JFActivist

Protecting Medicaid across Faith Lines

From AAPD (11.18.2011):

By Lara Schwartz, AAPD VP of External Affairs

 

When we honor and treat all people with dignity and respect across faith lines, we are a powerful force.  –David Feinman, Senior Legislative Associate, the Jewish Federations of North America

As advocates and activists, we often frame our civil rights agenda as a set of policy goals to achieve or specific bills to pass.  People often tell me that they don’t get involved in promoting civil rights laws because they feel like the conversation involves topics that they don’t have time to learn about during their busy, full lives.  That’s especially true for large, complex programs like Medicaid, a program that serves millions of people with disabilities.

While Medicaid and programs like it might be complicated, the justification for them is not.  We promote this vital program because it is consistent with our values.  Opportunity. Fairness.  Justice.  Treating  our neighbors as we treat ourselves.  Our leaders need to be reminded that if our core values are not driving their decision making, they aren’t really representing us. 

Many Americans’ values are rooted in their faith practices and traditions. It’s essential for faith voices to influence the conversation about Medicaid and other civil rights matters.  That’s why we held a web chat on November 10 along with United Cerebral Palsy (UCP), and the Interfaith Disability Advocacy Coalition (IDAC).  The web chat featured representatives from the Christian, Jewish, and Muslim faiths along with AAPD and UCP staff members.   

The web chat created an intimate conversation that reached across the country. We received questions from Montana, Florida, Texas, New Jersey, and California, to name a few.   You can see the transcript at:
http://www.ucp.org/public-policy/america-s-super-committee/live-webchat-protecting-medicaid-across-faith-lines-for-people-with-disabilities

Participants from interfaith coalition wrote eloquently about the connection between values and policy.  Maggie Siddiqui of the Islamic Society of North America observed: “we all have a religious or moral responsibility to serve those in our communities who need our help the most, and our country should reflect those values.”

Participants brought their own strong voices to the conversation.  Linda Starnes of Florida sent this powerful statement:

"We ask that the President, Congress, and our state governments look to other means of creating a fiscally sound country, and to not cut funding from Medicaid.  Medicaid provides a lifeline to so many of our most vulnerable citizens.  For as we are reminded within the parable of Matthew 25,  'Truly I tell you, whatever you did for one of the least of these brothers and sisters of Mine, you did for Me.'" 

The deadline for a deficit reduction plan is next week.  We need to follow Linda’s eloquent example and speak our minds—and our values—to the elected leaders who will make decisions about Medicaid’s future.

America's Supercommittee Member David Feinman Says: "Cuts to Medicaid will Hurt People with Disabilities"

via Alternet (11.14.11):

The Joint Select Committee on Deficit Reduction, also known as the “Super Committee,” is getting closer to its deadline to determine how to reduce our nation’s deficit and meet our financial obligations. They are weighing their options regarding programs that form the fabric of our safety net, including Medicaid. If they can reach an agreement, it will have a profound impact on millions of people with disabilities for whom Medicaid is a lifeline to health and independent living.

Corporations, associations, experts, and other organized interests will weigh in on this issue, but their voices cannot and should not be the only voices that the “Super Committee” hears. It is vitally important that everyday Americans weigh in too. Speaking as someone who has worked in politics and public policy for a number of years, I can’t emphasize enough how important constituent engagement is in our democratic process. The twelve members of the “Super Committee” have a huge responsibility on their shoulders. Considering the challenges they and the rest of the Congress face coming to a consensus on most issues, it is critical that they hear from people who want to have a constructive conversation.

I am one of these people. As a person of faith and as an advocate for Jewish federations across North America, I want the Joint Committee to protect the dignity of all Americans. As a person who has worked in politics and public policy, I want smart, pragmatic solutions. As the brother of someone with a disability, I want real people, like him, to have access to Medicaid, which ensures a higher quality of health and life for millions.

From a very young age, I was taught to be involved with my community and to care about the welfare of others. In our home, the Jewish faith informed our sense of social justice. Thanks to my faith and my parents’ example, I always felt a compelling interest in the welfare of others. In my experience, most Americans believe, as I do, that we must love our neighbors and do right by them. Reasonable people differ over what that means, but I believe that if politicians would return to their faith roots and their values, that would inform them about the decisions that they have to make.

When we turn to our core values for guidance, we know that we cannot abandon those who rely upon Medicaid. Loving thy neighbor means doing what we can to ensure that our neighbors are able to live with dignity, comfort and security. Those values get lost in the rhetoric and the politics of ensuring victory in the next election, but we can restore these values to our political system. People of all faiths and belief systems can refocus our leaders’ attention to their responsibilities as our elected leaders by reminding them of how these values inform our own decisions, as individuals, families and communities, to make wise decisions that ensure the common good and protect those most vulnerable.

I speak from the personal experience of seeing how the fiscal insolvency of our government affects my family. My brother, Paul, has Asperger Syndrome. Medicaid is his secondary health insurance, supplementing his coverage under Medicare as a result of our mother’s passing several years ago. Medicaid insures that should Paul have a catastrophic illness, he would not lose the few assets he has earned and would not be financially destitute for the remainder of his life. Earlier this year, the State of Florida dropped him from Medicaid as part of an effort to cut the state budget. Fortunately, after three months of appeals, his Medicaid coverage was reinstated. Paul is fortunate to have me and our father to advocate on his behalf, but I know that most people do not have voices speaking for them. It is in that vein, and on behalf of all persons with disabilities and others who rely on Medicaid, that I am telling the “Super Committee” that we as a nation must do right by these people and ensure they are able to have access to the care they need.

The fact that our complex and overwhelming debt problems are now before the “Super Committee” does not diminish our own role in the process. As Franklin Delano Roosevelt once said, “the ultimate rulers of our democracy are not a President and Senators and Congressmen and Government officials, but the voters of this country.” Call your Member of Congress. Attend a town hall. Write a letter. Make a phone call. Most of all, start a conversation with your neighbors, friends and family. Make sure that your values are front and center when the “Super Committee” makes its decisions, and make sure that your voice is heard.

David Feinman is Senior Legislative Associate for The Jewish Federations of North America. He is one of six Americans on a shadow Super Committee called “America’s Super Committee” established by United Cerebral Palsy and the American Association of People with Disabilities.

>>>To See David's Article on Alternet

States Will be Limiting Medicaid Services to Contain Costs

By David Heymsfeld, AAPD Policy Advisor 

An extensive survey by the Kaiser Family Foundation’s Medicaid  Commission shows that most States plan  to reduce the costs of their Medicaid programs next year by reducing Medicaid services  and payments to providers .

The pressures for cuts come from the recession which has increased enrollment in Medicaid while decreasing State tax revenues.  At the same time, since June 2011, the states are not  getting the benefit of   the additional federal funding for Medicaid made available by  federal stimulus legislation.

 The steps taken by the states  to reduce the costs of their Medicaid programs include ending dental and vision services, limiting other services, increasing co-payments, increasing the use of managed care,, and lowering payments to doctors, hospitals  and other providers.

 State Funding Problems

The basic problem for the States is that as a result of unemployment and reduced incomes from the recession, the number of persons eligible for Medicaid increased by 5.5% in 2011 and is expected to increase by an additional 4.1% in 2012. In addition, federal funding for Medicaid will be reduced in 2012 because of the end of a temporary increase in federal funds from stimulus legislation. The  States plan to increase their Medicaid funding, but the increases will not offset the reduced federal funding and the costs of increased enrollment.

 Overall, total funding (state and federal) for Medicaid will increase by 2.2% in 2012, while total enrollment will increase by 4.1%.

 State Reductions in their Programs

The Kaiser report asked State Medicaid directors to evaluate the problems they would face in 2012. After analysis of these responses the report concluded that  “Pressure to control costs was identified as the most significant Medicaid issue by program officials for 2012.”

The survey shows that nearly every state will implement at least one new policy to control Medicaid costs in 2011 and 2012. Many of these changes could adversely affect beneficiaries.

Provider Rates

The survey indicated that most common cost cutting measure (39 states in 2011, 46 states in 2012) is to freeze or cut the rates paid to Medicaid providers, including physicians, hospitals , nursing homes and medical supply companies. These cuts could cause a decline is service for Medicaid enrollees. Generally Medicaid  reimbursement  for providers is less than reimbursement under Medicare and commercial insurance. Reductions in Medicaid rates may cause physicians and other providers to refuse to participate in the program.                    

 The federal government has authority to prevent excessive reductions. By law, Medicaid rates must be high enough to maintain adequate provider participation and access to services for enrollees. The federal department of Health and Human Services has recently begun rule making to develop procedures for better federal oversight of reductions in provider rates.

Copayments

The survey indicated that some States will require higher co-payments for various services, including emergency rooms and prescription drugs.

Reduction or Elimination of Services

 The survey indicated that 6 States are eliminating some benefits in 2011, and 7 States will do so in 2012. The services eliminated include dental and vision care. In 2011 and 2012,  18 States are planning to limit benefits for a variety of services, including occupational, speech or physical therapy,  personal care services and mental health services.  The limits include limits on total dollars and  on the number of treatments per year.

Managed Care

The Kaiser report concluded that “Across States, the fiscal pressure has accelerated a trend toward the use of managed care and care management, particularly for duals and for beneficiaries with disabilities or with high-cost, complex needs”.

17 states in 2011 and 24 states in 2012 plan to expand their managed care programs by expanding the areas and populations covered. For 2011, the most common changes will be adding counties to managed care service areas and adding persons with disabilities to managed care. For 2012 the most common changes will be inclusion of persons with disabilities and dual eligibles.

 For further information

The survey results make it clear that no two states are making exactly the same changes to reduce their Medicaid costs

Click here for detailed information on each state 

 

 

 

 

 

 

Protecting Medicaid across Faith Lines for People with Disabilities: Leaders from the Religious Community to Host a Web Chat

Dear Religion and Disability Leaders:

The shared values of our faiths lead us to support policies and programs that promote independence and dignity for people with disabilities so they can continue contributing to their communities and congregations. Medicaid is one such program.  As we pursue our mission of preserving Medicaid, it is important that the voices of the faith community be a vibrant part of the national conversation.

As you may know, IDAC Steering Committee Member David Feinman is working with AAPD’s “America’s Supercommittee” project to preserve Medicaid.  He is one of six Americans from a variety of backgrounds who are sharing their perspectives on why Medicaid must be preserved.  To learn more about that project, visit the America’s Supercommittee website at:  http://www.ucp.org/public-policy/america-s-super-committee

We now have a powerful opportunity to bring leaders and supporters of the Interfaith Disability Advocacy Coalition (IDAC) into the conversation.  On November 10th, AAPD, IDAC, and project partner UCP will host a faith community web chat titled: Protecting Medicaid across Faith Lines for People with Disabilities.

Our November 10th web chat is essentially a panel discussion where the “panelists”—including David Feinman—are communicating from laptops and the “audience”— members and supporters and people of faith from across the nation—are asking questions via email and seeing the answers on their computer screens.  Through this technology, we can share questions, concerns, and statements of belief with a wide variety of people.  Unlike a live panel, however, we will retain everything that is shared that day in the form of a transcript.  We can then use these powerful questions and statements to educate leaders and our communities about this urgent social justice issue.

Please save November 10th for the web chat.

In the coming days, you will be hearing from us about how this coalition and our supporters across the country can engage in this web chat, including by emailing questions and statements to the moderators, spreading the word among our grass roots, and promoting this event and its message.

Blessings, Ginny

Director, AAPD Interfaith Initiative

 IDAC Convener

 

United States Supreme Court will decide important cases on the rights of persons with disabilities

By David Heymsfeld, AAPD Policy Advisor

In the next few months the United States Supreme Court is expected to decide two important cases on the rights of persons with disabilities.

The first case, Douglas v. Independent Living Center of Southern California, is a challenge to the decision of the State of California to lower the rates paid to doctors and hospitals for Medicaid services.  The suit was brought by persons receiving Medicaid and doctors and hospitals, who assert that the lowering of rates will cause doctors and hospitals to drop out of the program, making it harder for enrollees to get services.

The question before the Supreme Court is whether Medicaid enrollees and doctors and hospitals can also go to a court and ask the court to prevent this type of reduction in rates. If the Supreme Court decides that the courts can consider these cases, Medicaid enrollees will have an important new tool in advocacy to ensure that State Medicaid programs provide adequate services.

In the second case, Hosanna-Taylor Evangelical Lutheran Church and School v EEOC, the Court will decide whether ministers and other teachers in religious schools are protected by the Americans with Disabilities Act. The case involves a teacher in a church-affiliated school who was fired because she threatened to bring an ADA case to protect her rights to continue in her job despite a history of sleep disorders. The church claims that in her teaching role she was also serving as a minister of the church, and that the courts have ruled that the ADA does not apply to ministers.

In this case, the Supreme Court may develop broad principles on whether employees of a church with religious duties are exempt from the ADA. If so, the court may also decide which employees are exempt; only those who teach classes in religion, or those who teach subjects such as history and literature, but are expected to be guided by religious principles in their teaching. Hundreds of thousands of employees could be affected.

Have 1,000 People Transitioned Out of Institutions with Mainstream Category 2 Vouchers?

via Steve Gold (7.12.11):
 

Have 1,000 People Transitioned Out of Institutions With Mainstream Category 2 Vouchers? Information Bulletin #335

It’s been about seven months since HUD awarded its Mainstream Category 2 Vouchers. These were the special vouchers that were intended to be used solely for people with disabilities to transition from institutions to the community. Housing Authorities and other public entities had to apply for these vouchers, and HUD awarded them on a competitive basis.

We know there were a lot of advocates for individuals with disabilities who were very disappointed that their Housing Authorities had not been awarded these vouchers. This was particularly so, after advocates had worked with and encouraged their Housing Authorities to apply.

Okay folks - now is the time to check out if the “winning” Housing Authorities have actually used these Category 2 Vouchers as they were intended - to help people to leave institutions.

Has your State Medicaid agency been actively involved? Has it helped identify people who want to transition out? How has the Housing Authority identified the person who was institutionalized?

 

>>>To Read the Full Blog Post

"Blended Rate" Proposals: Could Drastically Reduce Medicaid Funding

via AAPD (7.15.11):

"Blended Rate" Proposals for Medicaid Could Lead to Substantial Reductions in the Program

By David Heymsfeld, AAPD Policy Advisor

In the on-going negotiations to reduce the deficit in the federal government budget, one proposal frequently mentioned as a means of reducing Medicaid spending is the so-called “blended rate” proposal. This proposal would change provisions in the current program which establish different rates for the federal match for State  Medicaid expenditures, depending on the type of beneficiary. The blended rate proposal  would replace the differing rates with a single rate for the federal match for all beneficiaries. This may sound like a technical adjustment to simplify the program. But in reality, the proposal has the potential for substantially reducing federal Medicaid payments to the States, forcing the States to cut back on beneficiaries and services.

How the blended rate would work  Under the Medicaid program, each State establishes a Medicaid program, and the federal government pays a share of the costs of each State’s program. A different rate is established for each State based on per capita income. This rate, known as the federal medical assistance percentage (FMAP) averages 57%. However, the States receive higher percentages than the FMAP rate for services to some beneficiaries ;  for example, the federal share for services to beneficiaries made eligible by the health care reform act will be 100% for three years.

The blended rate concept is to develop a single rate for each state, by averaging the rate for all  federal funds the State would receive.

How the blended rate could reduce funding.  By itself, replacing the multiple rates with a single average rate would not reduce the federal funding a State would receive. However, the major purpose of going to the single rate would be to reduce funding. This would be accomplished by lowering the average rate below the rate which would result in no loss of funding. The more the rate is lowered the more federal funding would be reduced.  The proposals now on the tab le in the deficit reduction talks would reduce federal funding by about $50 billion over ten years. This is modest compared to the $700 billion reduction in the Ryan budget passed  by the House, a reduction of more than  30% in the program. But the blended rate proposal is not tied to any particular reduction, and it would be simple to change the rate to produce reductions of hundreds of billions in Medicaid.

Suggestions for Advocates

Because the federal negotiations are so fluid, advocates for persons with disabilities have focused on opposing large cuts to Medicaid generally, rather than on the details of how this is accomplished.  However, as negotiations get more specific advocates should be aware that blended rate proposals have the same potential for large cuts as earlier proposals, such  as “block grants” or “global spending caps.”

For more detailed analysis of blended rates, see http://www.cbpp.org/cms/index.cfm?fa=view&id=3521

Interfaith Disability Coalition Delivers Medicaid Letter to Capitol Hill

via AAPD (7.11.11): 

Interfaith Disability Coalition Delivers Medicaid Letter to Capitol Hill

The Interfaith Disability Advocacy Coalition (IDAC) delivered a letter to members of the House and Senate today urging them to protect Medicaid from drastic cuts and other harmful changes to the program.

“This is a moral issue,” said AAPD’s Director of the Interfaith Initiative and IDAC’s convener Ginny Thornburgh. “This issue has touched the hearts of people of faith from many religions. Medicaid is one of the tools that helps people with disabilities stay in their communities and continue to live as independently as possible.”

The letter, which was signed by 36 national organizations across the faith spectrum, states that while the coalition understands deficit reduction efforts are necessary, drastic proposed cuts to Medicaid would be devastating to the disability community.

According to the letter, “The shared values of our faiths lead us to support policies and programs that promote independence and dignity for people with disabilities so they can continue contributing to their communities and congregations. Medicaid is one such program…Any decisions about Medicaid funding or the structure of the program should take into consideration the ability of people with disabilities to live healthy, independent lives"...

>>>To Read the Press Release

Watch AAPD's First Virtual Town Hall on YouTube

From AAPD (7.8.11):

Watch AAPD's Virtual Town Hall on YouTube

People with disabilities from across the country watched, listened to, and questioned AAPD's new President and CEO in our first ever Virtual Town Hall on June 29.  The event was also live tweeted at @AAPD.  If you were not able to participate on the day of the event, you can still watch and listen to the event which has been captioned and posted to YouTube.  Topics of discussion included voting, employment, Medicaid cuts, and more.  Viewers asked questions about getting involved in the legislative and electoral processes and how to improve educational access for kids with disabilities.  The discussion was lively and informative. Furthermore, Mark shared his vision for our organization and his plan include more town halls.  So check out this event and check back for information about the next town hall.

>>> To Watch the Virtual Town Hall

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.