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Stigma, healthcare barriers compound disabilities

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GREENPORT–The Columbia County Community Services Board in partnership with the Columbia County Department of Human Services held its 16th annual Legislative Forum Friday, October 23, at Columbia-Greene Community College, with federal, state and local officials on hand to listen and respond to concerns about the delivery of physical health care to persons with disabling conditions. Many of the problems were identified at a public hearing held by the board September 17.

The Columbia County Community Services Board (CSB) is responsible under state law to assess the needs of individuals with chemical dependency, mental illness and intellectual/developmental disabilities, and among those present at the forum to hear that assessment were Benedict McCaffree, representing Congressman Scott Murphy (D-20th), Senator Stephen Saland (R-41st), Assemblymen Marcus Molinaro (R-103rd), and Supervisors Roy Brown (R-Germantown), William Hughes (D-Hudson)and Lynda Sheer (R-Gallatin), along with county Sheriff David W. Harrison Jr.

Facilitated by Columbia County director of Human Services Dr. Michael O’Leary, the forum interspersed video clips of several segments of testimony given by family members, service providers and persons directly affected by mental illness, developmental disabilities, or substance use disorders at the September 17 hearing. The clips were organized around five themes that Dr O’Leary said “resonated” at that hearing, which were:

*Stigma associated with disabilities and the need to educate and sensitize healthcare professionals

*Dental care and limited access

*Prescription drug abuse, particularly pain management

*Health Insurance Portability and Accountability Act (HIPAA) and how confidentiality rules can interfere with healthcare

*Prevention services that are targeted to persons with disabling conditions

Following each segment, audience members–approximately 60 advocates, family members, consumers and service providers–were given the opportunity to respond.

In reference to stigma, state Office of Alcohol and Substance Abuse Services Deputy Commissioner William Phillips noted that his agency is seeking to create a “recovery movement” in which persons battling addiction openly express their struggle at such events as the Brooklyn Bridge Walk. He also noted that through interagency efforts, New York was the first state in the nation to ban tobacco at its addiction facilities.

Robert Slawinsky from the state Office of Mental Retardation and Developmental Disabilities pointed to ongoing discussions with Columbia Memorial Hospital to provide training to hospital staff on how best to treat persons with intellectual/developmental disabilities.

Several others present noted the importance of employment in bolstering self-esteem and pointed to the Oasis Deli, which catered the forum, as a model of a “real business” that provides a “path to self worth.”

During the discussion of dental care, Supervisor Hughes noted that the lack of access in Columbia County results in increased medical transportation costs to local taxpayers, while others cited the over-reliance on tooth extractions due to Medicaid reimbursement rates, which in turn plays into the self-esteem problems discussed earlier.

On the hopeful side, mention was made of the collaborative effort by New York University, the Health Care Consortium and Columbia Memorial Hospital to provide on-site dental services in two childcare programs, which may serve as a model for bringing enhancing access to quality dental care to other groups.

Senator Saland remarked that his own familiarity with the issues being raised was based on his legislative work as well as through his son’s work in the field. But he cautioned the audience about the difficult financial times facing New York and his expectation that the state legislature would soon be called back into session to address the $3 billion in spending cuts proposed by the governor. He said that he will work to avoid cuts to local services.

Assemblyman Molinaro praised the CSB and the others in attendance for the work they do and echoed concerns about the state fiscal picture. He stressed that the problem was not created by those in the room but that they should consider identifying areas where savings can be achieved or where efficiencies can be gained by shared services.

Persons with disabling conditions should be “the last group to be impacted by fiscal cuts,” said Dr. O’Leary in closing remarks. Referencing the national healthcare debate, he stressed that “the government option already exists.” Persons without insurance are not denied service in emergency rooms or public clinics, which are supported by state and local taxes, he said. 

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