JFActivist

Tuesday, July 26th --- Call-In Day to Save the CLASS Act

via Leading Age (7.22.11):

 

The Community Living Assistance and Supportive Services (CLASS) Act, which many of you worked so hard to help create, is under threat of repeal and we need your help to save it.

On Tuesday, we'll be hosting a Call-In Day to Save CLASS.

We hope you'll participate by sending by calling 888-785-9795 on Tuesday, July 26, and telling your members of Congress 3 main reasons repealing the program would be a mistake:

1.    CLASS Helps Americans - The CLASS program provides families with an affordable way to plan for future supports and services. CLASS will allow more Americans the ability to remain in their homes while getting the care they need.

2.    CLASS Saves Money - The Congressional Budget Office said CLASS will reduce the budget deficit by $83 billion over 10 years. The program also saves federal dollars spent on Medicaid by reducing the number of people relying on the program for long-term services and supports.

3.    Americans Support CLASS - A Kaiser Family Foundation/Harvard poll found that 76% of Americans support the CLASS Act program.

Twitter Campaign for CLASS

If you and your organizations are Twitter users, you can tweet the following messages:
@kaiserfamfound poll found that 76% of Americans favor #CLASSAct http://bit.ly/qw6Q1G CC: @whitehouse

Feel free to author your own tweet, but we ask that you include the #CLASSact hashtag.

The coalition supporting CLASS is strong, but your voice makes it stronger.

Lawmakers Suggest Bipartisan Medicaid Reform - Community Choice

From the Hill (6.30.11):

Modernize Medicaid to better support people with disabilities
By Sen. Tom Harkin (D-Iowa) and Rep. Cathy McMorris Rodgers (R-Wash.)

This month marks the 12th anniversary of the Supreme Court’s landmark decision in Olmstead V. L.C., ruling that the needless institutionalization of people with disabilities is illegal discrimination.  Despite that decision, misguided Medicaid rules continue to force millions of people with disabilities to remain in nursing homes, against their wishes and at a much greater cost to taxpayers than many home and community-based alternatives. 

Today, as we seek ways to reduce budget deficits, we must seize on the opportunity to make our Medicaid dollars go farther while finally giving millions of individuals with disabilities one of the most fundamental of rights: the choice to live independently.

The Olmstead decision is sometimes called the Brown v. Board of Education for people with disabilities. It questioned the widespread practice of forcing people with disabilities to live in segregated settings in order to receive services, and it opened the door for people with disabilities to live full lives and participate in their communities.

Adhering to the ADA’s “integration mandate” not only allows people to live the same kinds of lives that the rest of us do, but actually saves money...

>>> For the Full Article

Take Action:

Call your Senators and Representatives and tell them to support the Community Choice, Medicaid reform that saves money and supports freedom and choice for people with disabilities.

Creative Budget Solutions: Invest in Medicaid Buy-In Programs

From AAPD (7.8.11):

AAPD-Boston University Research Project Reveals Medicaid Buy-In Programs' Strengths

This spring AAPD partnered with the Knowledge Dissemination Project at Boston University in an effort to synthesize and disseminate research on the effectiveness of state Medicaid Buy-In (MBI) programs.  MBI programs allow people with disabilities to “purchase” Medicaid health insurance with a monthly premium.  Research synthesized at Boston University indicates that not only do Medicaid Buy-In programs help people with disabilities transition into employment by giving them access to affordable health options while working, but the programs have measurable impacts on state budgets.   Medicaid Buy-In programs increase income tax revenue, stimulate local economies, reduce demand for social services, and reduce medical expenditures and health costs.

AAPD has launched web resource center to provide information on the Medicaid Buy-In program and the results of the research.   At www.aapd.com/medicaidbuyin activists can learn about the success of the programs in that MBI enrollees earn more money, work more hours, contribute more taxes and rely less on food stamps that those with disabilities who are not enrolled.  Activists can also learn how to take action to advocate for program improvements which include clarifying program logistics, coordinating with SSI work incentive programs and limiting grace periods for enrollees.

Take Action

AAPD believes that information from the success and challenges of MBI programs should inform policy considerations about how best to facilitate increased earnings and employment for people with disabilities. AAPD will be circulating more information on this topic through the Justice For All blog at www.jfactivist.com in the months to come.

Spread the Word

Download the below resources to share with family members, clients, policy makers and service providers.

>>> For a Fact Sheet Medicaid Buy-In (Word)

>>> For the Medicaid Buy-In Research Summary (Word)

>>> For a Medicaid Buy-In PowerPoint of Highlights

>>> For the Full Medicaid Buy-In Report (Word)

Invest Wisely, Support Medicaid!--Call Your Reps on Recess THIS WEEK

via AAPD (6.28.11):

 

Invest Wisely, Support Medicaid!

With Medicaid on the chopping block, the lives of 8 million people with disabilities are at risk.

It is critically important that Congress be made aware of our strong opposition to large cuts in federal funding for Medicaid.

If we are to protect vital services for people with disabilities, our community must dialogue with lawmakers.

With the House of Representatives on recess this week, they need to hear YOUR support for Medicaid!

To find your U.S. House of Representatives Member:  Go to: https://writerep.house.gov/writerep/welcome.shtml.

For your representative’s phone number, go to http://www.house.gov/.

Tell them…

DON'T CUT MEDICAID. "Cuts to this vital program will only shift costs to states and transfer the burden onto people with disabilities, children and their families.”

 “Investing in home and community-based supports is a proven cost-saving measure!”

If they don’t hear from you – and thousands of others -- how will they know what we all think?

New Long-Term Care Insurance Program in Jeopardy

From AAPD (6.10.11):

CLASS in Jeopardy: Policy Options to Reshape the Program

By David Heymsfeld, AAPD Policy Advisor

The Community Living Assistance Support Program (CLASS), as established by the Affordable Care Act, was a huge victory for the disability community.  It will create a national, voluntary disability insurance program that will help people with disabilities stay in their homes and communities and pay for services that they need. But now it is in jeopardy. This is because the law provides that CLASS cannot be implemented until the U.S. Department of Health & Human Services (HHS) finds that the premiums paid by purchasers of the insurance will cover benefits for 75 years. It is widely agreed that this cannot be done without significant changes and adjustments to the program. HHS intends to issue a proposed rule on necessary changes in October 2011.  Recent reports by the Robert Wood Johnson and the SCAN Foundations suggest options to save this important new long term care insurance program.

Potential Benefits of CLASS program

The CLASS program - very strongly supported by the disability community during health care reform debates -- would offer an opportunity to purchase long term care insurance. If an insured person incurred a disability they would receive a cash benefit to be used for long term services and supports, including home care, adult day care, or a stay in a nursing home.

CLASS was designed to provide some of the same benefits as existing long term care insurance. It is intended to be much more widely utilized than existing insurance because the CLASS premiums would be lower. These are estimated at about $125 a month, compared to an average of about $184 a month for private policies. Also, unlike existing long term care insurance, CLASS premiums could not be adjusted for preexisting health conditions, and persons below the poverty level would be charged a premium of $5 a month.

The expected daily benefits under CLASS of $50-$75 a day would be less than those of private policies which may pay $150 a day. The CLASS benefits would probably not be sufficient to cover all the costs of long term care facilities, but might be sufficient to cover medical and non-medical expenses costs of home health care. CLASS benefits would be available to persons unable to perform two or more Activities of Daily Living. The persons receiving benefits would have more flexibility to self direct the benefits than is available under many private policies, and unlike most private policies there would be no limit on the time for which CLASS benefits would be paid. Note that many private plans only pay benefits for five years.

Implementation Problems

The Congressional Budget Office (CBO) estimated that CLASS would reduce the federal deficit by $87 billion over a ten year period, primarily because the law requires a five year vesting period. This means that in the early years of the program, premiums will exceed payouts. However, concerns are being raised about implementation of the CLASS program over the 75 year benefit period.

The main potential problem for CLASS is "adverse selection"; the possibility that the policies will be purchased disproportionately by those who are likely to need care, and that younger, healthier persons will not buy them. This would result in major payouts and limited premium revenues. This prevents the program from being financially self-sufficient.

Possible Reforms

To improve financing of CLASS, the Robert Woods Johnson Foundation suggests:

• Lengthening the vesting period of five years (including three years employment) to collect benefits. The report raised the period before participants could draw benefits to 10,15 or 20 years as possibilities, recognizing that if the vesting period is too long it will dampen enrollment, and prevent most baby boomers from getting benefits;
• Adjusting premiums to discourage people from waiting until they are older to enroll;
• Requiring people to achieve a reasonable level of income before collecting benefits (as a way of screening out persons who are already disabled and unable to work steadily);
• Giving employers incentives to participate by covering their costs in collecting premiums;
• Indexing premiums to inflation.

The SCAN report did not make specific suggestions, but includes technical briefs with an in-depth analysis of issues involved in designing and administering a long term care program.

Comment Below: What do you think?

What do you think HHS should do to make CLASS financially feasible?  Which of the options mentioned above seems fairest to you? Contact Kathy Greenlee, Assistant Secretary for Aging, US Department of Health and Human Services, to give her your views on any of these options, via email to [email protected] OR Comment in the box  below or write [email protected]

Suggestions for Further Reading:

Robert Wood Johnson Report at http://www.healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_46.pdf

SCAN Foundation Report at http://www.thescanfoundation.org/sites/default/files/TSF_CLASS_TA_Comprehensive.pdf

Do You Support Services in Truly Integrated Settings? Take Action Today!

Via Luda Demikhovskaya (6.13.11):
 

Push New Medicaid Rules Supporting Services in Truly Integrated Settings by:  

TODAY, Tuesday at 5pm!

 

TAKE ACTION HERE!

 

Support Proposed Regulations for Medicaid Home- and Community-Based Waivers!

June 13, 2011 -- The Bazelon Center for Mental Health Law urges you to support rules proposed by the Centers for Medicare and Medicaid Services (CMS) that would help ensure scarce waiver dollars are used to support services in truly integrated settings -- not settings that are institutional in nature!

Use the Bazelon Center's comments as a model, or tell CMS that you agree with our comments. Also, consider telling CMS to include the "qualities of an institution" list in the regulation -- not in the background; and that there is no reason to have separate rules for assisted-living facilities.

Submit Comments by Tuesday, June 14, 5 PM EST electronically via http://www.regulations.gov.

Follow the instructions under the "More Search Options" tab.

Include reference code CMS-22296-P.

You can find the Notice of Proposed Rulemaking here.

The Proposed Rules:

• Permit states to serve individuals with different types of disabilities in one waiver.
• Define "home and community-based."
• Include requirements for person-centered planning.
• Indicate that waiver services must not be provided in "a building that is also a publicly or privately operated facility that provides inpatient institutional treatment or custodial care; in a building on the grounds of, or immediately adjacent to, a public institution; or a housing complex designed expressly around an individual's diagnosis or disability, as determined by the Secretary." 
• And, among other things, indicate that waiver services must not be provided in a setting that "has qualities of an institutional setting." CMS notes that such qualities may include regimented meal and sleep times, limitations on visitors, lack of privacy and other attributes that limit individuals' ability to engage freely in the community.

Don't 8 Million PWD Need Health Care? Stop Medicaid Cuts!

via AAPD (6.10.11):

 

ACTION ALERT!  

 

National Call-In Days: June 14, 15, 16!

 

SAVING MEDICAID FOR PEOPLE WITH DISABILITES!

NO CUTS!

Call 1-866-922-4970 to reach the U.S. Senate and then ask for your Senator.

With both the House and Senate in session THIS WEEK, we expect the debate about how to reduce the deficit to be front and center. Only with you and others calling in to your U.S. Senators and your House Representative can we hope to stop the cuts.

Here is your simple 1-2-3 message:

1. DON'T CUT MEDICAID. "Cuts to this vital program will only shift costs to states and transfer the burden onto people with disabilities, children and their families.”

2. Remind Members of Congress of any of the following points:

• Medicaid is critical for the health care of 8 million people with disabilities.
• Medicaid pays for wheelchairs and prosthetic devices for people with disabilities such as spinal chord 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.
• Medicaid’s Early and Periodic Screening Diagnosis & Treatment program helps identify children’s disabilities early and gets them the care they need.

3. If you or someone you know with a disability benefits from Medicaid directly, be sure to mention that in your phone call.  Tell them “I am a registered voter.”

If they don’t hear from you – and hundreds of others -- next week, how will they know what we all think?

Action Steps!

a.    To find your U.S. House of Representatives Member:  Go to the official site at https://writerep.house.gov/writerep/welcome.shtml. To find out your U.S. Congressional Representative’s phone numbers, go to http://www.house.gov/

b.    To Find Your Two Senators’ phone numbers: Go to website at http://www.senate.gov/general/contact_information/senators_cfm.cfm

c.    If you are not a registered voter, go to your state election website at http://tinyurl.com/29x7g5a and register today!

Action Alert -- Tell U.S. Congress "Don't Slash Medicaid!"

From AAPD (6.2.11):                                                             

                     

Action Alert

  Tell U.S. Congress: “Don't Slash Medicaid!”

Contact your Representatives and Senators to advocate against more proposals to slash funding for Medicaid.

It is critically important that Congress be made aware of our strong opposition to large cuts in the federal funding for Medicaid. These cuts are under serious consideration in on-going discussions in a current legislative package. The discussion involves linking an increase in the total amount of debt the federal government can incur with cuts in annual federal spending. The deadline for this legislative package is now set at August 3.  This is the date on which the federal government believes it will be unable to pay existing debt if the debt ceiling is not increased. Our voices must be heard before then!

Background: There is a consensus that a failure to increase the debt ceiling by August 3 would have catastrophic consequences for the United States and global economies. At the same time, it is believed that it will not be possible to pass legislation to raise the debt ceiling without accompanying legislation to reduce the annual federal budget deficit.

In discussions about reducing federal spending, Medicaid is a natural target. In fiscal 2011, Medicaid cost $275 billion, about 7.6% of all federal spending. The cost will increase significantly over the next decade due to an aging population and increases in medical costs. The pressure to cut Medicaid will intensify because it will be difficult to make substantial cuts in the other large entitlement programs, Social Security and Medicare, because they have larger constituencies than Medicaid.

Proposals:  There are a number of pending concepts for reducing Medicaid, and it may not be clear until close to August 3 which proposals will be seriously considered. In these circumstances the best approach for supporters of Medicaid is to make every Member of Congress (and the Administration) aware of our strong opposition to any proposals which would make major cuts. Our opposition needs to be expressed early and often.

Ryan Plan: The most prominent proposal is the Ryan plan that passed the House in May. The Ryan plan would reduce Medicaid funding by about $772 billion (about 35%) over the next decade compared to a status quo program. It would be left to the states to limit their programs to deal with reduced federal support. They are likely to curtail the services they cover and limit eligibility. The Ryan plan is unlikely to be accepted by the Senate.

Other proposals: These are generally less specific than Ryan’s plan. Most would also lead to major cuts and consequential changes at the state level. These include proposals to limit all federal spending to a percentage of Gross Domestic Product (GDP), or to impose this type of limit on all health care programs, or all entitlement programs. It would be difficult to meet these limits without major cuts in Medicaid.

Suggested Disability Talking Points:

• Medicaid is critical for the health care of 8 million people with disabilities.
• Medicaid pays for wheelchairs and prosthetic devices for people with disabilities such as spinal chord 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.
• Medicaid’s Early and Periodic Screening Diagnosis & Treatment program helps identify children’s disabilities early and gets them the care they need.

Pending proposals for “block grants” and “global spending caps” would undermine these important programs by reducing funding for Medicaid.  They would deny health and long term care to millions of vulnerable Americans.

The Ryan block grant plan would reduce funding over the next 10 years by $772 billion (35%) compared to continuation of the status quo. Global spending cap proposals would also lead to substantial reductions in Medicaid funding.

Reduced federal funding would compel the states -- that have serious financial problems of their own -- to sharply restrict enrollment, eligibility and benefits for the populations they now serve.  These changes could impact many of the current waivers that support community-based living for people with disabilities. The changes could have a disproportionate impact on people with disabilities who rely on Medicaid to enhance their ability to live and work in their communities and to avoid costly and unnecessary institutionalizations.

Ten Advocacy Steps

1. Write or e-mail your Representatives and Senators today.  
2. Call your two U.S. Senators and U.S. House Representative in their local state offices to set up a time to meet when they are home next. Under the current schedule:
   1. U.S. House Members are expected to be in their districts June 4-12, June 25-July 5, and July 16-24. Make an appointment today!
   2. To determine who is your U.S. Congressional Representative, please go to the official site at https://writerep.house.gov/writerep/welcome.shtml 
   3. To find out your U.S. Congressional Representative’s local address and phone numbers, go to http://www.house.gov/
   4. Senators are scheduled for a recess July 2-10. To find your U.S. Senator, go to http://www.senate.gov/general/contact_information/senators_cfm.cfm
   5. This list includes their Senate address and phone numbers. If you can only get a meeting with a staff person, do that too.
3. If you or someone you know with a disability benefits from Medicaid directly, be sure to mention that at the meeting.
4. Be sure to write a letter (send snail mail) using the Talking Points above; organize a “Save Medicaid for Us” Letter Writing event.
5. Go to Members’ websites and write them Emails or fill out the online form and let your opinion be heard. Organize an “Email to Save Medicaid” party.
6. If Members hold Town Meetings, show up, sit at the front and make the points above. If you have facts and figures about your state Medicaid program, be sure to mention that at the meeting. Tell ‘em what the cuts would really mean to you! Remember, personal stories stick in Members’ minds.
7. Be sure to state that you are a “registered voter” in any letter or at any Town Meeting.
8. If you are not a registered voter, go to your state election website at http://tinyurl.com/29x7g5a and register today!
9. If you see letters to the editor or op eds or TV news items decrying wasteful Medicaid spending, be sure to respond quickly using the Talking Points above.
10. Let AAPD know what you hear or learn in your meetings, via email to [email protected]  We can take your information – without your name -- with us when we meet any Congressional Members or Administration officials.

Action Alert: Strengthen Social Security for Those That Serve our Nation

via StrengthenSocialSecurity.org (5.30.11):  

Action Alert

Strengthen Social Security for Those that Serve our Nation!

Memorial Day is more than a three-day weekend to celebrate the unofficial start of summer with a BBQ.  It’s a day when we remember the service and sacrifice of the men and women who have served in our nation’s military.  

Military men and women contribute to Social Security just like other working Americans, from their first paycheck at boot camp, to their last paycheck at the end of their career. As for any other working American who contributes, Social Security needs to be there for veterans and their families. For example:

● More than 771,000 veterans receive Social Security disability benefits.

● Most of the more than 4,000 children who lost a parent since the beginning of the Iraq and Afghanistan wars now receive Social Security survivors benefits.   

● Social Security currently pays benefits to over 9 million veterans—about 4 in 10 veterans today—and the vast majority of veterans will become Social Security beneficiaries in the future.

Take Action Here! Strengthen Social Security Now!

Veterans and military families gave their all for our country.  It is our obligation to fight to ensure that they receive every benefit they deserve.  This means reminding Congress that those who serve our nation, should never have to worry about any benefit cuts. After all, Social Security belongs to them – and to all of us.

>>>To See a Copy of the Veteran's Report

 

Action Alert: Tell Congress NO to Three More Years of the "Combating Autism Act"

via The Autistic Self-Advocacy Network (5.26.11):

Action Alert

Tell Congress NO to Three More of the "Combating Autism Act"

Please call!

You can reach them through the Capital Switchboard at (202) 224-3121 by giving your state and asking to be put through to your Senator.

Today, Senators Menendez and Enzi will be introducing legislation extending the Combating Autism Act for three more years. The Combating Autism Act was passed in 2005 without the involvement or consultation of a single Autistic person, let alone the broader self-advocate community. Without legislative action by Congress, the Act would expire on September 30^th of this year. While we respect the Senators' good intentions, the Menendez-Enzi legislation would freeze in place the current flawed CAA programs, which fail to make any provision for services, do not incorporate anything about adults on the autism spectrum and exclude self-advocates.

What you can say:

• A three year extension of the existing Combating Autism Act means a three year delay before Congress takes any meaningful action on services for Autistic people across the lifespan. It means three years before any new supports for adults on the autism spectrum are introduced and three years before any of the problems with the status quo are fixed. We can't afford to wait that long. 

 

• CAA's existing programs enable a severe bias in the autism research agenda against services and adult issues. According to the recently released IACC Research Portfolio, less than one percent of autism research dollars spent in 2009 went to research relating to adults while only three percent went to research about improving services, supports and education! This inequity calls out for change.

  

• CAA's existing structure excludes the very people who should be at the center of the autism conversation: Autistic people ourselves. By locking in place for another three years a bill that was passed without the involvement of self-advocates, Congress would be sending a message that the needs and perspectives of Autistic adults don't matter.

 

Call Congress today at (202) 224-3121! Remember to call twice in order to reach both of your Senators.

If for accessibility reasons you need to e-mail your Senators instead you can find their e-mails on the Senate website at this link.

 

We need your help to remind Congress they can't ignore the voices of the Autistic community. As always, Nothing About Us, Without Us!