, mental, or developmental disabilities that is characterized by the belief that these individuals need to be fixed or cannot function as full members of society (Castañeda & Peters, 2000). As a result of these assumptions, individuals with disabilities are commonly viewed as being abnormal rather than as members of a distinct minority community (Olkin & Pledger, 2003; Reid & Knight, 2006). Because disability status has been viewed as a defect rather than a dimension of difference, disability has not been widely recognized as a multicultural concern by the general public as well as by counselor educators and practitioners.
Laura Smith, Pamela F. Foley, and Michael P. Chaney, “Addressing Classism, Ableism, and Heterosexism in Counselor Education”, Journal of Counseling & Development, Summer 2008, Volume 86, pp 303-309.
You can also get a degree in Disability Studies. There is a Disability History Association. There are several academic list-serves dedicated to discussion disability. You can go to disability-studies focused conferences. You can go to Deaf-studies focused conferences. You can get a degree in Deaf Studies. You can read a wide variety of academic books that discuss the history of ableism.
Or you could read people talking about their lives on their blogs. There are a lot of blogs where people talk about experiencing ableism.
4. Ableism can be accidental. This doesn’t make it okay.
A. I don’t think Google woke up one morning and decided to make some of their products completely inaccessible to certain users. I know they managed to pull it off anyway.
B. I don’t the mainstream media woke up one morning en masse and decided to ignore protests in support of the Community Choice Act. I know they managed to do it anyway. More than once.
C. I don’t think Canada’s Minister responsible for Disability-related issues deliberately sought out a wheelchair-inaccessible space for her constituency office. I do think continuing to have it 7 months after this was pointed out to her in Parliament is deliberate, though.
5. Ableism kills.
Record of the Dead: October 2010
Record of the Dead: September 2010
Betty Anne Gagnon and Murder Most Foul
Quick Hit: Parents of Disabled Children
Tracy Latimer is dead because her father is a murderer
Here’s what affirmative action is: A policy and programme adopted in many regions of the world to encourage employers and educational institutions to consider the history of discrimination against certain classes of people when it comes to admission and hiring decisions. Such policies usually cover women, people of color/nonwhite people, and people with disabilities. The goal of affirmative action is to counteract the effects of centuries of discrimination to create more opportunities for oppressed groups of people by not shutting them out of education and employment opportunities, acknowledging that prejudices are often deeply internalised and people can’t overcome them by sheer force of will. (And are often not aware of how deep they run.)
Here’s what it isn’t: A demand to always hire/admit the marginalised person, no matter what. Yet, it’s often framed that way, as seen in the ‘reverse discrimination’ slang. Everyone, it seems, has a sob story about how ‘someone they know’ didn’t get a job because there was a less qualified Black woman or disabled man or someone else who was there to swoop in and take the employment opportunity away, riding smugly on a cloud of affirmative action1. I have had dyed in the wool liberals informing me with clear, innocent faces that their white, middle class, nondisabled, heterosexual, cis friends and relatives have been horribly oppressed by being passed over in favour of ‘underqualified’ marginalised people who just happened to compete for the same jobs/places at school. They inform me that this is unfair and awful and should stop immediately because it’s wrong.
Here’s what affirmative action is about: When you have, say, an employer who is considering a group of job applicants, that employer is asked to consider the applicants equally. Not to, for example, throw out an application from a woman who uses a wheelchair for mobility because it will be ‘too hard’ to accommodate her. To give everyone reasonably qualified a chance to interview and to honestly and fairly evaluate applicants for a job, rather than deciding that someone is automatically unfit on the basis of personal characteristics. And, yes, if you have two equally qualified candidates, one of whom happens to be a member of a dominant group and one of whom does not, to consider preferentially hiring the person who has not benefited from discriminatory practices throughout life. No affirmative action policy demands that people hire the less qualified people, deciding whom to hire solely on the basis of who is the most oppressed.
People talk about ‘quotas’ and they talk about how businesses and educational institutions ‘get in trouble’ if they don’t have enough ‘token minorities’ and they miss the point entirely. I see this depicted everywhere from pop culture (Cuddy yelling at House for not having a female physician on this diagnostic team) to casual interactions with people who inform me that they ‘would’ apply for a job somewhere but ‘some Latina will probably snag it from me anyway because they’re worried about not having enough brown faces behind the front desk so what’s the point.’ Actual cases where businesses and schools have been punished for failing to adhere to affirmative action policies haven’t involved a government auditor checking to see how many marginalised people they have, but documented discrimination against marginalised groups in interview and admissions policies.
Do affirmative action programmes in colleges and universities ask for more leeway on things like test scores? Yes, they absolutely do, and there’s a reason for that: People in oppressed classes are less likely to do well on standardized tests, for a whole lot of reasons ranging from unequal access to educational opportunities to biases built in on the tests themselves. This means that, yes, when an applicant identifies as poor, for example, that the school will weigh that in the student’s application and will consider the impact that poverty might have on test scores and academic performance. The school won’t say ‘oh, we should let a clearly unprepared student in because she’s from a lower class background,’ but the school will say ‘this student clearly has potential, even if she’s not there yet, so let’s give her a chance, given that she’s had an uphill slog to get to the point where she can even apply for college.’
What this asks people to do is to consider the historic role of discrimination in access to everything from education to employment, to recognise that because of the widespread and deep biases in society, some people can’t access the qualifications/experience that others can. And, yes, affirmative action does ask people to consider marginalised people preferentially, in the hopes of balancing out internalised biases and attitudes; trust me, people, in terms of how people actually behave, it’s a wash.
People say this is ‘unequal treatment’ and that ‘if you want to be treated like everyone else, you need to be held to the same standard.’ What they miss is that the standard is inherently discriminatory and biased. Holding everyone to the same standard is effectively an act of discrimination, because it demands that people fit into a mold they can never fit into, reach goals they can never attain, because the deck is stacked against them from the start.
It’s an attempt to compensate for privilege to say that the lived experiences of applicants should be considered to contextualise their applications. Not an act of discrimination. A corrective measure, an attempt to address and rectify an entrenched culture of prejudice by creating more chances for people who have historically been denied those chances, is not ‘reverse discrimination.’ And I’d like to humbly suggest that people retire that particular slang term, post haste.
All of these people will have some contact with the health care system at some point in their lives and ideally, at more than one point. And, according to the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality, having a health care provider who speaks the same language as the patient has lots of important benefits to patient care (internal cites omitted):
A growing body of literature finds that language concordance between patients and providers (i.e., both speak the patient’s primary language well) results in greater patient understanding, leading to increased satisfaction, better medication adherence, greater understanding of diagnoses and treatment, greater well-being and better functioning for persons with chronic disease, and more health education.
The report goes on to note that only some of these problems can be mitigated by having the conversation interpreted. Using an interpreter can also disrupt the human connection between provider and patient and curtail full discussion. Interpretation, no matter how competent, is somewhat cumbersome and inefficient. This all means that having the health care provider be bilingual is by far the best solution, both for patients and providers. And often, cultural conceptions of health issues like pain, disability, and mental illness can be very important in understanding how a patient is describing symptoms or experiences, so a native speaker is the best.
The problem, of course, is that not all health care providers are bilingual. This means those who can speak another language are relatively valuable, so they can be more exclusive or take more high-paying jobs. If you are a patient who can afford to pay high rates or has great insurance, you may be able to get a provider who speaks your language, but you’re not guaranteed. And if you are a poorer patient and rely on emergency rooms and county health clinics for care, you just have to hope to get lucky. As I once heard it put, “If you’re a Cambodian therapist, you can basically write your own ticket. You’re not going to work at the County Department of Mental Health.”
So how can we go about getting more bilingual health providers, especially for relatively low-paying jobs to care for low-income patients? There’s no obvious answer. Here are some ideas, and their potential drawbacks:
Personally, I support a little bit of all three. (Equivocation is a policy-maker’s prerogative.) Increasing incentives for health care professionals to know and learn non-English languages, aggressive recruiting for native non-English speakers to become health care professionals, and paying bonuses or other incentives to bilingual providers. To make the best of the current situation, I also support training interpreters and ensuring they’re used appropriately.
Are there other policies you think would help the problem?]]>
A 1988 amendment to the Fair Housing Act in the United States specifically banned housing discrimination on the basis of ability status. Under the law in the United States, landlords, mortgage lenders, and management companies legally cannot discriminate against people with disabilities when it comes to renting and selling housing. ‘All types of housing transactions,’ according to the Department of Justice, are covered.
Specific provisions are included to oblige landlords to make ‘reasonable accommodations.’ If housing has a no pets policy, service animals must be permitted. Tenants who need to make modifications to make their residences accessible must be allowed to do so, although landlords are not required to pay for them. Other accommodations that might be necessary must be permitted, under the law, if they withstand the ‘reasonable’ test.
Provisions were also specifically provided to regulate construction of new housing. Landlords are not required to retrofit old housing, but companies building new housing must build it in ways that meet accessibility standards. At multiunit developments in particular, apartments designed to accommodate wheelchair users must be designed and implemented. This is designed to increase housing access for people with disabilities in the future, and it also benefits older adults, who are not necessarily disabled, but do appreciate modifications made for people with disabilities, like shower chairs and grab bars.
So, under the letter of the law, housing discrimination shouldn’t happen to people with disabilities1. Yet, in actuality, discrimination happens all the time. The Department of Housing and Urban Development released a study in 2005, ‘Barriers at Every Step2,’ documenting discrimination against people with disabilities. Using a time-honoured HUD technique known as paired testing, HUD used functionally identical applicants for housing, one disabled and one nondisabled, and compared responses.
What they found is that, well, landlords discriminate against people with disabilities. Realtors discriminate against people with disabilities. So do mortgage lenders. Management companies. Workpeople. All sorts of people involved in housing transactions. As many people with disabilities could have told HUD if they were asked, and as many did in reports to the agency documenting discrimination and asking for help.
Sometimes, housing discrimination is the small cut. It’s arriving at a house for rent and seeing that there’s a step to the door, a bathroom too narrow to wheel a chair into, stairs. In housing that’s actually accessible, it takes the form of turning in endless applications and being assured ‘you’ll get a call’ or ‘oh, we just rented it,’ it’s being asked probing questions about disabilities, ostensibly to see if you can afford the rent, but really with the goal of prying and snooping. Deaf applicants with landlords who refuse to communicate with them. Applicants who ask if they can make a reasonable modification, say, like installing a ramp to get in the front door and being told ‘no.’
This isn’t legal, but it happens anyway. Just like it’s not legal to refuse to rent to a single mother, or a young Black man, or a woman, on the basis of those traits alone, and it happens anyway. Housing discrimination is widespread and it’s entrenched. A lot of landlords are ignorant of the fact that there are laws governing this kind of activity, and others know, but don’t care. Because they know it’s highly unlikely that these laws will be enforced. They can continue on their merry discriminatory way as long as they like.
Few people report housing discrimination, because, when you are searching for a place to live, reporting discrimination isn’t high on your list of priorities. You sigh and cross that information off your list, you tell friends not to bother with that house if it comes up for rent in the future, and you move on. You’re struggling to pack, and get organised, and deal with a thousand tiny details that aren’t going to go away on their own. You don’t have time to file a discrimination complaint. To pull together the documentation. To go through questioning and court and investigations. You are too busy trying to survive.
There are occasional victories, which shouldn’t have to happen at all because the victims shouldn’t have been discriminated against in the first place, but these victories are thin on the ground. HUD uses what funding it can to identify and pursue egregious cases, in addition to following up on complaints filed by people who experience housing discrimination, but it can’t keep up. No one could keep up.
Because this is all the result of entrenched social attitudes. Combating discrimination with laws is great, because those laws provide a framework for identifying, investigating, and prosecuting discrimination, but legislation alone cannot be relied upon to address issues like housing discrimination. As long as people genuinely think that people with disabilities are bad people or difficult tenants or unreliable or ‘difficult,’ they are going to continue refusing to rent to us, refusing to grant us loans, refusing to show us houses for sale.
We need a two pronged approach, which is why I applaud organisations that are working on public outreach and education to familiarise landlords with the law so that they can learn, you know, why legally they should not do this, while also providing people with education about why it’s not ok ethically, as a human being, to engage in housing discrimination. These programs realise that the only way to stop housing discrimination is not with a law, is not on a case by case basis, but rather by actively fighting social attitudes that contribute to discriminatory beliefs and practices.
Our housing options are limited by so many things. Many of us don’t make very much money, and can’t afford the cost of living. Many of us have disabilities that render many types of housing inaccessible. Must we also endlessly combat discrimination from landlords and other people of power when it comes to property transactions?
Los Angeles County Hospital serves about 39,000 inpatients a year, with over 150,000 emergency room visits a year. This is utterly massive, and has led to a lot of complaints about overcrowding, with allegations that emergency room visitors wait an average of 35 hours to be seen – sometimes without even having their vital signs taken. A recent LA Times story showed that likely because of administrative policy hiccups, a patient was admitted to another county hospital and was an inpatient for two days before being assigned a doctor. In another county facility, since closed down, a woman waiting to be seen in the ER bled out and died in the waiting room without being seen. Having spent some time at those hospitals, I can attest that while the relatively new buildings are pretty nice, the old building, in which a lot of care is still provided, feels like a rickety relic of the early 1970s, with sliding metal doors that make the patient rooms feel like drawers in a filing cabinet.
In contrast, this other hospital felt like a palace. There was free valet parking for outpatients. All of the rooms were private and spacious, with room for 9 visitors to fit inside and with a window looking out on trees in gorgeous fall colors. The nurses all knew my grandfather’s name, and his wife’s name, and my name, and my mom’s name. The emergency room in the facility had a gorgeous waiting room looking out into an interior courtyard with fountains and plantings and even a creek running through it. I visited that waiting room often, because that’s where the vending machine with the Diet Coke was, and I never saw more than a handful of people there. Certainly nobody was going to die there without being seen.
Describing the two hospitals like this, I can guess which one we would all choose for ourselves, our loved ones, and our friends. (The nice hospital, just to be clear. I’d rather be at the nice one.) But often when we’re making policies – especially policies for the health care of low-income people – policy makers are not thinking about how they would like to be taken care of, the facilities they would like to be in. They are making policies for other people, policies they know will never apply to them.
That’s why I’m such a big fan of the concept of the “veil of ignorance.” The idea comes from American philosopher John Rawls’ book Theory of Justice, considered an important text in political philosophy. The veil requires a person to create a standard of justice without knowing what place or value they will have in that society. As Rawls described it:
Among the essential features of this situation is that no one knows his place in society, his class position or social status, nor does any one know his fortune in the distribution of natural assets and abilities, his intelligence, strength and the like. I shall even assume that the parties do not know their conceptions of the good or their special psychological propensities. The principles of justice are chosen behind a veil of ignorance.
I like this idea so much. This would require us to make health care policy without knowing whether we would have the most super expensive fancy health insurance policy possible, or have no health insurance and depend on the indigent care available through the county; without knowing whether we would have a disability or be in perfect health; without knowing any of the categories or identities we would be a part of.
It is, of course, impossible to think about policies without drawing from personal experience, but I believe that policymakers should do their best to assume this veil of ignorance. At the very least, they should consider how their policies will apply to and affect the most disadvantaged person possible, to understand the full scope of potential problems that could be created by the policy. Now if only we could get voters to look at things this way…]]>
In Georgia last week:
A sweeping agreement this week between the Justice Department and the state of Georgia highlights an aggressive new campaign by the Obama administration to ensure that people with mental illness and developmental disabilities can get services in their communities — and not be forced to live in institutions.
As part of the accord, Georgia agreed to specific targets for creating housing aid and community treatment for people with disabilities. Those with disabilities have often cycled in and out of the state’s long-troubled psychiatric hospitals in the past. The state said it will set aside $15 million in the current fiscal year and $62 million next year to make the improvements. (source)
This is huge, and will get more help to people who need it in Georgia. The DOJ has been on fire this year with Olmstead-related cases, and the Obama administration has been a major player as well when it comes to pushing the DOJ to pursue deinstitutionalisation and more community-based services for people with disabilities. This is often framed as something ‘too expensive‘ for states to afford, which is I guess a nice way of saying ‘your life just isn’t worth that much to us.’
For people struggling to stay out of institutions and stay in the community, for people in the community without adequate care who are facing the possibility of institutionalisation because they don’t have options, and for people in institutions who want out, legal cases like this recent one in Georgia are huge. Potentially even life and death. It’s particularly galling that many states cling to the ‘too expensive’ cloak when organisations like ADAPT have documented that community based services are actually less costly; yes, it’s actually more expensive to force people into institutions than to let them live in their communities and provide them with appropriate assistance.
The agreement focuses on moving people with developmental disabilities out of institutions into community settings, where they can be closer to their community and family. There are 1,800 people in state mental hospitals, 711 of whom have developmental disabilities, which are genetic disorders that cause cerebral palsy, autism, Down syndrome. Under the agreement, the state will stop admitting people whose primary diagnosis is developmental disability into state hospitals by July 2011, and instead place them directly into community services.
Gov. Sonny Perdue said in a statement, “I am confident that we finally have an agreement that moves us towards our common goals of recovery and independence for people with mental illness and developmental disabilities.” (source)
Another important aspect of this agreement involves providing interventions to people at risk of institutionalisation, preferably before they reach the point of needing it. This is key; it’s not enough to simply change the way people are processed when they start interacting with the system, but to identify community-based needs and fill them before those people end up needing emergency care. Early diagnosis and supportive care is an important part of a programme designed to limit institutionalisation, by keeping people out of institutions in the first place.
This case was filed in part to respond to a series of revelations about horrific abuses in Georgia’s institutions, with The Atlanta Journal-Constitution playing a key role in the unmasking of systemic abuse and other problems. What this case represents, in addition to victory for people with disabilities, is also a victory for the free press. The paper’s decision to cover this issue led directly to more public attention and an outcry, and that resulted in positive change for disabled Georgia residents.
Too often, people with disabilities are covered indifferently in the news or set up as figures of tragedy rather than human beings with their own lives and autonomy and needs. It’s very rare to see one article discussing abuse of people in institutions, let alone to see a series of articles, including investigative journalism, delving deep into this issue and presenting information to members of the public.
I wish that more papers around the United States and in other regions of the world were doing this, because too often I encounter the attitude that institutionalisation should be considered the first option, and that ‘those people’ (you know the ones) would just be better off in institutions. People are routinely shocked when I provide statistics about abuse in institutions, and they shouldn’t be. The fact that they are is indicative of the paucity of coverage disability issues receive in the media.]]>