Self-Directed Personal Assistant Services

  Karen Vaughn went into the hospital with pneumonia in 2016. She did not return to her apartment in Indianapolis until 2019.     
She became a quad when she was shot in 1976. Prior to her hospitalization she lived in various apartments with the aid of assistants paid for by Medicaid and state programs.

When she was ready for discharge, the state informed her she would have to be in a nursing home since no home health agency would take her on. She filed suit because she didn’t want to accept being in a nursing home. “Why should I? I had a beautiful apartment, was active in the community.”

Nursing home care isn’t necessarily better care. At home she didn’t get skin breakdowns because she slept on a waterbed. At home she slept using a ventilator that sometimes needed suctioning. At the nursing home there is only one respiratory therapist, and you can wait a long time for them to get to you. Ms. Vaughn felt she could hire and train her own people for suctioning. But the state wouldn’t respond to her request. They stated they couldn’t find an agency willing to take her on as a client. 

Perhaps it’s time to lobby that Self Directed Services can be cost savings. States would need to approve training for ventilator suctioning to be done by CNA’s instead of RN’s. States pay as much as $65 an hour for RN’s when most of the time this training can be done by the client and cost much less. 

Ms. Vaughn said she hopes her successful use of litigation to enforce the ADA will inspire others to do the same. “To other people (with disabilities) out there: keep fighting!” she said.