A recent report found New York State can do more to bolster health care for people with complex needs.

The Rockefeller Institute report detailed how to fill the gaps of care for people with intellectual and developmental disabilities, serious mental illness, extensive medical needs and more. The Healthcare Association of New York State reported hospitals are facing serious delays in treating groups with additional needs.

Sally Dreslin, executive director of the Step Two Policy Project and the report's co-author, described why this element of health care has gone long unnoticed.

"We tend to structure the services that are provided in a way that is divided by need," Dreslin explained. "We have an increasing understanding that individuals receive services and need services across various sectors. And, our health care delivery system has not been built that way, and it is a challenge for it to evolve."

To bolster their efforts, New York care providers have been doing their own innovating of care models. For people with serious mental illness or substance-use disorder, the care model addresses health-related social needs such as community support, trauma-informed care and harm-reduction strategies. This model led to an almost 32% decrease in hospital readmissions.

Some challenges to bringing the different models of care to fruition are lack of funding, severe staff shortages, and lack of aligned state and federal laws.

Courtney Burke, senior fellow at the Rockefeller Institute of Government and co-author of the report, said there are ways to bolster these programs across the state.

"We have been seeking to get funding to scale the different innovations going on," Burke pointed out. "As we noted in the paper, we've been working with the McSilver Institute because they're very good at providing technical assistance that enables models to be replicated."

Burke added there are opportunities to enhance training from people who have been running the pilot programs for the new models.


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New York disability-rights advocates are celebrating the 34th anniversary of the passage of the Americans with Disabilities Act.

The 1990 legislation prohibits discrimination against people with physical or mental disabilities. Along with becoming a standard part of employment law, it bolsters accessibility in the public environment.

As seminal as the ADA is, said Dr. Sharon McLennon Wier, executive director of the Center for Independence of the Disabled New York, more work must be done to achieve true accessibility.

"Even though ADA has been around for many, many years," she said, "there is still ignorance regarding what is true accessibility and how new construction at times can still be put up without following the principles of ADA universal access."

Downstate New York's transportation systems lack ADA compliance. Only 31% of New York City's Subway system is accessible to people with disabilities. Funding has been allocated to make the system 95% compliant. The work would have been done by 2055, but since Gov. Kathy Hochul paused congestion pricing, these plans have been put on hold indefinitely.

A New York City Comptroller report finds only 40% of the city's disabled population is employed. Statewide reports show post-pandemic employment for people with disabilities is recovering much slower than the nation.

To change this, said McLennon Wier, classroom instructional materials need to be more accessible, "having more raised line drawings, having more Braille available, having more assistive technology that can read various types of charts and diagrams."

She said she thinks certain industries are siloed, but once they open up to better comprehend universal accessibility, more people with disabilities will join them. One place this can work is in STEM fields, as only 3% of that workforce includes people with disabilities.

July is Disability Pride Month, and today is the 34th anniversary of the signing of the Americans with Disabilities Act.

Federal data show that more than 42 million Americans have a disability affecting their cognition, mobility, hearing, vision or ability to provide self-care or live independently.

"Studies over and over demonstrate that people with disabilities are a very solid
part of our workforce," said Joe Xavier, director of the California Department of Rehabilitation, which helps people with disabilities thrive at work. "They stay in their jobs, they're committed to the work that they do, and so there's much less turnover with people with disabilities, thereby reducing the cost and all the work associated with that."

Advocates have said companies are responsible for providing accommodation in the same way they provide chairs and technology for all their workers. They encourage companies to follow principles of universal design when building new spaces, so access is not an afterthought.

Britanny Comegna, a member of the State Rehabilitation Council, runs a company called Deaf and Disability Mediation Services and said people shouldn't be shy about direct communication with disabled people.

"When you meet a new disabled person," she said, "you have to ask, 'How do you want to identify? What do you need? And what can I learn from you?' Ask those questions because we really do appreciate that you're making that effort to connect with me and understand me as a person."

The Centers for Disease Control and Prevention is working to reduce health disparities among adults with disabilities, who have higher rates of smoking, obesity, heart disease and diabetes.


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Advocates for individuals with disabilities want the state of Nevada to further embrace what is known as the "independent living" model.

Dawn Lyons, executive director of the Nevada Statewide Independent Living Council, said the philosophy is centered around people with disabilities being their own experts on their needs and the services they require. Lyons acknowledged within the state's disability community, there exists what she called "inter-conflict," leading to a lack of a unified voice and sending mixed signals to policymakers.

"Even though we have these other voices interfering, saying different things, what it comes down to is 'We don't need to fight each other,'" Lyons emphasized. "I think the reason why we end up with that inter-conflict is because we've been put down so often and we've been told that we don't matter."

Lyons has been with the council for the last eight years and pointed out progress has been made but more needs to be done. She argued education related to independent living is key to moving the needle and the council supports developing educational materials as well as consulting with a state currently employing an effective independent living approach. Lyons explained one of those states could be Colorado, which she adds even has its own independent living agency.

John Rosenlund, program director for the Nevada Assistive Technology Collaborative, said independent living boils down to empowerment. He said he recognizes the state cannot move forward with implementing a philosophy if there are those who do not agree with it or are comfortable with the status quo.

Rosenlund contends centers for independent living across the state have strayed from independent living values such as peer support, individual and systems advocacy and independent living skills training.

"Things aren't right, they've lost the meaning of what independent living is, perhaps," Rosenlund suggested. "Or they're too focused on certain things so that stability at centers for independent living is, in my mind, instrumental."

Rosenlund added the lack of awareness and adoption of independent living's core values is having real effects across the state, with some missing out on real opportunities to enhance their lives. He reminded people without any change or challenge, there will not be any growth.