

His voice is soft, but he makes sure itโs heard.

By Tony Leys
Rural Editor/Correspondent
KFF Health News
Garret Frey refuses to be sidelined.
Frey has been paralyzed from the neck down for more than 37 of his 42 years. He has spent decades rejecting the governmentโs excuses when he and others with disabilities are denied the support they need to live in their own homes and to participate in society.
The Iowan wonย a landmark caseย before the U.S. Supreme Court in 1999, after his school district refused to pay for the care he needed to continue attending high school classes in Cedar Rapids. He recently scored another victory when a complaint he lodged with federal officials pressured Iowa to agree to increase Medicaid payments for caregivers to stay overnight with Frey so he wonโt need to move into a nursing home.
โThese are civil rights issues,โ he said. โThey are human rights issues.โ
Frey makes his points a handful of words at a time. The cadence of his speech follows the rhythm of a mechanical ventilator, which pushes air into his lungs every few seconds through a tube in his throat.
His voice is soft, but he makes sure itโs heard.
Frey was paralyzed in an accident at age 4. He uses sip-and-puff controls to drive his wheelchair into courtrooms and through the halls of the Iowa Statehouse and the U.S. Capitol, where he demands policies that allow people with disabilities to live full lives.
โWeโll get there. It takes time, but Iโm not going to just let things go or let things slide,โ he said in an interview on the sunny patio of his Cedar Rapids home.

Frey emphasizes that anyone could find themselves needing assistance if they suffer an accident or illness that hampers their ability to care for themselves. He encourages other people with disabilities to cite his victories when seeking services theyโre entitled to under federal law.
He has served on numerous local, state, and national boards and committees focused on protecting disability rights. He composes emails and updates his website using voice commands and a sticker on his chin that can interact with his computerโs camera.
His activism has drawn admirers nationwide.
โPeople like Garret are critically important, because they are the trailblazers,โ said Melanie Fontes Rainer, director of the Office for Civil Rights at the U.S. Department of Health and Human Services.
In June, Fontes Rainerโs office announced an agreement with the state of Iowa to settle Freyโs complaint that Medicaid pay rates were insufficient for him to hire and retain overnight caregivers at his home.
Frey said he filed his federal complaint after being rebuffed by state officials. The resulting agreement increased his workersโ pay from about $15.50 to $22 an hour, the federal agency said. It also made other changes designed to allow Frey to continue living in the home he shares with his mother and brother.
Fontes Rainer said state officials cooperated with her office in settling Freyโs complaint. She said she hopes other people will take notice of the result and report problems they have in obtaining services that help them remain in their communities.
The federal administrator said she gets emotional when she sees how hard Frey and others fight for their rights. โYou shouldnโt have to advocate for health care,โ she said. โWhen I think about all that heโs been through, and that he continues to use his voice, I think it is so powerful.โ
The Iowa Department of Health and Human Services declined to comment on Freyโs case. But spokesperson Alex Murphy said the department is โcommitted to ensuring access to high-quality behavioral health, disability, and aging services for all Iowans in their communities.โ
This summer, Frey and his mother visited Washington, D.C., where they participated in a 25th anniversary celebration of the Supreme Court decisionย Olmstead v. L.C.ย In that landmark case, the justices declared that people with disabilities have a right to live in their own communities, instead of in an institution, if their needs can be reasonably accommodated.
Frey was reminded during the ceremony that others are still buoyed by his own Supreme Court case,ย Cedar Rapids Community School District v. Garret F.
The 1999 case focused on the Frey familyโs contention that the school district should pay for help Garret needed to safely use his ventilator so he could continue to attend classes. School district leaders said they shouldnโt have to pay for such assistance because it was health care.
The court, in a 7-2 decision, described Frey as โa friendly, creative, and intelligent young manโ who had a right to services enabling him to attend school with his peers.
At the recent Washington ceremony, a California teenager approached Frey. โHe said, โYouโre Garret F? Thank you. Without you, Iโd never have been able to go to school,โโ recalled Freyโs mother, Charlene Frey.
The 13-year-old fan wasย James McLelland, who breathes through a tube in his throat because of a genetic issue that impedes his windpipe. His breathing apparatus needs constant monitoring and frequent cleaning by a nurse.
His mother, Jenny McLelland, said she shows printed copies of the Garret F. court decision to school officials when she requests that James be provided with a nurse so he can attend regular classes instead of being sent to a separate school.
Because of the Supreme Court precedent, โwe didnโt have to litigate, we just had to educate,โ she said in an interview.

James, who is entering eighth grade this school year, is thriving in classes and loves playing percussion in band, his mother said. โJames has had the life that people like Garret had to fight to get,โ she said. โThese are the kinds of rights that are built brick by brick.โ
Frey said he found inspiration from earlier advocates, includingย Katie Beckett, a fellow Cedar Rapids resident who, four decades ago, drew national attention to the plight of children with disabilities who were forced to live away from their families. Beckett, who was partly paralyzed by encephalitis as an infant, was kept in a hospital for about three years. At the time, federal rules prevented payment for Beckett to receive care in her home, even though it would have been much less expensive than hospital care.
In 1981, President Ronald Reagan denounced the situation as absurd and told administrators to find a way to let the young Iowan go home. The Republican presidentโs stance led to the creation of what are still known asย Katie Beckett waivers,ย which make it easier for families to get Medicaid coverage for in-home care for children with disabilities.
Frey knew Beckett and her mother,ย Julie Beckett, and admired how their outspokenness prompted reforms. He also drew inspiration from meeting Tom Harkin, the longtime U.S. senator from Iowa who was the lead author of the 1990ย Americans with Disabilities Act.
Harkin, a Democrat, is retired from the Senate but keeps tabs on disability issues. In an interview, he said he was glad to hear that Frey continues to push for the right to participate in society.
Harkin said he is disappointed when he sees government officials and business leaders fail to follow requirements under the Americans with Disabilities Act. To maintain the lawโs power, people should speak up when theyโre denied services or accommodations, he said. โItโs important to have warriors like Garret and his mother and their supporters.โ
Iowaโs agreement to increase Medicaid pay for Freyโs caregivers has helped him hire more overnight workers, but he still goes some nights without one. When no outside help is available, his mother handles his care. Although she can be paid, she no longer wants to play that role. โShe should be able to just be my mom,โ he said.
At a recent board meeting of The Arc of Iowa, a disability rights group, Frey told his friends heโs thinking about applying for a civil rights job with the federal government or running for public office.
โIโm ready to rumble,โ he said.
Originally published by KFF Health News, 08.23.2024, under the terms of a Creative Commons Attribution-NonCommercial-NonDerivatives 4.0 International license.


