Every day, someone goes to Carolyn Zapata’s house to help her get out of bed, bathe, dress and prepare to take on the day.
“I have about five different workers who come in at all different times of the day and night,” she said. “I receive what they call home-based services.”
Zapata, 55, is paralyzed from the chest down.
“I was in an automobile accident – Jan. 7, 2002,” she said. “I have some limitations now, but once they get me in my wheelchair I’m able to maneuver myself around pretty good. I can feed myself, but I have to have somebody put the food in front of me.”
Zapata is one of more than 6,500 physically disabled Kansans who receive Medicaid-funded, in-home services through the Kansas Department of Social and Rehabilitation Services.
Zapata, who receives 66.5 hours of services a week, said without the help she would “probably be stuck in a nursing home someplace.”
“I’m a living, breathing human being,” she said. “I have an active life. I get out. I have to have somebody drive me, but I go shopping. I go to church. Just because I’ve been in an accident doesn’t mean I can’t be independent. It doesn’t mean I have to be in a nursing home.”
Typically, care for someone in a community setting is less expensive to taxpayers than care of that person in a nursing home or other institutional setting.
But because Zapata requires more help than most people with physical disabilities, her in-home care costs the state’s Medicaid program about as much as it would pay a nursing home – roughly $3,000 a month.
“If it costs the same or even if costs more for me to be at home, why would somebody want to shut me up in a building somewhere?” Zapata asked. “I know people like to talk about what everything costs, but for me this is about freedom. My accident took my freedom away from me. Don’t I have a right to get that freedom back?”
In Kansas, people with disabilities account for about 22 percent of the Medicaid program’s beneficiaries but more than half of the program’s costs.
The services Zapata receives are at the heart of a 1999 U.S. Supreme Court ruling referred to as the Olmstead decision.
The court ruled that people with disabilities are entitled to services in a community setting and that limiting their choices to a state hospital or a nursing home was discriminatory under the Americans with Disabilities Act.
President Barack Obama has directed the U.S. Department of Justice to make enforcement of the Olmstead decision a priority.
In recent months, federal officials have been meeting with Kansas advocates for people with disabilities to see if there are Olmstead violations worthy of a legal challenge or other enforcement action.
In Kansas, more than 5,000 people with developmental and physical disabilities are on SRS-administered waiting lists for services similar to those Zapata receives.
Related stories
→ Federal officials scrutinizing Kansas policies for the disabled
→ Olmstead actions in other states