Concerns About Discrimination in Covert Medicaid ABI Waiver Program Meetings.
" I didn't know I had a Team Meeting or people are meeting to discuss my life. "
Discrimination in Covert Medicaid ABI Waiver Program Meetings
In recent years, concerns have emerged regarding the Connecticut Department of Social Services' (CT DSS) practices in affiliation with Cognitive Behaviorists (CBT) providers and Care Management providers. At the heart of the controversy is the organization of covert Medicaid Acquired Brain Injury (ABI) Waiver Program meetings, where decisions and discussions about disabled individuals occur without their knowledge, approval, or participation. This may also be impacting the Families and Conservators.
Nature of the Issue:
Exclusion from Decision Making: Central to the principles of self-determination and autonomy is the idea that individuals should be at the forefront of decisions affecting their lives, especially when it pertains to their health and well-being. By excluding individuals from these meetings, the CDSS and its affiliates essentially strip them of their rights to be active participants in decisions about their own care.
Violation of Ethical Principles:
Ethical care in both cognitive behavior therapy and care management is grounded in respect for the dignity, autonomy, and rights of individuals. Covert meetings undermine these principles, placing disabled individuals in passive roles, thus treating them as subjects rather than partners in their own care.
Potential for Bias: Decisions made without the direct input of those affected can lead to assumptions and biases influencing care. Without direct feedback, there's a risk of perpetuating stereotypes, misunderstanding individual needs, or prioritizing organizational needs over the needs of the individuals.
Lack of Transparency:
The covert nature of these meetings raises questions about transparency. Without transparency, there's a potential for conflicts of interest, biased decision-making, and a lack of accountability in the process.
Implications and Consequences:
Erosion of Trust: Trust is a fundamental aspect of the patient-provider relationship. When individuals learn that decisions are made without their knowledge or input, this trust is eroded, which can impact the effectiveness of care and the willingness to engage in recommended treatments.
Risk of Inadequate Care:
By not involving the individuals directly, the CDSS and its affiliates may overlook critical information about their preferences, needs, and values, potentially leading to less effective or inappropriate care.
Legal Repercussions: Discrimination against disabled individuals and the infringement of their rights can result in legal consequences, including lawsuits and sanctions against the offending parties.
Inclusive Practices: The CT DSS, in conjunction with CBT providers and Care Management providers, should ensure that practices are inclusive. This means actively involving individuals in discussions and decisions that affect their care and well-being.
Training and Sensitization:
All stakeholders should undergo training to ensure they understand the importance of inclusivity, respect for individual rights, and the potential consequences of discriminatory practices.
Transparency and Accountability: Open communication and a commitment to transparency are critical. Policies should be in place to ensure that all meetings and decisions are documented, with appropriate checks and balances.
The organization of covert Medicaid ABI Waiver Program meetings without the awareness, approval, and participation of disabled individuals represents a clear form of discrimination. For a just, ethical, and effective system, it's imperative to center the rights and needs of those the system aims to serve.
ABI Resources Connecticut