shown here is nursing home survivor, one of hundreds of members of ADAPT
who, for two days in the autumn of 1991, blocked the doorways and driveways
and underground parking garages of the ten-block-square national headquarters
of the Health Care Financing Administration (HCFA) in Baltimore, Maryland.
is a national organization of disability rights activists, people with
little or no money at all who practice civil disobedience to effect
social change. (The name "ADAPT" stands for "American Disabled for Attendant
Programs Today.") They don't seem to have a boss of any kind. And they
don't have a national headquarters, but they do have people power. And
they want to live in their own homes, not in nursing homes.
result of ADAPT's action that autumn, and its continuing visits to a
variety of places where HCFA does business, some of its members were
invited to meet, repeatedly and over a number of years, with HCFA's
top managers. Since 1997, they have been meeting with HHS
Sec. Donna Shalala. It was Shalala who secured meetings between
ADAPT's people and President Clinton.
result of those meetings, HCFA has
changed its tune about home- and community-based services. Where
once states had to go through 57 varieties of hell over a period of
years to get HCFA to approve one measly waiver
application, today's waiver approval process takes 60 days or less and
requires little if any special pleading.
HCFA positively encourages waivers and Donna Shalala, today a true believer
in Our Homes Not Nursing Homes, told state legislators that much and
more face to face in a recent speech. See
excerpts from her speech to the National Conference of State Legislators.