The chickens have come home to roost. When the Department of Labor issued its Overtime ruling in June 2015 it was widely believed that the viability of Personal Assistance Services nationally was in serious jeopardy. Now, with some 10 months to settle into state Medicaid agencies, we are witnessing a full scale attack on the programs that we’ve fought for and built over the last 40 years.

New York, Texas, California, Illinois and soon Massachusetts PAS programs are on the chopping block for governors and legislatures to "find savings" by capping hours, prior authorizing services and hours, increasing difficulty of program eligibility and other measures that will result in less attendant hours and a more onerous and less responsive state Medicaid program. The carnage has just begun.

The new FLSA rules have required that the Massachusetts Medicaid program pay approximately $1 million more per month for overtime pay. Policymakers argue that this rapid growth in the program is not sustainable. They have a point! The question is what is our response as a community? There certainly is a strong civil rights position thanks to Olmstead. There is also a cost argument when comparing institutional living versus community living.

Bureaucrats and legislators are generally penny wise and pound foolish and just glaze over when you talk about the incredible amount of money that's saved when somebody leaves a nursing facility and uses PAS in the community. When a state is hemorrhaging Medicaid money now, they don't think long-term.

By default, if nothing else, the answer is that it's our civil right to live outside of an institution and it's the states responsibility to pay for the services we use. The rub is, what's reasonable. What do we demand as a reasonable level of service that meets our needs to live a quality life? Whatever the outcome, we need to move quickly to mitigate against the changes that have already been made and stem the flow of future attempts to gut the program.

I've been using state-funded PAS for the past 31 years to live outside of an institution. Prior to the Massachusetts PCA program in 1974, I lived for 7 years in institutions and I'll never go back. I'm going to do anything it takes to fight off unreasonable restrictions that jeopardize my independence and that of over 25,000 other people with disabilities in the state.

Our voices will be heard and we will prevail!