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Position Statement on Government as a Direct Service Provider
for Persons with Developmental Disabilities

Issue:  The State of Minnesota used to care for the majority of individuals with disabilities in government-operated state hospitals. Today, most individuals with disabilities are living in the community, and the State of Minnesota allocates and provides the funding for the care but does not provide direct care services.

However, some individuals with disabilities live in the community in state-operated, community-based programs funded by state and federal Medicaid dollars and staffed by state employees. As with the state hospitals, there are inherent conflicts of interest when the same entity pays for and provides the care. The government role in ensuring that the needs of individuals with disabilities are met is in conflict with the government’s interest in containing costs and with the government’s role as the entity which allocates the resources available to provide the care. These conflicts loom larger when the government is also the guardian of the person using the services. It is these conflicting roles affecting the quality of care provided to individuals with disabilities which are of concern to The Arc of Minnesota.

Position: The Arc of Minnesota believes that government should not provide direct services to individuals with disabilities. When government does act as the provider of direct services it must ensure that the conflicts of interest inherent in that role are minimized and that the rights of individual with disabilities are protected. The Arc of Minnesota believes that the best ways to effectively manage these conflicts are:

• Outside monitoring by a non-governmental entity is an essential check and balance to maintain appropriate services and asset allocation, as well as to protect the rights of the individual and evaluate the ongoing quality of services provided.
• Private case managers or service coordinators should be appointed when a person needs assistance to advocate for his preferences and to ensure that his individual needs are being met.
• Public guardianship should be replaced with a system that uses family members, relatives, friends, and private guardians.
• Direct services provided by the government must comply with all laws and regulations that apply to non-governmental entities providing the same or similar services, including limitations on aversive and deprivation procedures and funding rules. The government should not provide services for any individual for twenty-four hours per day. (See Position Statement on the Provision of Twenty- Four Hour Services to Persons with Developmental Disabilities.)

Approved by delegate body at The Arc of Minnesota Annual Meeting on November 12, 2005.

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