President-elect Obama must improve the lives of Americans with disabilities.

As a candidate, he put forth a detailed agenda on this issue, recognizing the unmet needs of millions of Americans. Now the work begins.

Here are three vital things his administration should do.

The first is radical reform of Medicaid long-term care policy. The biggest obstacle to self-determination that millions of people with disabilities face — especially poor people — is the lack of community-based support services. Medicaid rules force them into nursing homes and other institutions in order to receive the daily assistance they can’t live without. These institutions then impoverish them to the point where it’s nearly impossible for them to ever move out.

As a senator and as a presidential candidate, Obama supported legislation that would give people who need assistance funded by Medicaid much more control over how and where they receive this assistance. That legislation did not become law. But now that the Democrats will control the White House and Congress, Obama should get this law passed.

He also can implement substantial changes in Medicaid by executive action, without need for legislation. He must be aggressive on both fronts.

Second, Obama must also ensure that the Americans with Disabilities Act is vigorously enforced. The best way to do this is to appoint as judges, especially to the Supreme Court, only those who respect the spirit of the ADA. In recent years, the Supreme Court has so thoroughly diluted the ADA that earlier this year Congress had to pass the ADA Amendments Act to correct the Court’s wrongheaded decisions. Obama can also restore the power of the ADA by giving the agencies that enforce it, such as the Department of Justice, the mandate and resources they need to do the right thing.

Finally, the Obama administration will have to do something quickly about a deplorable backlog. Today, there are hundreds of thousands of people with disabilities who are simply waiting for the approval of the Social Security Administration to get the disability benefits they deserve.

In the Bush administration, some of these people with disabilities have been forced to wait more than 500 days — even sometimes up to three years — for hearings on their claims. The backlog grew from 311,000 to 755,000 during the Bush years, according to the New York Times. That’s a scandal.

Obama will soon have the power and the opportunity to prove that the promise of real change that swept him into office applies to people with disabilities.

He should make the most of it.

Mike Ervin is a Chicago-based writer and a disability-rights activist with ADAPT (www.adapt.org). He can be reached at pmproj@progressive.org.