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---PAST--PRESENT--FUTURE--- IN DEVELOPMENTAL DISABILITIES IN OHIO AND THE UNITED STATES David Braddock, Ph.D. Associate Vice President, University of Colorado System & Executive Director, Coleman Institute for Cognitive Disabilities

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“---PAST--PRESENT--FUTURE--- IN DEVELOPMENTAL DISABILITIES IN OHIO AND THE UNITED STATES

David Braddock, Ph.D. Associate Vice President, University of Colorado System & Executive Director, Coleman Institute for Cognitive Disabilities

ASSOCIATION OF COUNTY BOARDS OF SUPERINTENDENTS COLUMBUS, OHIO MARCH 19, 2012

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PAST--PRESENT--FUTURE

  • I. THE PAST--

THE INSTITUTIONAL ERA, ITS DECLINE, AND THE RISE OF COMMUNITY, FAMILY AND INDIVIDUAL

  • II. THE PRESENT--

OVERVIEW OF I/DD SERVICES IN OHIO AND THE U.S.

  • III. ECONOMIC UNCERTAINTY IN THE STATES--

THE GREAT RECESSION

  • IV. THE FUTURE--
  • EMERGING TECHNOLOGIES
  • GROWING INEQUALITY &

THE AMERICAN PROMISE

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FIRST MENTAL DISABILITY INSTITUTIONS

BETHLEHEM, LONDON, ENGLAND (1403) VALENCIA, SPAIN (1409) ZARAGOZA, SPAIN (1425) SEVILLE, SPAIN (1436) VALLADOLID, SPAIN (1436) PALMA MAJORCA, SPAIN (1456) TOLEDO, SPAIN (1480) GRANADA, SPAIN (1527) SAN HIPOLITO, MEXICO CITY (1566)

  • I. THE PAST: INSTITUTIONAL ERA: 1403-1960
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ERA OF INSTITUTIONALIZATION - NEW BETHLEM HOSPITAL IN MORE FIELDS: 1725

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STATE INSTITUTION FOR FEEBLE MINDED-CHILDREN SYRACUSE, NEW YORK (1851)

  • D. Braddock, University of Colorado, 2005.
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PENNSYLVANIA INSTITUTION FOR FEEBLE-MINDED CHILDREN, (ELWYN) 1853

  • D. Braddock, University of Colorado, 2005.
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OHIO STATE ASYLUM FOR EDUCATION OF IDIOTIC AND IMBECILE YOUTH (COLUMBUS) 1857

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LINCOLN STATE SCHOOL AND COLONY LINCOLN, ILLINOIS (1865)

  • D. Braddock, University of Colorado, 2006.
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NEW YORK STATE CUSTODIAL ASYLUM FOR WOMEN, NEWARK (1885)

  • D. Braddock, University of Colorado, 2006.
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STATE EPILEPTIC HOSPITAL, GALLIPOLIS, OHIO (1890)

  • D. Braddock, University of Colorado, 2006.
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LACONIA STATE SCHOOL FOR FEEBLE MINDED CHILDREN, LACONIA, NEW HAMPSHIRE (1901)

  • D. Braddock, University of Colorado, 2006.
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PENNHURST INSTITUTION FOR FEEBLE MINDED AND EPILEPTICS, SPRING CITY, PENNSYLVANIA (1903)

  • D. Braddock, University of Colorado, 2006.
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ILLINOIS INDUSTRIAL COLONY FOR IMPROVABLE EPILEPTICS, DIXON, ILLINOIS (1918)

  • D. Braddock, University of Colorado, 2006; Abraham Lincoln Pres. Library.
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“THE SHAME OF THE STATES”

Source: D. Braddock, University of Colorado, 2012.

January 4, 1952

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WHILE WASHINGTON SLEPT KENNEDY FOUNDATION DID NOT

Source: D. Braddock, University of Colorado, 2012.

February 20, 1952

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FAST FORWARD TO NEW YORK STATE INSTITUTION, 1960s

  • D. Braddock, University of Colorado, 2012.
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PENNHURST STATE SCHOOL, 1960s

Source: D. Braddock, University of Colorado, 2012.

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PROGRESS STIMULATED BY THE PRESIDENT’S PANEL: 1961

Source: D. Braddock, University of Colorado, 2012.

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PRESIDENT KENNEDY SIGNS STATE PLANNING ACT IN 1963 --”A BOLD NEW APPROACH”

Source: D. Braddock, University of Colorado, 2012.

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DAILY CENSUS OF STATE I/DD INSTITUTIONS, 1848-2009

Source: Braddock, D., State of the States in Developmental Disabilities, 2010.

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14 STATES WITHOUT STATE-OPERATED I/DD INSTITUTIONS: 2012

  • 1. DISTRICT OF COLUMBIA (1991)
  • 2. NEW HAMPSHIRE (1991)
  • 3. VERMONT (1993)
  • 4. RHODE ISLAND (1994)
  • 5. ALASKA (1997)
  • 6. NEW MEXICO (1997)
  • 7. WEST VIRGINIA (1998)
  • 8. HAWAII (1999)
  • 9. MAINE (1999)
  • 10. MICHIGAN (2009)
  • 11. OREGON (2009)
  • 12. ALABAMA (2012)
  • 13. MINNESOTA (2000)*
  • 14. INDIANA (2007)*
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156 STATE-OPERATED INSTITUTIONS CLOSED, PROJECTED TO CLOSE: 1969-2015*

Source: Braddock, D., State of the States in Developmental Disabilities, 2011.

*Data for 2015 projected based on 2000-2010 trend; 155 closures through 2011.

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UNITED STATES

Source: Braddock, D., State of the States in Developmental Disabilities, 2011.

WILL THERE ALWAYS BE STATE-OPERATED INSTITUTIONS?

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WHO’S NEXT?

Source: Braddock, D., State of the States in Developmental Disabilities, 2011.

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WHO’S NOT?

Source: Braddock, D., State of the States in Developmental Disabilities, 2011.

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II.1 STRUCTURE AND FINANCING OF INTELLECTUAL/DEVELOPMENTAL DISABILITY (I/DD) SERVICES II.2 MEASURING STATE COMMITMENT TO I/DD SERVICES: FISCAL EFFORT II.3 RECENT TRENDS IN FAMILY SUPPORT, SUPPORTED EMPLOYMENT AND AGING CAREGIVERS

  • II. THE PRESENT: OVERVIEW OF

SERVICES IN OHIO AND THE U.S.

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II.1 FINANCING I/DD SERVICES

  • DURING 2006, 2008 AND 2009, AGGREGATE

PUBLIC NATIONWIDE I/DD SPENDING GREW BY THE SMALLEST AMOUNTS WE HAVE OBSERVED IN 32 YEARS.

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ANNUAL % CHANGE IN TOTAL INFLATION- ADJUSTED I/DD SPENDING IN THE U.S.: 1978-09

3.8%

U.S. I/DD SPENDING

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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NUMBER OF STATES WITH INFLATION-ADJUSTED CUTS IN I/DD SPENDING : 1978-2009

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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23 STATES REDUCED INFLATION ADJUSTED I/DD SPENDING IN FY 2009

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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Utilization Rate: 194 per 100,000

INDIVIDUALS WITH I/DD IN OUT-OF-HOME PLACEMENTS IN THE U.S., 2009

Source: Braddock, D., State of the States in Developmental Disabilities, 2011.

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INDIVIDUALS WITH I/DD IN OUT-OF-HOME PLACEMENTS IN 2009

SMALL NEW ENGLAND STATES

(MAINE, NEW HAMPSHIRE, RHODE ISLAND, VERMONT)

Source: Braddock, D., State of the States in Developmental Disabilities, 2011.

Total Consolidated General Population in 2009: 4.3 million.

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Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

INDIVIDUALS WITH I/DD IN OUT-OF-HOME PLACEMENTS IN 2011

OHIO

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INDIVIDUALS WITH I/DD BY SIZE AND TYPE OF SETTING IN OHIO: 1977

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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SETTINGS FOR 6 OR FEWER PERSONS ASCEND RAPIDLY 2001-2011; INSTITUTIONS DECLINE

OHIO

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Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

STRONG GROWTH OF SETTINGS FOR 1-6 PERSONS DURING 2001-2011

OHIO

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OHIO

Source: Braddock, D., State of the States in Developmental Disabilities, 2012. *Ohio among last 9 states to initiate HCBS Waiver spending.

HCBS WAIVER PARTICIPANTS INCREASE 18% PER YEAR DURING 2001-2011*

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OHIO: I/DD REVENUE SOURCES IN 2011

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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OHIO

OHIO’S WAIVER SPENDING 62% ABOVE ICF/ID SPENDING IN 2011--ICF/ID PLATEAUS 1995-2011

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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COUNTY I/DD FUNDING IN OHIO SURPASSED NON-COUNTY FUNDING IN 2002

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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OHIO’S COUNTY FUNDING FOR COMMUNITY I/ DD SERVICES EXCEEDS STATE FUNDING*

Source: Braddock, D., State of the States in Developmental Disabilities, 2012. *NOTE: Drop 2006-11 in County Funding due to termination of Medicaid Community Alternative Funding System (CAFS) funding in 2005, resulting in drop in County Medicaid match funding.

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UNITED STATES

U.S. FEDERAL HCBS WAIVER SPENDING IS DOUBLE ICF/ID SPENDING IN 2009

Intercept (2001)

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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NEW YORK RECEIVES 20% OF NATION’S I/DD MEDICAID FUNDING

NY Times, August 2, 2011

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II.2 MEASURING STATE COMMITMENT TO I/DD SERVICES: FISCAL EFFORT

Fiscal effort is a ratio that can be

utilized to rank states according to the proportion of their total statewide personal income devoted to the financing

  • f I/DD services.

Fiscal effort is defined as a state’s spending for I/DD services per $1,000 of total statewide personal income.

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OHIO’S FISCAL EFFORT FOR I/DD SERVICES EXCEEDS U.S.1979-2011

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

(Ohio ranked 7TH in 2009 and 10th in Community Fiscal Effort)

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II.3 RECENT TRENDS: FAMILY SUPPORT, SUPPORTED EMPLOYMENT, AGING CAREGIVERS

  • A. FAMILY SUPPORT
  • B. SUPPORTED

EMPLOYMENT

  • C. IMPACT OF AGING

CAREGIVERS

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II.3A FAMILY SUPPORT DEFINED

FAMILY SUPPORT INCLUDES

  • Respite
  • Family counseling
  • Architectural adaptation of the home
  • In-home training, education, behavior management
  • Sibling support programs, and
  • Purchase of specialized equipment

“CASH SUBSIDY FAMILY SUPPORT” INCLUDES: Payments or vouchers directly to families;

families determine what is purchased

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FAMILIES SUPPORTED IN OHIO ARE 20% OF TOTAL ESTIMATED I/DD CAREGIVING FAMILIES

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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METHOD OF ESTIMATING NUMBER OF I/DD CAREGIVING FAMILIES IN OHIO*

  • A. Ohio state population: 11,545,485
  • B. Estimated I/DD (@1.58%): 182,419
  • C. Less out-of-home placements (38,038): 147,381
  • D. Estimated individuals with I/DD living with

spouse, relative, in own home: 47,162

  • E. Estimated I/DD with caregiving families: 100,219

(C. minus D.)

*Sources: Braddock et al. (2012). Coleman Institute and Department of Psychiatry, University of Colorado, 2012; based on Fujiura (1998), Larson et al. (2001).

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FAMILIES SUPPORTED: OHIO SLIGHTLY ABOVE THE U.S. AVERAGE

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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NUMBER OF U.S. FAMILIES SUPPORTED GROWS BUT ONLY 7% OF TOTAL I/DD SPENDING

Family support spending in 2009 constituted 7% of total I/DD long- term care spending ($53.2 billion).

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

UNITED STATES

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NUMBER OF OHIO FAMILIES SUPPORTED GROWS BUT ONLY 3% OF TOTAL I/DD SPENDING

Source: Braddock, D., State of the States in Developmental Disabilities, 2012; number of families reported to our study by personnel from the Ohio Department of Developmental Disabilities.

Family support spending in 2011 constituted 3% of total I/DD long- term care spending in Ohio ($3.15 billion).

OHIO

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22 STATES HAD CASH SUBSIDIES FOR FAMILIES IN 2009—OHIO DID NOT

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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  • “While supported employment

has made significant gains since its formal introduction in 1984 (P.L. 98-527), segregated services continue to outpace the growth of supported employment nationally.”

  • True in 2004 and true today.

(Rusch & Braddock, Research and Practice for Persons with Severe Disabilities, 2004)

II.3B SUPPORTED EMPLOYMENT

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PER CAPITA* SUPPORTED EMPLOYMENT WORKERS IN OHIO RANKED IN TOP 3RD OF STATES IN 2009

*Per 100,000 of General Population

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I/DD SUPPORTED EMPLOYMENT WORKERS GROWS RAPIDLY THEN PLATEAUS

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

UNITED STATES

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I/DD SUPPORTED EMPLOYMENT WORKERS IN OHIO PEAKS IN 2003, THEN DECLINES

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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LONGEVITY OF PERSONS WITH I/ DD, THE AGING OF AMERICA, AND AGING I/DD FAMILY CAREGIVERS

II.3C AGING CAREGIVERS

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  • 1970s: 59.1 years
  • 1993: 66.2 years
  • U.S. General Population: 70.4 years
  • In the future “…those without severe

impairment can be expected to have a life span equal to that of the general population.” LONGEVITY INCREASES FOR PERSONS WITH AN INTELLECTUAL DISABILITY

Source: M. Janicki. (1996). Rehabilitation Research and Training Center on Aging and Mental Retardation, University of Illinois at Chicago.

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AN ESTIMATED 27% OF PERSONS WITH I/DD LIVE AT HOME WITH CAREGIVERS AGED 60 YEARS OR MORE

OHIO

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OHIO RANKS 6TH IN U.S. IN POPULATION AGED 65+ YEARS, 2010

Source: U.S. Bureau of the Census, 2010

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AGED 65+ YEARS: 2010-2050

AGING POPULATION DOUBLES 2010-40, U.S.

Source: U.S. Bureau of the Census, 2009

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ECONOMIC UNCERTAINTY IN THE STATES AND THE GREAT RECESSION

  • III. ECONOMIC UNCERTAINTY
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WHICH STATES ARE CONFIDENT ABOUT THE U.S. ECONOMY? NONE ARE! DC IS!

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FOUR US RECESSIONS: AGGREGATE STATE GENERAL FUNDS DROP

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FACTORIES, UTILITIES, MINES

U.S. INDUSTRIAL CAPACITY UTILIZATION: JANUARY 2005-JANUARY 2012

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STATE BUDGETARY SHORTFALLS:2002-12

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STATE BUDGET SHORTFALLS FOR FY 2012

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STATE TAX REVENUE FELL FROM 2008 Q2 THROUGH 2009 Q2. REBOUNDED TO 2011 Q 2 – BUT DOWN Q3

Source: The Nelson A. Rockefeller Institute of Government, January 2012.

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STATES’ SALES TAX REVENUES INCREASE 6.1% IN 3rd QUARTER OF 2011

Source: The Nelson A. Rockefeller Institute of Government, January 2012.

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Source: Bureau of Economic Analysis, U.S. Department of Commerce (2012).

AGGREGATE PERSONAL INCOME GREW 3.4% 2010-12, BUT REMAINS BELOW 2005 LEVEL

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ECONOMIC MOMENTUM IN THE STATES: TOP FIVE AND BOTTOM FIVE

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POPULATION MIGRATION IN THE STATES: 2006-09

Source: Federal Funds Information for States (2009). State Policy Reports, Vol. 27, No. 21.

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  • IV. THE FUTURE: EMERGING

TECHNOLOGIES

“I think we can do a ‘virtual nursing home’ with technology”…

Andy Grove Co-Founder, Intel Corp. In USA Today, 2006

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PROJECTED U.S.GROWTH IN RESIDENTIAL SERVICES IN THE NEXT DECADE: 165.6k

Projected from 2000-2009

Source: Braddock, D., State of the States in Developmental Disabilities, 2012.

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INTEGRATED WIRELESS SENSOR NETWORKS IN THE FUTURE:

  • A combination of wireless cell phone,

Internet, and sensor technology will connect people, objects, and events.

  • Smart homes/care will play key roles in

assisted living for persons with I/DD, allowing seamless connectivity between clients, caregivers/health care providers, and parents.

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MIT PLACELAB - BEHIND THE SCENES

Context-aware PDA with wireless sensors/motes

Source: MIT PlaceLab website at http://architecture.mit.edu/house_n/placelab.html

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Source: Braddock, D., Coleman Institute, University of Colorado, 2010.

U.S. SMART HOME SERVICE PROVIDERS FOR PERSONS WITH ID

  • IMAGINE!

BOULDER AND LONGMONT COLORADO

  • REST ASSURED, LLC.
  • SOUND RESPONSE,

MADISON, WISCONSIN

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IMAGINE! SMART HOME, BOULDER, COLORADO: COMPLETED 2009

Imagine! Smart Homes in Boulder and Longmont, Colorado http://www.imaginesmarthomes.org/

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IMAGINE! SMART HOME, BOULDER, COLORADO: GREEN TECHNOLOGIES

Geothermal systems heat and cool the home Photovoltaic cells generate electricity

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IMAGINE! SMART HOME, LONGMONT, CO, OPENED MAY 2010

Imagine! Smart Homes in Boulder and Longmont, Colorado http://www.imaginesmarthomes.org/

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  • Private donations
  • HUD
  • Cities of Boulder and

Longmont

  • State of Colorado/Medicaid

FUNDING FOR HOMES

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  • Employee/manager portal for centralized

information collection and reporting

  • Web-based medication prompt system
  • Location based activity prompting/logging
  • Web based training courses
  • Lifelogging of resident histories
  • Family portal for daily activities and health

status with text and picture-sharing STAFF SYSTEMS

IMAGINE! SMART HOMES, BOULDER/ LONGMONT

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  • Accessible control of environment and appliances
  • Accessible, safe kitchen and bathroom
  • Cameras monitor high-risk areas
  • Automated windows and doors
  • Task prompters and reminders
  • Specialized, accessible PC, Internet, journaling

and web conferencing

CONSUMER, ENVIRONMENTAL AND COMMUNICATIONS ADAPTATIONS

IMAGINE! SMART HOMES, BOULDER/ LONGMONT

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REST ASSURED PROGRAM

Staff person monitors several apartments simultaneously.

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  • Uses PTZ (Pan, Tilt, Zoom) cameras for monitoring

in high risk areas like the kitchen

  • Remote supervision via two-way audio/video

communication with caregiver

  • Motion, temperature, carbon monoxide, and door brake

sensors used in, in addition to a Personal Emergency Response System

  • Consumers report increased independence; caregiver

is not a constant physical presence in the house

  • Reduced overall cost of care
  • Currently used primarily for third-shift support

Source: Rest Assured, Wabash, Indiana.

REST ASSURED PROGRAM

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  • Developed in collaboration with EPICS

(Engineering Projects In Community Service) at Purdue University

  • Serves consumers with ID
  • Nearly 300 homes and apartments with
  • ver 400 consumers served in eight states:

FL, GA, IL, IN, KS, MD, OH, & WI

Source: Dustin Wright, General Manager, Rest Assured LLC, Wabash, Indiana.

REST ASSURED PROGRAM–ATTRIBUTES

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  • Professional Monitors
  • Communication between

Monitor and staff/ individuals served

  • Access to protocols and

personal intervention strategies

  • Provider agency back-up
  • Individualized alarm

readings

  • Generates reports

SOUND RESPONSE SYSTEMS: MADISON

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  • Completely Wireless in the Home
  • Cellular Transmission- No Phone or Internet

Connection is Required

  • 2-Way Communication
  • Event Sequencing
  • Data Tracking
  • Portable and Adaptable to People’s

Homes and Abilities

EQUIPMENT FEATURES

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INDIANA GOVERNOR MITCH DANIELS ENDORSES SMART HOME TECHNOLOGY

“We can alleviate some of the demand for Direct Support Professionals (DSPs) by identifying new service options for people who do not need intensive DSP support. The system is tailored to the needs of each person who uses it and has been shown to improve personal independence, as well as alleviating the needs for a direct support professional where one is not needed.”

Mitch Daniels, Governor, State of Indiana The Arc of Indiana, Meet the Candidates, Summer 2008

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MEDICAID WAIVER AMENDMENT APPROVED

  • INDIANA, KANSAS, LOUISIANA,

OHIO*, WEST VIRGINIA STATES EXPRESSING INTEREST

  • KENTUCKY, MASSACHUSETTS,

NEW JERSEY

STATES WITH MEDICAID SUPPORT FOR SMART HOME TECHNOLOGIES

* Ohio’s Individual Options Waiver includes payment for equipment used to operate systems such as live video feed, live audio feed, motion sensing system, radio frequency identification, web-based monitoring system…and equipment used to engage in live two-way communication with the individual being monitored…Ohio will collect data to determine if the proposed amount is reasonable.

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PDA TASK PROMPTING SOFTWARE

Visual Assistant (Prompting System)

Source: Ablelink Technologies, Colorado Springs (Terry & Jonathan).

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 A pocket personal computer with an integrated PC-slot digital camera;  Staff/caretakers take pictures of— and narrate--the steps in a task;

SOURCE: Ablelink Technologies, Colorado Springs.

 The verbal instructions and images guide users through the steps: – Grocery shopping – Medications – Personal hygiene – Using public transportation, etc.

VISUAL ASSISTANT

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Adapted Web Browser

The Web Trek adapted web browser improves access to the World Wide Web for people who have difficulty with reading and writing.

ADAPTED WEB BROWSER AND E-MAIL

SOURCE: Ablelink Technologies, Colorado Springs.

Adapted E-mail Program

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Source: Ablelink Technologies, Colorado Springs; www.ablelinktech.com

ROCKET READER AUDIO BOOKS

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LOCATION TRACKING

  • Nextel mobile locator:

http://www.nextel.com/en/services/gps/mobile_locator

  • Wherifone:

http://www.wherify.com/wherifone/

  • Accutracking:

http://www.accutracking.com/

  • 911 to go:

http://www.travelbygps.com/articles/tracking.php/ Contact your cell phone provider for phones/services

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TREKKER BREEZE GPS

Verbally announces the names of streets, intersections and landmarks as you walk.

Source: http:// www.visabilitystore.org/ browse.cfm/trekker-breeze- gps/

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INDOOR WAYFINDING SUPPORT

SOURCE: http://cognitivetech.washington.edu/assets2006_liu.pdf.

Participants preferred images with arrows, not audio alone

[In Development]

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  • V. INEQUALITY REIGNS SUPREME

CONCLUSION “… inequality is the ill that underlies all the others…”in the United states Between 1979 and 2006, middle-class incomes after taxes increased by 21% The poorest saw their incomes rise by

  • nly 11 percent.

The top one percent, by 256%.

George Packer The Broken Contract: Inequality and American Decline Foreign Affairs, November/December 2011.

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THE AMERICAN PROMISE IS BROKEN

“…Some argue that this inequality was an avoidable result of deeper shifts: global competition, cheap goods made in China, technological changes….Book after book by economists and other scholars over the past few years has presented an airtight case: over the past three decades, the government has consistently favored the

  • rich. This is the source of the problem: our

leaders, our institutions.

George Packer The Broken Contract: Inequality and American Decline Foreign Affairs, November/December 2011.

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AVERAGE TAX BREAK FOR THE WEALTHY IS 25 TIMES THE POOREST

AVERAGE/TAXPAYER SHARE OF TOTAL TOTAL ($ BILLIONS)

Source: Eduardo Porter, A nation of too many tax breaks, NY Times, 3/12/12, p. B1

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AMERICA’S TAX BURDEN IS AMONG THE SMALLEST IN THE DEVELOPED WORLD

Organisation for Economic Co-operation and Development (OECD). (2008). Tax burden: Personal income, employee and employer social security contributions, and payroll taxes as a % of GDP (households of married couples, two children).

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SOCIAL JUSTICE IN THE 31 OECD* COUNTRIES

*OECD: Organisation for Economic Co-operation and Development

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WHAT IS TO BE DONE? GALBRAITH’S GUIDANCE

“…we could begin to develop a society in which our work, our cultural accomplishments, social life, sense of fairness, the general standard for the whole population, your work with helping people who come into society with disabilities and impairments, these things become the true and dominant measure of how well we’re doing….”

James Galbraith University of Texas Economist and Professor of Government At the Coleman Conference, November 5, 2009.

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MEASURE OUR WELL-BEING: NOT JUST OUR GROSS NATIONAL PRODUCT

…the time is ripe for our measurement system to shift emphasis from measuring economic production [GDP] to measuring people’s well-being….

  • J. STIGLITZ, A. SEN, & FITTOUSI, Report by the Commission on the

Measurement of Economic Performance and Social Progress, 2010, p. 12. [www.stiglitz-sen-fitoussi.fr]

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EXERCISE WORKS > It promotes health AND WELL BEING LET’S TRY MORE PHYSICAL ACTIVITY, NUTRITION EDUCATION, AND HEALTH PROMOTION PROGRAMS EXERCISE: THE MOST COST-EFFECTIVE “MEDICINE” YET INVENTED SPEAKING OF “WELL-BEING…”

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PHYSICAL ACTIVITY BENEFITS EVERYBODY AND MIND

  • PHYSICAL ACTIVITY HAS SUBSTANTIAL BENEFITS IN

IMPROVING THE HEALTH OF PEOPLE WITH INTELLECTUAL AND OTHER DISABILITIES BY:

  • REDUCING THE INCIDENCE OF DISEASE (e.g., TYPE 2

DIABETES, HEART DISEASE, OBESITY)

  • IMPROVING SECONDARY CONDITONS ASSOCIATED

WITH DISABILITY; (e.g., WEAKNESS, FATIGUE, REDUCED MOBILITY, JOINT STIFFNESS, SOCIAL ISOLATION, DEPRESSION);

  • AND ALLOWING INDIVIDUALS TO MAINTAIN A HIGHER

LEVEL OF INDEPENDENCE IN PERFORMING ACTIVITIES OF DAILY LIVING. STAFF MUST BE ROLE MODELS.

Source: Rimmer (2007); Rimmer, Riley, Wang, Rauworth, & Jurkowski (2004).

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SELF-REPORTED HEALTH STATUS

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OBESITY,SMOKING & INACTIVITY RISKS: TWICE AS LIKELY FOR PERSONS WITH DIABILITIES

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WILLIAM POUND, Executive Director, National Conference of State Legislatures: The State of the States in the Great Recession and It’s Aftermath. DAVID BRADDOCK, PhD, Associate VP, University of Colorado: The State of the States in Developmental Disabilities: 2012. BILL COLEMAN, Silicon Valley Entrepreneur, Founding Donor of the Coleman Institute, Partner, Alsop-Louie Partners, San Francisco: Cloud Computing and its Implications for Disability PETER BLANCK, PhD, JD, Chairman, Burton Blatt Institute, Syracuse University: Is There a Right to Technology Access for People with I/DD? CATHY BODINE,PhD, DIRECTOR, COLORADO ENGINEERING RESEARCH CENTER ON COGNITIVE TECHNOLOGIES

COLEMAN INSTITUTE CONFERENCE, NOVEMBER 2012 IN WESTMINSTER, CO

THE STATE OF THE STATES IN COGNITIVE DISABILITY AND TECHNOLOGY: 2012 ANNUAL REVIEW AND FORECAST ColemanInstitute.org

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CONTACT INFORMATION

David Braddock, Ph.D. Associate Vice President, University of Colorado Coleman-Turner Chair/Professor in Psychiatry & Executive Director Coleman Institute for Cognitive Disabilities (SYS 586) 3825 Iris Avenue, Suite 200 Boulder, CO 80301 E-mail: braddock@cu.edu Phone: 303-492-0639

http://ColemanInstitute.org https://stateofthestates.org