Disability at the Dawn of the 21st Century and the State of the States

by Braddock, David L.

• ISBN13: 9780940898851
• ISBN10: 0940898853
• Edition: 6th
• Format: Hardcover
• Copyright: 2002-06-01
• Publisher: Amer Assn on Intellectual & Devel

Table of Contents

Tables and Figures	viii
Preface	x
Acknowledgments	xii
PART I: CROSS DISABILITY PERSPECTIVES
An Institutional History of Disability	1	(62)
David Braddock
Susan Parish
Impairment and Disability	3	(1)
Foreview of the Chapter	4	(1)
Antiquity	5	(3)
Prehistory	5	(1)
The Old Testament	5	(1)
Ancient Greece and Rome	6	(2)
Middle Ages	8	(4)
Demonology	8	(1)
Compassion and Support	9	(1)
Residential Institutions Emerge	10	(2)
Early Modern Period Through the 18th Century	12	(7)
Renaissance and the Scientific Method	12	(1)
Poverty and Disability	13	(1)
Philosophical Enlightenment	14	(1)
Distinguishing Between Intellectual Disability and Mental Illness	15	(1)
Institutions for People With Mental Illness Established	15	(1)
Developments in the American Colonies and Early United States	16	(2)
Schools for the Deaf and Blind Persons Opened in Europe	18	(1)
The 19th Century	19	(10)
Educational Developments	19	(2)
First North American Mental Hospitals and Residential Schools	21	(2)
Overcrowding and the Demise of the Moral Treatment	23	(2)
Deaf Community Organizing	25	(1)
First U.S. Institution for People With Intellectual Disability	26	(1)
From Training Schools to Custodial Asylums	26	(1)
Freak Shows	27	(1)
Threat of the Eugenicists	28	(1)
The 20th Century	29	(12)
Segregation and Expansion of the Institutional Model	29	(3)
Developments for Persons With Physical Disabilities	32	(1)
Emergence of Family, Community, and Consumer Models	33	(1)
The Social Model of Disability	33	(1)
Organizational Developments	34	(1)
Beginnings of Deinstitutionalization	34	(1)
Political Activism and the Right to Treatment	35	(2)
Independent Living and Self-Advocacy	37	(2)
International Disability Rights Initiatives	39	(2)
Conclusion	41	(4)
References	45	(18)
PART I: CROSS DISABILITY PERSPECTIVES
Public Financial Support for Disability at the Dawn of the 21st Century	63	(20)
David Braddock
Method	65	(1)
Results	66	(6)
Public Sector Spending for Disability Programs in the US	66	(1)
Income Maintenance	67	(1)
General Health Care	67	(1)
Long-Term Care	67	(1)
Special Education	68	(1)
Institutional Versus Community Services Spending	68	(1)
Medicaid Long Term Care Spending	68	(2)
Assessing Fiscal Effort in the States	70	(2)
Discussion and Conclusion	72	(3)
References	75	(2)
Appendices	77	(6)
Public Financial Support for Disability Services in the United States	78	(1)
Public Spending for Medicaid Long-Term Care Services	79	(1)
Recipients of Disability Services, Payments, and Benefits	80	(1)
Long Term Care Spending and Participants	81	(2)
PART II: THE STATE OF THE STATES IN DEVELOPMENTAL DISABILITIES
Summary of the Study	83	(268)
David Braddock
Richard Hemp
Mary C. Rizzolo
Susan Parish
Amy Pomeranz
Introduction	85	(2)
Community Residential Services	87	(2)
Cost by Setting	88	(1)
Community Staff Wage Initiatives	89	(1)
Public and Private Institutions	89	(7)
Public Institutions	91	(1)
Census Trends	91	(1)
Public Institutional Closures	91	(1)
Average Costs of Care	92	(3)
Privately Operated Institutions and Nursing Facilities	95	(1)
Nursing Facility Utilization	95	(1)
General Trends in System Financing	96	(3)
Impact of Economic Recession in the States	98	(1)
Community Services Trends	99	(20)
Sources of Revenue	99	(2)
The HCBS Waiver	101	(2)
Leveraging Federal Funds	103	(1)
Local Funding	103	(1)
Variations in State Commitments for MR/DD Services	104	(8)
Individual and Family Support	112	(1)
Family Support Services	112	(3)
Supported Employment	115	(2)
Supported Living and Personal Assistance	117	(2)
Significance of Medicaid	119	(1)
Assessing Fiscal Effort in the States	120	(1)
State Spending Patterns	121	(1)
Conclusion	121	(10)
Aging Caregivers and the Growing Demand for Services	121	(4)
Increased Longevity of Persons with Developmental Disabilities	125	(1)
Waiting Lists in the States	126	(1)
Civil Rights and Advocacy	127	(1)
Litigation in the States	128	(3)
References	131	(6)
Notes on Data Sources	137	(4)
State Profiles	141	(210)
Alabama	143	(4)
Alaska	147	(4)
Arizona	151	(4)
Arkansas	155	(4)
California	159	(4)
Colorado	163	(4)
Connecticut	167	(4)
Delaware	171	(4)
District of Columbia	175	(4)
Florida	179	(4)
Georgia	183	(4)
Hawaii	187	(4)
Idaho	191	(4)
Illinois	195	(4)
Indiana	199	(4)
Iowa	203	(4)
Kansas	207	(4)
Kentucky	211	(4)
Louisiana	215	(4)
Maine	219	(4)
Maryland	223	(4)
Massachusetts	227	(4)
Michigan	231	(4)
Minnesota	235	(4)
Mississippi	239	(4)
Missouri	243	(4)
Montana	247	(4)
Nebraska	251	(4)
Nevada	255	(4)
New Hampshire	259	(4)
New Jersey	263	(4)
New Mexico	267	(4)
New York	271	(4)
North Carolina	275	(4)
North Dakota	279	(4)
Ohio	283	(4)
Oklahoma	287	(4)
Oregon	291	(4)
Pennsylvania	295	(4)
Rhode Island	299	(4)
South Carolina	303	(4)
South Dakota	307	(4)
Tennessee	311	(4)
Texas	315	(4)
Utah	319	(4)
Vermont	323	(4)
Virginia	327	(4)
Washington	331	(4)
West Virginia	335	(4)
Wisconsin	339	(4)
Wyoming	343	(4)
United States	347	(4)
PART III: FORCES SHAPING DEVELOPMENTAL DISABILITIES SERVICES IN THE STATES: A COMPARATIVE STUDY	351	(126)
Susan Parish
Introduction	353	(1)
Background	353	(1)
Statement of the Problem	353	(1)
Literature Review	354	(5)
The Deinstitutionalization Movement and Related Research	354	(1)
Determinants of State Policy	355	(1)
Variables	356	(2)
Conceptual Framework	358	(1)
Methods	359	(11)
Overview	359	(1)
Data Collection Procedures	360	(1)
Sample	360	(3)
Document Evaluation	363	(1)
Interview Phase	363	(1)
Instrument Development	364	(1)
Sample	365	(1)
Data Analysis	366	(1)
Credibility of Findings	367	(1)
Internal Validity	367	(1)
External Validity	368	(1)
Reliability	369	(1)
Study Strengths	370	(1)
Michigan Case Study	370	(34)
Trends and Developments in Residential Services	371	(13)
Adminstrative Overview	384	(1)
Scandals	385	(2)
Politics	387	(1)
Federal Influences	388	(4)
Public Officials and Bureaucratic Leadership	392	(1)
The Governors	392	(2)
The Legislature	394	(2)
The Judiciary	396	(1)
The Department of Mental Health	397	(2)
Advocacy Groups	399	(3)
Conclusions	402	(2)
Illinois Case Study	404	(31)
Trends and Developments in Residential Services	405	(9)
Adminstrative Overview	414	(3)
Scandals	417	(3)
Politics	420	(1)
The Illinois Constitution and Home Rule Powers	420	(1)
Structure of the Legislature	421	(1)
Campaign Finance and the Consolidation of Legislative Power	421	(1)
The Emergence of AFSCME as a Political Power	422	(1)
Political Patronage	423	(1)
Politics and Developmental Disabilities: Conclusions	424	(1)
Federal Influences	424	(2)
Public Officials and Bureaucratic Leadership	426	(1)
The Governors	426	(2)
The Legislature	428	(3)
The Department of Mental Health and Developmental Disabilities	431	(1)
Advocacy Groups	431	(3)
Conclusions	434	(1)
Discussion and Conclusions	435	(12)
Sociopolitical Factors and the Development of the States' DD Residential Systems	436	(1)
Economic Factors	436	(1)
Prisons	437	(1)
Governmental Structure and Politics	438	(1)
Federal Policy Influences	439	(1)
Leadership	440	(1)
Dimensions of Leadership	440	(2)
Policy Entrepeneurs	442	(1)
Legislation	443	(1)
Litigation	443	(1)
Limitations of the Study	444	(1)
Implications for Advocates	445	(2)
Developments in Michigan and Illinois: 1990-2000	447	(14)
General Trends	448	(1)
Types of Residential Settings	448	(3)
Financial Trends	451	(1)
Family Support	452	(1)
Michigan	453	(1)
Reduced Reliance on Institutions and the Ongoing Transformation to Community	453	(1)
Changes in Elected Leadership	453	(1)
Innovations	454	(1)
Illinois	455	(1)
Advocacy Efforts	456	(1)
Federal Influences	457	(2)
Conclusions	459	(2)
References	461	(16)
Author Index	477	(10)
Subject Index	487