Creative Commons
What is the definition of the word “infrastructure”? Apparently, in Washington, D.C., at least, there is a big dispute.
So for guidance, I turned to my wise and venerable friend, Merriam-Webster, who is an expert on all things wordly.
To me, HCBS is vital infrastructure. It is the means by which I accomplish my daily goal of getting out of bed every morning and living my life.
She offers up three infrastructure definitions. They are: 1. the system of public works of a country, state, or region; 2. the resources (such as personnel, buildings, or equipment) required for an activity; 3. the underlying foundation or basic framework (as of a system or organization).
Thus, it seems, infrastructure is a means for accomplishing an end. Suppose, for instance, that you want to cross a river. A bridge is the means that makes achieving that goal possible, or at least a helluva lot easier than swimming or building a raft.
But in Washington these days, what constitutes infrastructure seems to be in the eye of the beholder. One lawmaker’s idea of infrastructure is another lawmaker’s idea of a frivolous socialist scheme to bankrupt the United States.
We have Joe Biden’s $2 trillion American Jobs Plan, his blueprint for investing in U.S. infrastructure. But it goes far beyond putting money into traditional infrastructure stuff like highways and bridges. He proposes investing $400 billion in what the White House American Jobs Plan fact sheet calls the “infrastructure of care.” This would mean a much more serious commitment, financially and otherwise, to home and community-based services (HCBS).
That sounds great to me. I have a physical disability and use a motorized wheelchair. so I need the daily assistance of other humans to do basic things like putting on my pants and getting out of bed. I’ve hired a crew of assistants who come to my home and their wages are paid through my state’s HCBS program, which is primarily funded by Medicaid.
To me, HCBS is vital infrastructure. It is the means by which I accomplish my daily goal of getting out of bed every morning and living my life.
But a whole lot of disabled folks who need this same type of assistance can’t get it because the necessary infrastructure doesn’t exist where they are. In their states, HCBS programs are too puny to accommodate them. So they languish on waiting lists. The White House fact sheet says, “Hundreds of thousands of people who need better care are unable to access it, even though they qualify under Medicaid. In fact, it can take years for these individuals to get the services they badly need.”
Senate Republicans, however, have a different concept of infrastructure that is typically stingy. Their counter proposal to Biden would spend $568 billion on stuff like roads, bridges, and airports, but of course it leaves out HCBS.
That’s because the ability of disabled folks to live rich lives in supportive communities is of no importance to them. So HCBS does not register in their small imaginations as important infrastructure.
For the hundreds of thousands of disabled folks who are waiting for the basic infrastructure for their happiness to be put in place, they offer nothing.