In 1955, Milton Friedman introduced the concept of vouchers as a method for introducing competition into public education and sparked the longest running education debate in American history. Proponents say that vouchers will make education more efficient and more fair. Opponents says that school vouchers will destroy public education and increase inequality.
When I was defending my dissertation on the politics of school vouchers back in 2000, five normally dignified professors got into a raging debate about the evils of school vouchers around our conference table. My research focused solely on the politics and not outcomes, so I was a little surprised at their strength of their opinions, but I shouldn’t have been. School vouchers will lead to a Yellowstone-style bar fight faster than any other nerd topic.
Reality may have made the debate irrelevant. As I’ve seen first hand, government is gradually giving up directly providing services in the disability arena, and in a more subtle way in education. States aren’t passing any law with the word “voucher” screaming in newspaper headlines, yet they are slowly decentralizing responsibilities to families and third-party vendors, especially in the disability world. Government workers process our paperwork, but won’t actually administer programs or actually have any contact with the people who need help.
Read more at my newsletter, Apt. 11D
Apt. 11d 
I think the reason parents are given “monopoly money” is to prevent fraud.
Here is Ohio for example, if a disabled adult with a Medicaid Waiver chooses to go to a particular day program (and there are a range of them that cater to differing levels of ability) say on Tuesdays and Thursdays, the funding moves as follows:
The person’s case worker from the county board of developmental disabilities arranges for the funding to go from the governmental agency that handles the funds (which is NOT the developmental disabilities board, it’s another agency altogether) to the organization providing the day program.
The county board recently gave my 25 yo autistic son an Uber account. The money goes from the other agency to Uber; neither the county board or Son/his family get even a whiff of the money.
If anybody absconds with the Medicaid Waiver money, it won’t be Son, his caseworker, or his parents!
P
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I don’t want to have to figure out a schedule for Monday here and Tuesday there. I want him to have permanent school — something that keeps him busy all day, every day.
I don’t really care who actually touches the money. I just don’t want to have to do all this shit full time. I can’t think of anything more awful. This is a massive pain in the ass. I want to work full time, not deal with this crap.
And Ian will not go into a building where he sees anybody with physical, behavioral, or cognitive disabilities, so that really limits our options. He’s got OCD, language comprehension deficits, and social-emotional delays, which will keep him out of the workforce until he learns to manage his issues, but he’s smart. He only wants to be around people like himself.
I’m not optimistic about him actually getting any help, after I have spent a million years filling out forms. I’m going to show up to the state legislature with a bull horn, if that happens.
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I felt that way about school, that I wanted a place where my kids could get what they needed, some of what they wanted and I didn’t want to invest significant time or cognitive energy in figuring out what was best. So a discussions of vouchers and choice always made me very tired. I feel similarly about health care and very much appreciated the one stop shop I got with my two pregnancies.
That solution probably won’t work for all children. Some have needs unique enough that they can’t be met in systems that are “good enough” for most. It’s easy to imagine as a parent that every child would benefit from optimization, and maybe that might be true, for something specific, like how much math they’ll learn by the end of middle school, but there’s so much to learn in not having everything optimized, for the typically developing child (which is a broad distribution).
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Yeah, I hear you Laura. Depending on my mood and my audience, I sometimes answer the question, “What do you do?” or “What have you been up to lately?” with “I’m Son’s case worker” or “I’m running a day program for one.”
I think to myself, I’ve had this job(mother to an autistic) for 25 years now, can I please get a transfer to a different department already?
I have always expected Son’s twenties to be a slog for me. I watched other mothers with slightly older kids try out one set of programs and placements after another, until a suitable niche is found. It can take years but most families I’ve seen and know seem to find their place by the adult child’s thirties.
And it doesn’t matter what level of functioning/support needs the adult child is, it’s a lot of experimenting.
Someone might think that people with higher needs are easy to find a slot for but I know one family with an extremely autistic kid who got kicked out of the county’s day program (back when the county had a day program). And that was the day program of last resort. That fellow turned out to have a nice enough life; he lives in a condo (bought with money left by his grandfather) and has aides with him. I’ve seen them in my supermarket, cruising the aisles like the rest of us shoppers.
My Son is racking up the failed experiments. He also doesn’t want to be with more disabled peers and I don’t really blame him for that.
In one experiment, he tried a trip group that went different places in the community, and there were interesting guys in the group. One with a job as a guard in an art museum, another with a girlfriend. But they were all different ages and not interested in the same things he is, and really, would I want to make small talk with strangers for five hours straight? And I’m NT, I don’t have social-communication issues.
It is true that many of our local options are one-size should fit all and that size doesn’t fit autism well. I have half a dozen stories but this is only a comment. Also, we lost a lot of momentum during Covid when programs snd agencies shut down.
It’s the end of December, the world is shutting down. I’m putting up my feet until January.
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Anonymous was me, Ohio Mom.
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The second anonymous was me, not the first.
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Oh, the first anonymous was me. Glitch when I pressed the return button
bj
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I do think concerns about fraud play a big role in the way that our government support systems are designed. In the US, I’ve thought this was generally overkill, that we spend 30% of the money to save 2% of it. But, I think there are specific forms of fraud, usually executed by people who have custody of the money and can divert it.
The Uber solution seems like it might be a good one, because it uses the safeguards that are already in place (like, whatever keeps Uber from stealing money from my account). It also limits solutions, though, replacing, for example, a consistent caregiver who might also drive a person who needs it. Solutions like those are thought to be working to mitigate diversion and fraud in countries where corruption is more endemic (things like monitoring school buildings to see that the teachers who are being paid are there, electronic tickets so that bus drivers don’t take bribes instead of fares, . . . ).
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I have no problem with parents and agencies having an intermediary handle the money. That’s not actually why this is a voucher program. A voucher is a monetary payment to a third party, so government doesn’t actually provide that service. Right now, government directly runs schools. If there was a voucher system, people could spend that Monopoly money at any school they liked. Right now, government does not directly provide services for disabled people. Everything is done through third parties. One major downside is that parents have to do a lot of legwork.
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Yes, I know. It’s what I don’t like about voucher programs for schools, too, that the government doesn’t provide the service, but gives money to children/parents to find the services they need. I didn’t want to look for services or have to create them.
I think there are conflicted forces at play about vouchers and the independent services model. I think some of these forces will play out differently in different states. Missouri, for example, rejects federal funds in order to continue their sheltered workshop model v Washington state which is shutting down, completely, the sheltered workshop model by not issuing waivers. California is firmly in the independent services model (sorry for not using technically correct legal terms). Washington is somewhere in the midst of transitioning.
I try in my comments to stay at the policy/general level, because I think it’s ridiculous for me to think that I know more than you what your kiddos need and I think that’s truly dangerous ground that should be breached only when abuse might be occurring. I’d think it if you tried to tell me what my kids need, but people don’t do that nearly as often.
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Eh, there’s plenty of Medicaid fraud, it’s just at the levels of Rick Scott, Pharmacy Benefits Managers and the like. The grift is not for the little people.
The biggest plus for the Uber program (aka “Self-directed transportation”) is it allows my Son independence. He gets to do something on his own.
His dad and I aren’t going to live forever, his day-to-day caretakers are going to be as set as a revolving door so the more he can feel he’s in charge, the better. Because one day he will be in charge, his challenges and all (gulp).
Laura has one asset my family doesn’t, lots of nearby cousins in her son’s generation. They are busy being young right now but I bet a few of them could be convinced to step up and be supports for Ian in the future.
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I will add that our county board did run a couple of day programs for the more severely disabled adults (one on each side of town) but then the state decided it was a conflict of interest for the county board to run them, so they were turned over to private agencies.
I have no idea what that was about or anything about the private agencies.
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And Ian will not go into a building where he sees anybody with physical, behavioral, or cognitive disabilities, so that really limits our options.
Yeah, good luck finding and holding down a job with that. You are basically describing most of middle management at any Fortune 500 company.
Seriously, though, the new wfh revolution could be good for him. Check out your project, write your impeccable code, check in your part of the project, go to the occasional zoom meeting, and direct deposit your pay, all from the comfort of your own couch. No dealing with people who annoy you at all.
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Yeah, Ian could definitely do a computer job remotely and not have to deal with people who annoy him, but becoming a shut-in is not his Plan A for life.
Every autistic person has their own quirks. Ian’s quirk is that he does not suffer fools gladly. He tells people that they’re stupid and yells at his classmates for doing their autistic-y stuff. We had to quadruple his anti-anxiety meds, so he would tolerate his classmates. It’s not ideal. He falls asleep in public now. Sigh.
We’re working on having him become more tolerant this year, so he can finish college in an actual school and not on the computer.
(Side note: we’re all doing a Princeton Causer Java programming class together. Ian needed a little help, because the professor had too much banter and not enough “do this, do that.” He just needs two second of me telling him what’s important and what’s not. And I’m learning Java, too. Kinda fun!)
I will probably delete this comment in 30 minutes.
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So I read it just in time???
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bj, Yes there are wide and wild differences among the states as far as disability services go.
As you probably already know but other readers here may not, services are funded by Medicaid Waivers, which in turn are funded partly by the feds and partly by the state. It appears that one of the strings attached to the federal funding is the requirement that money go through third parties.
I’ve heard of families moving to states that they think will provide better services for their kids. That’s a big commitment. One imagines Missouri is on no one’s short list.
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That was Ohio Mom again, talking about the differences among states. I may get the hang of the word press commenting system yet.
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