Saving Medicare billions: Trying too hard can get in the way

Memorial Note: Tonight Jack Seidner aged 93, my neighbor and friend at Addison Court, State College. PA, died while talking to his son who had called from Israel. He died at Centre Crest, an assitive care facility in Bellefonte, PA, 11 miles from Addison Court.

Jack was a veteran of World War II and was a monthly calendar boy on the Jewish War Veterans calendar last year  He will be buried beside his wife in Harrisburg at a private funeral.

Jack was a wonderful man. He was basically an intellectual although he hid it as much as possible. When I wrote a story about home medical oxygen, oxygen which he received to stay alive, he refused to be photographed saying, "I have been studied enough." 

His sense of humor was ever-present, sometimes to the point of reciting bawdy limericks to the residents of Addison Court. I will miss him. He died at Centre Crest. The article below, originally published in HME News on September 27, 2011, is dedicated to his memory. In these days of turmoil at Penn State University, the need to care for the real needs of this community should be apparent.

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Saving Medicare billions: 
Trying too hard can get in the way 

The money saved as a consequence of concentrating on what is right will astonish the body politic

"I have saved up enough pills to kill myself," a neighbor told me, "if I ever have to go to Centre Crest."

I live in an independent housing apartment building in downtown State College, Pa. The nearly 100 residents of Addison Court are disabled or elderly. Most of us are poor--the more affluent are on Social Security or Social Security Disability and Medicare.

At least once a week, the ambulance stops by my window and a resident goes off to the hospital. The lucky return. The not-so-lucky move on to Centre Crest, the default public nursing home about 11 miles away, where assisted living means expensive round-the-clock care, diaper changes, attachment to machines that keep the biological aspects of life going, medical personnel who make sure medications are taken correctly, and a world view that echoes Dante's inscription over Hell: "Abandon hope, ye who enter here."

Last year, Pennsylvania's Department of Aging estimated it costs Medicare $40,000 extra each year for a resident to move from an independent living to an assistive living facility. The loss of dignity to the individual is incalculable.

The French philosopher Jean Paul Sartre observed that when one tries especially hard to listen, often the trying gets in the way of hearing. Medicare is trying too hard to do the wrong thing. Medicare's purpose is not to save money, but to provide health care in a way that concentrates on improving the quality of life. Recent evidence on the brain's adaptive capacity provides hope that not only can individuals resume physical capacity from the devastation of a variety of afflictions that affect us at Addison Court, but also we can regain our talents to improve this society, not simply take from it.

"The Brain that Changes Itself, Stories of Personal Triumph from the Frontiers of Brain Science," by Columbia University's Norman Doidge, M.D., points to the brain's ability to recover from strokes and other disorders with rehabilitation and concern.

"Traditional rehabilitation," Doidge writes, "typically ended after a few weeks when a patient stopped improving, or 'plateaued.' And doctors lost the motivation to continue.  But...these learning plateaus were temporary...Though there was no apparent progress in the consolidation stage, biological changes were happening internally, as new skills became more automatic and refined."

The Obama administration's penny-wise-and-pound-foolish cutbacks on availability to durable medical equipment, rehabilitation services, and home health care are forcing residents of independent living facilities into the Centre Crests of this country. For example, the narrow focus is apparent in Medicare's frequent citations of the Congressional Budget Office's competitive bidding estimates of relatively insignificant savings for Medicare Part B ignoring the astronomical costs that will result to Part A when disabled individuals like me can no longer pick up the phone and call my local medical equipment provider. Instead, I must wait for a competitive bidding winner (several have unsavory reputations and some are based out of state) to provide a battery. Delays could easily force me into Centre Crest as a result of falls, problems getting to the bathroom, etc. Delays would rob me of the ability to work as an adviser on virtual reality models for construction of future aging in place housing--construction which will result in significant Medicare savings.

Medicare is discouraging the necessary alliance between rehabilitation therapists and medical suppliers. This alliance will help restore the ability of my fellow residents to function and contribute to society.

"Individuals with disabilities remain one of our nation's greatest untapped resources," said Rep Jim Langevin, D-R.I., the only quadriplegic in Congress. To release the untapped resources of the elderly and disabled, Medicare must stop thinking about saving money and start thinking about improving health. The money saved as a consequence of concentrating on what is right will astonish the body politic. Providers of durable medical equipment require the support of consumers like me. Providers and rehabilitation therapists have been slow to recognize that in unity there is strength. Together they must spread the word that when an individual becomes old or disabled, science is rapidly increasing the ability to regain talent and good health.

Joel Solkoff is the author of "Learning to Live Again, My Triumph over Cancer" and is adjunct research assistant at Penn State's Department of Architectural Engineering.

http://www.hmenews.com/?p=article&id=hm201109OayJh3 

What’s the fuss? [Grilled 101]

What’s the fuss? [Grilled 101]

I originally created this blog as a convenient way for readers to have access to my monthly column in Voices of Central Pennsylvania, published from October 2009 to February 2011. While recovering from minor cardiac surgery where the medical standard of “do no harm” was once again violated, I decided to quit my column rather than continue to be a person unable to change Medicare and thus always angry all the time. I wanted to love.

I am a frequenter of hospitals for pneumonia, rehabilitation to a right shoulder that cannot be repaired, diabetes, etc.--invariably released by Medicare dictate before it is necessary; frequently saved by homecare agencies now foolishly required to reduce their services.

In writing my column for February (the one below that begins with bull riding), I opted to reject anger.
Similarly, the once favorable economic conditions in downtown State College, PA where I live had given me the hope that government favorable to the disabled and elderly might provide us with the infrastructure, training, and understanding required to develop and benefit from the talent of those of us who are broken in body but sound in mind.

It is foolish to be angry at my fellow-town mates (in a place that is rapidly turning into a Bruce Springsteen song) who are so beset with troubles of their own that…

So, I gave up the column to work with engineers, architects, and designers who are planning a future that follows the Americans with Disabilities Act (ADA) and where segregation of the sort I experience daily at Ye Olde College Diner and the like (whose lack of access is grandfathered ) does not exist.

What does exist is that I continue to live an independent life. I cannot get from my bed to the bathroom without a scooter or other mobility device. Yes, there is a point where reality requires that I cannot engage in submission, cheerful or otherwise.

I must have access to mobility devices. President Obama, for whom I worked and voted, should be ashamed of himself for not only tolerating, but personally advocating a competitive bidding program for durable medical equipment.

This plan, which the President inherited from President Bush (who used it as part of an effort to gut Medicare) is already, in Pittsburgh and other locations, so altering the process of providing medical supplies such as oxygen, wheelchairs, power chairs, scooters and other mobility devices that local suppliers, such as the three here in State College, would only be able to serve the rich.

The rest of us are or would be at the mercy of often out-of-state suppliers of dubious reputation who would take their sweet time providing batteries and maintenance, resulting in people like me falling and going into assisted living facilities. Thus savings in Part B of Medicare would result in large costs in Part A.

Last year’s measure to end competitive bidding received the bipartisan support of so many members of the House that if the Democratic leadership had called it up for a vote it would have passed. The Senate followed the lead of Senator Robert Casey, Jr. (D-PA) and no member of the Democratically-controlled senate endorsed the legislation.

While Sen. Casey publicly dithered about his position on the subject, his real position appeared to become clear. Sen. Casey is reportedly a friend of the President. The President, for reasons of his own, an informed source told me, personally believes in competitive bidding. Sen. Casey is not going to take a position that would make his friend angry.

Two columns below express the views of Rep. Jim Langevin, a liberal Democrat from Rhode Island, and Rep. Glenn Thompson, a conservative Republican who represent me here in the Fifth Congressional District of Pennsylvania, expressing their opposition to competitive bidding. Their specific advocacy was to the legislation introduced last year, but this year’s legislation is déjà vu all over again.

My friends who meet regularly at the Corner Room in this sliver of left wing political power here in the small borough of State College (surrounded on all sides by Republicans; Republicans to the north; Republicans to the south; Republicans to the east, and Republicans to the west) cherish the liberal’s dream that someday these evil Republicans will turn into progressive Democrats.

My fixation on competitive bidding has made me a source of jest and some mistrust. My support of Rep. Thompson, especially, has made some Democrats suspect my loyalty to the party.

I am a loyal Democrat who believes in the party of Eleanor Roosevelt and Adlai Stevenson. I have no trouble picturing Eleanor Roosevelt shaking her trademark index finger at President Obama and Senator Casey. If they want my vote, they had better start acting like Democrats. Democrats don’t treat people who cannot walk in a way that causes us to feel like cripples.

Shame on you President Obama. Shame on you Senator Casey.

I will pray that you find your way back to the ideals of the Democratic party.

Shame. Shame. Shame.

--Joel Solkoff, March 2011

“Individuals with Disabilities Remain One of Our Nation’s Greatest Untapped Resources”

“Individuals with Disabilities Remain One of Our Nation’s Greatest Untapped Resources”


A shot from the revolver of the Rhode Island policeman went off by mistake. The bullet hit Jim Langevin, a 16-year-old boy, who was a police cadet in a Boy Scout Explorer Program. It hit Langevin’s spine and kept going. The damage made him a quadriplegic (paralysis of both arms and both legs).

Rep. Langevin is the first quadriplegic to serve in the U.S. House of Representatives. To enter the House chamber 10 years ago, when he was first elected, the maintenance crew made the chamber wheelchair accessible and removed two fixed seats in the front row so Langevin could maneuver his power chair and effectively address his fellow colleagues. Langevin has made his reputation in Congress as an expert in terrorism, computer security, and biological warfare.

This column comes to you at an awkward time. This column will appear in early December, before the seasonal gloom causes you to cheer up others with presents. This December/January issue of Voices stays on the stands until Jan. 31, by which time you will have already broken the New Year’s resolutions you have not made yet.

More to the point, for those of us who care more about politics than football, December marks the end of the lame duck Congress, controlled in the House by the Democrats and is succeeded in January by a new 112th Congress with a large majority of Republicans (63) new members) and not enough Democrats in the Senate to break a filibuster, but enough to sustain a presidential veto.

In short, the next two years promises to be a period when NOTHING will get done. Since Congress controls spending, it is possible that legislation that was dear to the president’s heart will find itself without the money to implement. For those of you so inclined, Gloom is a gift that will not go out of style, especially between now, February first, and beyond.

This column focuses on the problems and opportunities of the elderly and disabled here in Centre County. I chose to interview and profile Langevin because of a letter he signed at the end of the summer, just as the vacuous senate race in Pennsylvania was beginning to heat up. The other signer was Glenn Thompson who represents us here in State College. Langevin is a liberal Democratic; Thompson a conservative Republican. Langevin voted for Obama’s health care reform bill; Thompson voted against it. Why are these two unlikely representatives working for the same cause?

The cause is the fight to keep local medical suppliers in business. This is a cause that affects me personally because without a battery-operated wheelchair I would not be able to go from my bed to the bathroom, or to the kitchen to make dinner, or outside to work and make a life for myself. Previous attempts to reduce costs by giving large corporations, some outside the Commonwealth, contracts to provide wheel chairs, scooters, power chairs and oxygen, have resulted in companies with unsavory reputations receiving the lowest bid and raising the likelihood that poor and middle class individuals who are unable to walk face long waits for equipment delivery, maintenance and repairs. The consequence of these waits are likely to be accidents of the kind that would force independent people with disabilities to move to assistive living resulting in cost increases many times greater than Obama’s penny pitching savings on medical equipment.

Langevin and Thompson agree to end competitive bidding and (the subject of the end-of-summer letter) to halt Medicare’s requirement that customers be given the option of renting their chairs for a 13 months, rather than buying them—through Medicare--in the first month. Power chairs are custom designed to the needs of individual patients, and forcing medical suppliers to pay for them in advance will badly damage a business that is already strapped for cash.

Langevin’s exclusive written interview of over 1,700 words is available on my blog at voicesweb.org. Thompson and Sen. Robert Casey, Jr. have expressed the desire to give you their points of view. Stay tuned.

The big issue, of course, is money. Does our country have enough money to invest in the talent of those of us who are disabled and elderly? Langevin maintains, “Individuals with disabilities remain one of our nation’s greatest untapped resources, and they continue to face challenges in accessing employment, transportation, housing and even health care.”

--Joel Solkoff, author of The Politics of Food. Contact him at jsolkoff@gmail.com or at voicesweb.org.

Exclusive Written Interview of Rep. Jim Langevin (D-RI)

Exclusive Written Interview of Rep. Jim Langevin (D-RI) by Joel Solkoff, Voices of Central Pennsylvania
1. Why do you oppose the Obama Administration’s efforts to create competitive bidding for medical suppliers of durable medical equipment, such as medical oxygen, power chairs, scooters, wheelchairs, and other mobility devices?

The competitive bidding program was enacted as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) in an effort to improve quality of service and eliminate excess costs in Medicare. While I support these overall goals, flaws within the bidding process sparked early concerns within the program.


Competitive bidding was implemented in July 2008. However, Congress delayed the program two weeks after it began, recognizing the new system was not generating the savings and competition the law had intended. Further, the program was acknowledged to be a potential threat to access and quality of services, vulnerable to corruption, and resulting in fewer suppliers capable of meeting the unique needs of patients.


During the moratorium, the Centers for Medicare and Medicaid Services pursued other avenues that achieve higher quality care and succeeded in cutting costs, yielding savings of 16.5 percent. These alternatives underscore my belief that the original program is ineffective and unnecessary to keep as written law. For this reason, I cosponsored H.R. 3790, which would repeal the Competitive Bidding Program.

2. What are your objections to the attempt to repeal the first month purchase option for users of mobility devices?

Currently the Medicare program allows beneficiaries a choice as to whether they want to purchase the power wheelchair that is right for their size, disability, functional level and home situation, or if they want to rent it. Over 95 percent of beneficiaries choose the first month purchase option because their disability often involves a chronic, long-term condition and they require use of a power wheelchair to remain active and independent in their homes and communities.


The Affordable Care Act repeals the first month purchase option and requires a mandatory 13-month rental, regardless of the acuity of the condition or long-term need of the patient. Unfortunately, many power wheelchair providers do not have the capital or lines of credit in the current economy to bear the burden of paying the up-front costs to procure the appropriate wheelchairs from the manufacturers. Without a one-year delay, this policy could create significant access and quality-of-care issues as providers of this equipment struggle to make the significant changes to their business model to adapt to a new payment model, which has the costs front-loaded with reimbursements from Medicare spread over 13 months. They may also simply go out of business.


A one-year delay of this provision will allow providers of power wheelchairs more time to implement this significant policy change.

3. Why do you think President Obama waited so long to appoint an administrator of Medicare and Medicaid? (I would think a Medicare Administrator could have given the President valuable information and advice during the health care reform process.)

While I cannot speak for the President, I believe that vetting and selecting high-caliber individuals to lead departments and agencies can be a long and challenging process, particularly those that require Senate confirmation. As health reform was considered in Congress, counsel was sought from numerous stakeholders at all levels and throughout all steps of the process. Now that the law has been enacted, the Administrator of the Centers for Medicare and Medicaid Services (CMS) is one of many Administration officials tasked with its implementation, which is equally, if not more important to the success of health reform.

4. What affect will Donald Berwick’s recess appointment, with its limited duration, have on the future of Medicare and Medicaid, especially given the strong Republican and Tea-party desire to cut Medicare even more.

Donald Berwick is a highly respected leader in the field of health policy. His knowledge and experience make him uniquely qualified to head CMS, particularly as we begin to institute payment and delivery reforms to maximize quality and efficiency in Medicare and Medicaid. While a Senate confirmation would have been preferable, some senators intended to make Donald Berwick’s confirmation process a referendum on health reform, placing ideology over his qualifications as a potential administrator. Republicans have long stated their intentions to “repeal and replace” the health reform law. We cannot dismiss the probability that they will use every means at their disposal to accomplish this, including the use of controversial amendments, defunding the program through the appropriations process, and blocking future nominees for positions in the Administration.


5. What are your views on the half trillion dollar cuts in Medicare as a way of helping to pay for the health care reform bill?

Health care costs in the United States are rising at an alarming rate. Yet despite the fact that we spend more per capita on health care than any other industrialized country, we produce disappointing outcomes by a number of important health measures. Furthermore, the U.S. remains the only developed nation that does not guarantee health coverage as a right to its citizens.


Health reform will expand coverage to 32 million Americans, promote a strong health care workforce, reduce the deficit by $143 billion over 10 years and protect Medicare for our seniors by extending the trust fund by a decade. These reforms are funded in part through Medicare savings, not benefit cuts.


Reducing health care costs and expanding insurance coverage does not mean we have to raid Medicare. On the contrary, we can and must use the money already in the system more efficiently to ensure a sustainable health care model.

6. As a Democrat who worked for President Obama’s election (and as a paraplegic), I have been disappointed by the President’s insensitivity to issues relating to disability, especially as they relate to the on-going difficulties in obtaining needed assistive technology. What are your views on the subject?

On July 26, 2010, we celebrated the 20th anniversary of the Americans with Disabilities Act (ADA). This was an opportunity to both celebrate our accomplishments, and reflect on the continuing challenges.


Individuals with disabilities remain one of our nation’s greatest untapped resources, and they continue to face challenges in accessing employment, transportation, housing and even health care. This will only continue as we see increasing numbers of veterans returning with Traumatic Brain Injury, Post Traumatic Stress Disorders and other disabling conditions.


It is more important than ever that we educate businesses and connect them with proper resources to create more employment opportunities in our communities. We must collaborate with local and state governments to ensure that transportation is available and accessible to everyone so they can get to their job, or the doctor, or the grocery store. We need to provide more resources for our teachers so that every child can receive a proper education, which is the stepping stone to a better future.


We must also continue the development of assistive technologies and make sure that computers, PDAs and phones are fully accessible for the vision and hearing impaired. To that end, on the 20th anniversary of the ADA, the House of Representatives passed the Twenty-first Century Communications and Video Accessibility Act, which would require that certain technologies be compatible with devices used by individuals with disabilities, and attempts to increase access to technology through various funding and regulatory requirements. This was signed into law by President Obama on October 8th.

7. Here in State College, PA, I am a constituent of Rep. Glenn Thompson, a Republican with whom you have been working on issues affecting local suppliers of medical equipment. Would you describe what your working relationship with Rep. Thompson is like?

Disabilities don’t discriminate on the basis of party affiliation. I have a long record of working in a bipartisan fashion to enact policies that increase the quality of life for all individuals with disabilities. My relationship with Representative Thompson is no exception.

8. What are your views on the future of productive working relationships with Republicans on health care-, Medicare-, and disability-related issues over the next two years?

While the climate in Washington has been particularly partisan during the elections, it is my greatest hope that we will not let the issues that divide us keep us from the work we were elected to do. Nothing would be more detrimental to our economic, fiscal and social progress than the continuation of partisan rhetoric and the lack of courage to make the tough choices that will ultimately lead us into a more prosperous future.

9. Do you think a Republican-dominated Congress will be effective in preventing full implementation of the health care reform bill?

Passage of the health reform bill wasn’t the end; it was the beginning of a new chapter for health care in America. This law will be judged by the court of public opinion, just as it will be challenged in the courts and in Congress. Some changes will have to be made, and the policy will evolve as our society does. At the end of the day, I believe the reforms will prove popular and successful.

10. Donald Stockman, budget director for the late President Reagan, says the country is out of money, must cut back on everything, and said on ABC’s This Week with Christiane Amanpour that scooter manufacturers should cut back on production. Is the country out of money? Can we afford to provide our disabled population with the assistive technology we need to be productive? Can our economy afford not to develop the talent of people with disabilities?

Americans are innovative and resilient. Although we will have to make tough budgetary decisions to put our country on a fiscally sustainable path, we still have the resources to invest in key areas that will plant the seeds of economic and social growth. We can make transportation and technology even more accessible and available. We can provide more resources to teachers and students to achieve a better education. We can focus on income and asset development so families have the means to become productive members of their communities. If we act with courage and commitment, then we will provide the means for every individual to realize their true potential.


Thank you.

Joel Solkoff, November 19, 2010, Voices of Central Pennsylvania

[Please note: As a columnist, I have the liberty of injecting personal notes in my writing, such as the fact that I am a Democrat.]

Llike_an_old_rock_star....

Like an old rock star who does not know when to quit:

 This disabilities journalist continues to blog through the night to describe how 3-and 4-D technology will help elderly and disabled individuals lead better and more productive lives as a result of novel engineering techniques that make your head feel as if it will explode. Of course, the fourth dimension is Time.

You Can't Always Get What You Want

                                                  

Bill

I am waving from over here trying to reply to your reply of my reply on the Voices of Central Pennsylvania site. Other readers: http://voicesweb.org/won%E2%80%99t-ride-%E2%80%98em-cowboy-my-final-column#comment-2634 Start at the beginning to keep up to date on my ongoing correspondence with Bill Eichman, President of Voices and its brilliant webmaster, regarding why I have stopped writing a column on disability and elderly related issues.

Joel
                                                 

Regarding: "You Can't Always Get What You Want,"  I can.

Right now, I am publishing a blog on 3- and 4-D technology instrumental in improving the design of elderly and disability housing, a subject on which I have some experience since I live in housing intended for elderly and disabled people such as myself.

The blog will discuss such tools as:

• Google’s Sketchup (available for free)http://sketchup.google.com/download/#utm_campaign=en&utm_source=en-ha-na-us-google&utm_medium=ha&utm_term=SketchUp
•  Second Life describes itself as "a free 3D virtual world where users can socialize, connect and create using free voice and text chat."
  
  The free download does not occupy much computer room: http://www.amazon.com/You-Cant-Always-What-Want/dp/B0016CRWW0/ref=dm_att_trk3

• WOW

.















 Sketchup is a favorite.  I just made my first 3-D drawing. It is not exactly a drawing. It is OY VAY! in what appears to be 40  foot 3-D letters. I can see Oy Vey! from:

• Top
• Bottom
• Forward
• Back

It iis a strange experience to draw huge letters and look at the drawing from underneath the letters, creating a paranoid fantasy of being crushed by letters (or more conventional objects like wheelchairs).

 I make the letters take shape. Type fonts such as Arial black begin to take over my world.

Join me in my new world at Disability Beat Covers Virtual Reality. http://disabilitybeatcoversvirtualreality.blogspot.com/

Won’t ride ‘em cowboy: This is my final column

Note: The following is the text of my February, 2011 column at Voices where I announce the end of my From Where I Sit column. The hard copy text, complete with a phograph of me, is available at newstands in Centre County. I am reproducing it here for two reasons. First a reader insisted that I was required to explain my rationale more fully or, in her words, "face a grilling." I therefore intend to call my next blog Grilling in which I not only explain but provide the reader with reassurance that the issues of the elderly and disabled will continue to be covered at Voices--only not from me. Not within the context of this From Where I Sit monthly column. Writers interested in covering such subjects are requested to get in touch with me at the email address below.]

The handler applies the fully-charged cattle prod to the rear of a bull bred for ferocity. The cowboy—Slim really is his name—holds onto his hat with his left hand. In his right hand are the reigns, two strips of leather held on tightly at first, but capable of falling apart to help the rider jump away from the bucking bull to safety after the regulation eight second ride is complete.

The maximum score is 100 points; 50 for the rider and 50 for the bull. A mean angry bull is the most desirable because he gives the rider the opportunity to make the most money. This bull is mean. When the bull jumps higher after the cattle prod, Slim smiles with optimism. The gate leading to the ring fails to open. Historically, when the gate sticks, a confined maddened bull has been known to break both legs of a rider. Slim, who attended rodeo schools, is aware of the danger.As a reporter at the World Series of Rodeo at Oklahoma City (before it moved to LosVegas), I am sitting next to the handlers on the inside wooden planks of the chute. It took considerable effort to get permission to be this close to Slim—close enough to watch his pupils dilate into huge ovals displaying a fear he cannot disguise. The lead handler asks Slim if he would like to wait 20 minutes before beginning the ride. Slim nods him off. The gate opens.

Sometimes it is prudent to know when to give up. I have been writing this column since October, 2009. One reader observed that my columns made her suspicious because of their apparent clarity, establishing a formula where I said clearly what I was going to write about and wrote it. She asked if I were hiding something amid this seeming clarity. I have been hiding my overall intention; namely, the necessity for the physically disabled, regardless of age, to achieve independence—independence for those of us whose bodies may not work, but whose minds do. The requirements for getting a good job include the tools to do the job, the income necessary to get off public assistance, and the opportunity to develop our talents so we can improve the nation’s economy. This is a complex set of tasks and does not fit neatly onto a piece of paper affixed with a magnet to the refrigerator.

For those of us unable to walk, hear, or see the first task of necessity must be to rid ourselves of anger or at least pretend it isn’t there. Whatever the virtues of expressing how I feel, I have learned that when I am angry in public, I am on the express lane to defeat.

The Roman poet Catullus wrote, “I love and I hate. Do not ask me why I do so, but I am in torment.” Often when I write this column I am overwhelmed by the fluctuations (depending on my mood over the day) of love and hate projected on to a specific person or situation. Often I write multiple drafts of the same column, each thousands of words long until the emotion subsides and I can describe calmly a discrete 800 word section of my overall objective.Today’s current political situation leads me to despair that independence for individuals with physical difficulties will not come in my lifetime. It will not come because Democratic and Republican leaders do not regard it as a priority given our country’s other pressing problems.

Fortunately, I have the opportunity to leave my anger with the present and work on a training program at the virtual reality lab where Dr. John Messner has been creating 3-D programs showing how to construct accessible buildings before workers even begin to dig the foundation. Specifically, I am working with Sonali Kumar on what she calls “the bleeding edge” of technology to design models for independent elderly housing.

I am providing advice based on my experience as a disabled person who lives in independent elderly housing. Instead of maintaining the self-destructive illusion that I know more than everyone else, I am returning to a land of technology where what I don’t know fills the air like the thick steam on the top bench of a Turkish bath. There is so much to learn and all of it will help my people—individuals with disabilities. It is time for this cowboy to stop riding. I do not have the energy to both write this colum and plunge into the future.

When I am sufficiently trained, I will report to Voices on what the future will be like.

—Joel Solkoff, author of The Politics of Food. Contact him at jsolkoff@gmail.com

Protect disabled, elderly from fires and disasters

From Where I Sit: My column in Voices of Central Pennsylvania, November 2010

My only experience with an earthquake was in the Silicon Valley of California where I was staring at my broken computer when the earth moved beneath me. The following day The San Jose Mercury News put the earthquake on page one because of its intensity and also contained an editorial on the
importance of being prepared.

My home—wife, two daughters, two cats—was back in North Carolina where I had worked in Research Triangle Park for two years (focusing on linking a computer to a telephone switch) when suddenly jobs in documentation that in one job interview I had been told was fated for life (gold watch and all) had disappeared. At the same time, my ability to walk had gone from being able to jog on the beautifully wooded track on the corporate campus, to being unable to stand without holding onto something, to tripping on my toes and dislocating my right shoulder.

 An extensive search of databases showed San Jose, California, could not hire technical writers quickly enough. A longtime friend had extra room nearby and invited me to go west. I was hired immediately. I fell three times during a critical interview. My cane could not hold my weight. I had not yet acquired my first mobility device, a frontwheel drive scooter.

 After my third fall, directly in front of my prospective boss’ feet, Vicki, who was in charge of the corporate quality assurance team, said, “Don’t worry. We have to hire you.” The reason I had to be hired was that the company, a global leader in computer wafer inspection devices, needed a writer for its new product which could predict when a wafer in the production process would be faulty and remove it from its production line on a timely basis. What the company had not prepared for was any safety orientation for disabled workers.

***

 These details are relevant to the evolution of fire safety policies at Addison Court in downtown State College. They are relevant because first, until recently the idea of protecting the disabled and elderly from fire and other emergencies was low on our society’s consciousness. Second, limiting safety and access to one location and one building has long-term negative consequences to our country’s economy—an economy which to its detriment fails to make use of the talent of its disabled and elderly population.

 R e g a r d i n g safety at Addison Court, a residence for 90 elderly and disabled individuals, where as a result of faulty fire alarms about two years ago, we learned from Steve Bair, fire director of Centre County’s Council of Governments (COG) and head of Alpha Fire Company, the proper way of evacuating a building made of brick with adequate sprinklers:

Do not evacuate. Wait for the fire company to come. Evacuation of disabled and elderly residents (in a multi-story building), especially when they have power chairs, wheel chairs, and the like, can induce panic.

 More on this do not evacuate concept which the fire authorities refer to as “defend in place” later. It makes good economic sense to protect disabled and elderly individuals from dying or being hurt in a fire or in some other disaster. A larger question is whether this society has the will to pay for safety, the understanding of where safety belongs in our order of priorities, and the willingness to teach and implement concepts like “defend in place.”

The most recent available Census Department statistics for Centre County (based on a 2006-2008 estimate) shows a total population of a little more than 144,000; 45,000 residents are 45 years old and older. Nearly 16,000 residents range in age from 65 years to over 85. What is the cost to Centre County and society at large to keeping these 16,000 residents safe and productive if many of them require special safety procedures? Who should pick up the tab? IWe need to invest in quieter, gentler fire alarms so that residents stay in place until the fire trucks come.

Several subjects require elaboration on the voiceswepage.org webpage: direct your browser to future blogs on the following subects:

• Administrative efforts to reduce panic.
• The continuation of my meandering earthquake story and where it fits into a larger picture.
• Plans to make Lady Gaga Fire Prevention Celebrity for Centre County. 

—Joel Solkoff, author of The Politics of Food. For a continuation of themes raised in this column, see Joel;s blog at voicesweb.org.Tell me how you liked the photograph of Lady Gaga and an illustrated critique of her disability-related video Paparazzi.