Mike Irvin: President-elect Obama Must Improve Our Lives
President-elect Obama must improve the lives of Americans with disabilities.
As a candidate, he put forth a detailed agenda on this issue, recognizing the unmet needs of millions of Americans. Now the work begins.
Here are three vital things his administration should do.
The first is radical reform of Medicaid long-term care policy. The biggest obstacle to self-determination that millions of people with disabilities face — especially poor people — is the lack of community-based support services. Medicaid rules force them into nursing homes and other institutions in order to receive the daily assistance they can’t live without. These institutions then impoverish them to the point where it’s nearly impossible for them to ever move out.
As a senator and as a presidential candidate, Obama supported legislation that would give people who need assistance funded by Medicaid much more control over how and where they receive this assistance. That legislation did not become law. But now that the Democrats will control the White House and Congress, Obama should get this law passed.
He also can implement substantial changes in Medicaid by executive action, without need for legislation. He must be aggressive on both fronts.
Second, Obama must also ensure that the Americans with Disabilities Act is vigorously enforced. The best way to do this is to appoint as judges, especially to the Supreme Court, only those who respect the spirit of the ADA. In recent years, the Supreme Court has so thoroughly diluted the ADA that earlier this year Congress had to pass the ADA Amendments Act to correct the Court’s wrongheaded decisions. Obama can also restore the power of the ADA by giving the agencies that enforce it, such as the Department of Justice, the mandate and resources they need to do the right thing.
Finally, the Obama administration will have to do something quickly about a deplorable backlog. Today, there are hundreds of thousands of people with disabilities who are simply waiting for the approval of the Social Security Administration to get the disability benefits they deserve.
In the Bush administration, some of these people with disabilities have been forced to wait more than 500 days — even sometimes up to three years — for hearings on their claims. The backlog grew from 311,000 to 755,000 during the Bush years, according to the New York Times. That’s a scandal.
Obama will soon have the power and the opportunity to prove that the promise of real change that swept him into office applies to people with disabilities.
He should make the most of it.
Mike Ervin is a Chicago-based writer and a disability-rights activist with ADAPT (www.adapt.org). He can be reached at pmproj@progressive.org. This article ran in Progressive magazine and numerous op-ed articles throughtout the country.
Sen. Harkin Praises NCDR’s Road To Freedom
Advocates Praised as President Bush Signs ADA Amendments Act into Law
(Washington, DC) U.S. Senator Tom Harkin (D-IA) praised the efforts of the Road To Freedom bus crew for their part in the advocacy leading to the passage and signing of the ADA Amendments Act. For nearly two years, disability rights advocates have traveled the Nation in a modified bus educating citizens and policymakers alike of the pressing need to restore vital civil rights protections of the Americans with Disabilities Act (ADA).
On September 25, President George W. Bush signed the ADA Amendments Act into law and ADA Watch and the National Coalition for Disability Rights, the nonprofit organizations behind the Road To Freedom bus tour, praised all of those involved in this successful campaign to advance disability rights.
In recent years, the ADA - the world’s first human rights law for people with disabilities - has been dramatically narrowed in the courts leaving citizens with epilepsy, diabetes, mental illness, HIV-AIDS and other disabilities unprotected from discrimination. The ADA Amendments Act clarifies the intent of Congress and reverses the “judicial activism” that has resulted in more than 95% of employment-related ADA cases being dismissed on summary judgment.
Senator Harkin, lead sponsor of the ADA Amendments Act, acknowledged ADA Watch/NCDR’s role in passage of this legislation on the floor of the Senate, thanking the Road To Freedom’s crew for “dedicating almost 2 years of their lives traveling on a bus around the country to every State, showing people about the importance of restoring the protections of ADA.”
ADA Watch/NCDR founder and president, Jim Ward stated today, “This is a monumental victory for people with disabilities. As America seeks to respond to the economic challenges we face, this law - if enforced - will assure that people with disabilities are fairly included in the workforce and that we can do our jobs free from discrimination.”
“ADA Watch and the National Coalition for Disability Rights praises the thousands of Americans who produced and participated in Road To Freedom bus stops as, together, we called for restoration of the ADA. Likewise, we praise the tireless efforts of advocates such as Andy Imparato, Sandy Finucane, Curt Decker, Chai Feldblum, Jennifer Mathis, Arlene Mayerson, Shereen Arent, Donna Meltzer, Nancy Zirkin, Michael Collins, Yoshiko Dart, Tom Olin, Debbie Fletter Ward and so many others.”
The National Coalition for Disability Rights (NCDR) is a coalition of national, state and local disability, civil rights and social justice organizations united to protect and promote the human rights of children and adults with physical and mental disabilities.
Steve Gold: Medicaid Reductions and People with Disabilities
As the economy continues to dramatically impact on State budgets, Medicaid expenditures will come under attack. Here are some suggestions advocates might wish to consider. I think it is very important to keep emphasizing the ADA and the importance of keeping people with disabilities and the elderly in the community.
1. Focus on your state’s Medicaid nursing facility expenditures.
Nationally, from FY 2002 through FY 2007, the national % increase in Medicaid nursing facilities’ expenditures was only 1.3%. However, many states had significantly larger increases.
The following 21 states had more than a 20% increase in nursing home expenditures during these six years: Alabama, Alaska(45%), California, Colorado, Connecticut, Delaware, Florida, Hawaii, Kentucky, Maine, Maryland, Mississippi(55%), Nevada(45%), New Hampshire, North Carolina, Oregon, South Carolina, Tennessee, Utah(70%), West Virginia (35%), and Wyoming.
Organize to force your state to cap its nursing facility expenditures.
As long as your state continues to increase its Medicaid nursing home expenditures, nursing facilities will have an incentive to admit people who could otherwise live in the community. Therefore, no more Medicaid increases to unnecessarily institutionalize people with disabilities.
2. Save Medicaid funds by transferring nursing homes expenditures.
Get your state to tell nursing home residents that if a person moved to the community each of them will receive at least 90% of the amount of Medicaid funds your State spends on them in nursing facilities. In FY 2007, nationally states spent nearly $47 billion of Medicaid expenditures on nursing homes, compared to only $6.3 billion on all Aged/Disabled Waivers in the community.
For people who want to live in the community, your state could save 10% of the nursing home expenditures and, at the same time, do what people want
– permit them to reside in their own homes and apartments with services paid with the 90% of the nursing home costs.
3. Save Medicaid funds in hospital reimbursements.
In FY 2007, nationally states spent $43 billion on in-patient hospitalizations. Many of those people were hospitalized for some time because there was not a community-based support system where they could receive the same supportive services they were receiving in the hospitals.
I do not have good data that reflects how many days people were unnecessarily hospitalized primarily because there was not system to provide services in the community. However, I do know that nearly 60% of nursing home admissions are directly from acute care hospitals. Many of those people would not have gone to a nursing facility if there were a real choice and if someone explained to talked to them about community-based services.
4. Close the front door of nursing homes.
I am still dumbfounded why 11% of nursing home admissions are for persons who were in their own homes and apartments and had not received any home health services before they went straight into a nursing facility. (This 11% is separate from the 60% who were admitted from an acute care
hospital.) Clearly, states have not “closed the front door,” but still permit people to be admitted directly into nursing homes without the state Medicaid officialsb or advocates for elderly and disabled b asking these folks what services they might need and want to stay in their own homes and apartments.
5. Other Suggestions - Send In Your Ideas!
Please email to stevegoldada@cs.com, subject: “save Medicaid funds”.
Steve Gold, The Disability Odyssey continues
Back issues of other Information Bulletins are available online at http://www.stevegoldada.com with a searchable Archive at this site divided into different subjects.
To contact Steve Gold directly, write to stevegoldada@cs.com or call 215-627-7100.
