By Contributor on July 27, 2010

By Mike Ervin

States must halt their assaults on the elderly and people with disabilities.

Facing an economic crunch, more than half the states in the country have opted for cruelty. They are slashing crucial services, such as providing meals or paying for home health care or housecleaning for those who need assistance.

These services help the elderly and people with disabilities like me function in our homes and our communities.

But state governments are given a perverse incentive by the federal government to pursue this destructive course. Medicaid rules require states to pay the cost of keeping someone receiving Medicaid in a nursing home, while states can refuse to pay for home and community supports.

Ironically, this may end up costing states more in the long run.

The Deloitte Center for Health Solutions recently published a study entitled “Medicaid Long-Term Care: The Ticking Time Bomb.” It shows that if the current trend of long-term care expenditures continues, more than 35 percent of states’ budgets will be dedicated to Medicaid by 2030. Half of that spending will be on long-term care.

This report concludes that cuts by states in home and community services “will further aggravate state Medicaid performance since in-home/community programs are less expensive to provide and often reduce the need for institutional care.”

The Center on Budget and Policy Priorities details how savage these cuts are.

Tennessee, for instance, “has reduced community-based services for people with intellectual disabilities and cut nursing services for some adults with serious disabilities,” the research group says.

Florida “has cut Medicaid reimbursements to hospitals and community-based services for the elderly, such as meals and homemaker services,” the center notes.

And Georgia has reduced services for people with Alzheimer’s.

Millions of elderly and people with disabilities, like me, rely on publicly funded assistance to live productively in our homes and communities.

Those of us who rely on these services don’t want to be punished by being segregated away into nursing homes.

It makes sense economically and in every other way for us to be among our families and friends.

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.

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By Wendell Berry

Manifesto: The Mad Farmer Liberation Front

Love the quick profit, the annual raise,
vacation with pay. Want more 
of everything ready made. Be afraid 
to know your neighbors and to die.
And you will have a window in your head.
Not even your future will be a mystery 
any more. Your mind will be punched in a card 
and shut away in a little drawer.
When they want you to buy something 
they will call you. When they want you
to die for profit they will let you know. 
So, friends, every day do something
that won’t compute. Love the Lord. 
Love the world. Work for nothing. 
Take all that you have and be poor.
Love someone who does not deserve it. 
Denounce the government and embrace 
the flag. Hope to live in that free 
republic for which it stands. 
Give your approval to all you cannot
understand. Praise ignorance, for what man 
has not encountered he has not destroyed.
Ask the questions that have no answers. 
Invest in the millennium. Plant sequoias.
Say that your main crop is the forest
that you did not plant,
that you will not live to harvest.


Say that the leaves are harvested 
when they have rotted into the mold.
Call that profit. Prophesy such returns.
Put your faith in the two inches of humus 
that will build under the trees
every thousand years.
Listen to carrion—put your ear
close, and hear the faint chattering
of the songs that are to come. 
Expect the end of the world. Laugh. 
Laughter is immeasurable. Be joyful
though you have considered all the facts. 
So long as women do not go cheap 
for power, please women more than men.
Ask yourself: Will this satisfy 
a woman satisfied to bear a child?
Will this disturb the sleep 
of a woman near to giving birth? 
Go with your love to the fields.
Lie easy in the shade. Rest your head 
in her lap. Swear allegiance 
to what is nighest your thoughts.
As soon as the generals and the politicos 
can predict the motions of your mind, 
lose it. Leave it as a sign 
to mark the false trail, the way 
you didn’t go. Be like the fox 
who makes more tracks than necessary, 
some in the wrong direction.
Practice resurrection.

Wendell Berry is a poet, farmer, and environmentalist in Kentucky. This poem, first published in 1973, is reprinted by permission of the author and appears in his “New Collected Poems” (Counterpoint).

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