Defending Our Freedom

Shortage of living spaces for disabled outside nursing homes is costing Colorado

2010-12-05T09:20:00.000-08:00

By Laura Frank and Joe Mahoney

I-News Network

Posted: 12/05/2010

One out of every five residents in Colorado nursing homes wants out, an analysis of state and federal records shows.

But a shortage of places for the disabled to live outside a nursing home and regulations that critics say make it hard to qualify for home services mean many who want out continue to receive expensive nursing care.

"Long-term care in general is costing the state more and more each year, just as more people need long-term care services and the cost of care continues to increase," said Tim Cortez, who was hired by the state in June to reform long-term care with the goals of serving more people and saving money.

In 1999, the U.S. Supreme Court said people who can live independently have that right. But Colorado doesn't have the resources or infrastructure to assist all the people who want out.

Many are people like Cliff Seigneur.

Seigneur was an assistant state attorney general, but his multiple sclerosis eventually made it impossible for him to work. He wound up in a Denver nursing home at age 48.

"I don't want to be brought out of this place in a body bag," Seigneur said.

For more, see http://www.denverpost.com/technology/ci_16782066.

Washington State Cuts Needed Medicaid Drug Program

2010-11-30T05:27:00.000-08:00

From the Columbian:

Cuts To Medicaid Threaten Real Pain

November 23, 2010

OLYMPIA, WASHINGTON-- [Excerpt] Debb Snyder's slender lifeline to independent living is her government-paid prescription for Klonopin, the expensive anti-seizure drug that controls her grand mal seizures and allows her to remain in her small apartment off St. Johns Road. She's been taking 0.5 milligrams of the drug six times daily for 20 years.

That's why it was intensely personal for Snyder when she saw the list of cuts to Medicaid programs the Washington Department of Social and Health Services is preparing to implement between Jan. 1 and March 1 to achieve its share of 6.27 percent across-the-board cuts in state agency budgets.

The department will eliminate coverage for outpatient prescription drugs provided by retail pharmacies to an estimated 277,000 clients, effective March 1. As a "discretionary" program under Medicaid, the prescription drug program is one the state has the option to discontinue while still maintaining its partnership with the federal government in providing health coverage to the poorest of the poor under Medicaid.

Drugs administered in a hospital, doctor's office or long-term care setting won't be affected by the cut.

For more, see: http://www.columbian.com/news/2010/nov/21/cuts-to-medicaid-threaten-real-pain/.

Liberating Women with Disabilities

2010-09-22T14:59:00.000-07:00

Today 300 ADAPT activists called on Speaker Nancy Pelosi to liberate women with disabilities from institutions by supporting the Community Choice Act. We covered all the entrances at 1st and Constitution NW in DC where Pelosi was receiving the Alice Paul award at a luncheon. Alice Paul was a first wave feminist leader and the annual award is sponsored by the Sewell Belmont House.

68.4 % of all nursing home residents are women. You can bet they would rather be in their own homes with services and supports. Most are seniors and women with disabilities and definitely not rich. These women are not exactly on Speaker Pelosi's high priority list.

Sadly these women are also not high on the priority list of most feminists. All the women in ADAPT and many women with disabilities around the country were stoked about today's action. Most of us are feminists and would love to build links to a women's movement that, for the most part, ignores us.

What's the story here? Women with disabilities are among the most excluded and oppressed in the country. One would think the women's movement would be all over us. Not.

Instead it is often conservatives who attempt to build political alliances with us. The ADA was signed by President Bush 1 and President Bush 2 implemented and funded Money Follows the Person to get people with disabilities out of institutions, receiving services and supports in our own homes.

We still cannot get Speaker Pelosi to support the Community Choice Act and mainstream women's groups keep us off their agendas.

When will the women's and progressive movements welcome all excluded groups?

In the meantime...the women of ADAPT will continue to come out and rock and roll...until we Free Our People from nursing homes and other institutions.

If Alice Paul were still alive, she would have been in the streets with ADAPT.

ADAPT Protest Brings Real Solutions to HUD-blocks 3 entrances

2010-09-21T10:16:00.000-07:00

As I write this, 300 ADAPTERS are blocking 3 entrances to the HUD building in Washington, DC. What's up with that?

These are folks that live full lives and have better things to do with their time so why protest how federal housing dollars are spent?

There are still many in our society who want seniors and people with disabilities locked away in nursing homes and other institutions..out of sight out of mind. That's especially true if you are a senior or person with a disability who has a low income....and with 1 in 7 Americans living in poverty....well do the math. Tens of thousands of seniors and people with disabilities need affordable, integrated, accessible housing.

Yet 20 years after the ADA was signed into law, HUD still spends our tax dollars so that seniors and people with disabilities are forced to live ....and too often die...in institutions.

ADAPTers can launch a great chant, can block the doors and chain themselves to HUD with a flair...yet also among us are top policy wonks in the housing arena. We want to work with HUD Secretary Donovan to implement a solution to this housing crisis.

What is so scary or hard about that?

What do we want? Affordable, accessible, integrated housing. When do we want it? NOW

2010-09-20T09:26:00.000-07:00

Right now 300 plus ADAPTers are blocking streets around the White House. ADAPT was headed to the White House to tell President Obama to live up to his campaign promise to end the institutional bias and support the Community Choice Act. Sadly, the Obama White House is limiting the right to protest. No more than 25 people can protest at the WH without a permit. No other administration has done this.

Can you help tell the Obama administration to meet with ADAPT and hear our demands?

Right now we need YOU to contact the White House at http://bit.ly/aX7aab! The action is nationwide, help us get the President's attention. YOU can make it happen!

Why is giving people the right to live in their own homes and communities so difficult? Why will the federal government pay for people to live in a nursing home but not in the community when the aggregate costs are less? Sane policy in this arena is not rocket science.

Have you ever heard anyone say "I can't wait until I age enough to live in a nursing home?" No one chooses such a horrid, constricted life if they can live in the community with services and supports.

It is past time for politicians to say no to all those dollars from the nursing homes and end the institutional bias.

What If...

2010-09-19T15:51:00.000-07:00

By National ADAPT

What if your landlord decided if you could go out...and when, where and with whom?
What if someone made it their business to decide that you could not have anyone spend the night, and even though you were 43 years old?
What if you could only have alcohol on special occasions, and only if you were "good"?
What if there were no guarantee you and your spouse, let alone a friend, could live together?
What if your entire living space was 10 by 12 feet and you had to share it with a roommate your landlord picked for you?
What if they sedated you because you were "uncooperative"?
And that said it was all "for your own good"?

That's life in a nursing home or institution.

What if you could have a REAL CHOICE?

That's what the Community Choice Act (CCA) would do. ADAPT is fighting to give people the opportunity to decide where they live and receive long term services and supports. People cold choose to stay in their own homes rather than be forced into nursing homes or institutions.

Press Release: ADAPT to Storm Washington, DC

2010-09-18T18:24:00.000-07:00

For immediate release

Contact:

Mike Oxford, (785) 224-3865

Bruce Darling, (585) 370-6690

www.adapt.org

ADAPT Activists to Storm Washington DC; Vow to Fight State Cuts to Medicaid Home Services

Fighting dangerous state Medicaid budget cuts across the country, the national grassroots disability rights action group ADAPT is planning direct actions at several venues in Washington, DC between September 19 to 22 to demand that states save Medicaid-funded home and community based services. These services support low income people with disabilities and who are aging to stay in their own homes instead of being forced into nursing facilities to obtain services. During this critical election season, ADAPT plans to make it clear that saving Medicaid services is key to winning the disability vote.

"During this time of fiscal panic, governors are looking for ways to save dollars," notes Mike Ervin of Chicago ADAPT. "Hundreds of us are coming to Washington because Congress and the White House need to step up efforts to protect Medicaid community services in the states. I use home services and without someone to assist me, I'd be waiting on some nursing home aide to change me or feed me whenever she was done with the other fifty people living in the same facility. With home services, I am in charge of my life."

Current Medicaid law mandates that states use their Medicaid programs to pay for nursing homes, but the law does not equally mandate that states pay for the same services in a person's own home. Today, most states recognize that providing home and community based services (HCBS) is a less expensive solution than institutions. However, in these tight fiscal times, Medicaid dollars funding "optional" services like HCBS are first on the budget chopping block, while the mandatory institutional budgets are rarely touched. ADAPT's current "Defending Our Freedom" campaign is a direct response to states' attacks against HCBS, services that allow people with disabilities to take care of themselves, raise their families and be part of society.

"Without the home services funded by Medicaid, hundreds, if not thousands, of people with disabilities in my state would be forced to live in nursing homes or institutions," said Joe Stramondo of Michigan ADAPT. "Some states are virtually on the edge of bankruptcy. It makes no sense to spend extra dollars on institutions when those same dollars could fund more people with disabilities to live in the communities of our choice."

To learn more about Defending Our Freedom, please visit http://www.adapt.org/adapt-campaign.php.

Center for Disability Services Cuts 10 Jobs

2010-09-17T19:30:00.000-07:00

2010-09-17 17:37:14

ALBANY – The not-for-profit Center for Disability Services is eliminating ten jobs, forcing remaining service coordinators to double their caseload from 25 to as many as 50, a spokeswoman said Friday.

Each consumer will only receive about three yearly visits instead of 12, she said.

“We remain committed to providing the best program possible,” Anne Scheider Costigan said in a statement. “We are doing everything possible to make this a smooth transition."

The Center will attempt to find another position for the affected employees, as it did in 2009 when 50 jobs were eliminated by the termination of daycare and pre-school programs.

Scheinder Costigan blamed the layoffs on a reduction in Medicaid Service Coordination funding mandated by Gov. David Paterson at the height of New York’s fiscal crisis.

For more see http://www.cbs6albany.com/news/services-1278479-albany-center.html.

Minnesota Governor: Obstructionist?

2010-09-10T19:26:00.000-07:00

From the Minnesota Consortium for Citizens with Disabilities: http://mnccd.wordpress.com/

Update on Minnesota’s ability to pursue federal healthcare reform grants
September 10, 2010
by mnccd

Many of you are already aware that last Tuesday, Aug. 31, Governor Pawlenty announced an executive order requiring all state agencies to send any federal grant requests related to federal healthcare reform through his office, noting that he would likely not allow these grant requests to move forward unless they are required by law. The federal healthcare reform legislating that was passed this past year contains a variety of opportunities for states to apply for specific healthcare reform grants from the federal government. At this point it is unclear exactly how much this action will cost the state of Minnesota, but some estimates place this number as high as tens of millions of dollars in lost potential grant money. You can view a Star Tribune story on the decision here.

Minnesota’s disability community will feel the impact of this decision. First of all, federal monies that would have come to MN in the form of specific healthcare reform grants would have lessened the strain on Minnesota’s overall Medicaid budget. Secondly, a number of the state grant opportunities outlined in federal healthcare reform legislation were designed to support states in their work to serve individuals with disabilities in their homes and communities, rather than in institutions. The inability of Minnesota to move forward with applying for these grants will negatively impact our state’s progress in this area.

As a specific example, federal healthcare reform legislation included a $200,000 planning grant for a Money Follows the Person program that would have supported states in helping individuals with disabilities to move out of nursing homes and into the community by providing an increased federal Medicaid match for the individual’s first year in community services. A Minnesota state agency’s plan to move forward with applying for this grant was stopped as a result of this executive order.

MN-CCD leaders will continue to meet with state officials and other stakeholders to discuss this issue, so stay tuned for updates.

All Politics Are Local...

2010-08-10T18:35:00.000-07:00

The contentious debate going on in our country is primarily focused on one critical question: what is the balance of the roles between the federal and state governments?

For disability advocates who have spent years fighting for federal legislation to end the institutional bias, you would think their vote would be to support a strong federal role. The answer however is not that simple.

At the state level is where all Medicaid programs are implemented. Who the Governor is determines who the Medicaid Director is. Who is elected to the State Legislature determines funding levels as well as policy decisions that affect things such as level of consumer direction, nurse delegation, wage rates for attendants, types of waivers and programs provided, as well as more macro but extremely important legislative decisions such as redistricting, etc.

If the institutional bias was gone tomorrow, we would still be confronting some of these same issues at the state level the next day.

In the DEFENDING OUR FREEDOM Campaign the question isn't “Should we end the institutional bias?”

We agree - YES!

The strategic tactical question is: the balance of our advocacy resources between federal and state action.

Remembering the old adage “all politics are local" might be helpful in deciding what that balance should be.

Metamorphosis

Attendant Speaks Out on Monroe County Crisis

2010-07-30T09:36:00.000-07:00

http://spillingofthoughts.blogspot.com/2010/07/unwarranted-attack-on-health-care.html

Unwarranted Attack on health care

Today I learned from the Monroe County, NY government that I will no longer have a job as of August 1. I am a attendant with the program Consumer directed health care of New York State. The County pulled the contract from 4 "so called" reports of abuse/neglect. They stated 12 cases of abuse or neglect, but found 4.

One case was reported that a young man was left alone, those attendants were fired, case closed. One man who is the director of a committee was not in attendance, seems to me that he may well be the mole that caused the cancerous attack that led to the downfall of the agency. The County never really tried to work out the issues, they just handed us our walking papers.
It seems that politics in New York State have gone from the hand shake, baby cooing to let's see how much mud we can throw at people. It is deplorable that you can't close nursing homes, but you can throw 3 hundred people onto a hot bed of issues that disabled people get all the time; the shaft. The real losers aren't the attendants from Center for Disability Rights, but the consumers who have their aides in place and now have to scramble for a new agency.

The other agencies are like what I used to have to deal with in the assisted living places. They pay jack squat, give no medical insurance, 3 days per year for sick time, and NO VACATION. By the time I make my money most of it has gone to a roof over my head, electric & gas, food, car/car insurance. Not much money left after that for medical or dental. It is hard work to lift, push, pull all day long; but I want to be treated like I matter. The Center for Disability Rights even gave me a bonus for Christmas!!! I was floored, a bonus? I usually get a lousy bottle of wine, but from Emeritus; one year I received NOTHING !!! But, my boss' all received gifts and bonus'. I am the foundation of an agency, I can make or break your agency; so please treat me well and I will try really hard to please you.

Rochester Disability Community Under Attack

2010-07-30T09:05:00.000-07:00

The Center for Disability Rights is under attack - Tell Maggie Brooks to Restore the CDPAS Contract by phone and in person!

The Center for Disability Rights is under attack by the Monroe County Executive, Maggie Brooks. Without warning, on July 22nd, CDR received a terse, 5 sentence letter informing us of the contract termination with no explanation included. All of our CDPAS consumers received a letter the same day telling them that the county is terminating its contract with CDR and that they have until just August 1st to choose from one of five for-profit agencies for their Consumer Directed Personal Assistance.

The next day, we received from a friend in the local media, a copy of a three page letter from the County Executive to the media. The letter was filled with blatant falsehoods mixed with misunderstandings of the roles of CDR and the county in the CDPAS program. Here is CDR's letter to Maggie Brooks debunking her allegations against CDR:
http://www.whec.com/whecimages/cdr_letter-to-county.pdf. Videos of consumers refuting the county's charges are here: http://www.youtube.com/user/cdrnys. Share these; make them go viral as meanwhile, Brooks continues to use the media as a buffer to not have to talk with us. Many more documents available on CDR's website at www.cdrnys.org.

Our consumers and their attendants have been thrown into chaos and Ms.
Brooks refuses to talk to them. Nearly 300 consumers are in danger of losing their attendants and possibly their services outright.

Currently consumers, supporters and staff have camped out in front of the County Building on Main Street in Rochester. We have been out there 24/7 since Monday and will continue until this is over.

We need your help!

TAKE ACTION: CALL MAGGIE BROOKS!

Call Maggie Brooks and urge her to restore CDR's contract for the sake of the hundreds of people who like their services and want to continue them.

Then ask at least two friends to do the same.

Be respectful, but be firm. Her phone should not stop ringing!

County Executive Maggie Brooks: (585) 753-1000

TAKE ACTION: JOIN US FOR A RALLY!

The Center for Disability Rights and Rochester ADAPT will be having a rally on Monday, August 2, 2010

11:00 AM at 39 West Main Street, Rochester, NY

Although this has been mentioned in the media, key issues are not being raised or addressed:

- Monroe County is not explaining why CDR's program is still being shut down when most of the people who were investigated are actively refuting claims that they were neglected.

- Monroe County is not explaining why a successful program run by a disability-led, consumer controlled organization is being dismantled and given to for-profit entities.

- Monroe County is not explaining why it continues to refuse to acknowledge the voices of the people with disabilities who want to stay and let them make their own choices.

Monroe County folks are the same people who used the R-word.

Now they are talking ABOUT us, and refuse to talk WITH us.

Please come and help us make our voices heard!

39 West Main Street, Rochester, NY

Monday, August 2, 2010

11:00 AM

We will be continuing our vigil throughout the weekend.

People can feel free to come and join us!

Defending Our Freedom in Rochester, NY: Call Maggie Brooks and Tell Her Don't Take Away Our Choice!

2010-07-28T14:58:00.000-07:00

By The Roving Activist

For three days, I have been on the sidewalk with the folks from the Center for Disability Rights (CDR) as we fight for the freedom of our sisters and brothers who use the Consumer Directed Personal Assistance Services (CDPAS) program through CDR.

On July 22, 2010, CDR, and each of its 300 CDPAS consumers received a letter from the Monroe County Department of Human Services stating that CDR's contract with the county had been terminated, and that consumers had until August 1, 2010 to find another agency. No reason was given for the termination of the contract.

A list of five agencies was provided for consumers to transfer to in order to receive services. All are for-profit, and two have central offices that are located out of state. In a separate letter to the media, the county made several allegations which were either patently false, or misrepresentations of CDR responsibilities. CDR responded to this letter with facts and documentation so that the truth would be known.

On Monday, July 26, 2010, the 20th anniversary of the signing of the ADA, over 300 people packed a forum originally organized to celebrate the ADA, but it quickly became a venue to express their outrage over what had happened, and how it would have a devastating impact on their lives.

After the forum, 100 activists and CDPAS consumers and attendants, along with CDR staff and ADAPT members marched to the Monroe County Building to demand the restoration of the CDPAS contract to CDR. Over 30 people, including myself, held vigil through the night in front of the building. Today, Wednesday, is day three of our vigil at the County Building. Maggie Brooks, the Monroe County Executive, has dug in her heels and is refusing to meet with CDR, or restore the CDPAS contract.

I am appalled at the actions of Ms. Brooks and Kelly Reed, Commissioner of the Monroe County Department of Human Services. They are well aware of the fact that their decision has done three things: It has taken away our people's ability to direct their own attendant services (something unheard of in traditional home care agencies), it has endangered their lives because traditional home health agencies will not accept or cover those with complex needs, and those who need 24-hour care, leading to health deterioration, and it has put people at risk of placement in nursing facilities, where neglect and substandard care is common. They simply don't care!

The county also doesn't seem to mind that due to it's actions, it is potentially in violation of Olmstead, and lawsuits from consumers and their families are a likely result, as well.

I am sure that the county knows the status of the agencies that it is referring CDPAS consumers to transition to. According to one worker who called each agency, one of the agencies is closed, another is not accepting new clients, and the others are saying that they don't have the human resources to deal with the influx of clients with complex needs.

These machinations by the county are in my opinion, nothing more than politics in action. It is a ploy to silence the advocacy, activism, and voice of CDR and it's consumers. I can't help but believe that when I hear stories of people dying of neglect in the county jail, yet that contractor still has a contract. It is my understanding that children have died in the care of the Monroe County Department of Human Services, yet, Kelly Reed, it's Commissioner, still has a job.

CDR has not neglected CDPAS consumers, and no one has died, yet CDR's contract has been terminated without due process. When the County tolerates long-standing abuse and neglect of clients in other programs that it oversees, but terminates the contract of an agency well-known in the community as outspoken disability rights activists and advocates, it is a clear sign that big government is attempting to silence the voices of downtrodden people.

Call Maggie Brooks, Monroe County Executive, at 585-753-1000, and tell her don't take away our choice. Restore the CDPAS contract to CDR!

Without FMAP Extension, More Cuts Loom

2010-07-25T14:55:00.000-07:00

This story is from New York, but the FMAP extension problem is part of what is threatening funding for services that support our freedom to live in the community. The US Congress needs to extend FMAP asap! This affects most states, particularly ones facing serious budget crises.

Counties to lose millions in federal medical reimbursements

By Don Lehman dlehman@poststar.com Posted: Sunday, July 25, 2010 3:51 pm

The term FMAP may not mean much to the general public, but to local officials they are four very important letters.

The acronym stands for Federal Medical Assistance Percentage, a program that increased Medicaid reimbursement percentages during the recession and expires at the end of the year unless Congress extends it.

Warren County officials are expecting to receive $3.2 million in FMAP funds this year, and were expecting at least a portion of that money next year as well if the reimbursement remained heightened for the first six months of 2011 as expected.

But so far, Congress has not approved an extension and national media reports indicate many think it won’t as a way to rein in expenses.

Not having that money would leave a hole in the Warren County budget that would require a tax increase of 9 percent if budget cuts weren’t made, said Fred Monroe, the Chester supervisor who is chairman of the Warren County Board of Supervisors.

Monroe sent a letter Thursday to U.S. Rep. Scott Murphy, D-Glens Falls, and the state’s U.S. senators asking that Congress extend the program.

"It’s an extension everyone thought was going to happen, but it hasn’t happened," Monroe said. "We’re going to have some tough choices if that FMAP money doesn’t come through."

The county will see some savings next year when its contract with the Hudson Falls trash plant ends, but the FMAP loss — along with what many believe is an inevitable cut to state aid when a state budget is passed — will still be a hurdle, Monroe said.

"Our situation isn’t as bad as it was last year, but we’re going to have some heavy lifting without that (FMAP money) and with whatever the state is going to do to us," Monroe said.

In Washington County, FMAP provided $1.8 million this year, and like most states and counties, was leaning on a portion of the money for next year.

"We’re praying for it," said Washington County Administrator Kevin Hayes. "It’s a big hole to go back from if it’s not extended."

Saratoga County hoped to receive $2 million next year under the six-month extension, county Administrator David Wickerham said.

"We all know it’s going to end eventually," he said. "Everyone is going to have to start structuring their budgets so they don’t rely on it."

He questioned why New York’s federal Medicaid reimbursement rate is normally 50 percent, while other states normally receive up to 67 percent, FMAP notwithstanding.

Hayes said the extension was initially included in a federal bill that extended unemployment benefits, but was pulled out before the bill passed.

"Everyone thought the extension was going to pass," Hayes said.

On Thursday, Gov. David Paterson called on the federal government to pass the FMAP extension bill before the House of Representatives leaves for its August recess.

The state expected $2.2 billion next year from FMAP, with another $800 million to go to counties in the state, according to Paterson’s office. Paterson said the state Legislature needs to come up with a contingency plan to deal with the possibility the funding will not be coming.

http://poststar.com/news/local/article_50d467ec-9826-11df-86d2-001cc4c002e0.html

An Open Letter from ADAPT to the Disability Community on the 20th Anniversary of the Signing of the Americans with Disabilities Act

2010-07-25T14:52:00.000-07:00

Sisters and Brothers in the Disability Community: As the 20th anniversary of the signing of the Americans with Disabilities Act draws near, we approach the milestone with mixed emotions.

Securing national civil rights legislation, protecting the rights of people with disabilities, was truly historic. It is important that we recognize the incredible nature of this accomplishment and the hard work of those that made this happen, but 20 years after President George H. W. Bush signed this civil rights legislation into law and as our community is preparing for the celebrations, we pause in disappointment that the promise of freedom has still not reached our sisters and brothers in nursing facilities and other institutions.

Our sisters and brothers remain locked away, unseen and unheard. For them, the act is just words on paper. They are not given the opportunity to exercise their civil rights under this law because they still do not have the basic freedoms that other Americans enjoy.

As the Anniversary date draws closer, they may hear about the progress our community has made over the past 20 years, but knowing that you are protected against discrimination in employment means nothing when the hub of your life is a bedroom you share with a stranger. Knowing that buildings and public accommodations are accessible means nothing when the facility staff won't let you leave; and even having access to lifts on buses - as dear to our hearts as that is - means nothing when you cannot afford to go anywhere on the allowance that is left over after the institution has taken its share of your money.

When we gather together as a community, we must remember that our sisters and brothers in institutions will not be toasting those that authored or advocated for the Act. They will not be celebrating independent living, either as a movement or personal achievement, and they certainly won't share in the power or pride of the disability community. For them, July 26th will be the same as every other day in the institution.

Recently, ADAPT has been criticized by some of the provider-based advocates in our community because we are publicly demanding that Speaker Pelosi sign onto the Community Choice Act and agree to eliminate the institutional bias once and for all. They tell us that publicly questioning "our friends" is inappropriate. We are told we should be grateful for the efforts that have been made so far, and that we must be patient because change takes time.

We will not apologize for our impatience. We do this because our brothers and sisters have waited long enough for their freedom. We cannot sit by, patiently and quietly waiting for our government to give our people the freedom which should be our birthright.

We had great hopes for President Obama and this Congress. Many of us believed that his promise for change included the promise of freedom. When President Obama was taking the oath of office with his hand on Lincoln's bible, it seemed like fate was telling us that he would free our people.

When the President and Congress took up health care reform, we were sure that they would finally eliminate the institutional bias, and we hoped that this historic anniversary in the disability community would be celebrated with historic change. Unfortunately, the President and Congress did not have the political will to make this happen. While we recognize that some gains were made, unlike any other class of Americans, our freedom remains a state option.

It is, indeed, true that one of the tools we are using to help people leave institutions and move into the community is the Supreme Court's Olmstead decision, which is based on the requirements of the ADA, and it is true that President Obama's administration has demonstrated an unprecedented commitment to enforcing the Olmstead decision. But such efforts are transitory.

We have seen, during the last 20 years, that new administrations have their own priorities, and although there may now be a commitment to enforce the Olmstead decision, the pendulum will ultimately swing back in the other direction. We also know that the gains we may make in the courts are hard-fought, slow, and constantly subject to attack.

Even right now, as many in the disability community commemorate the ADA's anniversary, the Attorney General in Connecticut is coordinating legal efforts by the states to fight against some of the recent gains we have made in court which will allow more of our people to live in freedom. Ironically, the deadline for states to join the effort is just one day after the anniversary, July 27th.

In America, freedom shouldn't ever be optional, but - in fact - for us it is. While federal Medicaid rules require states to pay for institutional placement, community-based alternatives are state options and continually subject to elimination in state budget cuts. It is ironic that as we celebrate a civil rights victory that is 20 years old, our freedom is becoming even more precarious and the situation becoming more dire. States, facing record budget shortfalls, are cutting the services that support community living options for seniors and persons with disabilities. These budget cuts force people into unwanted placement, stealing from them much of what is most precious: their homes, their families and their freedom.

Some people have moved across the country to a different state to get supports and services to live outside of the institution. There, they have been able to share in the promise of the ADA, but many people don't know about the services available in other states or simply might not be able to make the journey on this modern underground railroad.

But as long as community services are only an option, those who have escaped to freedom cannot escape the fear. No place is safe because their freedom can easily disappear at the whim of state policy makers. They will be called upon to help solve their state's budget crisis by sacrificing their freedom, home and lives.

We all need to recognize that through personal circumstance or state policy change any of us can lose our freedom. No one in our community is exempt. No one is safe. No one in our community can afford to be comfortable, but it is also our hope that - from this discomfort - the disability community will be mobilized to take action and, together, we will build on a 20-year legacy to address this injustice.

Our movement isn't about the civil rights for some of us; it is about the freedom of all of us. We cannot wait any longer. ADAPT asks you, during this ADA 20th anniversary celebration, to recommit your energy to ending the institutional bias during the next Congress. The time is now to end the institutional bias and FREE OUR PEOPLE!

Sincerely, The ADAPT Community

New York Times Covers Cuts to Home Services

2010-07-25T14:46:00.000-07:00

July 16, 2010

Cuts in Home Care Put Elderly and Disabled at Risk

By JOHN LELAND

HILLSBORO, Ore. — As states face severe budget shortfalls, many have cut home-care services for the elderly or the disabled, programs that have been shown to save states money in the long run because they keep people out of nursing homes.

Since the start of the recession, at least 25 states and the District of Columbia have curtailed programs that include meal deliveries, housekeeping aid and assistance for family caregivers, according to the Center on Budget and Policy Priorities, a research organization. That threatens to reverse a long-term trend of enabling people to stay in their homes longer.

For Afton England, who lives in a trailer home here, the news came in a letter last week: Oregon, facing a $577 million deficit, was cutting home aides to more than 4,500 low-income residents, including her. Ms. England, 65, has diabetes, spinal stenosis, degenerative disc disease, arthritis and other health problems that prevent her from walking or standing for more than a few minutes at a time.

Through a state program, she has received 45 hours of assistance a month to help her bathe, prepare meals, clean her house and shop. The program had helped make Oregon a model for helping older and disabled people remain in their homes.

But state legislators say home care is a service the state can no longer afford. Cuts affecting an additional 10,500 people are scheduled for Oct. 1.

For more, see: http://www.nytimes.com/2010/07/21/us/21aging.html?_r=3&th&emc=th.

2010-06-27T15:00:00.000-07:00

Via Steve Gold:

"Forced Institutionalization of People With Disabilities Is Illegal" -
DOJ and Federal Court Ruling.

By Gail Zoppo - Jun 25, 2010 reprinted from DiversityInc.

The U.S. District Court in Jacksonville, Fla., ruled this week that
Michele Haddad must be provided with services that will allow her to stay
in her home. Haddad, who has a spinal-cord injury caused by a motorcycle
accident with a drunk driver three years ago, was at risk of being forced
into a nursing home because of changes in her caregiver situation.
Although the 49-year-old woman has been on the waiting list for Medicaid
community-based waiver services for two years and had alerted the state of
her need, she was told that the requested services would only be available
if she was admitted to a nursing home for 60 days.

In Haddad v. Arnold, the plaintiff argued that she would suffer
irreparable harm if forced to enter a nursing home.

The court agreed, ordering the state to offer Haddad community-based
services. The reason: Segregating people with disabilities is a form of
discrimination, as found in Olmstead v. L.C. This landmark
disability-rights decision determined that isolating people with
disabilities in institutional settings deprives them of the opportunity to
participate in their communities, interact with individuals who don't have
disabilities and make daily choices. The ruling also acknowledged that
unnecessary institutionalization stigmatizes people with disabilities.

The Olmstead decision, which marks its 11th anniversary this week, is not
the first such case that the U.S Department of Justice has filed briefs.
The DOJ is involved in several other cases in Illinois and New Jersey, as
part of its mission to end discrimination against people with
disabilities.

"In the Olmstead case, the court recognized that the unnecessary
segregation of individuals with disabilities stigmatizes those individuals
as unworthy of participation in community life," stated Assistant Attorney
General for the Civil Rights Division Thomas E. Perez. "By supporting Ms.
Haddad in this case, we seek to ensure that individuals with disabilities
can receive services in the most integrated setting appropriate, where
they can participate in their communities, interact with individuals who
do not have disabilities and make their own day-to-day choices."

The Department of Justice's involvement in these cases reinforce the Obama
administration's national efforts to protect the rights of all people.

"This work is a priority for the Civil Rights Division, and we are
committed to aggressive enforcement of Olmstead so that we can build upon
progress made over the last 11 years," said Perez earlier this week. "But
our work is only one piece of a larger, administration-wide effort to make
the promise of Olmstead a reality for individuals with disabilities
nationwide. Real reform requires a holistic approach. As a lifelong public
servant, I recognize that the most vexing problems a government faces are
those that require unprecedented interagency collaboration and
coordination. The unnecessary and illegal institutionalization of
individuals with disabilities who would be better served, and better able
to contribute to their communities, if they were provided services in
integrated settings, is one of those problems."

Back in the Saddle

2010-06-27T07:49:00.000-07:00

ADAPT and Defending Our Freedom is happy to announce that we are back in the blog saddle after some time out of commission. Expect to see new updates on our struggle for community choice! We have also recruited some helpers so the workload of posting posts is shared. Onward and upward...

Money Follows the Person in USA Today

2010-04-26T05:27:00.000-07:00

Nursing-home residents get aid to move out

By Phil Galewitz, Kaiser Health News

PEACHTREE CITY, Ga. — Richard Hasselbach and Deborah Kadlec met in a nursing home and dreamed of a life together outside its walls.

Their health conditions made living on their own a challenge: Hasselbach, 63, is disabled from a stroke and lost a leg to a blocked artery. Kadlec, 52, has multiple sclerosis. They both use wheelchairs and need help with basic chores such as bathing, cooking and remembering to take their medicines. Most of their relatives live in other states.

Despite those obstacles, Hasselbach and Kadlec got their own apartment and a personal care aide last summer through the help of a federally funded program run by the state. The program, known as Money Follows the Person, is the nation's most ambitious effort to move people out of nursing homes and other long-term-care facilities. It aims to help them live on their own and also save tens of millions of dollars for Medicaid, the state-federal health insurance program for the poor and disabled that pays for two-thirds of nursing home bills in the U.S.

Nationally, nursing home care averages about $75,190 per patient each year. Care in the home, through such services as meals-on-wheels and daily visits by a health aide, averages $18,000 a year, according to the AARP Public Policy Institute.

The program gives nursing home residents personal and financial help to live on their own or in small group settings, as well as payments for costs such as apartment security deposits, household furniture and alterations to make homes or cars accessible to the handicapped.

Georgia is one of 29 states and the District of Columbia participating in Money Follows the Person. Its experience shows both early successes and an illustration of the program's slow start nationwide. Georgia had hoped to move 1,312 people from nursing homes and other long-term-care facilities by 2013. Through the end of last year, though, it had moved only 221.

Combined goal: Moving 37,000 out

Congress established Money Follows the Person in 2005, and states set a combined goal of moving out more than 37,000 residents from nursing homes and other facilities by 2013. Most states, including Georgia, started their programs in 2008. Two years later, just 5,774 residents have moved nationally.

Most states are moving slowly for various reasons: problems finding affordable housing, resistance from nursing homes and stringent federal rules that limit who is eligible and what types of community settings they can move into, according to a study by Mathematica, a Princeton, N.J.-based think tank that is evaluating the program for the federal government.

For more, see http://www.usatoday.com/news/health/2010-04-21-nursing-homes_N.htm.

North Carolina Faces In Home Services Cuts

2010-04-26T04:46:00.000-07:00

Proposed N.C. budget has personal impact
Posted: April 22
Updated: April 23

Born with cerebral palsy, Valerie Harper is paralyzed on her right side. Swollen limbs and severe arthritis, she says, cause her constant pain.

"I can't stand very long. I can't walk that far," Harper, 51, said Thursday.

Yet, she lives on her own, with the help of an aide who comes in two to three hours a day, five to six days a week, to assist with day-to-day tasks such as fixing meals, dressing and bathing.

"She's really like a part of me," Harper said.

But proposed budget cuts could leave Harper and thousands of others who qualify for a state-funded program called In-Home Personal Care Services without that extra help they need to live independently.

Gov. Bev Perdue's $19 billion spending plan, which includes cutting about $386 million from the Department of Health and Human Services' budget, recommends eliminating the program and creating a new one for adults with the most severe needs.

Patient advocates say the move would force thousands of people from their homes and into state facilities, where the cost of care is more expensive.

For the full story, go to: http://www.wral.com/news/local/story/7470899/.

"It appears that in Texas there is no justice for sadists..."

2010-04-24T06:19:00.000-07:00

January 23, 2010
Tom Perez
United States Department of Justice
Criminal Investigation Division
P.O. Box 66018
Washington D.C. 20035-6018

Dear Mr. Perez,

On behalf of Community Now! a Texas statewide advocacy group with a mission to support people with disabilities to live in their communities please accept this sincere and critical request to investigate numerous former Texas state employees who committed horrific acts of violence against residents of several state institutions for people with intellectual disabilities. Upon investigation and if warranted, we sincerely request that those individuals found guilty of criminal acts be charged by the DOJ with Hate Crimes against people with disabilities. It was recently reported in the Texas Tribune (note enclosed article) that since 2000, 75 former employees were fired because of confirmed Class 1 Abuse. This level of abuse is the most heinous and includes sexual and physical assault, murder and gross neglect. Of those 75 individuals, only two were incarcerated for their crimes.

It appears that in Texas there is no justice for sadists who commit violent crimes against our most vulnerable and at risk citizens. The Department of Aging and Disability Services (DADS), the agency who operates these facilities points to Adult Protective Services, (APS) the agency that investigates abuse and neglect at these facilities. APS points to local law enforcement and local law enforcement points to the County Prosecutors and the Prosecutors do little to nothing with these cases. And with everyone pointing fingers at everyone else, people in these facilities are abused without accountability thus sending a clear message to other facility staff that you can get away with murder.

Even with state institution reform legislation passed in the previous Texas Legislative Session (SB 643), it appears that the Ombudsman position with increased oversight authority of these facilities has not been appointed by Governor Perry and even with a network of Ombudsman, there is limited authority by the Texas Attorney General to investigate and prosecute state employees with confirmed Class 1 Abuse if the County Prosecutor is not willing to do so.

As you most likely know, Texas entered into a settlement for numerous civil rights violations investigated by the DOJ CRIPPA division. Currently, the conditions of these facilities are being monitored by the DOJ. Hopefully something will come of this monitoring to ensure the safety of those who live in these facilities.

Further, the hope is that the DOJ will ensure Olmstead is honored by closely monitoring the right of residents to leave the facility to live in the community upon their request.

Let me be clear, I am not asking for any further investigation from the DOJ regarding CRIPPA. On behalf of Community Now! we strongly request the immediate investigation and charges of Hate Crimes against those perpetrators of these despicable crimes. I was provided your name by the leadership at the Regional Office of Civil Rights. If you are not the right person to make the decision to investigate these crimes, I implore you to forward this letter to the individual charged with leading Hate Crime investigations at the DOJ with all haste. And if this is not within the authority of the DOJ, please provide me with the contact information of the appropriate person and agency to contact.

I look forward to your prompt response and immediate action to our requests. Thank you for your time and consideration.

Sincerely,

David Wittie, President
2316 Bristol Street
Bryan, Texas 77802
512-577-8982

CC;
Governor Rick Perry
Lt. Governor David Dewhurst
United States Senator John Cornyn
United States Senator Kay Bailey Hutchison
United States Representative Lloyd Doggett
State Senator Jane Nelson
State Senator Steve Ogden
State Senator Jeff Wentworth
State Representative Abel Herrera
State Representative Larry Phillips
State Representative Patrick Rose

State Budget in Kansas a Life and Death Struggle

2010-04-24T06:17:00.000-07:00

Lives on the line in budget crisis, advocates for disabled say
By Scott Rothschild
April 16, 2010

Topeka — For Kansans with disabilities, the fight over the state budget is a life and death struggle.

Since 2009, 65 Kansans have died while on waiting lists for services that provide assistance in-home or in the communities, according to organizations that advocate on behalf of those with disabilities.

“They did not die in dignity,” said Shannon Jones, executive director of the Statewide Independent Living Council of Kansas. “People are languishing. Reducing their quality of life does lead to their death without dignity,” she said.

Because of plummeting tax revenues, Gov. Mark Parkinson in November ordered a 10-percent cut in Medicaid. Other social service spending was approved by legislators in February.

That has left more than 4,300 people on waiting lists for services.
Parkinson, who has proposed a temporary state sales tax increase of 1 cent per dollar, and an increase in the cigarette tax, has vowed to restore the 10 percent Medicaid cut when the wrap up session of the Legislature starts April 28.

But Parkinson has said he doubts there will be enough funding to take care of all those on the waiting list.

“I think the best we can do is restore the Medicaid rates that I previously cut,” he said recently.

For more, see http://www2.ljworld.com/news/2010/apr/16/lives-line-budget-crisis-advocates-disabled-say/?kansas_legislature.

Young Alabamian Forced to Live in Nursing Facility

2010-04-24T06:12:00.000-07:00

Some needs of Alabamians with disabilities unmet by state-funded programs
By The Associated Press
April 18, 2010, 7:31AM
Written by Michelle Rupe Eubanks -- The Times Daily in Florence

FLORENCE -- Haylee Cain doesn't belong where she lives.

At 21, she's a spirited and vivacious Crimson Tide fan, thinks wrestler John Cena is the best thing ever, and loves logging on to social networking sites such as Facebook and MySpace to catch up with friends.

But because she has cerebral palsy, Haylee lives in a nursing home.

The state of Alabama offers little or no services for people like Haylee, those with potentially debilitating physical ailments who are over the age of 21 and with an IQ of more than 70. One reason for the dearth in care, according to state and local officials, is that there is no money available to support an organization that would provide around-the-clock care or organized day programs.

"It's an issue we talk about. What happens when someone turns 21?" said Kerry Boswell, executive director for the Alabama Department of Rehabilitative Services in Montgomery.

He offers little hope the situation will change in the near future.

For more, see http://www.gadsdentimes.com/article/20100418/APN/1004180506.

Missouri Looks to Reduce In Home Services

2010-04-24T04:49:00.000-07:00

Bill cutting in-home care moves forward in Missouri Senate

By Michael Bushnell and Rebecca Berg, State Capitol Bureau
April 20, 2010

JEFFERSON CITY - The Missouri Senate advanced a bill Monday that would reduce in-home services for those on the state's Medicaid program, over the objections of some Senators who said it would cut benefits without saving money.

Legislative staff estimated the bill, as written, would save the state $11 million in 2011. Sen. Tom Dempsey, R-St. Charles, who sponsored the bill, said this would be achieved in part by reducing reimbursements to those on Medicaid and allowing the state to privatize its assessments of who is eligible for in-home health care.

Currently, the state's health department is responsible for all assessments.
As of September, 42,827 Missourians on Medicaid received some kind of in-home health care treatment. Dempsey said reducing services is just one step towards balancing the state's budget, a process he said Gov. Jay Nixon made more painful.

For more, see http://www.globe-democrat.com/news/2010/apr/20/bill-cutting-home-care-moves-forward-missouri-sena/.

Money Follows the Person in USA Today

2010-04-22T11:50:00.000-07:00

Excellent Write Up of Community First Choice Option's Value

2010-04-17T05:27:00.000-07:00

From www.stateline.org:

Thursday, April 15, 2010
Hope for the long term
By Christine Vestal, Stateline.org Staff Writer

A casual observer of the health care debate might think the historic new federal law does little to help older Americans. In fact, emotional talk of "death panels" likely led more than a few people to expect bad news for end-of-life care.

It’s true that the new law promises to pay only a tiny share of states’ biggest and fastest growing health care bill – long-term care for the elderly and other adults with disabilities. Still, its attention to the issue may end up paying much bigger dividends in the future.

The law, known as the Patient Protection and Affordable Care Act, includes the first-ever national long-term care insurance plan – called Community Living Assistance Services and Supports, or CLASS – a federally administered program financed through payroll deductions. If a significant number of people sign up for the voluntary program – a heavily debated issue – individual long-term care benefits could defray a portion of states’ costs.

But the real gift the new law presents states is a detailed roadmap to the most successful ways to cut costs and improve services for the elderly. By offering incentive payments of 2 to 6 percent of costs, the federal government is encouraging states to adopt and expand successful programs pioneered by a handful of states that give elders more options for their care at much lower expense.

Health reform’s incentive funding for long-term care would flow through Medicaid – the federal-state health insurance plan for the needy – in the form of a slightly increased federal share for certain programs. And although the amounts are small, the power of the bully pulpit could accelerate state long-term care reforms, yielding billions in savings and substantial improvements in the care of our elders.

It is well known that nearly all seniors and adults with disabilities want to remain in their homes as long as possible, and it’s vastly cheaper for states to provide the help – meals, bathing and dressing, and other home services – that allows them to do so rather than resort to institutionalization. Yet, the majority of those who need long-term care are isolated in facilities estimated to cost at least three times as much as comparable home-based care.

For decades, states have experimented with programs to help elders age at home, saving millions that otherwise would be spent on costly nursing home stays. But the millions saved in a few states has barely made a dent in the behemoth national long-term care bill – $147 billion in 2009 and projected to reach $207 billion by 2020 and $346 billion by 2040.

Here’s the problem: Medicaid – which pays nearly 50 percent of all nursing home bills in the country and 40 percent of all long-term care -- is biased in favor of institutional care. When seniors qualify financially and are deemed to need care, Medicaid funding for a nursing home bed is guaranteed. But for those who want to remain at home, funding is only a possibility and a national shortage of home health providers often means long delays.

Meanwhile, waiting for help can be out of the question when a loved one has fallen and broken a hip or suffered a serious stroke. So nursing home care, an entitlement under Medicaid, becomes the fallback, while so-called home and community-based care remains an optional program in most states.

Still, states have made progress – some more than others.

In 2006, Oregon, New Mexico, Washington and Alaska spent more than 50 percent of their Medicaid long-term care dollars for the elderly and adults with disabilities on home and community care. Other states, including Iowa, Massachusetts, Minnesota, New Jersey, Ohio and Vermont are moving in the same direction.

In contrast, Tennessee, Indiana, Utah and North Dakota spent 5 percent or less on non-institutional care. As a national average, state spending on home and community-based care accounted for 41 percent or nearly $45 billion of total Medicaid long-term care spending in 2006, up from 13 percent in 1990.

Incentives in the new health care reform law aim to even out states’ progress in balancing long-term care options between nursing facilities and home and community care by setting goals of at least 50 percent of state spending on home care by 2015 for states that already spend 25 percent or more, and 25 percent by 2015 for states that spend less than 25 percent on non-institutional options.

Does the new federal law go far enough? Many policy experts say ”No.” But most agree that the final product of years of health reform debate went further than they expected toward recognizing the need to change our nation’s long-term care system.

After all, the historic law’s primary aim is to provide coverage for the nation’s masses of uninsured – and seniors aren’t among them. Those aged 65 and older are covered by Medicare, the federal insurance plan for the elderly. And those who require more than a brief stay in a nursing home can tap into Medicaid – once their own resources are exhausted.

But in addition to covering the uninsured, Congress and the Obama administration wanted to reduce the nation’s spiraling health care costs and ease the growing Medicaid burden on states.

Long-term care represents more than 30 percent of states' Medicaid bills, which occupy more than 20 percent of overall state budgets. Medicaid costs are growing faster than any other state expense and long-term care costs are growing even faster.

That’s partly because Americans are living longer. By 2020, the number of people aged 85 years and older -- those most likely to need long-term care -- will increase by more than 40 percent, according to U.S. Census Bureau estimates. By 2040, the number of these very old people will increase more than 250 percent, from 4.3 million in 2000 to 15.4 million.

Even without those demographic pressures, states’ long-term care costs are daunting. The elderly and disabled represent about 25 percent of the total Medicaid population, but they account for more than 65 percent of the spending, according to the most recent federal data available.

States have every incentive to find ways to reduce the costs of long-term care and the new health reform law just gave them one more. Over the decades, federal money -- even in small amounts – has been an effective catalyst for state innovation. These difficult fiscal times may provide one more example.

--Lauren Lambert, Pew Center on the States researcher, contributed to this article.
Contact Christine Vestal at cvestal@stateline.org.

New Hampshire Editorializes on Budget Cuts and Disability Waiting List

2010-04-17T05:23:00.000-07:00

From the Nashua Telegraph http://www.nashuatelegraph.com/opinion/editorials/693226-263/lets-not-reinstate-disability-waiting-list.html:

Let’s not reinstate disability waiting list

There was cause for celebration only a few short months ago, when the state’s waiting list for people who qualify for services for the developmentally disabled was finally eliminated. But the joy was short-lived and replaced by trepidation.

Last month, reinstating the waiting list was one of the budget measures the House Finance Committee unanimously recommended to help balance the budget. The proposal called for $47 million in cuts, the first phase of $132 million in reductions that must be made to balance the state’s books. The proposal was later tabled pending further study.

Any cut the state makes will be painful, but restoring the disability waiting list would also be expensive and illegal. The Legislature should not look to the disabled for help balancing the budget. If it once again does, we strongly encourage advocates for the developmentally disabled to sue, since that’s often the only way to get the state to act.

For decades, hundreds of people in need of services or placement in a community setting, rather than in an institution, languished on the list for months or even years. At one point, there were more than 400 people in line. The state, in part to respond to lawsuits, whittled that list down considerably between 1999 and 2004. Then the list began growing again.

In 2006, lawmakers passed a bill that required that no one qualified to receive services wait longer than 90 days to receive them. The new budget-balancing proposal would have repealed that requirement.

Caring for someone with a developmental disability or an acquired brain injury can impose an unbearable burden on families that can’t get the assistance they are entitled to by law.

Parents are forced to give up jobs to care for adult children, and the disabled with jobs may lose them. While the disabled wait for help, their skills regress and the quality of their life erodes.

Keeping people on the waiting list would likely be found illegal under the Americans with Disabilities Act, Medicaid rules or even under provisions in the recently adopted health care reform act.

The U.S. Supreme Court ruled long ago that the developmentally disabled must be cared for in their communities in the least restrictive setting appropriate for their condition. When a waiting list that exceeds Medicaid’s standard 90-day period exists, that right is abridged.
By definition, a person who qualifies for services has the right, if those services aren’t being provided, to be placed in a group home or an intermediate care facility. The cost for each placement typically comes to between $150,000 and $200,000 per year.

The Supreme Court did say that the resources available to a state to care for the disabled can be a factor in determining whether a violation exists. But New Hampshire’s current budget crisis is not the yardstick that court or any other would use in deciding that question. What counts is the effort the state makes, given its means.

New Hampshire ranks 34th nationally when its per capita spending on aid to the disabled is measured against per capita income. That’s down from 10th in 1999. The state spent an average of $43,594 per person on such aid in 2008. That’s the lowest sum in New England and just a little over half what the state of Maine spends.

People on the waiting list want to live in their community, and it’s cheaper to help them do so. It’s also the law. The next time lawmakers take scissors to the state budget, they should keep them an arm’s length away from funding for the services to the disabled.

– Concord Monitor

Memphis Files HHS OCR Complaints

2010-04-17T05:19:00.001-07:00

From ADAPTer Randy Alexander of Memphis, Tennessee:

The Memphis Center for Independent Living has assisted three individuals, stuck in nursing homes to file OCR complaints, with three more coming by the end of this week.

Surprisingly, OCR in Atlanta has already contacted us, for more info on the first three complaints.

Folks, HHS OCR needs to hear from residents of nursing facilities as to whether they are being moved out into the community fast enough. If not, they should file a complaint ASAP.

Illinois Battles Managed Care Situation

2010-03-28T09:26:00.000-07:00

Illinois lawmakers want to introduce managed care as a cost savings solution. Disability advocates are up in arms. Check out this blog post by Springfield advocate Tyler McHaley:

...The impetus behind this entire post, though, was Access Living's March 19 public forum on managed care, entitled "Managed Care, Managed Lives." Jennifer Thomas, the Personal Assistant Coordinator for Access, put together the event and did a masterful job. She and Tom Wilson, Access' Personal Assistant and Health Care Reform Team Leader, facilitated the forum as well as discussions on a myriad of topics, including the Division of Rehabilitation Services' Home Services Program (HSP), education, the managed care pilot program developed by the Department of Health Care and Family Services (HFS), and the Governor's proposed state budget in its totality.

There was a good crowd of, approximately, 50 people there to take part in the forum. Many who came to the meeting knew the state had many problems with its budget and its ability to manage money, but I suspect they did not realize how deeply the roots of those problems burrowed their way into every layer of the state's fiscal foundation, especially relating to social services. The job of those of us addressing the group that day was to inform and educate grassroots advocates about the problems facing those services particularly geared toward people with disabilities. This was not an easy task, as this is a difficult topic to discuss with people charged to implement policies with which we disagree. If those familiar with the problems as well as the proposed solutions have trouble giving informed answers to relatively simple questions, how is the average citizen supposed to understand all the nuances of pension reform, surcharge taxes for education only, and cuts to social service programs, which are cleverly disguised as "savings?"

For more, see: http://imnotsaying-imjustsaying-cowboy1369.blogspot.com/2010/03/question-and-answer-period.html

Illinois Cuts $90 Million in Community Services and Supports for Mental Health

2010-03-27T08:26:00.000-07:00

March 27, 2010

BY MONIFA THOMAS Staff Reporter mjthomas@suntimes.com

About 70,000 adults and children in Illinois would lose access to state-funded mental health services and another 4,000 would be displaced from community-based housing under Gov. Quinn's proposed budget, advocates for the mentally ill warned Friday.

More than $90 million in proposed cuts to the Department of Human Services would also leave the state without the infrastructure needed to start moving psychiatric patients from nursing homes to community housing, as agreed to in a recent legal settlement, mental health advocates say.

For more, see http://www.suntimes.com/lifestyles/health/2125775,CST-NWS-mental27x.article.

No Matter What You Call it…It’s Still a Cap!

2010-03-16T17:45:00.000-07:00

From Anita Cameron:

Disabled Activists Travel to Albany to Protest Proposed Budget Cap on Personal Care

38 activists from the Center for Disability Rights joined over 50 other people with disabilities from around the state, converging on Albany on Wednesday, March 10, 2010, to protest Governor Paterson’s proposed budget caps on personal care for people needing more than 12 hours of care per day.

Upon arrival, we broke up into teams of 10 – 15 people and visited the office of every member of the state legislature. Decked out in bright orange t-shirts and baseball caps that read, “No Matter What You Call it…It’s Still a Cap”, we were very noticeable as we scoured the Legislative Office Building. Armed with fliers and baseball caps, our members spoke to staffers and sometimes, the legislators, themselves, putting a human face on the issue by telling how these caps on personal care will send us into costly institutions. At the end of each visit, the legislator, or their staff were presented with a beautiful pledge sheet that they were asked to sign. It stated that the legislator would pledge to reject the Governor’s budget cuts to personal care. While most expressed support, three legislators – Senator Bonacic, Senator Huntley, and Assembly Member Towns signed the pledge on the spot. The rest will need follow up back home in their districts.

Each office was also left a bright orange baseball cap with our message on it, so that they would not forget why we were there.

After our visits, we gathered for our traditional lunch from McDonald’s, then headed upstairs to the Senate Chambers, where state senators were preparing to enter into a session to address the budget. The time had come for the senators to get a real lesson on how the caps would affect our community!

Activists formed a gauntlet down the hall and the entrance leading to the Senate Chambers. Huge banners mysteriously appeared, made from shower curtains reading, “Personal Care Is a Civil Right”, “Care, NOT Caps”, “Don’t CAP My Freedom”, among others. At the end of the hall was a banner cut to resemble a jail, with the words, “Nursing Facility” at the top. This banner would figure prominently in what happened next.

Loud chanting that reverberated throughout the entire floor greeted senators and their staffers as they entered the chambers. “No Cuts, No Caps!’ we chanted as we handed out fliers and baseball caps. “No Matter What You Call it…It’s Still a Cap!” filled the ears of the senators as they began their session. At times, an announcement would ring out, “Let us show you what we mean”, and people with disabilities would line up before three individuals with placards with the acronym for three different programs that the state is suggesting that they go to once their services are capped. These programs, Long Term Home Health Care Program (LTHHCP, also known as Lombardi), Managed Long Term Care plans (MLTC), and Nursing Home Transition and Diversion waiver (NHTD) have built-in hourly caps or, due to administrative constraints, are inappropriate for those needing more than twelve hours of care per day.

As each advocate went before the person with the placards and asked for service, they were told, “Sorry, you’re capped” or “Denied!” and sent to the next person with a placard until they were directed to the nursing facility “jail” at the end of the line. After several rounds of this theatre, a gentleman in a business suit (he looked like a legislator, but was actually the Executive Director of Action Toward Independence in Middletown) approached the nursing facility “jail”, signed our Pledge, signifying that the legislature had rejected the budget cap on personal care, and freed the captive activists.

Toward the end of the day, after the senators had been in session for some time, the Sergeant-at-Arms came out to ask that we stop the chanting or he would have to have us removed. He said that we could continue to pass out fliers and hats, so we agreed to his request. In an interesting turn of events, word reached us that some of the senators were asking if we had any more of our caps to hand out. It appeared that at least some of them had gotten our message: No Matter What You Call it…It’s Still a Cap!

http://cdrnys.org/wordpress/?p=432

Advocates Stake White Crosses For Those Who Have Died Waiting For Services

2010-03-15T20:55:00.000-07:00

(Lawrence Journal-World)
March 10, 2010

TOPEKA, KANSAS-- [Excerpt] Advocates for Kansans with disabilities on Tuesday stood at the entrance of the parking garage at the Capitol handing out information to legislators about budget cuts to social services.

The advocates, some dressed as the Grim Reaper, had set up white crosses to represent Kansans who they believe have died while on a waiting list for state services.

“We’re sending a message to legislators that people are in crisis,” said Greg Jones, an advocate from Parsons.

More than 1,800 people with physical disabilities are on a waiting list for home- and community-based services. The program is designed to help keep people out of more expensive nursing home care and provide a more independent quality of life.

The State Independent Living Council said 58 people have died while on the waiting list.

Entire article:
Advocates for disabled urging Legislature to restore cuts
http://tinyurl.com/yjmhqnn

Related:
Group urges disability funding (Topeka Capital-Journal)
http://tinyurl.com/ykm5ghz

Kansas priorities: Liquor industry first, disabled citizens last (Kansas City Star)
http://voices.kansascity.com/node/8054

Activist Reports From New York State

2010-03-08T18:11:00.000-08:00

New York State Budget Cuts Town Hall

Today, Gov. Paterson from New York held a Town Hall meeting in Brooklyn which I attended. Despite the room being filled with folks with many questions, I was able to get recognized by the moderator. As a response to the fiscal problems in New York State, the Department of Health is proposing a cap on community-based services which will have the effect of pushing people into nursing homes. I explained to the governor that 11 years ago I attended the arguments to the Olmstead case before the US Supreme Court and that this was really a matter of civil rights or people with disabilities.

Below is a link to the video of the entire event. If someone can download the entire clip you can extract my question and his response, which occurs approximately 70% into the event.
http://www.ny1.com/1-all-boroughs-news-content/114854/-i-ny1-online---i--paterson-discusses-budget-in-brooklyn
FREE OUR PEOPLE
T.K. Small

Tennesseans Sue State Over Budget Cuts

2010-03-08T18:09:00.000-08:00

http://www.tennessean.com/article/20100305/NEWS0204/3050334/2+sue+over+health+cuts
2 sue over health cuts
They want state to pay for home treatment
By Clay Carey • THE TENNESSEAN • March 5, 2010

Two Tennessee men with severe disabilities have sued the state's TennCare program over cuts in home health care that could force them into nursing homes.

Justin Cochran, 27, and Glen Barnhill, 49, say in the federal lawsuit that the state violated the Americans with Disabilities act by cutting off their access to home-based nursing.

Both men are seeking a court order requiring the state to pay for them to get treatment at home, not in a nursing home.

This year, TennCare is launching a new program called CHOICES designed to give people the opportunity to get long-term care in their homes rather than in a nursing home. But to qualify, the cost of home care can't be more than the cost of a nursing home, TennCare spokeswoman Kelly Gunderson said.

Related

Advocacy group warns that TennCare cuts would lead to more hospitalizations

TennCare cuts won't be quite so deep after break from feds

According to their lawsuit, filed last week in U.S. District Court, the state contends it is less costly to provide Cochran and Barnhill daily, around-the-clock care in nursing homes, so TennCare would not cover the cost of their in-home care.

"For both of them, it would be an extraordinary loss of independence," said Katie Evans, an attorney representing Cochran and Barnhill. She said both men are able to live in their homes, with the help of caregivers.

"It would be extremely damaging to their mental health as well as their physical health if they were to be forced into a nursing home," Evans said.

Gunderson and a spokeswoman for the Tennessee Attorney General's office, which represents the state in court, declined to comment on the lawsuit Tuesday.

Cochran, who lives in a Knoxville apartment, has exhausted his administrative appeals, the lawsuit says. Five years ago he suffered a spinal injury that left him partially quadriplegic and dependant upon a ventilator.

Barnhill, who was left partially quadriplegic after a shooting in 1994, is awaiting an administrative hearing. He is getting treatment at Vanderbilt University Medical Center. Before his hospitalization, he lived independently, with help from caregivers paid by TennCare.

According to court documents, Barnhill told a clinical psychologist that he had a bad experience in a nursing home before, and he fears he would die if he were to be placed in a nursing home again.

Contact Clay Carey at 615-726-5933 or mcarey@tennessean.com.

Take Five! ADAPT Steps It Up! Contact CongressWOMEN!

2010-03-08T08:52:00.000-08:00

As we Defend Our Freedom at the state level and call on the administration to enforce our rights established by the Supreme Court's Olmstead decision, we can't let Congress off the hook. After all, Congress has the power to end the institutional bias by passing the Community Choice Act (S683/HR1670). So how are we going to step it up? We're going to take on FIVE of them at a time, together!

Right now, we have 121 co-sponsors in the House (at least until Eric Massa's resignation takes effect) and 25 co-sponsors in the Senate. About one-quarter of each house has signed on as a co-sponsor of the CCA!

The number of people signing on slowed down a bit while we focused on health care reform legislation, so we are changing our approach. Instead of asking everyone to contact their local Representatives or Senators, ADAPT's Community Choice Workgroup is identifying FIVE specific members of Congress that we will ask everyone across the country to work on. We will do electronic action alerts that allow us to fax and email the DC office, encourage local people to call the office, and coordinate visits in the DC offices.

It's really important that we all reach out to local folks as well. Our elected officials do pay closer attention to the people who elect them. After doing an alert, everyone should try to identify people and groups we know are in the Representative's district (or at least close). These may be family, friends, or that friend from high school long ago that you now have a reason to call or email.

When we release new targets, we will offer talking points that can be used.

It can be really frustrating if you think you're the only one making calls and contacts. You don't know what other people have been told. When a staff person says, no one else has asked about this, you don't know what to say. ADAPT, as part of the Coalition for Community Integration, has set up a website, http://www.c4ci.org/http://www.c4ci.org/> , where we can post information about our legislative advocacy and visits. This will allow everyone to share specific information about their work. Also members of the Coalition are regularly in Washington, DC and set up appointments in the DC offices. The DC advocates can take the information you have shared online to those appointments and report back to you online about what they heard.

Take Five's First Round: IT'S TIME TO FREE OUR SISTERS!

In recognition that we are starting this effort on International Women's Day, we have identified five Congresswomen who we want to sign on as co-sponsors of the Community Choice Act (S683/HR1670). All have been previous co-sponsors of the legislation, but haven't signed on yet.

Judy Biggert, IL-13: Her district includes the cities of Naperville, Downers Grove, and Bolingbrook.

Nita Lowey, NY-18: Her district is in southeastern corner of New York State, just north of the Bronx, and includes parts of Westchester and Rockland Counties.

Carolyn McCarthy, NY-4: Her district is located in central Long Island in west-central Nassau County and includes Mineola, the Five Towns, East Rockaway, Rockville Centre, Oceanside, Garden City, Hempstead, Uniondale, East Meadow, Roosevelt, Franklin Square, Valley Stream, and Elmont.

Gwen Moore, WI-4: The Congresswoman is the first woman to represent the district which is based in Milwaukee and also includes South Milwaukee, Cudahy and St. Francis, and part of West Allis.

Loretta Sanchez, CA-47: California's 47th congressional district covers the cities of Garden Grove and Santa Ana and parts of Fullerton and Anaheim, in Orange County. The 47th congressional district is one of the few districts in California that does not have an overwhelming majority of voters favoring one party.

TAKE ACTION!

START by doing this electronic Action Alert: http://www.cdrnys.org/ccawomen http://www.cdrnys.org/ccawomen>

After you do the alert, forward it out to other folks, particularly people and organizations from the districts these Congresswomen represent. Consider sending it out to women's groups! FREE OUR SISTERS!

Some Talking Points: The Institutional Bias is a women's issue!

According to the most recent data on the CMS website, 68.4% of nursing facility residents are women.

Women typically live longer than men and, if married, tend to outlive their husbands. As they grow older, women are more likely than men to live alone, without a spouse or other family member to provide assistance. In fact, by the time a woman reaches the age of 75, the chances that she is living with a spouse have dropped below one in three.

Women are more likely to need assistance than men of the same age. Among people age 75 or older, women are 60 percent more likely than men to need help with one or more activities of daily living, such as eating, bathing, dressing, or getting around inside the home. One in nine women age 75 or older, and one in five age 85 or older, needs assistance with daily activities.

Women are 60 percent more likely than men to go into a nursing facility at some point in their lives.

According to a 2003 National Alliance for Caregiving/AARP survey, six out of ten informal caregivers were women. Among caregivers providing high levels of care, the proportion of women was even greater.

The 2003 survey reported that the "typical" caregiver is a 46-year-old woman, who has some college education, works, and spends more than 20 hours per week providing care to her mother.

More than 60 percent of female caregivers who were employed had to make sacrifices at work to accommodate caregiving, including going in late or leaving early, working fewer hours, turning down a promotion, losing some benefits, taking a leave of absence, or choosing early retirement or giving up working entirely.

Obama Administration Joins Suit Against In-Home Care Cuts

2010-03-07T20:02:00.000-08:00

http://www.sacbee.com/static/weblogs/capitolalertlatest/2010/03/obama-administr-1.html

March 5, 2010

Obama administration joins suit against in-home care cuts

The Obama administration has filed an amicus brief supporting a lawsuit against a state plan to cut or reduce subsidized in-home care to 130,000 seniors and disabled people in California.

Attorneys with the U.S. Justice Department's civil rights division filed the brief Tuesday in the U.S. Court of Appeal for the Ninth District.

An injunction in a lower federal court stopped the state with going forward with its plan pending the outcome of a suit filed by Disabled Rights California, the National Senior Citizens Law Center and others.

The Schwarzenegger administration appealed, saying officials had a right to reform the In-Home Supportive Services program.

The changes were intended to save the state budget $82.1 million this fiscal year by cutting services to certain people based on an index measuring their mental and physical abilities.

Disabled-rights attorneys argued that the index's purpose is to determine what kind of care the disabled require, not whether they could function in their homes without help. Cutting some people off based on scores, they said, would put people's health and safety at risk and could lead to putting them in an institution.

The U.S. Justice Department brief says: "The United States has a direct and substantial interest in this appeal, which involves the proper interpretation and application of Title II of the Americans with Disabilities Act."

The act, it says, "prohibits discrimination against individuals with disabilities in the provision of public services."

In-home care is financed by federal, state and county dollars with some contributions from individuals who get care.

DOF Gains Momentum in Texas: ADAPT Nation Wants Community Choice

2010-03-07T16:58:00.000-08:00

For Immediate Release:
March 8, 2010
For Information Contact:
Jennifer McPhail (512) 627-5869
Danny Saenz (512) 971-5311
http://adapt.adapt.org/

ADAPT's Defending Our Freedom Campaign Gains Momentum in Austin, Texas:
Local Communities Follow National Lead and Call for Community Choice

Austin, TX---Texas Independence Day Resolutions in support of the Community Choice Act and the "most integrated setting" mandate contained in the ADA were proposed on March 2 in several precinct caucuses. Introduction of these resolutions is especially important as they come on the heels of the passage of a Democratic National Committee resolution in support of community services.

"Barbara Jordan once gave a keynote address at the Democratic National Convention," said Jennifer McPhail, ADAPT organizer from Austin, Texas. "In that address she said of the Democratic Party, "We believe in equality for all and privileges for none. This is a belief-- this is a belief that each American, regardless of background, has equal standing in the public forum -- all of us. Because we believe this idea so firmly, we are an inclusive rather than an exclusive party. Let everybody come." So, the passage of these resolutions will make Barbara Jordan's declaration a reality for all of us who use community services in Travis County," emphasized McPhail.

Danny Saenz, another Austin organizer for ADAPT, added "I was inspired by President Obama's acceptance speech, particularly when he said, "I say to the people of America, to Democrats and Republicans and Independents across this great land: "Enough!" Well, I too, say enough - enough of the institutional bias! Pass the Community Choice Act now!"

The resolutions in support of the Community Choice Act and affirming the ADA's most integrated setting provision will be considered by members of the Travis County Delegation on March 20, 2010. If the resolutions are passed by the Travis County Delegation, they move on to the Texas Democratic Party Convention June 25-26, 2010. Local communities and political organizations across the country are encouraged to follow Austin's lead. For more information on the Defending Our Freedom campaign go to http://www.adapt.org/.

42 Governors Ask Congress for Extension on Medicaid Funds

2010-03-07T07:19:00.000-08:00

Out of Connecticut:

Congress urged to extend Medicaid
Published: Sunday, March 7, 2010
By ANGELA CARTER

Social services providers, researchers and state legislators Friday urged Congress to pass a pending jobs bill that would extend the provision of federal funds supporting Medicaid.

Gov. M. Jodi Rell and 41 other governors have already sent a letter to Congress requesting an extension, and various groups held a teleconference Friday echoing those sentiments.

Ron Cretaro, executive director of the Connecticut Association of Nonprofits of Hartford, said his organization represents more than 500 nonprofits in the state.

More than 300 of them hold human services contracts with government agencies, which makes those agreements vulnerable to state budget cuts.

James Horan, executive director of the Connecticut Association of Human Services in Hartford, said failing to extend federal Medicaid assistance would hurt both low-income families and the state economy.

For more, see: http://www.registercitizen.com/articles/2010/03/07/business/doc4b933a09cd2cd983470742.txt.

Illinois Budget Crisis Forces Jails to Serve as Mental Health Facilities

2010-03-06T19:34:00.000-08:00

Budget crisis keeps inmates from needed mental help

By Edith Brady-Lunny
Posted: Friday, March 5, 2010 7:00 am

BLOOMINGTON -- A 20-year-old man was deemed unfit to stand trial on aggravated battery charges on Jan. 22, a finding that should have triggered his transfer to Springfield's McFarland Mental Health Center for services that would restore him to fitness.

But he and three other inmates found similarly unfit remain in the McLean County jail, the victims of a state budget crisis that has reduced services at the state mental health facility.

McLean County Sheriff Mike Emery said the four men are among a dozen inmates currently requiring special housing arrangements due to mental health issues. The jail, said Emery, "is serving as a small mental health clinic."

For more, see http://pantagraph.com/news/local/article_1f890dc4-2809-11df-b2f3-001cc4c03286.html.

No Medicaid Cuts in Oklahoma...For Now

2010-03-06T18:48:00.001-08:00

Gov. Brad Henry OKs bills to put budget deal into action
Funds to prevent trooper furloughs, reverse medicaid provider rate cuts
BY MICHAEL MCNUTT The Oklahoman
Published: March 6, 2010

Gov. Brad Henry quietly signed bills Friday that complete a budget agreement that takes care of a nearly $300 million projected deficit at the end of this fiscal year. The bills’ approval provides emergency funds to head off trooper furloughs and reverse recently announced Medicaid provider rate cuts of 3.5 percent.

Bills signed Friday by the governor included emergency funding for several agencies:

• Corrections: $7.2 million
• Public safety: $3 million
• Public schools: $54.4 million
• Higher education: $25.6 million
• Health Care Authority: $33 million
• House Bill 1017 Education Fund: $50 million
• Rehabilitative Services Department: $1.2 million
• Central Services Department: $700,000 (to replace boilers in the Will Rogers and Sequoyah office buildings)

The governor signed 20 bills that implement the agreement through appropriations and funding transfers.

The budget agreement calls for spending $223.5 million of the state’s savings account — the Rainy Day Fund — and using $181 million of about $696 million in available federal stimulus funds to close out the 2010 fiscal year, which ends June 30.

Read more: http://newsok.com/article/3444382#ixzz0hSHu95rU.

Looking for the Money: Severe Cuts to Medicaid in Idaho

2010-03-06T18:43:00.000-08:00

Idaho lawmakers approve budget cuts for Medicaid
Brian Murphy - Idaho Statesman
Published: 03/04/10

Richard Armstrong, Director of the Idaho Department of Health and Welfare, speaks with reporters following the JFAC budget setting Thursday morning at the Idaho Legislature. Armstrong has some concerns with the language in the budget, which includes a severe cut to Medicaid.

Idaho legislative budget writers approved a Medicaid budget Thursday morning that forces the Department of Health and Welfare to finding savings of more than $47 million in the program and gives Gov. Butch Otter the authority to modify state statutes to keep the program in check.

The entire Medicaid budget is $1.55 billion dollars, with $298 million coming from the General Fund. More than $1.5 billion of the budget comes from the federal government.

Lawmakers expect $25 million to come from the Hospital Assessment Act, a bill that has yet to be introduced this session. Hospitals will pay the state in order to continue to keep its federal match.

That still leaves more than $22 million in savings for the department to find.

For more, see http://www.idahostatesman.com/2010/03/04/1104198/idaho-lawmakers-approve-budget.html.

State Budget Cuts and How They Lead to Managed Care: Update from Illinois

2010-03-06T18:38:00.000-08:00

An update on the managed care struggle in Illinois, from advocate Tyler McHaley:

Kill Bill, Vol. III

An interesting thing happened on the way to the Medicaid Reform Committee hearing yesterday. I was prepared to testify on behalf of HB 5113, a bill sponsored by Representative Mary Flowers, which would prohibit any state agency, including HFS, DHS, and the Department of Aging from using managed care providers or HMOs to pay for medical care for people receiving Social Security or benefits under other federal waivers. That may sound complicated, but it really is intended to kill the entire managed care pilot project proposed recently by HFS.

It was only after I realized I was at the wrong hearing room that I ran into Representative Chapa LaVIa. It was a fortuitous meeting, as she then told me the current state of her bill, HB 5086, which was heard in the Medicaid Reform Committee last week. Though it passed with only the requirement of some amendments being attached, she informed me the bill was going nowhere. She said the people in the Governor's Office had told her they were not going to work with her legislation. She felt her bill was likely dead even with passage from the committee. Therefore, she told me that she and, presumably, her cosponsors were rallying behind Representative Flowers' bill. Moreover, she wanted disability rights advocates to stand behind that bill as well. Her reasoning was simple inasmuch as she thought that if her idea for a task force to oversee the pilot project was a nonstarter, it was best to ensure the pilot project never had a chance to take root.

For more, see http://imnotsaying-imjustsaying-cowboy1369.blogspot.com/2010/03/kill-bill-vol-iii.html.

More from California

2010-03-04T08:22:00.000-08:00

http://www.kaiserhealthnews.org/Daily-Reports/2010/March/04/California-Cuts.aspx

Mar 04, 2010

The San Francisco Chronicle: "A federal appeals court barred California on Wednesday from lowering Medi-Cal payments to doctors and hospitals by 5 percent and from cutting in-home care workers' wages by nearly 20 percent, saying the state's budget crisis doesn't justify violating federal laws that protect the poor and disabled. In four rulings, the Ninth U.S. Circuit Court of Appeals in San Francisco rejected attempts by Gov. Arnold Schwarzenegger and the Legislature to reduce the state's deficit by paying less to the health professionals who treat 6.6 million low-income Californians, and to hundreds of thousands of workers who care for some of the neediest."

The appellate court said federal law requires "states to maintain poor residents' equal access to basic health care, and forbids cuts intended solely to save money" (Egelko, 3/4).

The Associated Press/Mercury News: State officials said they would appeal the decision. "'We strongly disagree with the court's decision, which interferes with the state's ability to manage its finances and reduce its spending to match its revenue,' Schwarzenegger spokeswoman Rachel Arrezola said. 'We are confident that the U.S. Supreme Court will overrule the 9th circuit's ruling.' Wednesday's decision does not affect California's $20 billion deficit because finance officials did not count on the savings in the governor's January budget, said H.D. Palmer, Schwarzenegger's finance spokesman" (Lin, 3/3).

The Sacramento Bee: "The Ninth Circuit agreed with lower court decisions that granted preliminary injunctions against the cuts because California did not comply with the federal Medicaid Act. The cuts were contained in budget agreements over the past two years. The court decisions not only have blocked past budget cuts, but they could also preclude the state from pursuing similar ways of solving its current $19.9 billion budget deficit. … The court previously determined that under the Medicaid Act the state Department of Health Care Services must set rates 'that bear a reasonable relationship to efficient and economical hospitals' costs of providing quality services, unless the Department shows some justification for rates that substantially deviate from such costs.'" (Yamamura, 3/3)

The Bee, in an earlier story:"A state appellate court ruled Tuesday that Gov. Arnold Schwarzenegger's line-item vetoes last year reducing funding for several programs were constitutional, rejecting a challenge from various social service advocates, unions and Democratic legislative leaders. In a 3-0 decision, Justice J. Anthony Kline wrote that the challenge failed to show that Schwarzenegger had overstepped his executive authority in further reducing expenditures during last July's budget revision. The case, St. John's Well Child and Family Center v. Schwarzenegger, called into question seven line-item vetoes worth $288 million, cutting programs ranging from the Office of AIDS to Healthy Families" (Yamamura, 3/2).

Texas Man Obtains Injunction Against State Budget Cuts

2010-03-04T07:37:00.000-08:00

Texas Man With Special Needs Obtains Injunction Allowing In-Home Care to Continue
Last Updated: 2/22/2010
A U.S. district court grants a Texas Medicaid recipient with severe developmental disabilities' request for a a permanent injunction barring the state from terminating his community-based waiver services after experts testified that placing him in a state home would kill him. Knowles v. Horn (N.D. Tex., No. 3:08-CV-1492-K, Feb. 10, 2010).
Ryan Knowles, a 26-year-old man with severe developmental disabilities, received round-the-clock care in his home under a Texas Medicaid waiver program administered by the Department of Aging and Disability Services (DADS). Because the cost of Mr. Knowles's care exceeded his individual cost limit under the waiver program, DADS attempted to place him in a state school. The U.S. District Court for the Northern District of Texas granted a temporary injunction preventing the state from cutting off his benefits and moving him to a school.
In the meantime, the state passed a rider to the DADS budget allowing DADS to continue funding a Medicaid waiver recipient's costly in-home care if there is no other living arrangement that would protect the recipient's health and safety. DADS refused to reevaluate Mr. Knowles, claiming that he could be treated in a state school. Mr. Knowles moved for a permanent injunction. In support of his motion, Mr. Knowles presented evidence that DADS gave the supposedly appropriate state school a rating of 22 out of 100, and he also introduced testimony from his treating physicians that Mr. Knowles would die if he were moved to the state school.
The same U.S. district court grants Mr. Knowles's motion, finding that "no harm could be more irreparable, and no remedy at law can adequately address the harm" Mr. Knowles faces if institutionalized. "Thus, despite Defendants' legitimate concerns over fiscal restraint, the balance of harms tilts decidedly toward Plaintiff."
For the full text of this decision, go to: https://ecf.txnd.uscourts.gov/cgi-bin/show_public_doc?2008cv1492-52

Maine Restores $37 Million in Community Based Services Funds

2010-03-04T05:47:00.000-08:00

Revised Maine budget unveiled, some cuts restored
By GLENN ADAMS

AUGUSTA, Maine

Maine Gov. John Baldacci presented a state budget rewrite Wednesday that reflects a slightly improved economy and restores some services he previously proposed cutting, most notably in social services and schools.

The restorations reflect $51 million in upgraded revenue projections and nearly $28 million in additional Medicaid funding from the federal government. Thanks to those funding boosts, Maine's revenue shortfall was lowered last week from $438 million to $360 million less than halfway through the two-year budget cycle.

Baldacci, who outlined his proposals at a news briefing in his office, did not rule out further changes in the weeks left before lawmakers adjourn, saying the economy -- which drives the state budget -- remains unpredictable.

"Despite today's good news, we know the economy is fragile and our economy is far from certain," the governor said.

The largest piece of the funding restoration -- $37 million -- is targeted for services including support for nursing homes, assisted living facilities, services for the disabled, home-based care and mental health crisis intervention. The restored funding represents more than half of the human services cuts that had been proposed by the governor in December.

For more, see http://www.businessweek.com/ap/financialnews/D9E7C6280.htm.

California Court Says No to Reduced Home Care Worker Wages

2010-03-04T05:44:00.000-08:00

Court rules against Calif. social, medical cuts
By JUDY LIN Associated Press Writer
Posted: 03/03/2010 04:32:04 PM PST
Updated: 03/03/2010 06:09:16 PM PST

SACRAMENTO, Calif.—Gov. Arnold Schwarzenegger and state lawmakers will have to find more ways to trim spending after an appeals court on Wednesday shot down two budget cuts made in recent years.

In separate cases before the 9th U.S. Circuit Court of Appeals, two judges ruled against the state's plans to cut spending in certain social and health care programs.

One was to reduce the state's contribution to the wages of home care workers by $2 an hour, from a maximum of $12.10 an hour to $10.10. The other was to cut Medicaid payments by 5 percent to pharmacists, hospitals and adult day care providers.

Finance Department officials estimated the state could be saving $79 million in the current fiscal year through June from reduced home care worker wages. At the same time, the state could be saving another $117 million from reduced Medicaid provider payments. California calls its Medicaid program, Medi-Cal.

Union representatives and home care workers said Wednesday's rulings help protect the state's most vulnerable. The groups argued that the state made cuts without studying the impact on the quality of care.

For more, see http://www.mercurynews.com/news/ci_14507093?nclick_check=1.

South Carolina, Oklahoma, Arkansas Medicaid Cuts

2010-03-04T05:41:00.000-08:00

From Kaiser Daily Health News (sent by Marsha Katz)

South Carolina, Oklahoma and Arkansas Grapple With Medicaid Cuts To Help Balance Budget

[Mar 03, 2010]

States consider major cuts to Medicaid services and reimbursement rates to help fill gaps in the budget.

The Associated Press: "Lawmakers are considering cutting all services for nearly 26,000 people with disabilities as South Carolina tries to plug a $560 million budget hole. Parents say the proposed cuts to day care programs and other services would force them to give up much-needed jobs to stay home and care for their young and adult children." But "[l]awmakers say they have little choice. They are trying to close a shortfall in next year's budget in a heavily Republican state where tax increases are not considered a viable option" (Davenport, 3/3).

McKnight's Long-Term Care News: "Starting April 1, the Oklahoma Health Care Authority is reducing Medicaid reimbursements to nursing homes by 3.25%. While the reduction is expected to save the Medicaid agency $5 million, it also will result in the loss of $15 million in federal matching dollars, according to a Tulsa World report. Long-term care and other healthcare providers that serve Medicaid patients will face the same payment cut" (3/1).

Arkansas News: "Suggestions received by the state on how to reduce future Medicaid costs by up to $400 million are being placed on the Internet for public viewing, and the state Medicaid director said today he hopes to finalize a recommendation to the governor this spring. Everything from cuts to Medicaid providers to charging Medicaid recipients additional co-payments is being considered, said Gene Gessow, director of the Division of Medical Services for the state Department of Human Services" (Moritz, 3/2).

DOF Update: Denver ADAPT

2010-02-26T16:32:00.000-08:00

For the past two weeks Denver ADAPT has been taking shifts at the Colorado Capitol building, in an effort work on the budget cuts at the state level that are starting to take a toll on the Atlantis Community and other home healthcare agencies. We’ve visited every member of the Joint Budget and House and Senate Appropriations Committee’s and marched down to Gov. Bill Ritter’s office to demand that they work with ADAPT to end the institutional bias.

While HCBS has already taken a 4.5% (with another 1% coming soon, and a threatened 20% cut on nursing rates,) the nursing homes continue to get their raises. Denver ADAPT has been there everyday to tell the state lawmakers that enough is enough and that if the budget is going to ever be balanced in a way that doesn’t cost human lives then you’re going to have to cut some of the funding from institutions; we’ve even gone as far as asking (oh my,) for a late bill in this session that calls for an end to the institutional bias.

And some lawmakers are listening.

Yesterday Rep. Riesberg told us that not only would he make sure that our literature would end up on all of his 100 of his colleagues desks, he also told us he would be going to Health Care Policy and Finance to see why they were cutting the vital nursing visits that people with disabilities need so badly.

We’ve also accomplished meetings with 5 other Representatives. With the midterm elections coming up many of them flinched when we asked for a late bill to end the institutional bias by taking away compulsory raises for nursing homes, but none of them have told us flat out “no.” But the hard work continues, as we speak there are two more ADAPTer’s at the Capitol who are advocating for our late bill.

Tomorrow we start round two with the JBC, Appropriations and the Governor; ADAPT doesn’t plan on resting until the institutions have to play by the same rules as the rest of us.

Letter from California: Magdalin Marinos

2010-02-26T16:30:00.000-08:00

The following letter was sent and will be resend to CA. District Senators as an advocacy effort to reach the CA. Congress that is being forced by Arnold Schwarzenegger to make drastic cuts to the IHSS programs in an attempt to eliminate this program, as to fix the CA. budget crisis.

-------------------------------------------------------------------------------------------------------------------------------

Jan. 20, 2010
Magdalin Marinos
Downey, CA 90241

Arnold Schwarzenegger is planning to make inhumane, and destructive cuts to the IHSS program that will bring about suffering, harm, hardship, destruction and death to lives of thousands of people. The apathy of the Schwarzenegger administration towards people of need is inconceivable, reprehensible, atrocious, and downright despicable. His administration is a violation of the human and civil rights of people with disabilities, the sick, the elderly and the indigent who are in need of services to meet their daily survival needs in a dignified and humane manner which allows them to exercise their freedoms of choice, life, and self determination.

The changes that have been made up to this point to the IHSS program and those that are currently being proposed for the IHSS program are creating for IHSS consumers extreme suffering, harm and hardship. The IHSS program was created to provide a certain level of home care for those in need. Many individuals have used this program as a supplement to other care service resources, since for many people the need is greater than the program actually meets, as to remain semi-independent and out of nursing homes. Due to the program’s financial shortcomings, the IHSS program consumers, who have been receiving services in order to have dependable, trained caregivers, have had some very distressful experiences with the program’s policies, even before the current negative changes to the program were proposed and passed. For example, finding skilled, responsible capable workers who could be long-term caregivers has always be a major problem for IHSS consumers due to the IHSS low wage rate and low service hours. The IHSS program has needed to be upgraded in the areas of provision of service hours of care (especially for the more severely disabled) and higher wages, as to ascertain a better level of care by qualified caregivers. Instead, the IHSS program changes are creating even more chaotic and distressful problems for consumers. These changes can and will completely jeopardize the well being, quality of care and even life survival of consumers.

In 2009, the changes made to IHSS policy including the length of time it can take for a consumer to hire a provider, based on the new policy rules for IHSS caregiver registration that were passed, has created an impossible situation to overcome without the experience of hardship and harm for people who have severe disabilities or, severe medical issues. Individuals whose physical functioning is limited and cannot live independently, “cannot” possibly wait for a lengthy and expensive enrollment process to be completed (a process which also must be essentially an agreeable arrangement with the potential worker) for hire and payment demands for the caregivers to be procured, so that consumers may have their required need for immediate assistance, being now prolonged by the system, met correctly. This delay of essential services is an inevitable cause of negative effects impacting the well being, quality of care, stability of service provision, safety, and medical status of the consumers.

The Schwarzenegger administration is currently proposing more severe cuts, to complete elimination of the IHSS program. Once more, he is showing complete indifference and apathy of what will happen to those who end up without caregivers. Further, the inhumane administration of Schwarzenegger wants to lower caregiver wages to minimum wage. This action will cause the complete elimination of qualified caregivers, who will be willing to work with such low wages and are needed to do the extensive provision of skilled care, medical and non-medical, that is required by many consumer cases. Much care at home is comparable to CNA work done in nursing homes, and in most instances it is that skilled type of provision of care that is required at home by consumers. CNAs are paid up to $11-$12 an hour while Mr. Schwarzenegger wants home caregivers/aides (CNAs or, not) who are needed to provide equal skilled assistance to medically afflicted individuals to get paid minimum wage. It is truly a complete disregard and degradation, by the Schwarzenegger administration, of the rights of all individuals participating in the IHSS program, caregivers and consumers.

Ultimately, IHSS consumers are on the program due to financial need in covering the high expense of home care. People cannot pay out-of-pocket for assistance, otherwise they would not be on IHSS, and may not have available caregivers or, family members to assist them. Should people be forced into nursing homes, even though they can fully participate in the community and live at home because of the reprehensible actions of Schwarzenegger’s administration, who is choosing to discriminate towards the indigent, disabled, and elderly individuals of this society, instead of doing what is right? It is utter “discrimination” when a government administration chooses a specific class of individuals to decimate by eliminating essential provisions of basic life assistance, leading to the degradation of their freedoms and rights to life, and choice for essential care, while refusing funding changes in other areas where people will not be impacted as atrociously.

These potential IHSS cuts are issues of crucial significance for the individuals in need as they can ultimately determine their lives. These issues however, seem to be insignificant and oblivious factors to those who ignorantly want to pass and choose to pass faulty service policies without any awareness, empathy, compassion, sensitivity and understanding of the needs of those who depend on the services of programs, such as IHSS, and how we will be individually affected.

Personally, I am an individual with a severe disability, needing full time care, and I have been receiving IHSS services as to supplement my resources and remain at home and out of a nursing home. I am a full participant in this society and an educated individual, having rights as anyone else, and wanting to live with dignity and choice to quality of care in order that I may have quality of life, as all people desire and strive for in our world. IHSS has been one resource that I have used in order to pay for some of the care that I need. Any loss of my available care service resources, paid and non-paid (immediate family members), would be a detriment to my ability to have stable home care, as I would not be able to cover the expense of full time care. Ultimately, without essential income and resources it is not possible to pay for the level and type of care that I require. Further, I personally know how difficult it is to search, interview, find, secure, hire, train, get-along with, and keep caregivers working long-term, while being on IHSS. It is a constant stressor and frustration, and since caregiver turn-over rate is very high, due to low wages and minimal service hours, finding new people is a constantly stressful, laborious, problematic, hard bearing and draining situation to deal with. If this administration destroys this program then, many people, including me, will suffer. Ultimately IHSS needs to be upgraded not downgraded, as it is being proposed, if it is going to be a program that will allow for quality of care to be a possibility for people, like me, who are in need of such services.

It is truly a shame, that people who have to deal with distressful medical conditions, and financial problems and depend on government assistance, need to go through so much more unnecessary stress, chaos, suffering, harm and problems due to the faulty and inadequate policy making being made by such inhumane, ignorant, biased, and discriminatory administration of Gov Schwarzeneger. I am sorry, that as the people's Governor, people's lives seem so insignificant to him, in comparison to meeting budget debts. His response, to our human concerns and needs, is truly inhumane, and discriminatory towards all who strive to have some quality of care and life in order to make it from day to day.

Please consider the depth of this issue and support our rights to quality of care and life as full citizens of this country, by rejecting any additional harmful cuts to the IHSS program. It is my hope that this matter can be resolved and corrected without a legal class action by all people who are affected and joining together to make this matter right according to our human and civil rights in this country.

Magdalin Marinos, MSW

IHSS Threatened in California

2010-02-26T16:26:00.000-08:00

Clients fear loss of in-home services

By Sam Womack/Staff Writer swomack@santamariatimes.com Posted: Friday, February 19, 2010

When taxes are paid, there’s a certain expectation that those hard-earned dollars will go to help children, the elderly, the disabled — the most vulnerable and helpless in our society.
And yet, in an effort to close the state’s estimated $20 billion deficit, one proposal is to take away Andrea Hylton’s lifeline.

Hylton is a 64-year-old Santa Maria resident with a multitude of debilitating mental and physical issues.

She is also one of approximately 427,000 California residents with disabilities who could lose their state-funded caregiver if the state Legislature agrees with the governor’s recommendation of cutting $1.8 billion from the program, according to a Santa Barbara County report.

Approximately three years ago, Hylton hired Susan Oeland through the state’s In-Home Support Services (IHSS), a program that identifies how much assistance a person needs, and then provides the money to hire a helper, either a family member, friend or a professional provider.

The services are available to low-income people who are over age 65, blind, or with disabilities, to enable them to remain safely in their home as opposed to committing them to more expensive options, such as institutions or nursing homes.

It is a cost-saving safety net and welfare program that has been around for 35 years.
Approximately 47 hours a month, Oeland helps Hylton with housework, laundry, cooking, shopping, bathing, dressing and making it to doctor’s appointments.

“Without (IHSS) I would be helpless, completely helpless,” Hylton said this week.

In Santa Barbara County, there are a total of 3,000 IHSS clients who require anywhere from a few hours a week to round-the-clock assistance in their homes.

Gov. Arnold Schwarzenegger’s proposed budget includes limiting services to IHSS recipients to those with a functional index score of four or less — one being able to perform a certain task and five being unable even with assistance determined by a social worker.

The index scores do not take into account whether the person resides alone, has cognitive disorders, such as Alzheimer’s disease or other forms of dementia, or needs protective supervision or paramedical services, according to Santa Barbara County analysis.

Approximately 2,700 people are at risk of losing their IHSS assistance in Santa Barbara County, and “a vast majority of these people are going to be left to languish or linger alone, without any support or assistance,” said Kathy Gallagher, director of the county Department of Social Services.

“I’m just scared of what might happen,” Hylton said.

The 30-year Santa Maria resident has no family, no social network and no car, and survives on a fixed income.

A few weeks ago, Hylton took a tumble in her apartment at about 3 a.m. and broke her knee cap. She crawled to the phone and called a friend, who didn’t call back until four hours later. She waited on the friend to call 9-1-1, but did not explain why.

“I was scared. I was in pain. There was no one to help,” she said of the upsetting experience.
Her recent accident is similar to what the county’s analysis predicts as a result of the program cuts.

“There will be a portion of recipients that will be at high risk of self-neglect as they cannot physically care for themselves or meet their basic medicinal needs. This could result in serious injury, institutionalization and even accidental death,” it stated.

Like many who receive IHSS assistance, Hylton doesn’t have the means to afford a nursing home, but even if she did, there are not enough beds in California.

An estimated 1,300 IHSS clients in Santa Barbara County could probably qualify for a nursing home bed, but there aren’t even close to that many on the Central Coast, Gallagher said.

In the state, there are only about 20,000 licensed nursing home beds, and a study from the UCLA Center for Health Research estimates that more than 200,000 clients would seek beds if the IHSS program was cut.

Ironically, in the 1980s, the IHSS program was created to reduce the high cost of nursing-home care and offer seniors a better quality of life in their own home, which is why nursing homes fell out of favor.

Hylton said she would avoid a nursing home or institutionalization for a long as possible because her constant companion “Peanuts,” her pudgy Jack Russell terrier, could not come along.
But she may never need to make that tough choice, because her IHSS provider, Oeland, has become more than a part-time helper; she is Hylton’s friend.

“She’s like a second mom to me, and I’m like her daughter,” Oeland said.

“I’ll never let her be alone. I’ll continue to take care of her if the program is eliminated,” she vowed, even though as an IHSS worker, she faces a wage decrease from $11.50 to $8 an hour in the proposed state budget.

IHSS assistance is just one human-services program on the chopping block in the governor’s proposed 2010-11 budget.

Also included are CalWORKS, Healthy Families, Medi-Cal, Supplementary Security Income (SSI) and the California Food Assistance Program.

The proposed budget also stipulates that if the federal government doesn’t come up with an additional $7 billion for the state, then IHSS assistance, along with CalWORKs and Healthy Families, will be completely wiped out.

Posted in Govt-and-politics on Friday, February 19, 2010

JFAAN Releases Agenda; Contact Steny Hoyer NOW!

2010-02-23T05:48:00.000-08:00

NATIONAL CROSS-DISABILITY, DISABILITY-LED COALITION RELEASES AGENDA THAT INCLUDES CCA!

Today, the Justice for All Action Network (JFAAN) is releasing a comprehensive agenda that calls for eliminating the institutional bias by passing the Community Choice Act (S683/HR1670)! JFAAN's cohesive policy agenda has three major themes: 1) safeguard human rights and respect human dignity, 2) enhance self-determination, and 3) make technology work for everyone.

JFAAN is a coalition led by 13 national organizations run by people with disabilities with identifiable grassroots constituencies around the country. The steering committee of JFAAN includes ADAPT, the American Association of People with Disabilities, the American Council of the Blind, the Autistic Self Advocacy Network, the Hearing Loss Association of America, Little People of America, the National Association of the Deaf, the National Coalition of Mental Health Consumer Survivor Organizations, the National Council on Independent Living, the National
Federation of the Blind, Not Dead Yet, Self Advocates Becoming Empowered, and the United Spinal Association.

At 12:30 pm, Senator Tom Harkin (D-IA), House Majority Leader Steny Hoyer (MD-5) and Representative Cathy McMorris Rodgers (WA-5) will join leaders from JFAAN at a press conference in the Capitol Visitors Center where the group will outline their legislative agenda of the disability community for the 2010 Congressional Session. Senator Harkin is the
Senate sponsor of the Community Choice Act in the Senate, and Representative McMorris Rodgers is a cosponsor of the CCA in the House of Representatives, but House Majority Leader Steny Hoyer has not yet signed on to CCA.

CALL TO ACTION: ASK THE HOUSE MAJORITY LEADER TO COSPONSOR CCA!

Congressman Steny Hoyer helped to lead the passage of the ADA, and he has previously co-sponsored MiCASSA, but he is not yet a co-sponsor of the Community Choice Act (CCA). ADA! He now needs to lead Congress to eliminate the institutional bias and pass the Community Choice Act. Contact Representative Steny Hoyer and ask that he end the institutional bias and become a co-sponsor of the Community Choice Act.

The ADAPT Community has set up a national alert so you can send his office a fax or email right now!

Go to: www.tinyurl.com/hoyer-alert and take action!

FREE OUR PEOPLE!

Bruce Darling

NATIONAL ADAPT

President Obama Tells Denver ADAPT: I Support Olmstead

2010-02-22T18:34:00.000-08:00

On Thursday, February 18, President Obama went to Denver to highlight job creation with Colorado's Senator Bennet. Four ADAPTers went to the event after and the indomitable Dawn Russell cornered the President and not only handed him the letter copied below, she made him read it to her and after reading it said he supports enforcing Olmstead. Another victory for ADAPT. The video above shows the President shaking his hands in a crowd and being snagged by Dawn Russell, then having the aforementioned conversation. ***The video is NOT captioned.

Joey, one of Denver ADAPT's new members, took the video and he also caught the attention of the President. Denver ADAPT also gave our letter to Senator Bennet and the Governor so they too could share it with the President and work with ADAPT to End the Institutional Bias. Then when President Obama and his entourage left the Filmore for their next stop members wearing the same level orange ADAPT gear worn inside waived goodbye.

While all of this was happening Denver ADAPT members were at the Capitol working for a late bill to end the automatic raises for nursing homes. There will be lots to blog about!

Free Our People! This report is compiled from writing by Dawn, Dale Reid and Bob Kafka.

The letter that Dawn handed the President reads as follows:

Dear President Obama:

In this “Year of Community Living” and the 20th Anniversary of the ADA we would appreciate you doing the following:

Direct Attorney General Holder and Secretary Sebelius to aggressively enforce the Supreme Court’s 1999 Olmstead Decision at the state level and END THE INSTITUTIONAL BIAS in Medicaid long term care.

Thank you for defending our freedom and enforcing the civil rights that people with disabilities continue to strive for.

For an Institution Free America

The ADAPT Community

Virginia, Nevada, Louisiana, Arkansas Continue Medicaid Cut Struggles

2010-02-21T17:38:00.000-08:00

Another set of massive budget cuts by the House

Another set of massive budget cuts were proposed today, this time by the House of Delegates to close Virginia’s $4 billion shortfall.

And a lot of it will sound familiar.

The reason: the House plan is largely in line with the cuts proposed by Governor Bob McDonnell.

The major differences are:

The house plan rejects McDonnell’s suggestion of 10 furlough days over two years for most state workers, it spares further cuts to higher ed, it kills a proposed out-of-pocket employee retirement contribution, and it provides a 2011 Christmas bonus.

For more, see http://www2.wsls.com/sls/news/local/article/another_set_of_massive_budget_cuts_by_the_house/82757/.

Nevada in Budget Squeeze

Nevada's $887 million deficit is puny compared with California's $20 billion hole.

But in a state that operates one of the leanest budgets in the nation, that amounts to a 22% shortfall, a gap that has some worried that the state might fall further behind in such areas as education and health care, where it already lags behind other states. Others sense an opening to chart a new course in small government.

"We are working on solutions to turn this recession into an opportunity to reinvent our state's government," Republican Gov. Jim Gibbons said in an emergency State of the State address this month. "We may never have an opportunity like this again," he said. Mr. Gibbons faces a tough primary battle this year and has had low approval ratings.

For more, see http://online.wsj.com/article/SB10001424052748703791504575079391267764362.html?mod=WSJ_latestheadlines#.

La. budget cuts outlined

Mid-article: Many agencies still will have to make do with less money in the upcoming budget year.

In health care:

• The more than $6 billion Medicaid program would get $350 million less than what was initially authorized in the current fiscal year.

The reduction translates into an average 3 percent cut in the reimbursement that doctors, hospitals and other Medicaid providers receive for treating the poor. The practical effect is that Medicaid program enrollees may have a tougher time finding someone to care for them.

State Health Secretary Alan Levine said he has not decided yet how to distribute the rate cuts. Some providers may get a larger percentage cut than others.

• In mental health services, the Jindal administration replaced only $30.9 million of a $42.9 million reduction in federal funding.

Levine said the administration wants to save money by caring for more of the mentally ill in the community rather than in institutions. He said institutions are more expensive than contracting for private beds in patients’ communities.

The state operates mental health institutions in Pineville, Jackson and Mandeville.

Levine characterized the shift as a reform rather than a reduction — a shift away from locking people in a mental hospital when they may not need that level of treatment.

However, the closure of beds in state institutions likely will mean a loss of jobs if workers cannot find employment with a private company or simply cannot relocate.

Levine said he is trying to prevent the reduction in federal money from causing a reduction in mental health services.

“Let’s catch our breath. Let’s try to make structural changes,” he said.

For more, see: http://www.2theadvocate.com/news/84877837.html.

Arkansas lawmakers fret over Medicaid budget cuts

Arkansas lawmakers on Tuesday told the state's Human Services chief they want more influence over how the state will reduce the cost of Medicaid programs by $400 million.

Arkansas Department of Human Services Director John Selig told lawmakers the department plans to keep next year's budget for the program at the same level as this year. But Selig says that means cutting $400 million in the program because of increasing costs and more clients.

For more, see: http://www.businessweek.com/ap/financialnews/D9DTFAUG0.htm

Washington Post's Broder on the Governors' Fiscal Black Hole

2010-02-21T17:27:00.000-08:00

From David Broder at the Washington Post:

As the nation's governors gather in Washington for their annual winter meeting, the states they lead are facing what one knowledgeable authority calls "a lost decade" of stagnant or declining revenue and budget crises.

Ray Scheppach, the man who used that phrase, has the credentials to call the situation "almost unprecedented." A veteran federal budgeteer, he has served as executive director of the National Governors Association for the past 27 years. In an interview just before the opening of this year's meeting, he told me that the most recent survey he'd conducted shows that "the states have not bottomed out yet; they're continuing to deteriorate. This year will probably be the worst for state budgets, and with the jobless recovery we're having, we're looking at a lost decade" before anything like normality returns.

For more, see: http://www.washingtonpost.com/wp-dyn/content/article/2010/02/19/AR2010021903045.html.

How Much Did Medicaid Enrollment Grow in Your State Last Year?

2010-02-21T17:20:00.000-08:00

USA Today created a cool tool that lists growth rates in Medicaid. See http://www.usatoday.com/news/washington/2010-02-18-medicaid-states-spending-cuts_N.htm to locate your state and its percentage. Maryland was the big "loser" with its Medicaid enrollment rate growing more than 20%!

Medicaid State Budget Cuts in the New York Times

2010-02-21T10:28:00.000-08:00

http://www.nytimes.com/2010/02/19/us/politics/19medicaid.html

February 19, 2010

States Consider Medicaid Cuts as Use Grows

By KEVIN SACK and ROBERT PEAR

WASHINGTON — Facing relentless fiscal pressure and exploding demand for government health care, virtually every state is making or considering substantial cuts in Medicaid, even as Democrats push to add 15 million people to the rolls.

Because they are temporarily barred from reducing eligibility, states have been left to cut “optional benefits,” like dental and vision care, and reduce payments to doctors and other health care providers.

In some states, governors are trying to avoid the deepest cuts by pushing for increases in tobacco taxes or new levies on hospitals and doctors, but many of those proposals are running into election-year trouble in conservative legislatures.

In Nevada, which faces an $881 million budget gap, Gov. Jim Gibbons, a Republican, proposed this month to end Medicaid coverage of adult day care, eyeglasses, hearing aids and dentures, and, for a savings of $829,304, to reduce the number of diapers provided monthly to incontinent adults (to 186 from 300).

“We are down to the ugly list of options,” the state’s director of health and human services, Mike Willden, told a legislative committee last week.

The Medicaid program already pays doctors and hospitals at levels well below those of Medicare and private insurance, and often below actual costs. Large numbers of doctors, therefore, do not accept Medicaid patients, and cuts may further discourage participation in the program, which primarily serves low-income children, disabled adults and nursing home residents.

In Kansas, a 10 percent cut in provider payments that took effect on Jan. 1 has prompted such an outcry that Gov. Mark Parkinson, who imposed it, now wants to restore the money by raising tobacco and sales taxes.

Even if Mr. Parkinson, a Democrat, overcomes resistance in his Republican-controlled Legislature, it will be too late for Dr. C. Joseph Beck, a Wichita ophthalmologist who informed his Medicaid patients last month that he could no longer afford to treat them.

Dr. Beck said that over eight months last year, his practice wrote off $36,000 in losses from treating 17 Medicaid patients. The state-imposed payment cut, he said, was “the final straw.”
“I’m out, I’m done,” Dr. Beck said in a telephone interview. “I didn’t want to. I want to take care of people. But I also have three children and many employees to take care of.”

Concerns about health care costs are likely to dominate the winter meeting of the National Governors Association, which begins Saturday in Washington.

In advance of the gathering, administration officials have urged governors to endorse President Obama’s health care proposals, or at least to avoid criticizing them. The Democratic plan, which is stalled in Congress, would vastly expand eligibility for Medicaid as one means of reducing the number of uninsured.

But many governors said they were more concerned about the growth of existing health programs. The recession and high unemployment have driven up enrollment in Medicaid while depleting state revenues that help pay for it.

A survey released Thursday by the Kaiser Family Foundation found a record one-year increase in Medicaid enrollment of 3.3 million from June 2008 to June 2009, a period when the unemployment rate rose by 4 percentage points. Total enrollment jumped 7.5 percent, to 46.9 million, and 13 states had double-digit increases.

Because Medicaid enrollment often lags behind unemployment, this year’s increase could prove even greater.

The National Association of State Medicaid Directors estimates that state budget shortfalls in the coming fiscal year, which begins in July in most states, will total $140 billion. Because Medicaid is one of the largest expenditures in every state budget, and one of the fastest-growing, it makes an unavoidable target.

“For most states, the fiscal situation is still dire, and the Medicaid cuts are significant,” said Scott D. Pattison, executive director of the National Association of State Budget Officers.

Governors and legislators have managed to defer the deepest cuts because the federal stimulus package provided $87 billion to states in Medicaid relief. The cost of Medicaid is shared by the federal and state governments, with states setting eligibility, benefit and reimbursement levels within broad federal guidelines, and Washington covering the majority of the expense.

But the stimulus assistance is due to expire at the end of December, in the middle of many states’ fiscal years, leaving budget officials to peer over a precipice. Congress and the White House are considering extending the enhanced payments for six more months, at a cost of about $25 billion.

The House has passed such a measure and Mr. Obama included it in his budget this month, but the Senate has not acted.

The extension would not come close to filling the Medicaid gap in many states. In Georgia, for instance, Gov. Sonny Perdue assumed in his budget proposal that the additional federal money would be provided, but that the state would still face a Medicaid imbalance of $608 million, said Dr. Rhonda M. Medows, the commissioner of community health.

Mr. Perdue, a Republican, decided it would be unwise to cut optional benefits because that might drive Medicaid patients into expensive emergency rooms. He proposed instead to levy a 1.6 percent tax on hospital and managed care revenues and to cut payments to many providers by nearly 2 percent.

Without the tax increases, which face opposition in the General Assembly, the state will have to cut provider payments by 16.5 percent, Dr. Medows said.

“I won’t have any primary care doctors left, much less specialists,” she said. “Certainly down here nobody likes to talk about taxes, but sometimes you have to bite the bullet and do what’s right for a whole lot of people.”

In the Kaiser survey, almost every state reported that Medicaid enrollment for the current fiscal year was exceeding expectations, making midyear budget cuts necessary.

The options are limited by several realities. To qualify for Medicaid dollars provided in the stimulus package, states agreed not to tighten eligibility for low-income people. And any time a state cuts spending on Medicaid, it loses at least that much in federal matching money.

Despite the ban on restricting eligibility, hard-hit states like California and Arizona are considering proposals by their governors that would remove hundreds of thousands from the rolls once the federal financing ends. Gov. Jan Brewer of Arizona, a Republican, has called for eliminating Medicaid coverage for 310,000 childless adults and ending the Children’s Health Insurance Program to help close a two-year budget gap of about $4.5 billion.

Gov. Phil Bredesen of Tennessee, a Democrat, is proposing the largest cuts in the history of TennCare, his state’s Medicaid program. To trim 9 percent of the TennCare budget, he would establish a $10,000 cap on inpatient hospital services for nonpregnant adults and would limit coverage of X-rays, laboratory services and doctor’s office visits.

“I have no choice,” Mr. Bredesen said.

New York State Builds Coalition

2010-02-20T15:44:00.000-08:00

From New York State: BROAD AD HOC COALITION URGES REJECTION OF 12-HOUR CAP ON PERSONAL CARE

The 2010-11 Executive Budget would require seniors and people with disabilities who need more than 12 hours of Medicaid personal care services per day to switch to other programs that are not designed to meet round-the-clock needs caused by quadriplegia, Parkinson’s, stroke, Multiple Sclerosis, Alzheimer’s disease, etc. By limiting access to services for the most disabled – 4,268 of the 67,937 people receiving personal care services - the cap will cause unnecessary nursing home placement of people who can and do live in the community, violating the 1999 Supreme Court Olmstead decision and the Americans with Disabilities Act.

Activists in New York State are seeking your help! You can send a quick online letter to help stop the caps at http://capwiz.com/rochestercdr/issues/alert/?alertid=14698626. Click today!

The New York State Coalition includes the following groups:

ADAPT – NYS; Alzheimer's Association, New York City Chapter; Alzheimer's and Aging Resource Center of Brooklyn; Bronx Independent Living Services; Brooklyn Center for Independence of the Disabled; Catskill Center for Independence serving Delaware, Otsego, Schoharie, and Chenango Counties; Center for Disability Rights, Rochester; Center for Independence of the Disabled in New York (CIDNY); Cerebral Palsy Associations of NYS; Cerebral Palsy of the North Country - St. Lawrence, Franklin, & Jefferson Counties; The Children's Aid Society; CLC Foundation, Inc., Trustee For The CLC Pooled Trusts I&II; Consumer Directed Choices, Inc.; Consumer Directed Personal Assistance Association of New York State, Incl Disability Advocates, Inc. (serving Albany, Clinton, Columbia, Dutchess, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, St. Lawrence, Ulster, Warren and Washington counties); Disabled in Action of Greater Syracuse Inc.; DOROT, Inc.; Empire Justice Center (all NYS outside of NYC); Enable, Syracuse; F.E.G.S Health and Human Services System; Options/CDPAS, Newburgh -- Dutchess, Orange, Sullivan & Ulster Counties; JASA/Queens Legal Services for the Elderly; The Legal Aid Society, New York City; Legal Services for the Elderly and Disabled, Buffalo; Lenox Hill Neighborhood House; Main Street Legal Services, Inc., CUNY School of Law; Medicaid Matters NY (140-member statewide coalition); Metropolitan Council on Jewish Poverty
MFY Legal Services, Inc.; Morningside Retirement and Health Services (MRHS); National Center for Law and Economic Justice; New Yorkers for Accessible Health Coverage; New York Lawyers for the Public Interest; New York Legal Assistance Group, New York City; PHI (Paraprofessional Healthcare Institute); Regional Center for Independent Living, Rochester; Resource Center for Independent Living, Utica; Self-Advocacy Association of New York State, Inc.; Selfhelp Community Services, Inc.; United Jewish Organization of Williamsburg; United Spinal Association; UJA-Federation New York; Westchester Disabled on the Move, Inc.; Westchester Jewish Community Services.

Contact:
Valerie Bogart, Selfhelp Community Services, Inc , vbogart@selfhelp.net 212.971.7693
Chris Hilderbrant, Center for Disability Rights, childerbrant@cdrnys.org 585.546.7510

Home Care Protests in Missouri

2010-02-20T15:20:00.000-08:00

From our friend Bob Williams:

Disabled protest state’s proposed cuts in home care
By Virginia Young
Post-Dispatch Jefferson City Bureau

JEFFERSON CITY — People with disabilities and their caregivers came to the Capitol today to protest a budget cut that could make it harder for the disabled to remain in their homes.

On the chopping block: personal care services, which include assistance with meals, dressing and bathing.

Gov. Jay Nixon’s proposed budget would limit personal assistance services that a person can receive under the Medicaid program to 3.5 hours a day, or 60 hours a month. Those with greater needs could appeal for an additional 20 hours a month.

Nixon’s budget counts on $8.6 million in savings — $3.1 million in state funds and $5.5 million in federal funds — from the cutback.

Many people on Medicaid receive more than 60 hours of personal care a month. They say that without the attendant services, they could be forced to move to nursing homes, which are more expensive and would cost the state more than home care.

At a Capitol press conference today, Bob Pund of Columbia, who was paralyzed in an auto accident 20 years ago, said he needs help “in nearly every aspect of my life. Attendants are like oxygen to me.”

Not only is it a safety net, it helps people maintain their dignity and quality of life, others said.

For more, see http://interact.stltoday.com/blogzone/political-fix/political-fix/2010/02/disabled-protest-states-proposed-cuts-in-home-care/

Staunching a Loss: How States Lose the Bucks

2010-02-20T15:18:00.001-08:00

From our friend Bob Williams:

Staunching a Loss

By Penelope Lemov February 17, 2010

By not opting out of a federal tax deduction, states stand to lose millions in revenues.

A few weeks ago, the Louisiana Legislature voted to allow the state to follow the federal tax code for the domestic production credit. The credit, enacted as Section 199 of the federal Internal Revenue Code, lets companies claim a tax deduction based on profits from "qualified production activities," a category that includes manufacturing and utility companies as well as such diverse business activities as food production and filmmaking.

Federal estimates suggest that allowing this deduction will reduce the revenue yield of corporate taxes by roughly 3.1 percent in 2011. States are not required to allow this deduction, and in the six years since the U.S. Congress passed the credit, 21 states and the District of Columbia have opted out. Twenty-five, however, have either done as Louisiana has and voted to allow the deduction or else they've taken no action to opt out of the credit. (Four states lack personal and corporate income taxes and so are unaffected.)

As the final year of the phase-in of the domestic production credit kicks in — and the cost of the credit to state income tax revenue rises — I talked to Nicholas Johnson of the Centers on Budget and Policy Priorities about the credit, how much it will cost states who have not acted and what states can do about it.

For more, see http://www.governing.com/print/column/staunching-loss.

Blind Man Asks Georgia Lawmakers to Open Their Eyes

2010-02-18T19:22:00.000-08:00

By Tina Terry tterry@nbcaugusta.com
Story Published: Feb 17, 2010 at 11:06 PM EST
Story Updated: Feb 17, 2010 at 11:42 PM EST

Things like living on your own, cooking, and finding a job can be hard, if you have a disability. Walton Options, a local center that helps people do these everyday things, could soon lose a lot of its state funding.

Brian Mosley says he traveled from tragedy to triumph with their help.

"I just heard a noise and the next time I awoke I was at MCG."

That noise Brian Mosley heard nearly 15 years ago was a gunshot to his head. It was a random crime that's never been solved. It left him blind in both eyes at 30-years old.

"I had no access to any resources or anything as far as services or support for the blind," said Mosley.

Eventually, he found Walton Options the Independent Living Center showed him he could work again, helped him go back to school, and taught him skills that landed him a job.

The director of the facility says 75-percent of people with a disability are unemployed. That's one of the reasons why they say the facility is so important.

Nonetheless, it could lose a total of 14-percent of its income before the end of this year, due to state budget cuts. That's more than $60,000 dollars. The center's director says that means a cut back in services they provide to people with disabilities or getting rid of nearly 5 part time jobs. She and Mosley want lawmakers to see the big picture.

For more, see http://www.nbcaugusta.com/news/local/84664407.html.

Potential Budget Cuts in Utah

2010-02-18T19:19:00.001-08:00

(KCPW News) Advocates are speaking out about steep cuts state legislators are making to Utah’s Medicaid program as they try to balance the budget. In a press conference at the Capitol Wednesday, the Utah Medicaid Partnership said reductions in these services will have a detrimental impact on the future of Utahns of all ages. Andrew Riggle, a public policy advocate at the Disability Law Center, said that Medicaid is a life support people rely on. He’s a beneficiary of state services himself due to cerebral palsy.

“For a good number of these services and supports that people access, there are no private alternatives. Either these folks can’t access private insurance, or the kinds of services and supports that they need aren’t covered by private insurance, or aren’t available in the amount that they need,” said Riggle.

For more, see http://kcpw.org/blog/local-news/2010-02-18/advocates-warn-of-impact-medicaid-cuts-will-have/.

Kentucky Faces Potential Budget Cuts Meltdown

2010-02-18T19:15:00.000-08:00

Coalition rallies for disabled

By Beth Musgrave - bmusgrave@herald-leader.com

FRANKFORT — With tears in his eyes, James Cheely paused before a House budget subcommittee Wednesday as he tried to explain his most important job title.

"I'm the father of a 21-year-old son, Bryan, that has a developmental disability," he said.
Cheely, a coordinator with the Special Olympics of Kentucky and a member of an association for the mentally handicapped in Barren County, was among dozens of people who asked legislators during a budget hearing to spare the mentally ill, mentally handicapped, elderly and chronically ill from budget cuts.

Adam McCoy of Nelson County got a hug from Gov. Steve Beshear during the 874 Coalition's rally.

Amy McCoy of Nelson County joined in the cheering before the start of a rally Wednesday for the disabled at the Capitol Rotunda in Frankfort. Advocates urged the legislature not to cut funds for the elderly and disabled.

Later in the day, the 874 Coalition — named for the estimated 874,000 people with disabilities in Kentucky — held a rally to repeat that message to lawmakers.

The rally came as House leaders are poised to unveil in coming days a two-year state budget that deals with a projected $1.5 billion shortfall in the General Fund. That plan does not include any major cuts to social services, said House Speaker Greg Stumbo, D-Prestonsburg.

However, the plan does remove about $220 million in General Fund money from the state's Medicaid program in hopes that Congress will approve more federal funds for the program by January. If that doesn't happen, Gov. Steve Beshear told those at the 874 rally, the state could lose $600 million in matching money from the federal government for Medicaid.
"We're going to have a total $800 million hole in the budget," Beshear said. "We don't need to be balancing this budget on the backs of the most vulnerable people in Kentucky."

House leaders also are considering cutting $90 million in professional service contracts and eliminating almost 250 political appointees across the three branches of government. That includes about 125 positions in the executive branch.

For more, see http://www.kentucky.com/latest_news/story/1144898.html.

300 Vermont Disability Rights Advocates Pack State House in Montpelier

2010-02-18T19:11:00.001-08:00

By Peter Hirschfeld and Louis Porter Vermont Press Bureau - Published: February 18, 2010

MONTPELIER – Proposed cuts to human services contained in the Governor's fiscal year 2011 budget plan represent an "assault" on the dignity and welfare of Vermonters with disabilities, advocates said Wednesday.

About 300 Vermonters piled into the Statehouse Wednesday to decry cuts they say will dial back home-based services and other programs that allow them to enjoy independent lives in their communities. As the 20th anniversary of the landmark Americans with Disabilities Act draws near, they say, the latest budget plan threatens to undo decades of progress.

Administration officials, including Gov. James Douglas, have said such cuts, as unpleasant as they are, are necessary in a time when state revenues are dropping.

"We're not asking for handouts. We're asking for opportunities for people with disabilities to be active and productive members of society," Deborah Lisi-Baker, president of the Vermont Coalition for Disability Rights, told a throng of supporters in the Cedar Creek room late Wednesday morning. "We have a right to be counted as equal citizens and to have government be there when we need it."

Lisi-Baker's organization represents 27 disability-rights organizations operating in Vermont. Next year's proposed budget, she says, represents a clear and present danger to the tens of thousands of Vermonters living with disabilities.

For more, see http://www.timesargus.com/article/20100218/NEWS02/2180324/1003/NEWS02.

State Medicaid Budget Struggles in Kentucky, Florida, Georgia

2010-02-18T09:20:00.001-08:00

http://www.kaiserhealthnews.org/Daily-Reports/2010/February/18/Medicaid-Budgets.aspx

Lawmakers Struggle To Find Solutions As Medicaid Programs Swell State Budget Gaps

Feb 18, 2010

The (Louisville) Courier-Journal: "Passport Health Plan, often praised for its efficiency as Kentucky's only Medicaid managed care venture, costs the state far more per person than the state's regular Medicaid program ... The assertion was made in a five-page letter sent Tuesday by state Medicaid Commissioner Elizabeth Johnson — and strongly disputed by Passport officials — to the staff of the House budget committee. The panel is considering an expansion of the Passport approach as one of many ways to save money to help plug a $1.5 billion revenue shortfall in the 2010-12 state budget" (Loftus, 2/17).

Associated Press/BusinessWeek: "With Medicaid costs now consuming 26 percent of Florida's budget, the upcoming session seems primed for a program overhaul. But legislators will tackle the issue amid a foundering pilot program, a class-action Medicaid lawsuit that could cost the state millions, all while waiting to see if and how a federal health bill will affect the state" (Kennedy, 2/17). Meanwhile, "a budget 'priority list' in the [florida] House Health Care Appropriations Committee identifies possible reductions that would amount to an overall 29 percent cut in mental health services statewide, according to the Ft. Myers News-Press (Gluck, 2/17).

The Atlanta Journal Constitution: "Hospital officials turned out in force at the state Capitol on Wednesday to oppose Gov. Sonny Perdue's proposed hospital tax, saying they preferred a tobacco tax to fill a massive Medicaid shortfall. … They called it a 'sick tax' and a 'bed tax.' They called it lots of nasty names, asserting that the 1.6 percent tax on patient revenues could increase health care costs, prompt job losses and postpone hospital improvements" (Schneider, 2/17).

ADA Poem by Frank Cuta

2010-02-17T07:40:00.001-08:00

Birth of the ADA
By Frank Cuta

I wrote this ten years ago at the tenth anniversary of the passing of the Americans with Disabilities Act. It is designed to be read by Maya Angelou, who would drive through it with determination, strong and powerful--chewing through each line word by word. The tone starts out slightly angry and winds up jubilant at the conclusion.

Note to blind readers: I never did corral Maya Angelou but with the proper setting on your
screen reader and a little imagination you can probably get the general idea. Please do not read it with your screen reader speed turned up--it really ruins the effect completely. In Jaws you can temporarily turn down your speech rate by holding down control+alt and hitting the page up key a few times.

Frank

Birth of the ADA

Access denied rights stripped ripped off out raged dreams shattered
righteous wrath.
Shackled cast aside special treatment smothered bitter pill lynch mob
math.
No ramps no trial no rights no Braille no doubt no clout legal rape.
hell fire burned bad endured forever fuse ignited now fire inside
virgin state.
Rallied round ground swell byte it off out in front fears ironed out
must not fail.
Not diverted not divided not denied determined directed pressure will
prevail.
1990 pulled it off glorious new world give us wings everybody wins sweet
victory.
Revered prize red rockets ablaze blue bunting awesome all american
alabaster ADA.

Virginia Gov Pushes Deep Budget Cuts (Privately)

2010-02-17T07:38:00.000-08:00

From the Washington Post:

In private, Virginia governor pushes deep budget cuts

By Anita Kumar

Wednesday, February 17, 2010

RICHMOND -- Virginia Gov. Robert F. McDonnell (R) has privately recommended cutting $730 million from K-12 education and $300 million from health programs, as well as changing the state retirement system and requiring 10 days of furloughs for state employees, all to help offset a $2.2 billion budget shortfall over two years, according to sources familiar with the plan.

The K-12 reductions would loosen the state's basic educational standards while reducing funds for support staff, supplemental salaries for coaches and teachers who serve as club sponsors, and health insurance for teachers.

The health cuts would reduce mental-health treatment beds by 232, take 5 percent in funds from community service boards that offer substance abuse and mental health treatment programs, and freeze enrollment for a program that provides insurance to low-income children.

The governor is also recommending millions of dollars in trims to public libraries, shuttering some state parks and phasing out all public broadcasting support over four years.

McDonnell has refused for weeks to release his proposals publicly, despite repeated requests from lawmakers and advocates. Instead, he and his staff members have been sharing recommendations with small groups of legislators for weeks behind closed doors -- a departure from the way governors have conveyed their budget priorities in Virginia for decades. The governor has scheduled a news conference on the budget for Wednesday, but it's not clear what he will announce.
A number of lawmakers and legislative staffers briefed on the proposals provided information about them to The Washington Post. They spoke on the condition of anonymity because McDonnell has not released the specifics publicly. McDonnell spokesman Tucker Martin declined to comment Tuesday.

For more, see http://www.washingtonpost.com/wp-dyn/content/article/2010/02/16/AR2010021605819.html.

Double Victory from HHS OCR and Democratic National Committee

2010-02-16T08:22:00.000-08:00

For Immediate Release: February 15, 2010

For Information Contact

Jennifer McPhail 512-627-5868

Nancy Salandra 215-779-1014

http://www.adapt.org/

DNC Resolution Pledges Olmstead Support; HHS OCR Agrees to Meet

ADAPT's Defending Our Freedom Campaign: Two Weeks, Two Victories

Philadelphia, PA - Two weeks into ADAPT's Defending Our Freedom Campaign, there are already two victories. One, a resolution passed by the Democratic National Committee (DNC), has its roots in ADAPT's four-day and four-night protest vigil last July, held outside the DNC headquarters in Washington, D.C. despite torrential rains and no shelter for activists. The second victory is a meeting with staff from the U.S. Health and Human Services Office of Civil Rights (HHS OCR) scheduled for mid-April just prior to the spring ADAPT action in Washington.

On Thursday, February 4, ten members of ADAPT from across the nation attended the DNC Resolution Committee meeting in Washington, D.C. The committee unanimously passed a resolution that states, in part, "WHEREAS, efforts must be made on the state and federal level to eliminate institutional biases that unfairly discriminate against Americans with disabilities in obtaining long term service and support in programs such as Medicaid ... the DNC will encourage and support efforts to vigorously enforce the Supreme Court's Olmstead decision."
The Olmstead decision affirmed provisions in the Americans with Disabilities Act (ADA) that mandate people with disabilities should receive needed services and supports in "the most integrated setting," typically the community.

"Some people thought our protest outside the DNC last summer was an exercise in futility," said Jennifer McPhail, ADAPT organizer from Austin, Texas, "especially because so many of us who use wheelchairs slept outside each night, in pouring rain and wind, with only garbage bags or the occasional tarp for shelter. We had provided our own accessible porta-potty, but the DNC had it hauled away. Despite all that, we persisted in following the process laid out by the DNC, and now we have this historic resolution to show for all hell we went through last July."

Members of the DNC Resolution Committee included Christine Pelosi, daughter of House Speaker Nancy Pelosi, and Lee Saunders, assistant to AFSCME President, Gerald McEntee. AFSCME currently represents staff in many state operated institutions, but is working to support the Community Choice Act (CCA), legislation that would let older and disabled individuals choose to receive needed supports and services in their own homes instead of being forced into nursing facilities and other institutions by the institutional bias in the nation's Medicaid program. In addition to passing the resolution condemning the Medicaid institutional bias, the committee also pledged to sending both the resolution and all of ADAPT's educational materials on the CCA to every Democratic state and federal legislator in the country.

"With the resolution from the Democrats and our upcoming meeting with the folks from HHS Office of Civil Rights, we feel like we are gaining ground in this battle to become free, and stay free," said Nancy Salandra, ADAPT organizer in Philadelphia. "You would think that between this country's Constitution, and laws like the ADA, we should already have the right to live in our own homes and communities, but that's not how Congress has structured the funding for the supports we are entitled to receive. So, the resolution and the meeting are two more actions to make sure that the law is followed and our civil rights are protected."

ADAPT's Defending Our Freedom campaign continues to gather media reports of the harm being done to disabled and older Americans by state budget cuts. The campaign also welcomes stories of how people in the states are fighting back against the cuts. ADAPT is additionally encouraging people who want out of institutional settings and the people assisting them to file OCR complaints. ADAPT will follow up on those complaints at the meeting with HHS OCR and the Department of Justice (DOJ), and will hold the HHS OCR staff accountable for resolving the complaints.

Send media reports, and "fighting back" accounts and pictures to defendingourfreedom@gmail.com.

See those reports, and accounts and pictures on http://www.defendingourfreedom2010.blogspot.com/.

File a complaint at http://hhs.gov/ocr/civilrights/complaints/index.html
and send a copy to DOF.complaint@gmail.com.

Sign on to support the Defending Our Freedom Campaign at DOF.signon@gmail.com, and see the growing list of supporters at http://www.adapt.org/doflist.php.

Additional information on the Defending Our Freedom Campaign can be found at www.adapt.org/adapt-campaign.html.

NATIONAL ADAPT MAILING LIST - Adapt Community Choice Act List http://www.adapt.org/

Hundreds Attend Texas Hearings on Budget Cuts

2010-02-14T08:26:00.004-08:00

From the Austin Statesman.com

By Tim Eaton Thursday, February 11, 2010, 05:54 PM

More than 300 people turned out on a rainy afternoon to hear how Texas’ health and human services agencies might cut their budgets.

Representatives from several health and human services departments were on hand to hear from the public before they present budget-cutting options to Gov. Rick Perry, Lt. Gov. David Dewhurst and House Speaker Joe Straus.

Under the Health and Human Services system umbrella there are several entities: The Department of Assistive and Rehabilitative Services; the Department of Family and Protective Services; the Department of State Health Services; the Department of Aging and Disability Services and the Health and Human Services Commission.

The departments were told to protect some vital areas. The leaders said that “there should be no reductions to benefits or client eligibility levels in the Medicaid entitlement, Children’s Health Insurance Program and foster care programs.”

Click here to read the letter.

Many of the cost-cutting options could be made through hiring freezes, the agencies said. But the Department of State Health Services also mentioned a reduction in trauma funds and the elimination of 200 beds and 420 full-time employees at four mental health hospitals.

The possible cuts also included a 1 percent reduction in the rates paid to health care professionals providing care to Medicaid recipients.

See an earlier blog here. And read a HHS-generated breakdown of possible cuts here.

Advocates for the elderly, the sick and those people who use services provided by Texas’ health and human services agencies spoke at the hearing.

Anne Dunkelberg, associate director of the non-profit Center for Public Policy Priories, which advocates for low-income Texans, said her organization was concerned about the rate cut to doctors and health professionals.

“Doctors right now in Texas Medicaid are getting paid around 65 percent of what Medicare pays,” she said. “The end result is you have lots and lots of doctors who won’t take Medicaid patients.”

David Thomason, senior vice president at the Texas Association of Homes and Services for the Aging, told the health and human services leaders that cutting services at this point will result in care for seniors being jeopardized.

Eva DeLuna Castro, the general budget analyst of the Center for Public Policy Priories, also spoke and told the room that there’s no real reason to make cuts right now. This fiscal year doesn’t end until August of 2011, and there’s enough money to cover operations through next fiscal year, too, she said.

Instead of calling for cuts now, lawmakers should return to work in January of 2011, and then tap into the $9 billion Rainy Day Fund to keep agencies going, Castro said. They also should find new ways to raise revenue, she added.

In their letter, Perry, Dewhurst and Straus said that action is needed now because of “uncertainly of the state’s short-term economic future. They also said they were told by the state comptroller that the recession has substantially weakened the tax revenues the flow into state coffers.

The health and human services leaders will submit their recommendations on Monday and Tuesday.

http://www.statesman.com/blogs/content/shared-gen/blogs/austin/politics/entries/2010/02/11/_more_than_300_people.html?cxntfid=blogs_postcards

Tennessee Debates Bredesen's Approach

2010-02-14T08:26:00.003-08:00

http://www.tennessean.com/article/20100214/OPINION01/2140338/1008

Editorial from the Tennessean:

There are times when evenhandedness can backfire. The proposed cuts to Tennessee's mental health services are a case in point.

By calling for cuts in virtually every segment of state government, Gov. Phil Bredesen appears to have fended off major opposition to his austere budget plan for 2010-11. But while most of the proposed cuts are tough, prudent, even admirable in the face of the state's continuing revenue shortfall, mental health is one area that should have been protected.

The state Department of Mental Health and Developmental Disabilities had to eliminate 672 positions, or a fourth of its staff, in 2008 and 2009. It also had to get rid of more than 247 beds at its state hospital. The budget for 2010-11 proposes $9.4 million in cuts, and it raises the question: What will happen to the many Tennesseans who rely on state help with mental health problems?

To its credit, the Bredesen administration has so far managed to keep the $21.5 million for the Behavioral Health Safety Net. That program helps the most severely ill mental-health patients who do not qualify for TennCare and do not have private insurance. But this does nothing for lower-income Tennesseans who get help with their mental illness through TennCare.

Jindal Announces LA Budget; Lays Out Disability Services

2010-02-14T08:22:00.000-08:00

Louisiana's Republican Governor Bobby Jindal recently announced the Louisiana state FY 2011 budget proposal with a clear outlining of impacts on disability services. To read the outline, go to: http://www.bayoubuzz.com/News/Louisiana/Government/Louisiana_Governor_Jindal_Announces_Budget__10291.asp.
It's a mixed bag, mainly because of the way funding streams are set up....state v federal, public v private. Go check it out.

300 Protest Disability Service Budget Cuts in Kansas

2010-02-14T08:14:00.000-08:00

BY RICK PLUMLEE
The Wichita Eagle
http://www.kansas.com/news/story/1179318.html#ixzz0fQtNTBQM
Jeff Tuttle/The Wichita EagleAldona and Pat Carney, of Wichita, with their son, Neil, on Friday (Feb. 12, 2010).

You can almost hear the weariness in their voices as Pat and Aldona Carney tell their story.

The youngest of their five children, 15-year-old Brian, has severe autism.

He also has pica, a medical disorder characterized by an appetite for inedible things. He has eaten insulation, charcoal briquettes and parts of mattresses.

Brian has tried to eat light bulbs. When he got a tooth caught while biting the carpet, he yanked the tooth out by its roots.

"He's a 24-7, one-on-one child," Aldona Carney said. "He's up at 3 in the morning a lot of times. Either Pat or I are up a little bit later, because he's tearing things up if we're not.

"We love him, he's ours. We want him in our house, but we also know we need help."

Because of state budget cuts, there is less help for the Carneys, others with disabled family members and Kansas' disabled citizens overall.

Friday, more than 300 people attended a rally at Exploration Place to tell their stories and help make the Legislature aware what losing disability services has meant.

"More than a generation ago the state saw the futility of state institutions," said Marla Flentje, who has a 34-year-old son with Down syndrome. "The state made a promise to help the disabled so they could be at home and work and play in the community."

That promise, she said, has been broken.

A 10 percent state budget cut has sliced $30 million from Medicaid for disability services, said Tom Laing, executive director of InterHab, a statewide resource center to support those with disabilities.

But state grants for the disabled have also been reduced drastically, cutting out funds for those who don't qualify for Medicaid.

Between Medicaid and grants, Sedgwick County alone has lost more than $3.4 million this year to help the disabled.

"When we go to the Legislature, they say, 'Money is tight, you need to be realistic,' " Laing said. "I say, 'Oh, you need to be realistic. These people's lives are vulnerable. There's no margin for the kind of error that budget cuts are creating. Have you met the people you're hurting?' "

For the Carneys, the cuts have meant losing 16 hours of respite care per month through Rainbows United, a Wichita nonprofit that serves children with special needs and their families.

That leaves the Carneys with only 40 hours each month. Not enough, they say, for a family with a child that demands as much care as Brian.

Pat Carney attributes his wife's migraines to the stress of caring for Brian.

Brian attends Levy Special Education Center. But when school isn't in session, someone has to be with him at home.

Aldona Carney used to teach school, then switched to substituting so she could be with Brian more. But she recently had to eliminate that job."I literally couldn't get in the shower in the morning," she said, "because I had to watch him. He can be very destructive."
Courtney Carpenter's 6-year-old son, Devin, is a kindergartner at Benton Elementary with a loving smile.

Devin has a rare chromosomal disorder known as Trisomy 22. He's been blind and deaf since birth and has developmental issues.

So far Carpenter hasn't lost any of the respite hours she uses with Rainbows.

"I'm just praying that it doesn't happen," she said. "That's my biggest fear. I don't know what I would do then."

In fiscal year 2009, Sedgwick County received $2.4 million in state grants for the disabled. It will be $382,000 in 2010, said Chad VonAhnen, director of the Sedgwick County Developmental Disability Organization.

That means Marc Lyon, 45, no longer has a job through Starkey Inc., which serves people with developmental disabilities.

"He's just lost now that he's home with me," said Betty Lyon, Marc's 80-year-old mother. "He asks me every day when he can go back to work."

Marc was born with brain damage and had worked at jobs through Starkey — such as cleaning shelves at Dillons — for 20 years. But his grant money was eliminated Jan. 1, and so was his job.

Because he doesn't have overwhelming health or behavioral issues, he's not eligible for Medicaid.With the grant money gone, so is his safety net.

Betty Lyon called Sen. Les Donovan, R-Wichita, who in turn called Jamie Opat, Starkey's communications director.

"He wanted to see if we could get him back in at Starkey," Opat said. "This is the real face of state budget cuts. I think it was an a-ha moment for him.

"There's no easy fix just to get somebody back in."

Agencies that serve the disabled are trying to be creative, such as increasing the size of group homes. That works against the original purpose of eliminating institutions so people with disabilities would be in smaller settings.

Those at Friday's rally plan to contact their legislators about restoring funds, send them videos with their stories and travel to Topeka to deliver their messages.

"We have to be Brian's voice," Aldona Carney said. "We all have to be the voices for those who can't speak up."

Read more: http://www.kansas.com/news/story/1179318.html#ixzz0fWix9oYk

Budget Cuts Fight in North Carolina

2010-02-12T15:07:00.000-08:00

http://www.wral.com/news/local/politics/story/7011863/

Group files suit against head of DHHS

Posted: Feb. 11 7:35 p.m.
Updated: Feb. 11 7:50 p.m.

Raleigh, N.C. — A disability rights advocacy group filed suit Thursday against the leaders of the state Department of Health and Human Services and a local health service provider alleging that planned cuts in funding for mental health services violate the rights of patients and inhibit their ability to live independently.

The two men, identified in the lawsuit as Clinton L., 46, and Timothy B., 44, are both developmentally disabled and mentally ill. They have been living independently with the help of federal and state support, according to the suit filed by Disability Rights North Carolina.

DRNC filed the suit to ask for a temporary restraining order against Piedmont Behavioral Healthcare and DHHS in implementing the cuts. Lanier Cansler, secretary of the Department of Health and Human Services, and Dan Coughlin, CEO and director of Piedmont Behavorial Healthcare are named as defendants.

The plaintiffs are representative of a class of individuals who receive services from Piedmont Behavioral Healthcare, a local management entity. A DRNC search of public records found 35 members of the class, spokeswoman Vicki Smith said.

PBH, which is funded by the state, plans to cut the rate it pays for those services as a result of state budget cuts.

According to the suit, PBH's planned cuts would prompt service providers to cease offering the support the plaintiffs need to live on their own. The suit alleges the cuts planned by DHHS and PBH violate the Americans with Disabilities Act.

Piedmont’s plan to cut the reimbursement rate for supervised living services from $162 to $116, scheduled to take effect on Monday, would constructively abolish that service for PBH’s clients, as providers would no longer offer the service at that rate, DRNC said in a statement released Thursday.

Both parties have agreed to keep the current reimbursement rate in place until a hearing on the suit Wednesday.

This is the second such suit filed against the state, but the first class-action. DRNC brought suit in December on behalf of two patients served by the Beacon Center, the local management entity serving Edgecombe, Greene, Nash and Wilson counties.

A judge granted a preliminary injunction against service cuts by Beacon, pending a full hearing on the matter. A date for that hearing has not been set.
Reporter: Bruce Mildwurf

Letter from Tennessee

2010-02-12T15:06:00.000-08:00

Sent to the DOF Blog this week:

Dear Friend,

My husband and I have been moving from town to town every year to be employed. We will buy a home after a period of time, and then learn the permanent job we were told about, is not longer available. We just left our home in Seminole, Alabama and we are renting a home in Memphis Tennessee. Paying two mortgages is costly. We like living in a home in the community, and not in assisted living. Keeping our independence is crucial to us.

Please ask congress to enforce the Olmstead Act, and keep long term support services in place. (CFC).

Just because a person has a disability, should not make any difference where one wants to live. Freedom is the number one deciding factor in the decision, and it is a matter of dignity.

Truly,
Deb and Jim

DOF Facebook Cause Link

2010-02-10T16:05:00.001-08:00

If you have been looking for our Facebook Cause page, try logging into Facebook and using this link: http://apps.facebook.com/causes/441657. Hope that helps! Join us! We have 231 supporters so far...can we get a thousand?

Nevada, Pennsylvania, Virginia Updates

2010-02-10T15:56:00.000-08:00

Passed on by Bob Williams:

February 10, 2010 – That’s The Way It Is: (Feel free to repost in full or in part)

PUBLIC OBSCENITY IN NEVADA: Former U.S. Supreme Court Chief Justice Warren Burger said that people know obscenity when they see it. The same is true of obscene public policy. Arguing that the state could no longer afford to pay for "bloated government services", Nevada Governor Jim Gibbons has proposed to cut 109 million in state Medicaid funding. According to news reports, such cuts would results in the “ration(ing of) adult diapers, eliminate denture and hearing-aid programs, and force personal care assistants to buy their own disposable gloves” as well as reduce services for persons with traumatic brain injury. "Cutting them off of dentures, hearing-aid services and diapers, “Assembly Speaker Barbara Buckley, D-Las Vegas, commented, “I don't know how we look the elderly in the eye." Not only would these cut degrade the civil rights and essential humanity of Nevadans with disabilities, their families and personal assistants but also expose them to potential health risks as well. See: http://journalstar.com/news/national/article_5743704b-b9ec-5b22-9b5a-88f00b0cca8f.html.

A FRIEND IN PENNSYLVANIA: When most other States are slashing Medicaid funding for community living, Pennsylvania Governor Ed Rendell says he wants to invest in making “major progress rebalancing and restructuring the long-term living system to ensure that older Pennsylvanians can age in place at home with dignity and a high quality of care.” The Governor’s 2010-11 budget includes a $17.3 million increase for direct services. “Over the last eight years, funding for aging and long-term living services has grown by $1 billion, a 307-percent increase. “ According to a release from his office, “Nursing homes will be eligible for $24 million more to support the increased needs of a more complex nursing home population. In addition, nearly 1,700 additional older adults and 1,525 additional persons with disabilities will be able to receive home- and community-based services so that they can live more independently. Finally, 4,000 additional older Pennsylvanians will be able to get their prescription drugs through the PACE and PACENET programs.The gains for older Pennsylvanians and persons with disabilities would not have been sustainable without major initiatives to rebalance the long-term living system. The share of consumers served in their home has doubled since 2003. Because home-based services are more cost-effective, scarce public resources can be stretched further.”” See: http://www.prnewswire.com/news-releases/governor-rendell--2010-11-budget-preserves-health-care-for-seniors-persons-with-disabilities-and-pennsylvanias-poorest-families-83890992.html.

LIFE DEFERRED: When Sam May graduates from a Fairfax Virginia high school next year, he should be able to look forward to his life – finding a job, attending community development, making plans to move into their own home someday. Instead, May, who has significant disabilities due to Fragile X syndrome, will have his life and future put on indefinite hold by being placed on a waiting list along with over 600 others with intellectual and developmental disabilities. At least half of these persons have been deemed by the county to have an “urgent need” for such Medicaid waiver services as personal assistance, supported employment and other supports to remain in their homes and communities. In 2007, Virginia agreed to put more resources into increasing accessing to these services and supports and to fall the waiting list. However, impending budget cuts threatens to make an already precarious and dire situation even worse. See: http://www.fairfaxtimes.com/cms/story.php?id=1049.

Join DOF on Facebook!

2010-02-09T20:45:00.000-08:00

An excellent way to keep up with news on Defending Our Freedom is to join our Facebook Cause! Just search on Facebook for "Defending Our Freedom' and you should be able to find us. This is a great way to connect with others who care about fighting state budget cuts and enforcing Olmstead. Recruit your Facebook friends and FREE OUR PEOPLE!

Roundup of state fights from Kaiser Health News

2010-02-09T05:27:00.001-08:00

We were made aware of Kaiser Health News' daily roundup by Bob Williams. To view updates on funding cuts that affect people with disabilities in Virginia, Tennessee, New Hampshire, Wisconsin and Alaska, go to http://www.kaiserhealthnews.org/Daily-Reports/2010/February/08/State-budget-and-Medicaid-issues.aspx. You can sign up for this daily alert at the bottom of the story.

Virginia Medicaid Funding Endangered; Endependence Fights Back

2010-02-09T05:21:00.000-08:00

From Hampton Roads, by Elizabeth Simpson for the Virginian-Pilot:

Virginia's budget-setting season is always a nail-biting time for people like Barbara Kimble.

Will there be enough money to help her and her husband care for their 25-year-old mentally disabled son at their Chesapeake home, or will they have to wait another year - or two, or three?
This year, the news was about as bad as it has ever been. Not only is there no additional funding for the Medicaid waiver program that helps families keep disabled or elderly relatives at home instead of at institutions, but there's a one-year freeze on the existing waivers.

That means even if someone already in the program dies, drops out or moves out of state, the money for that slot can't be used for someone on the waiting list.

"People will be institutionalized who never, ever would have considered it," said Maureen Hollowell, director of advocacy and services at The Endependence Center in Norfolk, which helps the disabled. "There will be no option for them."

For the full story, go to: http://hamptonroads.com/2010/02/medicaid-funding-disabled-chopping-block.

Illinois Introduces Managed Care Pilot to Save $$$

2010-02-08T20:32:00.000-08:00

Could it be happening in your state?

See http://www.chicagotribune.com/news/chi-ap-il-medicaidillinois,0,7621952.story.

CHICAGO - The state of Illinois is planning a pilot project to enroll Medicaid recipients in six counties in managed care, an effort being criticized by advocates for the developmentally disabled.

Illinois' Medicaid agency announced Monday it's seeking proposals from managed care organizations to run the program. It would affect 40,000 adults with disabilities and older adults in DuPage, Kane, Kankakee, Lake, Will and suburban Cook counties.

The state expects the program to save taxpayers nearly $200 million in its first five years.

Advocates for the developmentally disabled are concerned the effort to save money may lead to rationing of health care. Tony Paulauski is executive director of the Arc of Illinois, a group advocating for the developmentally disabled. He says managed care organizations have little experience with developmental disabilities.

New York State Deals With Governor Paterson

2010-02-08T20:26:00.000-08:00

Check out this video on the state budget fight in New York: http://www.cdrnys.org/video/proposedbudgetYNN.html. The video is captioned.

On Monday, February 1st, a group of New York disability rights advocates met with the Governor Paterson and key staff regarding his budget proposal to cap personal care at 12 hours per day.

After delays with security, we started the meeting with quick introductions and a brief context for the meeting. At about that point, the Governor walked in; we did a quick round of re-introductions and got back to business.

Throughout the meeting, the Governor played a calming role as his staff and the advocates argued. He expressed a willingness to admit that their proposal might have negative consequences that they had not intended. The advocates poked holes in the administration's proposal, but the Governor would intervene and say that they had already admitted that the proposal might not be perfect, suggesting the group "move forward"... then his staff would start defending the proposal again.

Michelle, who is directly affected by the cut, explained the effect that this proposal would have on her. She explained that just days before giving birth to her daughter, she got her spinal cord injury and became a quad. She left the hospital to live with her mother who was now taking care of both her and her newborn daughter. She wasn't ever able to get the personal care she needed in Seneca County so she moved into a less accessible apartment in Ontario County where she could finally get services. She pointed out that she now must take a 45-minute drive to take a shower, but that's how important her independence was to her. She emphasized that people who get this level of service really need it, and it clearly wasn't that easy to get. She spoke about how she was finally able to raise her own daughter and be a mom. And she spoke about how she feared that losing the services would mean she would lose her freedom... and her family.

So we asked the administration why they hadn't used the cost-savings proposals that we had developed in November, long before any of these cuts were proposed. Our proposals didn't eliminate community-based services. Instead, they actually promoted the independence of people with disabilities by maximizing community-based approaches and cost-effective consumer-directed services. We acknowledged that our original proposals may have been aggressive, so we had ratcheted them down. Even so, we still projected $30 million to $90 million in savings for the first year, easily covering the saving the administration expected from capping personal care.

In a nutshell, our proposals said that the state could save money by moving people from nursing facilities to the Nursing Facility Transition and Diversion Waiver. The staffers felt that our target of 1,300 people statewide was unrealistically aggressive, but never explained how they felt nearly 5,000 people could be enrolled in NYC alone under their proposal. They also argued that daily savings rate we used was too high, even though our revised version was taken straight from the DOH's TBI Waiver report to CMS.

The staff also complained that our proposal assumed that we would close nursing facility beds, but there isn't the political will to make that happen. We argued that the state, particularly in such difficult fiscal times, shouldn't prioritize the institutions over people. At this point the Governor stepped in and said that they wanted some time to review our proposals. We urged them to eliminate the 12-hour cap in their 21 day amendments.

The pessimistic side is that the staff seemed committed to the cap.

The optimistic side is that they agreed to look more closely at our revised proposal. The Governor has clearly made this something they have to address. They know that they are going to be flambéed every step of the way with the 12-hour cap.

We don't know what will happen, but whatever happens, this is only the start of the process!

To learn more about CDR, see http://www.cdrnys.org/.

First, the Access; Then, the Advocacy?

2010-02-05T18:19:00.000-08:00

Over the months of January and February, staff and consumers at Access Living in Chicago (many of whom are also ADAPTers) have been visiting our state legislators to educate them on the importance of not cutting human services in Illinois. Today, Rachel Siler, Amber Smock and Tom Wilson visited the Chicago office of State Senator Antonio Munoz, and came across a problem our community faces not infrequently: lack of physical access to our elected officials' offices. We cannot let stairs or lack of other forms of access stop us, however; our goal is to FREE OUR PEOPLE! The photo at left shows Rachel on the left in a power chair and Amber on the step to Munoz' office. We will be scheduling a follow up meeting in an accessible location to advocate against state budget cuts and to educate about the people's need for access to politicians' offices.

From New York State: Equal Rights Are Not a Budget Item

2010-02-04T05:45:00.000-08:00

Bigotry never trumps freedom and freedom is not possible without equal rights.

And so it is that people with disabilities are being given the message that their equal rights are depend on the state of the economy and thus relegated to a budget item. ADAPT, the country’s most prestigious disability rights organization in this writer's view, has launched what is calls a Defending Our Freedom campaign to address the carnage being inflicted on the lives of people with disabilities. Across this country state budget cuts are forcing people with disabilities, as well as seniors, back into nursing homes, all this in direct violation of the 11-year-old United States Supreme Court Olmstead Decision which says Americans with disabilities have the right to live in the most integrated settings.

For more, see http://thekahrmannblog.blogspot.com/2010/02/equal-rights-are-not-budget-item.html.

Americans with Disabilities Bleeding from Budget Cuts

2010-02-03T14:43:00.001-08:00

For Immediate Release:
February 03, 2010
http://www.adapt.org/

For information contact:
Bruce Darling 585-370-6690
Rahnee Patrick 312-320-5111
Marsha Katz 406-544-9504

Americans with Disabilities Bleeding from Budget Cuts:
Angry, ADAPT Fights Back

Denver, CO -- ADAPT today launched its ADA 20th Anniversary Campaign demanding that the Administration and the U.S. Department of Justice aggressively protect the civil rights of disabled Americans and enforce the Americans with Disabilities Act. The campaign, Defending Our Freedom:
ADAPT's Call to Action for Home and Community in America, also calls on people with disabilities and those who are older to file civil rights complaints if they have been forced into institutional settings, denied community services, or have had their community services reduced. And, finally, the campaign will collect personal and state stories about the effects of budget cuts, and the efforts to fight back against the cuts.

"People with disabilities are literally "bleeding to death" already because of state budget cuts, and there is no end in sight," said Rahnee Patrick , an organizer with Chicago ADAPT. "When states cut budgets, the first things on the chopping block are what are called "optional services," the services that states can choose to provide, but aren't mandated to provide...only they aren't so optional for us. Those are the services that pay aides to help us out of bed, get dressed, get ready for work, eat, and live in our own homes instead of being forced into nursing homes."

Nearly every state in the union is currently planning budget cuts that impact the ability of people with disabilities and older people to stay in their own homes. Federal law currently mandates states to provide nursing home services. Providing home and community-based services is considered "optional" under the law, which is why those services are usually cut when states are reducing their budgets. Because there is no provision in the law that tells states they must also provide the same services in a person's own home, countless thousands of people across the country are forced every day into nursing facilities and other institutions when they need help with the activities of daily living.

"For all these 20 years since the ADA was passed, Congress has refused to remove the "institutional bias from the law," said Mike Oxford, organizer from Kansas ADAPT. "That institutional bias has made older and disabled people America's political prisoners. We are deprived of our freedom, and deprived of our civil rights, and that is totally unacceptable, and most certainly illegal. Apparently, Congress is too politically scared to address the issue, but we aren't, and we won't stop until we have the first class citizenship and rights that our Constitution guarantees us!"

ADAPT is calling on individuals and groups of people who are aging or have disabilities to send in stories of cuts in services. ADAPT will collect these stories and post them on the ADAPT website in a "People's Forum to Fight Back." Stories and pictures can be viewed on the ADAPT Defending Our Freedom blog at http://www.defendingourfreedom2010.blogspot.com/ . The ADAPT website will also have a link to the forms that people can use to complain to the Health and Human Services Office of Civil Rights about a violation of their civil rights. Violations include being forced into a nursing home, not being allowed to move from a nursing home or other institution back into the community, or having home and community services decreased due to budget cuts so you don't have the hours you need.

ADAPT will also post on its website pictures of you visiting your state and federal senators and representatives, and your state Medicaid and other government officials. These pictures and descriptions will create a public record of the disability community's efforts to stop cuts, and will inspire others across the country to speak up and speak out, too. Send your personal "cut" stories, and your pictures, with a description of what occurred and what you were told by your public officials, to defendingourfreedom@gmail.com then watch for them on the blog. Let's hold public officials accountable for what they tell us!

FOR MORE INFORMATION on ADAPT visit our website at http://www.adapt.org/

The Center for Disability Rights Visits Governor Patterson

2010-02-02T08:46:00.000-08:00

To see the video, go to http://www.youtube.com/watch?v=FLBLwx5b9DQ&feature=player_embedded. Governor Paterson visited Rochester for an interview on WXXI, CDR was there protesting the NY state budget. Governor Paterson met with Bruce Darling and also agreed to further talks on Monday 02/01/2010.

Don't Mourn, Organize!

2010-02-02T07:34:00.000-08:00

As the 20th Anniversary of the signing of the Americans with Disabilities Act draws near, the disability community is not busy celebrating because we are literally in a fight for our lives and our most basic freedoms.

Eleven years ago, in the Olmstead decision, the Supreme Court said that Americans with disabilities have the right to live in the most integrated setting. Yet today, states are responding to budget shortfalls by drastically cutting home and community-based services. These draconian cuts are forcing seniors and people with disabilities into nursing facilities and other institutional settings because they don’t have the services they need to remain independent.

As states cut vital services, the federal government, which is charged with protecting our civil rights and enforcing the law, is simply standing by – silent – while Americans with disabilities have their most basic freedoms taken away by the states.

The disability community cannot sit by as our freedom is negotiated away in back room budget deals. We must take action!

Defending Our Freedom is a three-prong national campaign initiated by ADAPT to organize the disability community to:

· Demand that the Obama administration fulfill its duty to aggressively protect the civil rights of disabled Americans and enforce the Americans with Disabilities Act/Olmstead decision;

· File complaints with the Health and Human Services Office for Civil Rights and the U.S. Department of Justice that document the violation of rights of individuals who have been forced into institutional settings, denied community services, or have had their community services reduced as well as complaints that document the state policies and budget cuts that violate our rights; and

· Document the disability community’s efforts to fight back against state cuts so that we can learn from each other’s efforts, rally others to join our fight, and hold public officials accountable when they do not support our freedom.

I. Defending Our Freedom: Demanding action by the Obama administration

The federal government is responsible for enforcing federal law and assuring that states comply with the Americans with Disabilities Act/Olmstead decision. ADAPT is demanding that the federal government affirmatively and aggressively enforce the Olmstead decision. To do this, the Health and Human Services Office for Civil Rights, must:

1. Accept, investigate and resolve individual and systemic complaints which document state policies and budget cuts that threaten the freedom of Americans with disabilities;

2. Develop specific benchmarks/criteria for assessing state compliance with the Olmstead decision, assess the states and publicly release this assessment on an annual basis;

3. Conduct regular, on-going compliance reviews of states for compliance with the Olmstead decision, and provide technical assistance to states to help them understand how they can voluntarily comply with the law;

4. Work with the Department of Justice (DOJ) to develop “most integrated setting” criteria for determining when DOJ will step in and affirmatively enforce the Olmstead decision;

5. With the Center for Medicare and Medicaid Services (CMS), develop guidance with CMS for the states on the Olmstead decision that requires state Medicaid programs to comply with the “most integrated setting” requirement of the ADA, including a model Olmstead Plan that assures the freedom of Americans with disabilities who want to live in the most integrated setting;

6. With CMS, review state submissions for modifying their Medicaid State Plan and HCBS waiver services for the impact that these changes will have on the state’s ability to comply with the Olmstead decision so that those changes which limit the freedom of Americans with disabilities are not approved by CMS;

7. With CMS, modify Section Q of the Minimum Data Set so that people who indicate they want to return to community living are actively assisted to do so;

8. Publicly report on the progress that has been made so that these results can be discussed in a potential meeting between Georgina Verdugo, the HHS/OCR Director, and ADAPT representatives.

Take action: ADAPT is urging organizations across the country to sign on in support of these demands. If your organization would like to support this campaign, email DOF.signon@gmail.com.

If you go to the ADAPT page for the campaign (www.adapt.org/adapt-campaign.html), you can see the list of organizations that that have signed on in support of this campaign.

II. Defending Our Freedom: Filing complaints to protect our freedom

The Health and Human Services Office for Civil Rights and Department of Justice are charged with protecting the civil rights of Americans with disabilities who want to live in the most integrated setting. Although they are able to affirmatively enforce the law without specific complaints, these agencies typically take action only when complaints are filed. We need to file complaints that document the violation of rights of individuals who have been forced into institutional settings, denied community services, or have had their community services reduced. We must also file complaints that document the state policies and budget cuts that steal the freedom to we are entitled under the Olmstead decision.

Take Action: ADAPT has prepared a form you can download and fax to us toll free at 1-888-324-0787. We will forward your complaint to the Health and Human Services Office of Civil Rights, the appropriate HHS/OCR Regional office, and the Department of Justice. If you choose to file your complaint yourself, please notify us at DOF.complaint@gmail.com that you have filed a complaint and, if possible, send us a copy.

III. Defending Our Freedom: Fighting back and sharing our stories

Even though there are different battles in individual states, we are fighting the same fight. To strengthen these efforts across the country, our campaign will collect personal and state stories about the effects of budget cuts and the efforts to fight back against them. ADAPT has created a website (http://www.defendingourfreedom2010.blogspot.com/) where we can post information and pictures of your advocacy. This will create a public record of the disability community’s efforts to stop cuts and hopefully inspire others across the country to speak up and speak out, too. State advocates can also submit individual calls to action so that we can support each other’s efforts.

Take Action: Send submissions to defendingourfreedom@gmail.com. And remember to keep up on what groups are doing by reading the blog: http://www.defendingourfreedom2010.blogspot.com/.