NPR’s “All Things Considered” Looks at Self Determination Funding Programs for People with Disabilities

New Hampshire is one of 40 states experimenting with a new model of government assistance for people with disabilities, giving them "more say" over how government money is spent on their behalf, NPR's "All Things Considered" reports. Tom Nerny, a New Hampshire "advocate for the disabled," gathered public and private funding for his "self determination" program, which gives state money to disabled people and their families directly, rather than leaving spending decisions to the government. Nerny said, "Folks with disabilities have got to have the same ability to decide who they're going to live with, where they're going to live, and what important things they're going to do with their life, no different from any other American." NPR reports that a study of Nerny's pilot project found it "improved each disabled person's quality of life and saved the state money." But some officials remain "cautious." Sue Swenson, who as commissioner of the Administration on Developmental Disabilities is the "federal official in charge of setting national policy for people with mental retardation," said she supports the idea of self determination but that not all families are able to commit to the level of responsibility such models require. In addition, social service agencies are "reluctant to give up their control of state dollars." Nerny said, however, that the approach could "start a revolution in care," noting that some states are trying self determination in caring for the elderly. "[I]f you control the dollars...what system would emerge from that? You would not see institutions and nursing homes. We would see folks living in their own homes, calling on their friends and allies to support them, and paying them when necessary," he said (Shapiro, "All Things Considered," NPR, 4/16).