As the nation prepares to mark the 20th anniversary of the Americans with Disabilities Act next week, the New York Times presents disturbing evidence that cash-strapped states are dismantling home-care services that have been helping elderly people and those with disabilities to live in their communities.

Since the start of the recession, at least 25 states and the District of Columbia have made sharp cuts in programs that, ironically, have been demonstrated to save states money because they keep people out of nursing homes.

“The situation is grim, and it’s safe to say that present trends are expected to continue,” said JoAnn Lamphere, the director of state government relations for health and long-term care for AARP. “Nearly every state has proposed cuts of some sort to Medicaid. Some might seem small, but it’s death by a thousand slashes.”

… Bruce Goldberg, director of the Oregon Department of Human Services, said the agency did not have an estimate for how many of the people losing home care would end up in assisted-living facilities or in nursing homes — or, if they did, how the state would pay for them.

“We’re in new territory,” Dr. Goldberg said. “Long-term care is a cobbled-together system with many holes, and they just got deeper.”

From the New York Times:

“A little-remarked but potentially transformational provision” of the new health care law is the Class Act, which provides for people with long-term disabilities, writes Paula Span.

The measure sets up the first national government-run long-term care insurance program, allowing workers to pay into a fund that would pay a stipend if they need care. Because the program is set up to provide cash payments, it will allow recipients to choose the kind of assistance that best suits their needs.

Advocates for seniors and people with disabilities lobbied for the measure, which they say will help people stay in their own homes instead of being forced into nursing facilities. The private insurance industry opposed it, saying it will be too costly to be supported by premiums.

Earlier posts here.

In a column in the Oakland [CA] Tribune, Washington insiders Cokie and Steven V. Roberts call for approval of the Community Living Assistance Services and Supports Act. The measure, part of the health care bill, would allow workers to pay into a fund that would then pay a stipend if they become disabled.

CLASS, they say, could “make all the difference” for families facing the economic and emotional stress of long-term disability. It could allow an elderly person to pay for care at home instead of being forced to go into a nursing facility, or for a family caregiver to get help at home that would allow them to keep their day job. Presently, the Roberts’ say, many elderly and disabled people must impoverish themselves in order to qualify for government assistance. An excerpt:

How can pushing people into nursing homes be better than letting them stay in their houses? As a caller to a public radio program on the CLASS plan asked, “Why not try something where I can exercise my own responsibility for my future?”

Why not, indeed?

Cokie Roberts is a political commentator for ABC News and a senior news analyst for National Public Radio. Steven V. Roberts appears regularly on CNN, PBS and the ABC radio network, and hosts Voice of America’s “The Roberts Report.”

From the Associated Press/MSNBC:

Amazon.com Inc. has announced that it will add two features to the Kindle that are intended to make the e-book reader more accessible to users who are blind or have limited vision.

The company has come under fire from disability advocacy groups for allowing publishers to opt out of a read-aloud feature on the device that converts text to robotic speech. They say the decision will unfairly limit access for the estimated 15 million Americans who have difficulty reading printed material, including people with limited vision; dyslexia; learning or processing issues; seniors; people with spinal cord injuries, and people who have had strokes.

Amazon said it is developing audible menus and an extra-large font for people with limited vision.

Syracuse University in Syracuse, N.Y., and the University of Wisconsin-Madison have said they will not adopt the device until it is accessible to all students. The National Federation of the Blind and the American Council of the Blind have launched legal challenges to the use of Kindle for distribution of textbooks.

Earlier posts here.

From the Los Angeles Times Booster Shots Blog, Chicago Sun-Times:

A study published in the American Journal of Public Health  finds an increasing number of older Americans with disabilities.

The study by researchers at UCLA compared data from two time periods, 1988 through 1994 and 1999 through 2004. Researchers found that 60-somethings in the more recent period were 40 percent to 70 percent more likely to report having difficulty performing routine tasks, such as walking from room to room, getting in and out of bed and dressing.

Researchers said the trend was most prevalent among people who were overweight or obese.

UPDATE:

See also: Baby boomers may face more disabilities, may not enjoy ‘such a rosy older age’ as past generations did — Los Angeles Times

From Dow Jones/Wall Street Journal, Fox News, Washington Post:

President Obama’s proposal this week of a $250 emergency payment to seniors and people with disabilities drew fire from critics, who saw it as an attempt to buy political support at a time when Social Security recipients are learning that they won’t get an increase in their benefit checks for the first time in decades.

Critics said Obama’s plan, which would cost at least $13 billion, is inappropriate and unjustifiable at a time when the U.S. faces soaring deficits. Obama did not say how the payments would be financed.

“It makes no sense, it’s political pandering,” said Brian M. Riedl, budget analyst at the conservative Heritage Foundation. “This is how budget deficits grow — a few billion here, a few billion there.”

Jeffrey A. Miron, senior fellow at the libertarian Cato Institute, called the payments “outrageous.”

“Sending checks to seniors is a blatant attempt to buy their support for Obamacare, which promises to cut Medicare spending substantially,” Miron wrote in a blog.

From an editorial in the Kansas City Star: “Lobbying for a special $250 payment looks a lot like pandering to the senior voting bloc.”

From the Washington Post:

A campaign on conservative talk radio, fueled by President Obama’s calls to control exorbitant medical bills, has sparked fear among senior citizens that the health-care bill moving through Congress will lead to end-of-life “rationing” and even “euthanasia.”

The controversy stems from a proposal to pay physicians who counsel elderly or terminally ill patients about what medical interventions they would prefer near the end of life and how to prepare instructions such as living wills.

… on right-leaning radio programs, religious e-mail lists and Internet blogs, the proposal has been described as “guiding you in how to die,” “an ORDER from the Government to end your life,” promoting “death care” and, in the words of antiabortion leader Randall Terry, an attempt to “kill Granny.”

Defenders of the legislation, including lawmakers, the American Medical Association and the AARP respond that the accusations are untrue, offensive, and even cruel.

Earlier posts start here.