Drac's Oldest News

DRAC Presents Complaints to the Vocational Rehabilitation Advisory Committee

On November 30, members of DRAC met with the Vocational Rehabilitation Advisory Council to present our complaints of frequent turnover of counselors, poor transition between counselors, lack of back up for absent counselors, lost documentation, premature closings, and counselors who dispense wrong information.

Kyle Walker (see story below) repeated his line that what DRAC encountered was an isolated incident and that all problems have been corrected. We noted that the Disability Law Center's CAP program keeps getting more referrals every year and that a large number of those referrals are successfully resolved, implying that the Vocational Rehabilitation offices aren't getting it right the first time. This is our demand--that they get it right the first time and not force individuals, some of whom have a very difficult time, to appeal every wrong decision.

The council has asked the CAP program to give it a report. We trust that this report will collaborate our experiences and help highlight the need for significant changes before the Office of Vocational Rehabilitation gets it right.

DRAC Demands a Better "Money Follows the Person" Response from Michael Deily

On November 14, 2005 members of the Disabled Rights Action Committee descended on the Department of Health in a local action. The action was to let the Department of Health know that we are not satisfied with the structure, pace and lack of planning for moving individuals out of nursing homes. Mr. Deily met with us as we presented the following demands:

1)  Give us a real Olmstead Plan with real goals of numbers of persons who will be targeted to be able to move from nursing homes into the community in each of the next five years.

2) Change Flex Care so people who don't need and want case management aren't required to pay for it from their limited service dollars.

3) Change Flex Care so people can keep their income, while taking on more responsibility in paying for their groceries, rent and utilities.

4)  Work with the federal government to make community services less paternalistic, with less of a focus on safety--allowing program participants to take more risks.

5)  Coordinate with housing authorities to develop special housing vouchers for persons moving from nursing homes so they have housing waiting for them at the time they move out. As a first step towards this work with the housing authorities to automatically give persons moving from nursing homes longer to find suitable housing.

6)  Change the state's data use agreement with the federal government that will allow the use of the MDS data for the purpose of identifying individuals who have indicated they want to move out of the nursing home and offer them support in doing so.

7) Investigate the inherent conflict that exists when nursing home social workers and doctors become gatekeepers to community supports for persons who "live" in nursing homes and who express a desire to move out. See if there can be state employees such individuals can contact.

Mr. Deily agreed to pass our request for a real Olmstead Plan to other authorities in the state system who have the necessary authority. He agreed to look into everything else and invited us to meet with Tonya Keller, who is now over the Health Department's long-term care. Mr. Deily agreed to provide us with a written report of his actions in relation to our demands. Since then, Mr. Deily has stated that he will address our issues in the December 15 Medicaid Advisory Committee meeting, and that his comments will go in the public record/minutes. We also have a meeting set up with Tonya Keller on December 29 to follow up. Stay tuned--as with everything else, this is an ongoing saga!

DRAC, Lee Anne Walker and the Taxi Companies Round 4 (Or So)
October 21, 2005

We Won!!

The Salt Lake City attorney did a magnificent job defending the city's new  ordinance that requires the cab companies to provide at least one accessible van per fleet of vans. Proceedings began at approximately 9:30 AM and the judge delivered his decision at approximately 6:30 PM. The judge found that Handivan does have a property interest in their certificates of convenience and necessity, but then found that introducing competition from the taxi companies does not constitute a taking of that property. He also found no conflict between the new ordinance that was passed and the one that creates a license for specialized transportation.

What this means-

As of this moment, Salt Lake City has a valid ordinance requiring all cab companies that own vans (I believe this is City Cab, Yellow Cab and Checkered Cab) to provide an accessible van as of this moment. Thus, if you
call these cab companies today they must offer you an accessible ride, within twenty minutes that costs the same as all other fares. If, for any reason, you call for a cab and don't get this service, give us a call
immediately.

Caution-

In the hearing yesterday, the manager for Yellow Cab stated that he doesn't believe the city has the authority to require that he pick up anyone outside of the city limits who uses a power chair or to extend a trip that begins within the Salt Lake City limits to outside the Salt Lake City limits. Therefore they are warning us that if you call and say you need to be picked
up in South Salt Lake they will probably tell you they don't provide accessible taxi service in South Salt Lake. Also, the manager said that they may just drop us off at the County line if we ask to be picked up in Salt Lake City and then want to travel to South Salt Lake, or they will switch the meter over at the County line and start charging us exorbitant fees.

We obviously have some work to do. If anyone has an "in" with Salt Lake County,
you may want to start hitting them up for support of a companion ordinance. All the cab companies arguments about how they can't afford a lift would be moot because the City ordinance already required that they provide the
service one way or another. A county ordinance would just require that they extend this service so that people with disabilities outside of Salt Lake City aren't discriminated against based solely on where they live. If the taxis make good on the threat of charging us higher fees just across the city line or worse, dropping us off at the city line DRAC may explore further legal action for discriminatory treatment, so call us if you experience any of these problems.

Lee Anne and the taxi companies have talked about wanting to take this to trial, but they would be going before the same judge who just found most of their legal arguments to be without merit. However, we don't ever want to underestimate them the way they have so badly underestimated us.

Click here for more information about how you can help enforce this ordinance.

Lee Anne Walker and the Taxis (DRAC and the Taxis Round 4)

 

We here at DRAC pride ourselves on our tenacity, our creativity and our willingness to go over, under, through or around as necessary to get to our objective. The Taxi companies and their new allies are testing all of these qualities. When we lost round one in the courts we convinced the Salt Lake City Council to pass an ordinance requiring the Taxi companies that utilize vans to outfit at least one van for each company with a wheelchair lift as a requirement of maintaining their license.

Case closed? Hardly. Just as we were approaching the deadline for compliance, Lee Anne Walker, who runs Handi-Van, Pick-Me-Up and possibly another “special” transportation service joined forces with the Taxi companies and argued for, and won a temporary restraining order against the city, barring them from enforcing the ordinance.

Their rational? If we have access to regular taxi service at the same fare as everyone else they will have a difficult time attracting customers at twice the cost. In other words, they need a monopoly, at our expense, to stay in business. Sounds a little like the nursing homes. We become commodities to be bought, traded and sold, but never to be respected as customers who should be able to vote with our feet or wheels.

One of the really painful things about all of this is that Ms. Walker is also a person with a disability, but hey, so was Christopher Reeve, and if he could be Mouth Magazine’s number three or four number enemy because of his betrayal of the disability community’s principles, then…

As of this writing a full all day hearing is scheduled for Thursday, October 20. We are working to pull together a coalition and to prepare a range of affidavits that will refute the spurious claims of Ms. Walker and her taxi friends that we need specialized medical
transportation to go to the movies, that anyone providing such transportation requires hours of specialized training that is not available anywhere in Salt Lake, that we can only be picked up and dropped off for exorbitant costs and that denying us access to
the same transportation as everyone else will be hazardous to our health. If you are reading this before the 20th and would like to join our effort so the court knows Leanne Walker isn't speaking for us, contact us!

DRAC Goes to Bat for One of Our Own with Voc Rehab
September 29, 2005

Charlie Salazar has been waiting months for approval of funding for critical dental care from the Office of Vocational Rehabilitation. Three advocates from DRAC wrangled with his counselors, the Director of the Office of Vocational Rehabilitation and a supervisor and finally obtained a promise that the process would be complete on August 15. A week later Charlie and one of the advocates were informed that the needed approval had been obtained, but that the process had taken so long the dentist would need to re-affirm that the price he quoted was still good. The counselor then transferred to another office, but assured Charlie and his advocates that the new counselor would be apprised of the situation. Not so. The new counselor announced that he felt a need to start the approval process all over again, in spite of the fact that we obtained verification from the dentist that the price still holds.
Charlie gets interviewed by the media

This was just too much and we took action! On September 29, fresh from our actions and victories in Washington, DC, DRAC descended on the Taylorsville Office of Vocational Rehabilitation. Press releases went out the day before and we believe someone from the press contacted Kyle Walker, the supervisor there, because he called DRAC just prior to the action to apologize for the delay in getting Charlie his dental authorization and to promise that it was being approved today. That was wonderful news for Charlie, but our concern is also for all those individuals who don't have friends to back them with action. We need fixes for a broken system, not a quick fix for just Charlie.

Accordingly, we went ahead with the action. The press was kind enough to cover the event--Channel 4, Channel 5 and Channel 13. We collectively entered the offices and confronted Kyle Walker, the supervisor. Mr. Walker acknowledged that the ball had been dropped on Charlie, but insisted that he has been fixing the system and that what happened to Charlie was an exception to the rule. However, it is hard to believe that all of their exceptions happened to just Charlie. Calls have not been returned. Promised deadlines have not been met. Explanations as to why things have been held up have changed. When Charlie faced emergencies we called the office to see if they could do anything. We were told that Charlie's case worker was out on training, that the secretary didn't believe what Charlie was facing was any kind of an emergency, and that everything would have to wait until the worker returned. Charlie's old worker leaves just as months of procedural wrangling are coming to an end, only to have the new worker tell us that it has to start all over again. If these are all exceptions to otherwise excellent service, poor Charlie must be a magnet. However, with several other DRAC members telling their stories of lost records, wrong information and prematurely   closed cases, we believe that what happened to Charlie was much more the norm                    DRAC confronts Kyle Walker
than the exception.

DRAC members and Mr. Walker were able to agree on some things, in particular our demands. He agreed they were reasonable and necessary. He claimed that he has already addressed these issues so problems such as happened to Charlie won't happen. However, they did happen and DRAC insisted that we meet in thirty days to hear what changes will or have been made from when the ball was dropped on Charlie. Our demands are:

Ø     Authorize Charlie’s dental service today so he can move forward in becoming gainfully employed.

Ø     Establish polices and procedures and insure these are followed so that there is a seamless transition when a new counselor starts.

Ø     Put policies and procedures in place and follow them to ensure that our records and test results are not lost.

Ø     Establish policies and procedures to identify authorized back up for counselors who are in training or on vacation so critical service decisions can be made and services can go forward.

Ø     Hold a meeting within thirty days with DRAC to report on these policies and procedures and how they are being implemented.

Stay tuned to see how this turns out. Mr. Walker can be assured that DRAC will be back in thirty days and thereafter if permanent fixes aren't made to the system.

DRAC-ADAPT/Utah Back in Washington, DC September 2005
September 17-22, 2005

Deja Vu! Over 500 strong, including eleven activists from ADAPT/Utah--DRAC, we once again descended on Washington DC with one message--"Free Our Brothers and Sisters!!" With each passing year we think about our brothers and sisters who have spent another 365 days incarcerated in nursing homes for the crime of  having a disability. Our sense of urgency is heightened, and our efforts intensify. This was certainly evident in this year's fall action in Washington, DC.

On Sunday September 18, our first day, we made the long march--five miles each way--to Senator Frist's home.  As usual, it was a mellow way to ease into our action, complete with Johnny's music and chants. Still, five hundred angry people with disabilities on your doorstep should make an impression. A giant sign was displayed at the back of the crowd with holes cut in it like colonial era “stocks.” We took turns poking our head and hands through the seven-foot tall sign to find ourselves targeted by a rag of wet red paint, much as we have been targeted by killing cuts. Senator Frist has led the way with these cuts. In addition, his home state of Tennessee has cut hundreds of thousands from the Medicaid roles, condemning many to death and many more to nursing home incarceration as critical community services, such as ventilation, are eliminated. Hence, while it was Frist today, it will be his home state that we will be targeting in our Spring '06 Action.

Monday, September 19, our second day, things really heated up as we targeted six key Congressional Offices--leaders of both houses who can and should take the lead in passing MiCASSA and Money Follows the Person, but who have either ignored us or given only lip services to our cause. However, it's hard to ignore fifty to sixty protesters who have packed your office and hallway. Targeted were the offices of Senators Bill Frist, Chuck Grassley, and Harry Reid and Representatives Dennis Hastert, Tom DeLay, Nancy Pelosi, and John Barton. As we chanted and sang it became clear to the staffers that today it wasn't going to "be businesses as usual." Despite repeated warnings many of us refused to leave. On the third warning the police began their arrests--104 in all. The arrests started around 4-5 PM and the last of the arrestees weren't processed and released until 6:30 the next morning. The message was clear. We need more than polite meetings, we need more than lip service, we need to have MiCASSA and Money Follows the Person passed now. We need these Congressional leaders to lead.

Tuesday, September 20, day three, one action blended into the next. Many of us got to bed at around 7 AM only to be rousted at 10 AM for our next action, which was really more of a press conference and rally at the Department of Health and Human Services, our own Secretary Leavitt, as we vented our anger that persons with disabilities were hit hardest by the aftermath of Katrina. A lack of planning, combined with the fact that many persons with disabilities were abandoned in their nursing homes meant that once again our government failed us. Adding insult to injury was the fact that many survivors have been unnecessarily shipped off to nursing homes with the very real risk that they will be forgotten. Our rally was one way of insuring that this will not happen--at least we will not forget. A final demand was that Health and Human Services not target persons with disabilities and our critical services for the $10 billion in mandated Medicaid cuts.

This was no vacation--by 2 PM we were again on our way--this time in a  two-pronged "attack." The majority of our group headed to HUD with demands that Secretary Alfonso Jackson meet with our leadership and agree to explore the creation of housing vouchers for persons who are attempting to leave nursing homes. Mr. Jackson flatly refused to meet with the group--after all, he has his housing, which is secure, so why should he worry. However, when Mr. Jackson was informed that sixty activists with disabilities had showed up at his doorstep, all committed to stay for as long as needed or until arrested, he apparently began to reconsider the inviolability of his home and the reasonableness of our demands. In fifteen minutes he met with the group at his offices, agreed to a later meeting and to investigate the possibility of creating special housing vouchers to facilitate moving from nursing homes. Those of us at his home disbanded in a somewhat anti-climatic fashion.

Wednesday, September 21, day four was a day of "safer" rallies. First we marched to the headquarters of the National Governor's Association. ADAPT asked the National Governors Association (NGA) to support restoration of the proposed $10 billion cut in Medicaid, eliminate the institutional bias by implementing Money Follows the Person on a state level, and to plan for HUD vouchers for all people transitioning from an institution into the community. Additionally ADAPT asked the NGA to halt cuts to optional Medicaid programs by US states and to sponsor an initiative to address long-term care services, durable medical equipment, assistive technology, support services, service animals and community housing for Katrina evacuees with disabilities. Our message was highlighted by turning our march into funeral procession, headed by a coffin that represented ADAPT warriors who have passed on and untold thousand of nursing home "residents" who have died in desperation and horror. We held a rare moment of silence and then filed past the casket as we placed flowers and our wooden "Free Our People" coins on the casket.

The NGA agreed to fax our demands to all fifty governors and Barbara Toomer noted that each of our local organizations now has to take the fight to the state level.

All of the DRAC members who fought this good fight are now home, resting up (somewhat), mapping out how we can pressure our state to meet the ADAPT demands for the states and saving up for our spring action in Nashville Tennessee. Please plan to join us for both our local and our spring national action!

For a local photo gallery of this action, click here. 

DRAC’s Pothole Promenade a Success

DRAC takes on Secretary Leavitt—Again

August 16, 2005 Secretary Mike Leavitt was in town to tout the new Medicare drug plan. DRAC was there as well to let Mr. Leavitt know that trying to cut Medicaid costs by cutting so-called "optional" services and "optional" people is unacceptable. Optional people include persons with disabilities who do not receive Medicaid, regardless of what difficulties their disability presents. Optional services include medication, dental, vision, physical and occupational therapy. We know from painful experience the suffering that can come from cutting a service, such as dental care, that is critical for us, but labeled optional by the federal government. We also told Secretary Leavitt that increasing co-pays in the name of greater personal responsibility for one's health care is unacceptable.

We also gave Secretary Leavitt an alternative. Several options have been proposed at the national level for savings that could come from better negotiations on drug prices and slight tweaks in the formulas for establishing the reimbursement rates for various prescription medications. Click here for a more detailed description of these proposals. DRAC did a quick check and the CEO of Pfizer, one of the major pharmaceuticals, made $28,925,241 in total compensation including stock option grants from Pfizer Inc. A person with a disability, who is on Medicaid and who receives SSI, would have had an income of  less than $7,000. Put another way, a person with a disability living on SSI, would have to survive 4132 years on SSI to equal Henry A. McKinnell's 2004 compensation. It is therefore unconscionable that Secretary Leavitt and others at the Federal Level to take money from persons with disabilities in the form of higher co-pays, or to cut critical services while protecting the profits of the drug companies. Increasing the co-pays or cutting critical services for persons with disabilities means that they will go without vital medical care, often to their long-term harm, while this is less than pocket change for someone like Mr. McKinnell.

DRAC continues to call on Secretary Leavitt to look to the Pharmaceutical Companies for mandated cuts to Medicaid, and for Secretary Leavitt to formally endorse, in writing, MiCASSA and Money Follows the Person legislation. Attendant care has repeatedly been shown to save money over nursing home care. Secretary Leavitt, save money where it helps, not hurts us and our brothers and sisters.

DRAC Founder, Board Member and Nationally Recognized Activist Barbara Toomer

Receives the Utah Issues Joe-Duke Rosatti Hell-Raiser Award 

Utah Issues, honored Crossroads Urban Center and Disabled Rights Action Committee Founder Barbara Toomer at their 30 year conference awards program with the Joe-Duke Rosatti Hell-Raiser Award. Named after long term Salt Lake Community Action organizer and hell raiser Joe-Due Rosatti, this award recognizes Barbara's many years of fearless activism on behalf of Utah's and our nations persons with disabilities as well as others who live and struggle in poverty. Barbara received this award not only because of her national and local leadership and her willingness to charge in where others fear to tread, but also because of her tremendous strategizing and negotiating skills. Barbara is never one to overreact or overplay her hand. If someone will be reasonable and willing to work with her they will find Barbara to be a equally reasonable negotiator.  However, she never compromised on principles and has repeatedly shown her commitment by a willingness to suffer arrest and incarceration on numerous occasions rather than back down.

Barbara has also been a tremendous mentor to numerous people with and without disabilities. She has been ever patient with those who will remain true to the principles for which we fight. She is never quick to attack because of a slip of the tongue and is gracious in overlooking the ignorance of those who would be possible allies when educated. For her fearlessness in attacking attitudes, institutions, persons with and without disabilities who are truly the enemy of our civil rights and for her patient mentoring and recruitment of loyal followers to the cause we agree with Utah Issues that Barbara is a deserving recipient of this award and applaud them for their recognition. However, in true "Toomerisk" fashion, we hasten to add that this doesn't mean that Barbara or DRAC has been co-opted in any way!

DRAC Members Meet with Governor Huntsman

On June 2 after repeated misses members of the Disabled Rights Action Committee met with Governor Huntsman to make our case for flexibility in long term funding. We called for him to give us a real Olmstead Plan, one that provides concrete goals for each of the coming five years--numbers of individuals who will actually leave nursing homes for a place in the community, and a roadmap for making these goals a reality. Governor Huntsman is a businessman and knows that a business plan that lacks measurable goals--numbers is meaningless. In addition to calling for an actual Olmstead Plan, DRAC members called for Utah use the authority already granted it by CMS (Medicaid) to adopt a true "Money Follows the Person" rule. We outlined reasons why Flexcare, while a step in the right direction, falls far short of a true Money Follows the Person model. In conjunction with Money Follows the Person we asked for Governor Huntsman's support of MiCASSA or MiCASSA principles of allowing individuals to access nursing home funding to hire their own attendants before entering a nursing home.

Our delegation sprinkled personal stories of nursing home "life" from their individual experiences or those of our friends. Governor Huntsman appears to "get it" when he declared that this seemed to be more of a civil rights than a financial issue. We concurred. We also let Governor Huntsman know and reiterate our official position here that we are not attempting to close down all nursing homes nor eliminate nursing homes as an option for persons with disabilities. Rather, we are fighting for time-honored conservative principles of true choice and of competition. We believe that nursing homes should have to attract, not capture residents through their monopoly on long-term care funds. If nursing homes know that most persons with disabilities have a choice of hiring personal attendant care or living in their facilities they will work much harder to improve services. Competition works in the long-term care arena as well as it does in the business world.

Governor Huntsman extended an unprecedented thirty minute meeting into forty minutes as he asked questions and asked for information on successful approaches to MiCASSA and Money Follows the Person models from other states. We would like to express our sincere appreciation to Governor Huntsman for his time and respectful hearing of our issues. At the same time we renew our call for him to act on the information we provided and the successful models we will be providing from other states.

Free at Last--Kevin and Marjorie Hall Leave Their "Prison" of  a Nursing Home

Over four years ago Marjorie Jensen told DRAC Americorps Volunteer Tammy Miner (now Burton) that she desperately wanted to leave the nursing home and live in an apartment of her own. Marjorie uses a wheelchair, has a hearing impairment and sometimes likes to leave for a jaunt around the neighborhood without getting permission and doesn't always watch out for traffic when she does so. For these infractions she was sentenced to segregation and isolation in the nursing home. Perhaps thinking she would never accomplish the feat, the nursing home doctor said he would support Marjorie's move to an apartment of her own if she could learn to take her own medication. For months Marjorie worked on this with Tammy, finally learning the names of each of her medications, their purpose and the times she was to take them. She was then told that this wasn't sufficient. There were other hoops for her to jump through. Finally, frustrated with a system that gave almost total control over discharge from the nursing home in the hands of a doctor who really didn't know what community supports could provide, DRAC assisted Marjorie in choosing another community doctor who was supportive of her moving out.

Then Marjorie really threw a monkey wrench into the works. She fell in love with a man who also lived in the nursing home, Kevin Wall. They married with the shared goal of moving into their own apartment some day, just like many other married couples. Unfortunately, for them, Kevin had a number of medical problems, chief among them a seizure disorder that was very difficult to control. Possibly related to the seizure condition was a history of aggressive acts that had followed Kevin from nursing home to nursing home. We were told that if it was extremely difficult and unlikely that Marjorie would ever be "allowed" to move out, it was impossible that she could ever do so with her husband. She was given an impossible choice, one of getting out of the nursing home by agreeing to leave Kevin behind or live with him forever under the intolerable conditions of the nursing home.

Flexcare flatly refused to consider any options of working with this couple, since they were working strictly with assisted living programs at the time and no assisted living service would touch this couple. They would provide a modicum of case management services to them while living in the nursing home. We were flabbergasted when we sought to appeal this decision to withhold the possibility of community support and were told that there was no appeal. This was based on the presumption that Flexcare wasn't withholding services--they would provide them in the nursing home, they were just choosing not to provide services in the community, which we understood to be the whole reason for Flexcare's existence. In frustration we met with the Department of Health--John Williams, who finally agreed to develop a "grievance", but not an "appeals" procedure for Flexcare decisions to withhold community supports and services. Under this agreement, DRAC could assemble any group of advocates, experts, friends, family, and the persons whose lives were on the line to dispute the findings of Flexcare and to offer alternative solutions to the limited options provided by assisted living.

Its an old, but effective concept--sometimes called "Circles of Support." In convening our first meeting, we had Marjorie and John Harbert, a representative of UACS--the community services of most organizations that offer community supports under contract to the State Division of Persons with Disabilities— Kim Rognon-Sato and Tonya Keller from the Health Department, Don Fenimore from Flexcare, a representative of the nursing home and some new faces from DRAC--Jerry Costley and Cathy Garber. Blunt, probably painful appraisals were given by the experts on the problems that would prevent Marjorie and Kevin from moving into the community. However, our breakthrough came when Mr. Harbert said that he was aware of a number of providers who successfully support individuals with reputations that are more extreme than Marjorie and Kevin's, and that the funding that would come with them from the nursing home would probably allow for adequate community supports. With this appraisal, it was agreed that the Department of Health would put out an "Invitation to Offer Services" to all community providers, not just the assisted living services.

Three providers expressed an interest in providing support to Marjorie and Kevin. Of these, Columbus Community Center was the only one to purpose providing support in an apartment complex that was in the general vicinity of the nursing home, which is the area they had come to be familiar with, and which was within easy travel distance of some friends and supports they had established over the years. On this basis, Marjorie and Kevin made their choice of providers. It turned out to be a good choice. Columbus Community Center was creative in developing a plan that addressed all concerns for supervision, support and medical care, within the budget of the monies Marjorie and Kevin would bring with them from the nursing home. In order to make the budget work, Marjorie and Kevin had to agree to get their morning and early afternoon staff assistance at Columbus' sheltered workshop. As a rule we are opposed to segregated work as much as we are segregated living. However, Marjorie and Kevin agreed to give it a try. They have turned out to be very hard workers, and given that they have only ever been allowed $45 a month spending money, the funds they earned at the workshop have greatly enhanced the quality of their lives. For all of our ideology and principles, DRAC, as a group, is also pragmatic, and we agreed to support the Walls in participating in the workshop, with the plan that as they progress and do well in the program staff hours may be reduced in other areas such that funds will be freed up and participation in the workshop will be strictly voluntary and not a condition of receiving services within a few months.

However, all hurdles had not yet been cleared. Because Marjorie and Kevin occasionally argued and fought the nursing home had separated them. The committee we had assembled agreed that they should demonstrate that they could live together successfully. We argued that no one had taught them skills for successfully negotiating their differences and so got Flex Care to agree to provide a counselor. There were also doubters that they could successfully participate in the sheltered workshop, so a trial there was proposed. The Walls accepted each setback with renewed resolve to prove all doubters wrong, which they did. Despite the doubts and some rumors, they persisted and when all excuses for preventing the move had been exhausted, the long-awaited date for them to move out was set. There were a few further setbacks in getting a ramp built to their apartment, but finally on March 16 Marjorie and Kevin moved into their own apartment with basic furnishings provided by Flex Care.

They moved in with very few clothes and no underwear. Ironically, the nursing home prided itself on the outstanding Medical care provided to Marjorie and Kevin and seemed to feel that one of the greatest risks of community life would be a lack of adequate attention to their medical needs. However, within a couple of weeks of moving out Kevin was hospitalized with a bleeding ulcer that had gone undiagnosed and untreated for an extended period of time. Marjorie's hearing difficulty was found to be exacerbated by an untreated ear infection that had almost entirely closed off her ear canal.

 Both conditions are now being treated. Marjorie's ear is almost back to normal and will soon be fitted with a new hearing aide.

Marjorie and Kevin are having some difficulties adjusting to their new life, but both report that life is much, much better (and healthier) than life in the nursing home. They have a freedom in even the smallest of events--such as deciding what to have for dinner that was unimaginable just a couple of months ago.

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