Thursday, May 2, 2013

Least Restrictive Environment is Different for Each Individual

Closure of  two New Jersey developmental centers leaves families with limited placement choices for their relatives with disabilities.

Closure of two New Jersey developmental centers leaves families with limited placement choices for their relatives with severe disabilities.

by Deborah Smith -

On Feb. 26, Governor Christie announced his plans to increase his commitment to New Jerseyans with disabilities by moving away from a system that has historically focused on institutionalization to one that emphasizes home- and community-based services and support. Christie said his commitment is to provide people with disabilities the ability to live among family, friends and neighbors, as well as comply with the Supreme Court decision requiring that people with developmental disabilities be able to live in the least restrictive environment.

What Christie fails to recognize is that the least restrictive environment does not have the same meaning for everyone in the developmentally disabled community. There are at least two segments of the developmentally disabled community: the profoundly intellectually disabled (IQ level below 20 to 25) and the mild (IQ level 50 to 70) to moderately (IQ level 35 to 55) intellectually disabled.

Two distinct populations

For those with profound intellectual disability, the least restrictive environment for this population is developmental centers where comprehensive medical care is provided to the residents under the Intermediate Care Facility for the Mentally Retarded (ICF/MR) federal-care model for the most vulnerable of our society. Most of these residents have limited or no speech. They are toddlers in adult bodies, and most have a variety of chronic medical conditions. Developmental centers provide healthcare and social services, as well as medical services based on the residents needs determined by a team of professionals in conjunction with input from parent or guardians and family members.

For the mild to moderately intellectually disabled, the least restrictive environment means community-based programs, such as group homes where the objective is to increase the independence of the residents. These facilities do not have medical experts constantly available on-site and need to call local EMTs through 911 for any medical emergency. Group homes focus on increasing the daily living skills of?residents, which include meal preparation, laundry, housecleaning, even money management, and on self-care skills, such as bathing, dressing, toileting, eating, and taking prescribed medications.

Families left with poor choices

The Olmstead U.S. Supreme Court decision, on which the governor says he based his decision, actually recognized that one size does not fit all for care. The court decision states, ?We emphasize that nothing in the Americans with Disabilities Act or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings ? Nor is there any federal requirement that community-based treatment be imposed on patients who do not desire it.?

Read more at?Opinion: One size doesn?t fit all.

[Via North Jersey]


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