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Protecting Medicaid: Why the Oklahoma Waiver Proposal Is a Threat

/in , , , /by The Arc

Webinar: Protect Medicaid: Learn More About Why the Oklahoma Waiver Proposal Is a ThreatWhat is happening in Oklahoma?

Oklahoma is proposing to be the first state to implement a block grant or per capita cap based on the Center for Medicaid Services’ (CMS) recent guidance. The state planned to expand Medicaid by submitting a proposal to CMS, however the State legislature has not funded the expansion. There is a vote in Oklahoma on June 30 on whether or not to expand Medicaid so the state process is unclear. However, CMS is considering their proposal and is accepting comments on its contents. No matter what happens in the state, CMS will make a decision on whether to approve the state’s block grant/per capita cap proposal following the comment period that closes June 27.

TAKE ACTION NOW to tell the federal government: No cuts to Medicaid in Oklahoma or anywhere!

Why should advocates be concerned?

One in five people rely on Medicaid for health care. Over 10 million people with disabilities rely on it for health care services and to live independently. Additionally, Medicaid is critical to fighting the impacts of the global health pandemic. As a result of the pandemic, states will face budget crises, leaving Medicaid in great peril during a time when Medicaid should be strengthened to help more people access health care.

Instead, CMS’ guidance and Oklahoma’s proposal represent a drastic restructuring of Medicaid financing that would weaken the program. If approved, CMS would be allowing a per capita cap, a permanent restructuring of the Medicaid program in Oklahoma.

Approval of the waiver would set a dangerous precedent by allowing a potentially unlawful financing system to move forward that could cause great harm to people with disabilities and chronic health conditions. If approved, other states would be interested in advancing similar plans that would cut or cap Medicaid funding and reduce access to health care.

Approval of the waiver also signals to other states that they could similarly submit incomplete and vague proposals that do not fully explain how the state would operationalize the waiver including definitions, processes, and explanations. The lack of information makes it impossible to fully analyze the impact on people with disabilities, families, service providers and other interested stakeholders.

Oklahoma’s proposed waiver includes work requirements, increased premiums, and other harmful provisions that would reduce coverage and access to care. The proposal contains many of the same proposals that the courts have repeatedly found illegal since 2018. Below is a brief description of the harmful provisions of the Oklahoma waiver proposal.

Work Requirements

Oklahoma’s proposed plan would require enrollees to complete at least 80 hours of work or work-related activities per month to maintain Medicaid coverage. Enrollees who do not complete and report their work hours monthly would lose their coverage. In addition, individuals who fail to complete work requirements could not re-enroll in the Medicaid program unless they complete the work requirements or met one of the stated exemptions, meaning many people would not be able to re-enroll.

The proposal includes an exemption for people with disabilities but does not provide information about how the state plans to implement the exemption process or what the person would need to do to claim the exemption.

Per-Capita Caps

The waiver proposal provides almost no information about the funding overhaul the State seeks. The proposal does not explain how the transformation will affect stakeholders from enrollees to health care providers. There is an no explanation of what happens if Medicaid spending exceeds the federal caps and states must make up the difference.

Regardless of the lack of details, Oklahoma’s request for a per capita cap is potentially harmful. The Social Security Act constrains what provisions of the Medicaid Act states can seek to waive.1 It only permits waivers of sections of the Medicaid Act included in 42 U.S.C. § 1396a. Medicaid’s funding mechanism is not included in this section. Thus, the very structure of the Social Security Act makes it very clear that Congress did not grant CMS the authority to authorize a per capita cap or block grant funding.

Non-Emergency Medical Transportation

Oklahoma proposes to exclude coverage of non-emergency medical transportation (NEMT) for the Medicaid expansion population. NEMT is essential for many individuals enrolled in the Medicaid program including people with disabilities and chronic health conditions. Transportation barriers pose a significant problem for many low-income individuals and families to access care to maintain function and manage health conditions.  While the state assures that exemptions can be made based on an individualized assessment, it creates a barrier to accessing this critical service.

Prescription Drug Coverage

Oklahoma reserves the right to limit the list of preferred drugs and medications in the future and asks for flexibility to make future changes. The waiver proposal did not explain what process it would use to make changes, gather input from stakeholders or protect access to necessary medications.

Premiums

Oklahoma proposes to impose premiums on Medicaid enrollees in the expansion population. Individuals with household income that falls d below 100% of the Federal Poverty Level (FPL) would pay $5 every month ($7.50 for families). Individuals with household income from 100-133% FPL would pay $10 a month. ($15 for families). Coverage would not begin until an individual has paid the first premium. Individuals who successfully enroll in coverage but fail to pay subsequent premiums will lose their Medicaid coverage after a ninety-day grace period.

Heightened Copayments for Non-Emergency Use of the Emergency Room

Oklahoma also proposes to implement copayments for various types of health services, including non-emergency use of the Emergency Department. Initially, this would be $8. The state wants to be able to increase the copay in the future. Charging individuals a heightened copay for use of the emergency department is not permissible under the Medicaid statute.

Retroactive Coverage

Oklahoma proposes eliminating retroactive coverage for enrollees in the Medicaid expansion population. This would likely result in medical bills that would be difficult for beneficiaries to afford. Retroactive coverage also helps ensure the financial stability of health care providers and reduces uncompensated hospital care.

Early and Periodic Screening, Diagnostic and Treatment Program (EPSDT)

Oklahoma proposes to eliminate EPSDT services for nineteen and twenty year olds in the expansion population. Congress included EPSDT in the Medicaid program to provide comprehensive coverage of screening, diagnosis and treatment for individuals under the age of 21.

Please join The Arc for a live webinar on Monday, June 22 at 4:00 p.m. ET.
“Protect Medicaid: Learn More About Why the Oklahoma Waiver Proposal Is a Threat”

Register Here

Black and white photograph of justice scales sitting on a desk in a courtroom

The Arc Demands Full Pardon for Neli Latson, a Young Black Man With Autism, to Rectify Injustice

/in , , , , /by The Arc

WASHINGTON – As our country faces a critical reckoning of the systemic racism and racial injustice that have plagued our society and systems for generations, The Arc is seeking long overdue legal and moral justice for a young Black man with disabilities who has suffered irreparable harm.

Today, we call on Virginia Governor Ralph Northam to #FreeNeli and immediately grant Reginald “Neli” Latson a full pardon. Latson is Black and has autism and intellectual disability, identities which have led to his continued persecution in the criminal justice system.

“At this critical turning point in history, we believe the Commonwealth of Virginia must do more to hold itself morally responsible and accountable in the case of Neli Latson and the continuing injustice of his prosecution and horrifying mistreatment in the criminal justice system. We urge Governor Northam to issue Mr. Latson a full pardon and an apology on behalf of the Commonwealth,” said Peter Berns, CEO, The Arc.

Sadly, Latson’s case represents the discrimination people with intellectual and developmental disabilities (I/DD) experience in the criminal justice system and how that discrimination is compounded for Black people with I/DD. Latson’s nightmare began in 2010 when someone called police reporting a “suspicious” Black male possibly with a gun outside of a public library in Stafford County, Virginia, outside of Washington. Latson, at the time an 18-year-old special education student who had committed no crime and was not carrying a gun or weapon, was just waiting for the library to open. Latson was confronted by a Stafford County deputy, who quickly found that he was unarmed. Latson tried to walk away but was grabbed by the deputy several times. Latson reacted with a fight-or-flight response, a response even more common for people with autism, and in the resulting altercation, both Latson and the Deputy were hurt. Latson was later convicted of assaulting the deputy, setting in motion the next troubling decade of his young life.

While behind bars in Virginia, Latson was subjected to mistreatment and abuse for behaviors connected to his disability, including long periods of solitary confinement, Taser shocks, and the use of a full-body restraint chair for hours on end. Latson was granted a conditional pardon by then Governor Terry McAuliffe in 2015. It allowed him to move from prison to less restrictive facilities, but the conditions of that pardon, in effect until 2025, mean that Latson remains under supervision by criminal justice authorities and experiences the constant threat of reincarceration. Any misinterpreted behavior by Latson, who also now lives with mental health disabilities due to his traumatic experiences with law enforcement and correctional officers, could send the 28-year-old back to prison, resetting the cruel cycle.

It’s estimated that one third to half of all people in the U.S. killed by police have a disability – the majority of these are people of color.

As today’s national conversation intensifies over the clear need for criminal justice reform and an end to the murders of Black people at the hands of police, Neli Latson recently wrote to The Washington Post: “I hope there will finally be change and there will be equality for black people.” He also shared: “I understand how fortunate I am to be alive.”

Governor Northam has an opportunity to remove a major obstacle from Neli Latson’s path to healing. The Arc and The Arc of Virginia, alongside Latson’s attorneys, have been fighting for justice for Latson since 2011 and will not stop until he is free.

“Mr. Latson is a human being. He was criminalized for the color of his skin and his disability. He deserves justice. Governor Northam, #FreeNeli now,” said Berns.

 

Three people standing outside at a wedding. On the left is a bridesmaid wearing a strapless purple dress and holding a bouquet of yellow and purple flowers. In the middle is a man with Down syndrome. he is wearing grey pants with blue suspenders, a light blue short sleeve button up shirt and is wearing a purple flower pinned to his shirt. On the right is the bride, dressed in a white, lacey, bridal gown and holding a bouque of purple and yellow flowers. They are standing on gravel and behind them are stairs leading up to a stone and log cabin.

Sibling Perspectives: Helping My Sibling With a Disability Navigate COVID-19

/in , /by Pam Katz

The COVID-19 pandemic continues to leave us all navigating a very uncertain and disruptive moment in our world. However, the pandemic has presented uniquely challenging experiences for people with intellectual and/or developmental disabilities (I/DD) and their family caregivers. 

Caitie Jones and Cameron Kell are members of The Arc’s National Sibling Council and share how they each have been able to support their sibling navigate this unprecedented crisis.

Caitie Jones’ brother Chris is 31 years old and lives in a group home in Alaska.

Chris has severe sleep apnea, which puts him in the high-risk population. Caitie has been unable to visit Chris—and the lack of communication from his service provider brought a lot of fear and anxiety about his health. Although Caitie was able to rely on regular updates from Chris himself, she and her family remained anxious about the level of safety precautions and the health statuses of residents and staff at the group home.

To better support Chris, Caitie requested a meeting with leadership at the group home to address challenges with the lack of communications. Caitie and her family now receive weekly updates from the group home and continue to stay in touch with Chris by leaving him gifts and activities so he can stay active safely. Caitie is also a resource to the group home staff by sending them information about activities they can do to keep residents active while practicing social distancing. Caitie also notes that it’s been important for her to stay informed about legislation related to COVID-19 and advocating for the inclusion of provisions that will support people with I/DD, caregivers, and disability support professionals.

Cameron Kell’s brother Nathan is 29 years old and lives in an apartment on his own in St. Louis.

Nathan works at a concession stand at the National Museum of Transportation and attends the local community college. After living on his own for nearly eight years, the pandemic has meant a life of less independence for Nathan. He was furloughed from his job at the museum and the support workers that typically helped Nathan at his apartment have not been available. Although Nathan can spend time with his family at the current family home, he feels stuck and as Cameron notes, “(Nathan) just wants to be at his own apartment.”

To better support Nathan, Cameron has been mindful about communicating with Nathan on a regular basis. Cameron sets aside time to talk to Nathan about the stress of the pandemic and to help him understand why there has been a dramatic shift in his daily routine. Since Cameron is a medical student at Creighton University, Nathan also looks to his brother as a resource about the importance of social distancing and hand washing. Cameron wants to make sure Nathan understands without scaring him and providing assurance that everything will be ok.

Visit thearc.org/covid to view COVID-19 information for people with disabilities, families, and service providers.

Woman on escalator wearing a face mask; she's holding a cell phone in one hand and her suitcase handle in the other

COVID-19 Legislation First Step in Addressing Crisis for People With Disabilities, Families

/in , , , , , /by The Arc

Washington, D.C. – People with intellectual and developmental disabilities (I/DD) are facing threats to their health and wellbeing due to the global COVID-19 pandemic, and the legislation passed by Congress and on its way to President Trump’s desk is a start in addressing their needs in this crisis.

The legislation includes:

  • A 6.2% increase in federal reimbursement for state Medicaid programs (FMAP), which will help state governments in their efforts to combat the pandemic;
  • Emergency requirements for all health insurers to cover testing;
  • Expanded nutrition assistance and crucial waivers for the Supplemental Nutrition Assistance Program and school meals;
  • Expanded unemployment insurance; and
  • Limited paid sick day and paid leave provisions that do not explicitly include caregivers for people with disabilities.

“This crisis is going to have a major impact on people with intellectual and developmental disabilities, their families, and caregivers, and this legislation is a good first step in meeting their needs. As this crisis evolves, more will have to be done at the federal level for all Americans, particularly those with disabilities, their families, and caregivers,” said Peter Berns, CEO, The Arc.

The Arc is working hard with legislators to ensure that the next package more directly covers the unique needs of people with disabilities, their families and the direct support workforce:

  • An additional FMAP increase that creates a grant program to support access to home and community-based services and to support the direct support professional (DSP) workforce with better pay during the crisis, and greater flexibilities in hiring and service provision.
  • A permanent reauthorization of the Money Follows the Person program, or MFP, which gives funds to states to move people with disabilities out of segregated settings and into the community. There is a real threat to unnecessary institutionalization. The flexibilities and funds from permanent MFP will support states to continue transitions to the community and away from congregate settings.
  • Economic stimulus with increased asset limits. For people with I/DD receiving Supplemental Security Income (SSI) and/or Medicaid, strict asset limits must be maintained to receive the benefits. We strongly support stimulus for low income individuals, but because of the asset limits, people with I/DD may end up with too much money in the bank, jeopardizing their SSI and/or Medicaid. Asset limits should be increased or paused to ensure that people with disabilities are able to benefit from the stimulus without jeopardizing their benefits.

“Without addressing these issues, the lives of people with disabilities and their families could be altered with no turning back. People could be placed into institutions and other congregate settings in violation of their rights and posing risk to their health. Families could be more pressed to choose between a paycheck and health and well-being. And our current DSP workforce crisis could get even worse, impacting day to day life for millions of people with disabilities. We have an opportunity in the coming days to address these big issues, and we are urging Congress to act swiftly,” said Berns.

The Arc advocates for and serves people wit­­h intellectual and developmental disabilities (I/DD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of over 600 chapters across the country promoting and protecting the human rights of people with I/DD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

Editor’s Note: The Arc is not an acronym; always refer to us as The Arc, not The ARC and never ARC. The Arc should be considered as a title or a phrase.

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The Arc, Allies, and Self-Advocates Finally ‘Stop the Shock’

/in , , , , , /by Kristin Wright

WASHINGTON – After too long of a wait, The Arc celebrates a victory in our seemingly never-ending fight to underscore the value and human dignity of the lives of people with disabilities. After years in limbo, the Food and Drug Administration announced Wednesday it will finally ban the use of the electric shock device that has inflicted painful abuse on residents of the Judge Rotenberg Educational Center (JRC) in Canton, Massachusetts for decades. JRC is an institution for children and adults with intellectual and developmental disabilities and mental health issues.

By the FDA’s own count, as many as 50 JRC residents wear the shock device. Staff members use remote controls to administer shocks for perceived misbehavior. JRC uses the barbaric and inhumane practice, despite substantial evidence that the shocks are painful and traumatizing to residents.

“The Arc and The Arc of Massachusetts, alongside several disability rights organizations and empowered self-advocates across the country, fought for decades to ‘stop the shock’ and to end abusive and cruel practices masquerading as ‘behavioral treatments.’ People with disabilities deserve to live free from fear and torture. The FDA’s decision, years in the making, to ban the use of the electric shock device is a hard-fought victory and a testament to what is possible when disability advocates fight their hardest for change and for the civil rights of people with disabilities. We hope the ban is a significant step in ending the use of all aversive procedures on people with disabilities, who deserve to be supported with dignity,” said Peter Berns, CEO, The Arc.

A woman in a floral bathing suit lays in a beach chair by the pool, smiling

This Black History Month, We Salute Lois Curtis

/in , , /by Pam Katz
A woman in a floral bathing suit lays in a beach chair by the pool, smiling
Lois relaxing by the pool

This Black History Month, we celebrate the life and legacy of our African American heroes. They endured, persisted, and paved the way – for us all.

The Arc salutes Lois Curtis. Ms. Curtis’ bravery and refusal to live behind the dark walls of a state institution led to the landmark U.S. Supreme Court Olmstead v. L.C. decision in 1999. The case established that unjustified segregation of people with disabilities is a form of discrimination under the Americans with Disabilities Act – and that people with disabilities have a right to live in the community rather than institutions.

More than 20 years after Ms. Curtis returned to the community, she is living life to the fullest.

“I am doing pretty good,” Ms. Curtis tells The Arc.

She lives in her own home near Atlanta, Georgia. Ms. Curtis, 52, has a new and blossoming passion for singing and song writing. She enjoys writing original songs and her own versions of Motown hits. Ms. Curtis records at a local recording studio and takes keyboarding lessons. She is also invited to sing for groups in the Atlanta area.

Ms. Curtis says singing makes her feel good and reminds her of good memories with her mother.

These days, Ms. Curtis travels often with her family and direct support professional. She enjoys vacationing in Florida and her family is currently planning a trip back to Miramar Beach.

She loves church, going to the movies, shopping, getting her nails done, and going out to eat. Her favorite cuisine is Mexican.

Ms. Curtis’ longtime direct support staff Pertula Mark says it is a joy to see her happy. There are some tough days when Ms. Curtis talks about her time living in the institution or runs into people she knew at the facility.

Despite the pain of the past, Ms. Curtis, Olmstead co-plaintiff Elaine Wilson, who died in 2005, and attorney Sue Jamieson inspire us all to keep fighting for inclusion, community living, and equality for people with disabilities.

Thank you, Ms. Curtis!

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Threats to Medicaid and Social Security Resurface; The Arc Poised to Defend Critical Programs

/in , , , /by The Arc

Washington, D.C. – As reports circulate of further attacks on Medicaid and Social Security — programs that are vital to the quality of life for people with intellectual and developmental disabilities (I/DD) and their families — The Arc is preparing for battle to stop these threats in their tracks. Federal agencies have proposed regulatory changes to cut the Medicaid and Social Security programs, and just this week President Trump made comments to CNBC highlighting plans to cut these programs “toward the end of the year.”

Medicaid and Social Security could be on the chopping block. Yet these programs are essential for the health, well-being, and community inclusion of millions of people with I/DD and their families. Medicaid is the nation’s primary health insurance program for people with disabilities, and funds vital supports to keep them in their communities. Social Security insures individuals and family members for when a worker retires, dies, or acquires a qualifying disability. Many people with disabilities depend solely on their Social Security or Supplemental Security Income (SSI) benefits and related health coverage for their basic survival. Social Security Disability Insurance (SSDI) assists workers with qualifying disabilities, their children, and spouses. All of these programs are important to people with I/DD and their families.

“Cutting Medicaid and Social Security would be devastating for people with intellectual and developmental disabilities and their families, and we will fight with everything we have to protect these critical programs. There are millions of people with disabilities, their parents, siblings, family members and friends who all agree — we can’t turn back the clock on 70 years of progress we have made in including people with I/DD as valued members of our community and supporting them to realize their full potential. People with intellectual and developmental disabilities should have the opportunity to live fair, full, and promising lives, and have access to the services, supports, and income support to do so,” said Peter Berns, CEO, The Arc.

The Arc advocates for and serves people wit­­h intellectual and developmental disabilities (I/DD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of over 600 chapters across the country promoting and protecting the human rights of people with I/DD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

Editor’s Note: The Arc is not an acronym; always refer to us as The Arc, not The ARC and never ARC. The Arc should be considered as a title or a phrase.

Couple hugging outside both with eyes closed

Paid Leave for Federal Workers Approved by Congress but Falls Short for Disability Community

/in , , , , /by The Arc

Washington, D.C. – This week, Congress approved 12 weeks paid parental leave for federal workers caring for newborns, newly adopted children, and foster children, but the benefit falls short. Federal employees with disabilities and their family members need paid time off for their own medical needs and for caregiving for reasons beyond welcoming a new child and we are disappointed that the country’s largest employer now has a paid leave policy that does not include these crucial components.

“We are somewhat encouraged to see Congress take a small step in the right direction, but this paid parental leave policy is not enough. We need comprehensive paid leave for everyone that works for everyone, including people with disabilities and their families. We will continue to advocate for the needs of the disability community in paid leave – Congress can and should do more,” said Peter Berns, CEO, The Arc.

In the U.S. workforce, only 1 in 6 workers has access to paid family leave to care for a family member with a serious health condition. Roughly 2 in 5 workers report they lack access to any paid leave. People with disabilities and their families often experience greater financial insecurity and are more likely to face barriers to employment that can render the financial impact of unpaid time off particularly devastating.

Comprehensive paid leave increases opportunities to take time off for a serious medical condition or to care for someone with a serious medical condition without seeing a sharp drop in income or putting one’s job or employer-based health insurance at risk. In addition, it can increase access to preventive care, such as going to doctor’s appointments, and lead to better overall health and well-being. Access to paid family and medical leave can help workers balance their personal care needs while working and providing support to a family member.

“Our expectation is that the federal government set the tone for other employers to enact paid leave policies that work for everyone. We will keeping fighting on this issue so that workers with disabilities and families that include people with disabilities one day have the comprehensive leave they need to contribute in the workforce and take care of their families,” said Berns.

The Arc has cultivated several national partnerships to bring the issue of paid family and medical leave further into the public spotlight and advocate on the federal level. Learn more about our work.

The Arc advocates for and serves people wit­­h intellectual and developmental disabilities (I/DD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of over 600 chapters across the country promoting and protecting the human rights of people with I/DD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

Editor’s Note: The Arc is not an acronym; always refer to us as The Arc, not The ARC and never ARC. The Arc should be considered as a title or a phrase.

The Importance of Self-Advocacy: From China to The Arc’s National Convention

/in , /by Pam Katz

By Holly Miller

Disability Advocacy Scholar, The Arc

Holly with walkaround Julia, Muppet from Sesame Street

My passion for advocacy has grown stronger over the years and is taking shape as I learn more about the importance of fighting for your rights, no matter who you are.

I am a postgraduate student of political theory in Shanghai, China, pursuing a Master of Law degree. I am currently working on my thesis titled “Autistic Voices in China— A Critical Disability Research.”

My life experience as an autistic woman, growing up in Michigan, has guided my academic studies and understanding of the importance of self-advocacy for me and other people with intellectual and developmental disabilities (I/DD).

In October 2019, I flew from Shanghai to the U.S. for The Arc’s National Convention in Washington, D.C. The Arc awarded me a Disability Advocacy scholarship to attend the annual convention for the first time. It was an amazing opportunity to connect with other self-advocates and to continue to learn and grow.                                              

We were encouraged to attend sessions at the convention to learn about issues affecting people with disabilities and their families. My favorite session was “Supporting People with Intellectual and Developmental Disabilities (I/DD) to Make Their Own Decisions.” I learned how to advocate for myself in new ways and how other people with I/DD can learn to support themselves. I think it is vital that we all have the opportunity to live independently. I attended this session to learn more for my future career in disability advocacy.

Holly, left with Julia Bascom, Autistic Self Advocacy Network Executive Director

I also enjoyed an interactive session called “National Council of Self-Advocates: Everyone Votes!” I already know a lot about voting but during this session I got the chance to learn even more about why voting and raising issues impacting the disability community is so important. This session was especially powerful for those in the room who had never voted. As American citizens, we all have the right to vote!

The Diversity Breakfast was another highlight of the convention. It was interesting to hear concerns from other self-advocates and how their advocacy has made a difference. At the breakfast, I met others who are as interested in advocacy as I am, which put me at ease at my first convention.

I became interested in self-advocacy after giving several presentations in college about my life growing up autistic. I hope to one day help others with I/DD fight for their right to make their own decisions and live in the community with appropriate supports and services.

I have enjoyed advocating alongside The Arc – all the way from China – and learning from the organization how to be the best advocate I can be. The Arc listens to me. I am looking forward to working together to advocate for all people with I/DD and their families.

The Arc logo

The Importance of Paid Leave: A Sibling Perspective

/in , , , /by Pam Katz

By Nayma Guerrero, Member of The Arc’s National Sibling Council

My family is everything.

Nayma and her family

My younger brother is 23 years old. He loves computer science, animation, and art and design. He also enjoys working out at the gym. Things are sometimes challenging for my brother, who has autism, intellectual disability, attention deficit disorder, and depression. Then there’s my sister. Like many 14 year olds, she loves the mall. She also plays soccer and basketball, and likes playing with her dolls. I admire my sister for sticking to it at school, despite having learning disabilities.

Like a lot of families, the day starts at my parents’ house in controlled chaos. My mother takes on what seems like the biggest challenge of the morning shared by moms everywhere: getting my brother and sister out of bed! A true supermom, my mother helps both of them get their school clothes together and makes sure they eat breakfast every day. She truly believes breakfast is the most important meal of the day. After they eat, my mother drives my brother and sister to school before taking care of the grocery shopping and errands.

Both of my parents are very hard workers and make sure my siblings’ needs are met every day. My father works fulltime, so my mom is usually the one who is taking care of my brother and sister.  My brother requires a lot of care, attention, and daily reminders to make sure he’s dressed, gets to school on time, and takes his medication.

A few years ago, my mother ended up in the emergency room. It turned out to be life threatening. My mother needed emergency surgery. We were shocked and worried as any family would be. After her surgery, we were told my mother would need to be on bed rest for about two weeks minimum with little movement. She would need a lot of assistance to get around the house, use the restroom, and shower. We were concerned for my mother but also for my siblings.  My mother is the person my brother depended on the most. And my sister was only 10 at the time.  

My father and I realized it was up to us to help my mother, my brother, and sister. For my father, taking time off meant he didn’t get paid and it was already hard for my family to make ends meet – still is.  I was also working hard, but not getting full time pay or health benefits of any sort. I was working just under 40 hours a week and therefore, part time. Calling off also meant no pay for me. It was really hard for my father and myself to work out a schedule where we could both help my brother with his needs and care for my little sister and my mother. It was also hard because my brother has a difficult time trusting other people, so he needed us. Sometimes, there is just no substitute for family.

Now imagine what it was like for us to shift to relying on one income – we had to save every penny for rent and bills, that’s it. I didn’t know how I was going to make my car payments. We were barely getting by.

Paid leave from our jobs would have helped my family at a time when we needed it most. If I would have had access to paid leave, I would have been able to help my family without losing my pay. My father wouldn’t have had to call out of work with no pay and risk losing his job. I also wouldn’t have had to go some days without pay. I was also scared that my job was going to fire me because I had to call out. With paid leave, we would have been able to provide my brother and sister with better care, while my mom recovered from surgery.

There are many families like mine. When the unexpected happens, family members need to be able to be there for each other – and still keep their jobs.  The U.S. needs a paid leave system so that families like yours and mine can care for loved ones when they need our help.