Every state in the U.S. has a state program to serve people with intellectual disabilities. In each state, the way programs for intellectual disabilities are run differs. In some states, they fall under the department of health. In others, it is a department of public welfare.
In Colorado, the state Department of Human Services has housed the division that oversees programs for people with intellectual disabilities for many years. As our governmental agencies move more toward streamlining and efficiency, this arrangement is being reconsidered.
Local programs that serve people with intellectual disabilities have oversight from three different departments at the state level: the Department of Human Services regulates programs specifically for intellectual disabilities; the Department of Health Care Policy and Financing regulates the Medicaid programs that fund them; and the Department of Public Health and Environment monitors congregate housing such as group homes. This arrangement creates conflicting rules and requirements and, one must suppose, administrative inefficiencies.
As a solution to this problem, the executive branch of the state of Colorado has recommended moving the Division for Developmental Disabilities from beneath the Department of Human Services to the Department of Health Care Policy and Financing to streamline services and governmental oversight. What seems on the surface to be a simple cost-saving measure brings up some important philosophical issues in our support of people with intellectual disabilities.
The Colorado Department of Human Services operates under a model of social services and social justice. With housing programs that support equal opportunities for employment, children and family programs, nutritional programs and the like, CDHS claims a mission of being people who help people.
The Department of Health Care Policy and Financing, on the other hand, runs the Medicaid and Childrens Health Plan Plus programs in Colorado. Essentially, it is a state-run medical-insurance program.
Is having a disability a natural part of being human? Is it mostly the barriers of our society that make programs for people with intellectual disabilities necessary? Or is disability an illness that we need to treat and cure? These are important (though somewhat rhetorical) questions we must ask when we determine who sets policy and direction for services for people with disabilities.
There is evidence that intellectual disability is at least in part the result of social constructs. Researchers at the Centers for Disease Control and Prevention have found evidence of significant disparities between people of color and whites when it comes to the prevalence of intellectual disabilities. Although the cause is uncertain, it is enough to warrant further research and discussion about how other social disparities affect disabilities.
Streamlining government is essential, and the current system is not having the effects it intends. Perhaps moving the Division for Developmental Disabilities under the Department of Health Care Policy and Financing will transform the way all public health care in Colorado is designed. After all, were all people, regardless of our diagnoses or abilities, and successful health care addresses the whole person. Lets hope we are seeing the beginning of a revolution that puts health and humanity back in the same office.
Tara Kiene is the director of case management with Community Connections Inc.