From Truthout.org (Monday 12 January 2009):
President-elect Barack Obama orders lunch at the famous restaurant Ben's Chili Bowl in Washington, DC. (Photo: Reuters)
Yes, We Can Make the Stimulus More Stimulating
By: Dean Baker
President Obama could not find any economists who were able to see the housing bubble for his economic team. Fortunately, he indicated that he would be willing to listen to those of us who did in designing his stimulus package.
In response to his request for ideas on how to make his economic recovery package more effective, I have put together the following list of seven proposals. This is a mix or match list, intended to be added to the list of items already suggested, although given the severity of the downturn, all of them could probably be included without causing concern about excessive deficits.
1) Extend Health Insurance
Offer a $2,000 tax credit for any firm that gives health insurance to employees not currently covered.
2) Publicly Funded Clinical Trials
Start a system of publicly funded clinical trials. The point would be to take the conduct of trials out of the control of the drug industry so that doctors and researchers would have immediate and full access to all research findings.
...
4) Subsidies for Public Transportation
The government can encourage public transit and get money into the pockets of the people who use it (disproportionately low- and moderate-income people), by giving a $1 subsidy for each trip that gets directly passed on in lower fares...
Comment Below with ideas specific to disability.
Or better yet, send ideas to the new administration via http://change.gov/.
Some that I've already received:
From Barbara Kornblau
1. Build accessible housing.. This will put people in the building trades back to work, including small businesses and contractors. It gives people with disabilities and aging baby boomers an alternative to institutional care and promotes the transition intended by the Community Choice Act. Or as we put in our policy statement: Provide tax incentives for building accessible housing and other buildings and include making infrastructure and public building accessible in all economic stimulus packages. (from our policy statements)
2. Pay for ramps, grab bars, bath benches, and handheld showerheads in existing homes. Currently, neither private insurance, Medicare, nor (in most places) Medicaid, pay for grab bars, and other assistive devices that promote independence and prevent falls. Paying for these items will be a boost to small businesses and contractors, while at the same time, promote community living and prevent hip fractures and other injuries.
3. Make all public buildings accessible: Court houses, City halls, schools, hospitals, museums, sporting venues, arenas, stadiums, etc. More jobs for the building trades and consulting for individuals with disabilities.
4. Give employers a tax credit for a percentage of the salary to hire currently unemployed individuals with disabilities. The tax credit would be spread over 3 years of employment to encourage employment longevity. Fund assistive technology, workplace accessibility, etc. to promote hiring.
5. Fund job coaches for employers who create innovative programs that can hire multiple individuals with disabilities in competitive employment
6. Increase the FMAP…not an original idea but one that gives states lots of matching dollars so they can free up money to spend on other things, like fixing the infrastructure
7. Fund research into best practices that promote quality of life and participation for individuals with disabilities. This provides money to universities, keeps the pipeline of disability researchers open, and establishes best practices to support community living for individuals with disabilities
8. Launch a massive sensitivity, disability awareness, and disability rights campaign nationwide. Include police officers, court personnel, health providers at all levels, teachers, etc. This will provide employment opportunities for individuals with disabilities to work in the awareness campaigns and make an attempt at a more inclusive, fair, and just society. In theory, a fair society means better attitudes, more opportunities, and more employed individuals with disabilities.
9. Pay employers for 8 weeks of on-the-job training for new employees with disabilities. Incentives…
10. Require physicians and hospitals to meet quality indicators specifically designed to assure inclusion and good health care for individuals with disabilities. Things like weighing all patients, providing mammograms to all women, including women with disabilities, etc. Things we know based on the evidence, (article in JAMA) are not being done. The government can carry this out by requiring specific interventions for individuals with disabilities under Medicare (similar to how hospitals in the south were integrated overnight under Medicare) or via incentive payments for quality. I would prefer the former.
11. Any health information technology training included in the stimulus package (the current plan includes Health IT) should also include training in the medical needs of individuals with disabilities and/or how to treat people with disabilities, including people with intellectual disabilities. How to transfer patients, how to ask people what their needs are, etc. This is currently in Senator Harkin’s health and wellness bill. This would tie the electronic medical record with the health care needs of individuals with disabilities. HIT should also include specific indicators for everyone with screens that require an explanation if basic care, such as height, weight, and blood pressure is not rendered.
12. Install sidewalks in communities that don’t have them to promote wellness, healthy lifestyles, and access for individuals with disabilities. Make sure they have curb cuts and safety measures such as crosswalks and traffic lights.
13. Require all infrastructure changes made under the economic stimulus package to include a requirement to make that infrastructure accessible.
14. Require a percentage of new jobs created by the economic stimulus package to go to individuals with disabilities or an alternative affirmative action program of some kind, such as the requirements from Sections 501 and 503 of the Rehabilitation Act.
15. Create internships and mentoring programs for young adults with disabilities in the federal government in all agencies. The federal government has other capacity building programs. This is a good addition to those. [Take a page from AAPD's Disability Mentoring Day and Internship programs]
16. Fix the vocational rehabilitation system so it works.
17. Fully fund IDEA so the money schools are currently using to pay the federal government’s share can be used to buy textbooks and supplies so students have text books and teachers don’t have to spend their own money. This will be a boost in spending for the local economy.
18. Ensure the Economic Stimulus Package includes requirements to make school facilities accessible, such as health clinics, gymnasiums, playgrounds, and sports fields, and invite individuals with disabilities and community groups to use them for health, fitness, recreation, and wellness programs. (from our policy statements)
From Duane French
-- $125 million to the US Department of Education, Office of Special Education and Rehabilitative Services, Rehabilitation Services Administration to make funding available to Independent Living Centers funded in Title VII of the Rehabilitation Act to make home modification and assistive technology funding available to people with disabilities and seniors that live below 750% FPL. This would increase jobs for small contractors who do home remodeling and for small business owners who sell assistive technology or medical equipment. The funding formula in place for ILC's could be used to distribute this money quickly.
-- $150 million to the US Department of Education, Office of Special Education and Rehabilitative Services, Rehabilitation Services Administration to make funding available for people with disabilities to purchase American-made vehicles that require accessible modifications including wheelchair lifts or ramps. These funds would be available to any person with a disability that lives below 1000% FPL and requires the vehicle to enter or remain in employment or to attend school or training to help them get a job.
-- $50 million to the US Department of Education, Office of Special Education and Rehabilitative Services, Rehabilitation Services Administration to make funding available to people who are blind or visually impaired to purchase the assistive technology needed to increase their independence. These funds would be made available through state rehabilitation agencies for the blind.
-- $50 million to the US Department of Education, Office of Special Education and Rehabilitative Services, Rehabilitation Services Administration to make funding available to people who are deaf or hearing impaired to purchase the assistive technology needed to increase their independence. These funds would be made available through state commissions/offices for the deaf and hearing impaired.
-- $75 million to the US Department of Transportation to make funding available to local transit authorities to purchase wheelchair accessible van pool vehicles to promote ride-sharing that is accessible to people with disabilities.
-- $75 million to the US Department of Transportation to make funding available to local transit authorities to distribute to taxicab companies to purchase wheelchair accessible vehicles to transport people with disabilities. Each cab company receiving a vehicle would make vouchers available to transit authorities to make available to people with disabilities who need to use taxi services. The voucher amount would equal 50% of the value of the vehicle purchase for cab companies.
Great ideas. Add your own below.
Using Infrastructure Stimulus $ to make dramatic strides for accessibility and preparing the country for aging baby boomers
With the pending draft of another economic stimulus bill in Congress and its substantial focus on infrastructure projects, I am writing to layout some suggestions for public transit: preparing it for the coming tidal wave of aging baby boomers and improving compliance with the Americans with Disabilities Act.
To this day, 18 years after the ADA and 30+ years after the Rehab. Act, no large rail based RTA has achieved 100% accessibility of all of its stations and in fact many of the oldest RTAs are woefully behind in capital expenditures toward meeting Key Station access requirements. Thus, the Federal Transit Administration has had to grant numerous extensions to ADA Key Station deadlines and for riders or potential riders, their civil rights are violated. While many of us in the transportation and disability communities can justify the extensions, given the growth of ridership and the 70+m baby boomers, improving physical access to public transit infrastructure needs far more priority than it has previously been receiving. Key stations are for better or worse, islands of accessibility in large transit systems. For example: less than 40% of the 200+ NYC MTA stations have elevators (it is even worse in Philadelphia, see: http://maps.google.com/maps/ms?hl=en&ie=UTF8&t=h&msa=0&msid=115398286952551626238.00045fc9902cb910f9017&z=9 ) and that needs to change. We as a country would no more tolerate saying that X station can only be utilized by women or whites or the rich yet that is in effect what inaccessible stations continue to say to people with disabilities.
It is in that context, it would be timely and entirely helpful to contemplate the establishment of a line item in the stimulus bill that would exclusively fund the design & construction of ADA accessible platforms and elevators. For such a program to be meaningful nationwide, $2.5-5B would make substantial (or complete) progress towards making all systems accessible. The fund could allow rail based RTAs to draw upon it for this and the next two fiscal years to fund 80% of the design cost and 100% of the construction cost of accessibility features which make currently inaccessible non-Key Stations accessible. This restriction would maintain the RTA’s Key Station responsibility but help RTA’s improve, potentially dramatically, system-wide accessibility.
To further outline the twin goals of fiscal stimulus and improving accessibility, language should reflect: The project would have to begin construction within 18 months and be subject to fast tracked FTA review processes. I would propose that language should be developed to ensure that a minimum of 150 stations nationwide are made compliant with the ADA through this program. To guarantee wider class and geographic impacts, especially for large scale RTAs such as NYC or Philadelphia, language should ensure that the projects an RTA applies for must either be located in predominantly low income environmental justice neighborhoods or make the entire line accessible.
For RTA’s such as the MBTA in Boston, where for less than $75m the remaining 25 Green Line street level stations can be made accessible, language in the bill should specifically require the applying RTA to make one comprehensive application for the project. To ensure speedy approval, additional language could specify that within 30 days of the application the FTA would approve, deny, or approve with modifications the application. Finally, to ensure more meaningful projects, language should ensure that no single station receives more than $25m of construction funds specifically for accessibility. Language should ensure that such a limit does prevent the use other potential FTA formula grants (such as for MCEC or track modernization) toward a particular station / project.
If Congress wants to go beyond subway and light rail accessibility, it would likely be prudent to create a separate program for commuter rail. The program could be utilize similar parameters as the heavy/light rail access program. Based on general knowledge of existing commuter rail stations, one can generally assume $3-10m per station to raise platforms and construct accessible paths of travel. To have a significant impact nationwide, $750M-1.5B is likely advisable. It is conceivable that such a program, especially on the larger scale, would lead to a quantum leap in commuter rail accessibility.
A further $1b to make AMTRAK's remaining inaccessible stations accessible would complete the transit infrastructure.
Finally, there could be a nationwide program to fund the installation of bus stop shelters at major stops such as adjacent to housing complexes, office parks, shopping centers and medical areas.
On the road side:
Tying into the the President's initiative towards a greener more efficient future three areas deserve attention:
1. In conjunction with Safe Routes to Schools program and HHS focus on reducing the obesity epidemic, there needs to be a dramatic increase in pedestrian / bicycle facilities funding for new initiatives. Many communities and states have good plans but are largely underfunded. Any needed engineering is quick and local contractors can do most of the labor adding to the value to local economies.
2. Sidewalks and curb ramp maintenance is abysmal in much of the country. In cities such as Boston, outside engineering firms have identified a need of over $125m worth of work in the coming decade just to keep conditions as is. Thus, dedicating some portion of stimulus roadway $ to the installation of new curb ramps and maintenance of existing curb ramps and sidewalks would seem valuable. Further, any needed engineering is quick and local contractors can do most of the labor adding to the value to local economies.
3. A portion of stimulus funds should support upgrades of all existing traffic signals to LED units with Accessible Ped. Signals (APS) as well as count down walk signals. In countless cities, 20-50 year old signals remain in use drawing 5x more power to function and virtually all lack APS.
Taken together, Congress has, through including IDEAS similar to the above, an amazing opportunity to transform America’s transit and road infrastructure from being semi-accessible to substantially accessible for the coming 70m+ baby boomers and 50m+ people with disabilities. Please don’t miss the opportunity.
Posted by: Christopher Hart | January 14, 2009 at 10:57 AM
I am disabled and find nothing of value in this stimulus. Why? Because my disability is mental, not physical. Until the day when mental illness is recognized to be as serious and physical illness, I and millions like me will always be given the short end of the stick. I worked and paid my share. But every time I see a new ramp put in (and I'm not at all disparaging the rights of the physically challenged) I can't help but wonder where is the money for mental health care? We can fight your wars and you spare no expense in arming us with the most high-tech killing technology available yet when me and my brothers return we are quickly debriefed and left to fend for ourselves. It just makes me sick. We just spent a trillion dollars and yet I'm still going to have to take out a damn bank loan just to pay for a decent psychiatrist and the drugs he prescribes. I feel so cheated. My wife left me because of this mental illness. I lost my ability to work and support myself in society. My manhood is gone. What can I do? I feel like mental illness is still seen as something that we can cure by ourselves if we have the proper willpower. It's like telling jump rope if he just believes he can. They treat the injury but ignore the mental side of it. Last I knew, we were body-mind creatures. But as a society, we respect the body but anybody with a mental illness is a malingerer or a sloth who just doesn't want it bad enough. It sucks. I'll probably end up another one of the army's unpublicized suicides if things don't change. I just don't know what to do sometimes.
Posted by: P Thompson | February 11, 2009 at 10:54 PM