JFActivist

DOJ and Delaware Enter Agreement to Transform State's Mental Health System, Resolve ADA Violations

via the Department of Justice (7.6.11):
Justice Department Obtains Comprehensive Agreement Regarding the State of Delaware's Mental Health System

WASHINGTON - The Justice Department today announced that it has entered into a comprehensive agreement with the state of Delaware that will transform Delaware’s mental health system and resolve violations of the Americans with Disabilities Act (ADA).  The ADA and the Supreme Court’s landmark decision in Olmstead v. L.C. afford individuals with disabilities the right to receive services in the most integrated settings appropriate to their needs, and today’s agreement will ensure individuals in Delaware can exercise that right...

>>>For the Full Press Release

 

Know Your Rights! DOJ Issues New Technical Assistance Document on Enforcement of Olmstead

via The Department of Justice (6.23.11):

Justice Department Issues Technical Assistance Document on Enforcement of the Supreme Court Decision in Olmstead v. L.C.

WASHINGTON – The Department of Justice released a new technical assistance document describing public entities’ obligations and individuals’ rights under the integration mandate of title II of the Americans with Disabilities Act (ADA) and the 1999 landmark Supreme Court decision, Olmstead v. L.C.  The Olmstead decision held that the ADA requires public entities to provide community-based services to persons with disabilities when such services are appropriate; the affected persons do not oppose community-based treatment; and community-based services can be reasonably accommodated.  The document also provides questions and answers on a variety of ADA enforcement issues related to Olmstead. 

Additionally, in commemorating the 12^th anniversary of the Olmstead decision yesterday, the department launched a new section of its ADA website, www.ada.gov/olmstead, providing information and resources about the decision and its enforcement. In addition to the newly created technical assistance document, users can visit the site to find briefs filed by the Department, as well as other materials relevant to this important area of law. 

The ADA website provides easy access to an extensive collection of ADA technical assistance materials and settlement agreements, as well as information about enforcement, mediation, technical assistance and certification activities and links to other sites with ADA information. The addition of the new Olmstead section of the site will provide critical information to individuals with disabilities, advocates and state and local officials responsible for complying with the ADA’s integration mandate...

 

>>>To Read the Full Press Release

 

Knowledge is power! How will you help spread the word about this crucial information? Share your thoughts in the comments below.

Olmstead Champion Meets the President

via the White House blog (6.22.11):

Olmstead Champion Meets the President

by Sue Jamieson

The memories of living in institutional settings since the age of 13 will always be with Lois Curtis even though her life today is beyond what she ever could have imagined when she made the first of many brave phone calls to my office at the Atlanta Legal Aid Society saying, “I want to get out!” The journey (and struggle) from that day includes an historic Supreme Court decision, a home of her own and a successful career as an artist. And now, a meeting with President Barack Obama in the Oval Office as we observe the 12th anniversary of the Olmstead decision.  

The Olmstead story began long before the Supreme Court decision. Lois and another plaintiff, Elaine Wilson (who passed away in 2004), were in a state psychiatric hospital in Georgia. They filed suit in 1995 seeking disability services in the community...

...And, as we all now know, the U.S. Supreme Court eventually held that the unjustified institutional isolation of people with disabilities is a form of unlawful discrimination under the Americans with Disabilities Act, thus taking a giant step forward for the millions of people with disabilities across the country.

Lois’ story did not end after that landmark Supreme Court decision. In fact, that decision launched a new journey. After living in staffed residential homes since her release from the institution, Lois now rents a beautiful home in the Stone Mountain area of Georgia...

>>>To Read the Full Post

 

On this 12th anniversary of Olmstead, how can we honor Lois and Elaine's legacy? Please share your thoughts in comments below.

On the Anniversary of Olmstead, Obama Administration Recommits to Assist Americans with Disabilities

via the White House (6.22.11): 
 

On Anniversary of Olmstead, Obama Administration Recommits to Assist Americans with Disabilities

On June 22, 1999, the Supreme Court ruled in Olmstead v. L.C. that, under the Americans with Disabilities Act (ADA), the unjustified institutional isolation of people with disabilities was a form of unlawful discrimination.  Since taking office, the Obama Administration has taken many steps to uphold both the letter and the spirit of the ADA.

“The landmark Olmstead case affirmed the rights of Americans with disabilities to live independently,” said President Obama. “On this anniversary, let’s recommit ourselves to building on the promise of Olmstead by working to end all forms of discrimination, and uphold the rights of Americans with disabilities and all Americans.” 

Since the Olmstead ruling, much progress has been made. Many individuals have successfully transitioned to community settings, but waiting lists for community services have grown considerably and many individuals who would like to receive community services are not able to obtain them...

>>>For the Full Press Release

 

ADAPT Issues Call for Real Medicaid Reform, DC Rally to be Held Sept. 21st

via ADAPT (6.21.11):
 

ADAPT Calls on Washington and the States to Endorse Real Medicaid Reform that Protects the Civil Rights of Seniors and People with Disabilities

June 22nd is the anniversary of the landmark Supreme Court decision in Olmstead, which applied the integration mandate of the Americans with Disabilities Act (ADA) to long term services and supports.  In that decision, the Supreme Court affirmed that people with disabilities have a civil right to live in the community in the most integrated setting.  Twelve years later, members of Congress and state governments are trying to de-fund that right by cutting Medicaid and giving states “flexibility” to cut programs that assist people with disabilities and seniors to live in their own homes and communities. 

In response to these harmful federal proposals, ADAPT is launching a campaign for real Medicaid reform that protects people’s liberty in every state of the country.  Over the next few months, ADAPT and other disability organizations are mobilizing their members to visit their Congressional and state representatives and organize events in Washington DC and every state.  “We need to remind these federal and state policy makers that de-funding Medicaid de-funds our freedom and that is not acceptable,” said Rahnee Patrick, ADAPT Organizer from Chicago. 

While Congressional Democrats have vowed to protect seniors and nursing facilities, their current proposals also cut vital home and community-based services that allow seniors and people with disabilities to stay in their own homes.  “Congress and state governments need to recognize that the freedom of Americans with disabilities and seniors is a civil rights ‘entitlement’ that they shouldn’t eliminate or diminish,” said Bruce Darling, ADAPT Organizer from Rochester, NY.

The campaign will be highlighted with a rally in Washington DC on Capitol Hill, Wednesday September 21st.  ADAPT and the other campaign organizers are urging disability, senior and civil rights organizations in every state to hold their own events this summer and immediately begin working to bring people with disabilities and older Americans to our nation’s capital in September.  For more information on the rally, go to ADAPT’s website at www.adapt.org.

ADAPT continues to meet with Congressional representatives and identify ways to contain Medicaid spending that implement people’s right to live in the community and save taxpayer dollars at the same time.  These proposals include:

Expand the use of community-based services.  Studies have demonstrated that by reducing the over-reliance on institutions and nursing facilities and shifting toward more cost-effective community-based services, states can contain Medicaid spending.  Despite the growing body of evidence showing that community-based services are more cost effective, the federal government still allows states to continue their wasteful, institutionally-biased practices...

>>>For the Full Press Release

 

Mobilize for Medicaid! Please use comments below to share how you are organizing in your area, strategy ideas, thoughts on effective organizing tactics, etc! 

Medicaid Bed Taxes and Institutional Bias: Where Does Your State Stand?

via SteveGoldADA.blogspot.com (5.23.11):

Medicaid Bed Taxes and Institutional Bias.

Information Bulletin #333

by Steve Gold

In FY 2010, nearly $13.5 billion dollars were generated in 37 States as Medicaid “Provider Taxes,” a/k/a, Bed Taxes, Fees, and/or Assessments. At a minimum, these bed taxes generated another $13.5 billion federal match and more that States received.

What are Medicaid Bed Taxes and why should advocates for older and disabled Americans care?

37 States levy Medicaid provider/bed taxes against nursing homes (they can also be levied on hospitals or ICF beds). The $13.5 billion broken at the end of this Bulletin does not distinguish among NH, ICF or hospitals.

Often, bed taxes are based on, for example, the total number of nursing home beds in a nursing home. That is, a State requires each nursing home to pay the State a specific amount of money for each nursing home bed per day. We heard recently that one State taxed nursing homes $10 per nursing home bed per day whether or not the bed was even occupied.

The State then uses revenues generated from these “bed taxes” to bring down federal Medicaid funds, i.e., the federal match.

Here’s what happens over time. After a few years of these bed taxes, the federal reimbursement generated from nursing home bed taxes are then used to draw down more federal funds. (A type of Ponzi scheme?)

>>>For the Full Article and To See a List of 2010 Bed Taxes

What implications do you feel bed taxes have for the future of Medicaid?

Please share your thoughts in comments below...

ADAPT Storms DC, Demanding Protections for Medicaid Recipients

ADAPT Storms DC, Demanding Protections for Medicaid Recipients
by Diane Coleman, Center for Disability Rights, Inc.
 
From ADAPT (5.6.11):
 
Disability rights activists from ADAPT are back home today after a successful week in Washington, D.C. The focus of the protests was to oppose the Ryan Plan
and threats to block grant and cut Medicaid, due to the impact this would have on seniors and people with disabilities who rely on Medicaid home and community based services to maintain their freedom to live in the community. 
 
As the news coverage below reflects:

• On Monday this week, the activists occupied the Cannon Building rotunda, where a number of Congressional members spoke to them in support, and where 91 were later arrested for refusing to leave. 
• On Tuesday, protesters occupied Congressman Ryan’s office and the corridor outside, where 10 in his office were eventually arrested. 
• On Wednesday, a delegation from the group met with the “Gang of Six” who are working on the budget, and also with White House officials regarding the Community First Choice Option (which ADAPTsucceeded in pushing as part of health care reform). The group concluded by joining in the Families USA event at the Capitol Visitors Center spotlighting public opposition to the Ryan Plan.

National coverage (there’s more, but this is a sample):
http://www.politico.com/news/stories/0511/54157.html
http://firstread.msnbc.msn.com/_news/2011/05/03/6578328-disability-rights-group-steps-up-ryan-protests
http://thehill.com/homenews/house/158955-disability-rights-group-protests-at-ryans-office-over-medicaid-funding

YNN coverage of protest and arrest:
http://rochester.ynn.com/content/542162/disability-rights-protesters-arrested-in-dc/
 
We cannot afford to be silent.
 

 

What do Medicaid Block Grants Mean for PWDs?

From the National Council on Aging (4.25.11):

Webinar on Implication of Medicaid Block Grants

Please share information about this webinar with your state advocates who work on Medicaid issues for seniors and people with disabilities. Space is limited. Please target your grass-top state advocates.      

The Friday Morning Collaborative is a coalition of national aging and disability organizations working together to protect and strengthen Medicaid Home and Community Based Services.  With support from The SCAN Foundation, the coalition is hosting a series of webinars to provide information and resources to state advocates.  We invite you to join the following webinar:

Implications of Medicaid Block Grants and Spending Caps for Seniors and People with Disabilities

Friday, May 6, 2:00 – 3:30PM ET

John Holahan (Urban Institute)

Edwin Park (Center on Budget and Policy Priorities)

Patricia Nemore (Center for Medicare Advocacy)

Space is limited, so please register early and share lines when possible.  The webinar will also be recorded and made available for viewing following the event.  To register, please go to the following link: https://cc.readytalk.com/r/nu2i9fgqahf7

Action Alert: Tell Your Senators to Oppose Medicaid Block Grants

From the Center for Disability Rights (4.27.11):

Action Alert: Oppose Medicaid Block Grants
Urge Senate Finance Committee and Your Senators to Fight Medicaid Cuts
 
The recent budget proposal passed by the U.S. House of Representatives would seriously undermine Medicaid, cutting the program by a total of $772 billion from the current funding level.  That’s a 35 percent reduction.  In addition, the proposal would cap the reduced amount of funding as a block grant.  If enacted, the States would have to implement additional cuts or provide additional state funding to make up for the lost federal funds.  States are faced with significant budget shortfalls now, so it’s clear that this approach would mean that states would eliminate Medicaid services, cap enrollment, and impose high premiums and co-payments for Medicaid beneficiaries.

The battle over cuts to Medicaid is likely to involve a series of critical decisions and votes.  Medicaid pays for vital health care as well as services and supports for people with disabilities.  It’s important that we let Congress know that we oppose block granting and cutting Medicaid.  Please “Take Action” here

Write your senators and let them know:

I am writing to urge you to oppose Medicaid block grants and Medicaid cuts that would restrict access to long term services and supports.  The budget proposal from the U.S. House of Representatives would seriously undermine the Medicaid program which provides critical health coverage to 8 million Americans with disabilities including seniors who rely upon Medicaid for long term services and support, prescription drug coverage, and durable medical equipment.

Congressman Ryan’s proposal would reduce Medicaid funding for the next ten years by a total of $772 billion from the current spending level and cap the program while giving tax breaks to the rich.  States are already facing financial shortfalls which are resulting in cuts to services and eligibility.  If enacted, this situation would only become worse.  States would eliminate services, cap enrollment, and impose high premiums and co-payments on low income beneficiaries, including those on SSI who live well below the federal poverty line.

Medicaid provides vital services for millions of older Americans and Americans with disabilities.

- Medicaid pays for wheelchairs and prosthetic devices for people with disabilities such as spinal cord injury, cerebral palsy and other disabilities.

-Medicaid pays for prescription drugs for persons with mental illnesses and epilepsy and other medical conditions.

- Medicaid pays for programs to enable people with intellectual disabilities to live and work in the community rather than be forced into institutions.

- Medicaid’s Early and Periodic Screening Diagnosis & Treatment program helps identify disabilities early for children with disabilities and gets them the care they need.

- Medicaid pays for community based long term services and supports which allow seniors and people with disabilities to live independently in the community.

Block granting is described as giving states “flexibility”, but what it really means is that states will have no accountability for their Medicaid programs.  Medicaid pays for such vital services and provides the supports that allow Americans with disabilities to live in the community.  Too many states have already demonstrated that they will bow to local pressure from institutional facilities, and ignore the Supreme Court affirmed civil rights of Americans to choose to receive long term services in their homes and community.  Additional flexibility is NOT the answer.

I urge you to work to sustain Medicaid as the critical safety net for millions of seniors and people with disabilities and DEFEND – NOT DEFUND – OUR FREEDOM!

Health Reform's Community First Choice Option Progresses Toward October Implementation

From AAPD (4.28.11):

Medicaid Community First Choice Option: Rules Pending

By David Heymsfeld, Policy Advisor, AAPD

On Tuesday April 26, 2011 AAPD joined with many other disability organizations in the Consortium for Citizens with Disabilities (CCD) to file comments to the Centers for Medicaid & Medicare Services (CMS) on the proposed rule to implement the new Medicaid Program, the Community First Choice Option (CFCO).  As you may recall, this new Medicaid state plan option was established by the Affordable Care Act of 2010 – also known as health care reform -- with the strong support of people with disabilities.

About CFCO

The new Medicaid option provides  incentive payments for states to establish programs to allow people with disabilities to receive services in a setting most integrated with the community, including giving people with disabilities the ability to manage their own assistance, if they wish to do so. CFCO will give people with disabilities a full range of options for receiving home and community based services as an alternative to institutional care. The CFCO program begins October 1, 2011. States with an approved program will receive an additional 6% in federal funding for services provided under the approved program. The services which a program must fund include assistance with Activities of Daily Living, with Instrumental Activities of Daily Living, and with health related tasks.  There must also be back-up systems (such as beepers) and mechanisms to ensure continuity of service, and voluntary training on how to select, manage and dismiss attendant care workers.

In developing their CFCO plans, states must collaborate with a Development and Implementation Council that “includes a majority of members with disabilities, elderly individuals, and their representatives.”  The plan must include a quality assurance system to allow appeals from denials of proposed individual plans, and to receive feedback, and maximize consumer independence and control.

Disability Comments on the Proposed Rules

The disability groups’ comments commended CMS for underscoring throughout the proposed regulations the principles of consumer control articulated in the Community First Choice Options law. That is, for person-centered planning processes, choice in hiring, directing and firing workers, options for self-directed service budgets, and a robust implementation council as the central decision-maker in a long term services and supports system.

However, among several suggestions for modifying the language in the proposed rules, CCD was concerned that the statute and regulation may have been interpreted to extend program eligibility to lower income individuals who do not have an institutional level of care need, and that this does not reflect Congressional intent. CCD recommended that CMS final rule for the state’s CFC option must first address all individuals who have an institutional level of care need before a state opts to serve lower income persons who do not have an institutional level of care need.  CCD also recommended that states may establish medical eligibility criteria that would limit eligibility for the program to individuals who have an institutional level of care need, regardless of their income.

Note that the proposed rule and the comments to CMS are the first stage in implementation of CFCO.  A final rule from CMS should come out over the summer and before the October start date for this new Medicaid program that could go a long way to reduce trapping people with disabilities in institutional settings.  

Advocacy Steps:

1. Find out whether your state is planning to apply for these extra funds for CFCO.
2. See if your state has appointed a Community First Choice Options Development and Implementation Council by contacting your state’s Medicaid program or Governor’s Council on Disability or similar state entity.  If not, urge your state to do so. Councils are a prerequisite of the program.
3. Consider recommending yourself as a participant on this Council.
4. Ensure your state develops a CFCO plan with all the necessary elements and receives the funds intended.
5. Monitor your state’s progress with its CFCO plan.

 For a copy of the CCD comments in full, please write to policy@aapd.com and put “Community First Choice Option” or “CFCO” in the subject line.