Should an employer be required to hire an applicant who has HIV for work that could become bloody in a place where there is poor medical care?

Suppose the job is protecting diplomats in dangerous places. The employee would carry a gun, probably a big one, and would be trained to expect attacks. The result of an assault, of course, could be a bloody mess.

The answer is not an easy one, which is why the U.S. District Court for the District of Columbia has been asked to sort it out.

The case involves a 46-year-old former Green Beret, who received numerous decorations during his 20 years in the service. Shortly before the Obama administration took office, he sued the State Department and a private security firm, Triple Canopy, because he was pushed out of its training program. He was told the company’s government contract requires that employees have no contagious illness.

Court documents refer to the plaintiff as John Doe. Journalists don’t like to use pseudonyms, but exceptions are sometimes made. In this case Doe, who did tell me his real name, says he fears further discrimination. “I have a family and I want to protect my kids,” he said in a telephone interview.

In November 2005, Doe was at the end of his training with Herndon-based Triple Canopy when a supervisor pulled him from a session to say Doe would not be sent to protect diplomats in Haiti as planned.

According to Doe’s court brief, the supervisor cited paragraph C5 of the company’s contract with State, which says, “all contractor employees working under this contract should . . . be free from communicable disease.” Doe was told that provision is mandatory and includes HIV.

Now, instead of the $545 a day he would have made with Triple Canopy, he says he gets $12 an hour doing construction work.

Through his attorneys with the American Civil Liberties Union Foundation and the firm of Paul, Weiss, Rifkind, Wharton & Garrison in New York, Doe argues that the federal Rehabilitation Act and the Americans with Disabilities Act prohibits discrimination based on disabilities, including HIV.

“Despite these mandated protections, the State Department required certain of its contractors to terminate, or deem ineligible for employment, all individuals with HIV regardless of their ability to perform the essential functions of the job,” Doe’s brief states.

He doesn’t have any symptoms. And after Special Forces service and having already done similar work in Iraq, he has no doubt that he can do the job.

“There is not too many Americans that are as qualified as I am doing this kind of work” he told me. “I am a professional at what I do, and I’ve never had any problems doing my job.”

While in the Army, he worked as a Special Forces engineer, intelligence officer and a team sergeant in far-flung places like Haiti, Kenya, Kuwait and Pakistan.

He tested positive while in the Army but continued to serve until his normal retirement date.

After retiring from the Army in September 2001, Doe wanted to continue doing “basically what I’ve done my whole life.”

He was a Defense Department security contractor with two companies in Iraq, doing essentially the same type of work he planned to do for Triple Canopy in Haiti.

His HIV status was known to his employers while in Iraq, and that “did not impede his two years of employment for these contractors in any way,” his brief says. But when he went to work for Triple Canopy, it terminated him “because the State Department barred Triple Canopy from hiring anyone with HIV” for work under its World Personal Protective Services Contract.

The State Department denies that assertion without elaboration in its brief. While the government’s document is short on information, Triple Canopy’s brief does provide a rationale for giving Doe the boot.

With the hazardous conditions, the danger of bloodshed “and the consequent threat to the safety and health of other individuals, the deployment of John Doe . . . would pose a direct threat to other individuals (as well as to himself),” Triple Canopy argues.

If Doe were wounded, “his colleagues would face the choice of either refusing to render aid to him or doing so without the ability to comply” with proper procedures for treating those with HIV, meaning they wouldn’t have protective clothing such as masks or rubber gloves.

Triple Canopy acknowledges that “it is well-established that HIV-positive status does not present a direct threat to the safety and health of others in a normal working environment.”

But it also says federal law promoting employment for those with disabilities “is not intended to do so at the risk of their own health or safety or that of others.”

Banning discrimination against those living with HIV in a normal workplace is a no-brainer. But it’s a more difficult question if the workplace could become soaked with the employees’ own blood.

Contact Joe Davidson at federaldiary@washpost.com.

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.

“If there is anyone out there who still doubts that America is a place where all things are possible, who still wonders if the dream of our founders is alive in our time, who still questions the power of our democracy, tonight is your answer.”

“It’s the answer told by lines that stretched around schools and churches in numbers this nation has never seen, by people who waited three hours and four hours, many for the first time in their lives, because they believed that this time must be different, that their voices could be that difference.”

“It’s the answer spoken by young and old, rich and poor, Democrat and Republican, black, white, Hispanic, Asian, Native American, gay, straight, disabled and not disabled. Americans who sent a message to the world that we have never been just a collection of individuals or a collection of red states and blue states.”

“We are, and always will be, the United States of America.”

— President Elect Barack Obama
November 4, 2008

Barack Obama and Joe Biden’s Plan to Empower Individuals with Disabilities

Fifty-four million Americans – roughly 1 in 6 – personally experience some form of disability. And the wars inIraq and Afghanistan continue to increase those numbers. Yet seventeen years after Congress enacted the
Americans with Disabilities Act (ADA), Americans with disabilities still do not have an equal opportunity to
fulfill the American Dream. In 2006, working-age Americans with disabilities were almost three times more
likely to live below the poverty line than those without disabilities. While the average annual household incomeof individuals in the United States without disabilities was $65,400 in 2006, the average annual householdincome for people with disabilities was $36,300. And the employment rate for persons with disabilities in 2006was at least 40 points lower than the employment rate of working-age individuals without disabilities. These dismal statistics offer evidence of severe shortcomings in our country’s efforts to break down the barriers that exclude people with disabilities and deprive them of true equality of opportunity and independence.

Barack Obama and Joe Biden believe the United States should lead the world in empowering people with
disabilities to take full advantage of their talents and become independent, integrated members of society.
Dozens of countries have adopted laws modeled on the Americans with Disabilities Act, but America’s
leadership in the world has faded in recent years. As president, Barack Obama will renew America’s leadership by making the United States a signatory to the UN Convention on the Rights of Persons with Disabilities – the first human rights treaty approved by the UN in the 21st century and a vital foundation for respecting the rights of people with disabilities worldwide. He will urge the U.S. Senate to ratify the Convention expeditiously.

Barack Obama and Joe Biden have a four-part plan to provide Americans with disabilities with the greatest
possible access to the same opportunities as those without disabilities: (1) providing Americans with disabilities the educational opportunities they need to succeed; (2) ending discrimination and promoting equal opportunity; and (3) increasing the employment rate of workers with disabilities; and (4) supporting independent, community-based living for Americans with disabilities. And they will work closely with individuals with disabilities and disability rights advocates to achieve this vision of a society where all can live with dignity and respect.

I. PROVIDING AMERICANS WITH DISABILITIES EDUCATIONAL OPPORTUNITIES

Fully Funding the Individuals with Disabilities Education Act: Barack Obama has been a strong and
consistent advocate for fully funding the Individuals with Disabilities Education Act (IDEA). Congress
promised to shoulder 40 percent of each state’s “excess cost” of educating children with disabilities, but it hasnever lived up to this obligation. Currently, the federal government provides less than half of the promisedfunding (17 percent). Children are being shortchanged, and their parents are forced to fight with cash-strapped school districts to get the free and appropriate education the IDEA promises their children. Fully funding IDEA will provide students with disabilities the public education they have a right to, and school districts will be able to provide services without cutting into their general education budgets. In addition to fully funding IDEA, Barack Obama and Joe Biden will ensure effective implementation and enforcement of the Act.

Early Intervention for Children with Disabilities: Children’s ability to succeed in school relies on the
foundation they build in their first three years. Pre-kindergarten for four-year-olds is important, but it is notenough to ensure children arrive at school ready to learn. This is particularly so for children with disabilities and/or special health care needs, who already face challenges in the early years that can set them behind their peers before they ever enter school. Barack Obama and Joe Biden will invest $10 billion per year in early intervention educational and developmental programs for children between zero and five. Their plan will help expand Early Head Start to serve more children with disabilities, and will spur states, through programs like Early Learning Challenge Grants, to expand programs for children with disabilities, such as IDEA Part C, and integrate these programs with other early childhood programs.

Support Universal Screening: Roughly 90 percent of infants in the United States are screened for various
potentially disabling or life-threatening conditions, but fewer than half the states screen all infants for the
American College of Medical Genetics’ full recommended panel of 29 disorders. Many of these conditions, if
caught early, can be treated before they result in permanent impairments or even death. And parents are often unaware that the tests are available. Barack Obama and Joe Biden believe that we should ensure that all states have comprehensive newborn screening programs. In addition, they support setting a national goal to provide re-screening for all two-year-olds – the age at which some conditions, including autism spectrum disorders, begin to appear. Part of Obama’s early childhood intervention plan will be directed at coordinating fragmented community programs to help provide parents with information about screening for disabilities as infants and again as two-year olds. Achieving universal screening is essential so that disabilities can be identified early enough to help children and families get the special supports and resources they need.
Support Vocational Rehabilitation Programs: Students with disabilities who graduate from high school face
unique challenges that often serve as barriers to college matriculation or entry into the workforce.

Vocational rehabilitation programs currently exist in every state that have provided successful counseling to help high school students with disabilities and high school graduates with disabilities to develop the life skills necessary to move on to college and into independent lives. Barack Obama and Joe Biden support vocational rehabilitation programs and will assure there is sufficient funding to empower Americans with disabilities to succeed in college and beyond.

Improving College Opportunities for High School Graduates with Disabilities: If they are to succeed to
their fullest capabilities in the labor market, students with disabilities need more opportunities to obtain a
college education. Today, however, students with disabilities are less likely to attend college than their peers and are less likely to complete a degree program when they do attend. When students with disabilities do graduate from college, the first year of their participation in the labor market is roughly equal to their classmates without disabilities.

To improve college opportunities, Barack Obama and Joe Biden will:

• Make College More Affordable: Barack Obama and Joe Biden will help make college more
affordable and accessible by creating a new American Opportunity Tax Credit. This universal and fully
refundable credit will ensure that the first $4,000 of a college education is completely free for most
Americans, and will cover two-thirds of the cost of tuition at the average public college or university.

• Strengthen Community Colleges: Almost half of all college students with disabilities attend public
two-year institutions, particularly community colleges. Barack Obama and Joe Biden will create a
Community College Partnership Program to strengthen community colleges by providing grants to (a)
conduct more thorough analysis of the types of skills and technical education that are in high demand
from students and local industry; (b) implement new associate of arts degree programs that cater to
emerging industry and technical career demands; and (c) reward those institutions that graduate more
students and also increase their numbers of transfer students to four-year institutions.

These efforts will ensure that community college students are able to directly use their skills in the workforce following graduation, and be prepared to continue their higher education. And the grants will support programs that facilitate transfers from two-year institutions to four-year institutions.

Authorize a Comprehensive Study of Students with Disabilities and Transition to Work and Higher
Education: There has not been a comprehensive study of evaluating access to higher education or transition to the workforce by students with disabilities. As president, Barack Obama will initiate such a study and task his Secretary of Education with researching: the barriers that keep students with disabilities from seeking and completing higher education; the barriers that prevent students from making a direct transition to work; the extent to which students with disabilities are able to access loans and grants; reasons college students with disabilities drop out at a higher rate; and best practices from schools that have effectively recruited and
graduated students with disabilities that can be implemented more widely.

II. ENDING DISCRIMINATION AND PROMOTING EQUALITY OF OPPORTUNITY FOR PEOPLE WITH DISABILITIES

Restoring the Americans with Disabilities Act: As a former civil rights lawyer and a strong advocate for
workplace diversity, Barack Obama understands the critical importance of reducing workplace and labor market discrimination against people with disabilities, including by expanding employers’ provision of workplace accommodations. The Supreme Court has severely restricted the application of the Americans with Disabilities Act (ADA) by narrowly defining what it means to have a “disability.” As a result, lower courts have held that people with epilepsy, diabetes, heart disease and cancer can be fired from their jobs because they have those conditions. Obama strongly supports Senator Tom Harkin’s (D-IA) ADA Restoration Act, which would overturn the Supreme Court decisions that limit the ADA’s coverage and effectiveness and will sign it into law as president.

Appointing Judges and Justices Who Respect Laws Designed to Protect People with Disabilities:

Barack Obama will appoint judges and justices who respect Congress’ role as a co-equal, democratically elected branch of government and who exhibit empathy with what it means to be an American with a disability. The Supreme Court’s interpretations of the ADA have shown disrespect for Congress’ intent and frustrated the law’s goals of fully integrating people with disabilities into society.

Increasing Funding for Enforcement: The Bush Administration has cut funding for the Equal Employment
Opportunity Commission (EEOC) and the Department of Labor’s Office of Federal Contract Compliance
Programs (OFCCP), the agencies tasked with enforcing anti-discrimination laws that protect workers with
disabilities. Staffing for these agencies has also been significantly reduced. As a result, while the number of
complaints filed with those agencies has remained steady, the number of charges resolved by the EEOC has
declined. More than 100,000 charges were resolved in FY 1997 and FY 1998, but in FY 2006, fewer than
75,000 were resolved. Barack Obama and Joe Biden will fully fund and increase staffing for the EEOC and the
OFCCP to reduce charge backlogs and to prosecute efforts to remedy systemic discrimination.

To assure that the federal government holds itself to a high anti-discrimination standard, Obama will appoint a Chair of the EEOC and nominate commissioners who are committed to enforcing anti-discrimination laws.

Supporting the Genetic Information Nondiscrimination Act: With medical advances in the field of
genetics, getting genetically tested can be of increasing usefulness in diagnosing and treating certain health
conditions. In order to take advantage of those advances people need to be assured that their genetic code will not be used against them in a discriminatory way. Barack Obama is a cosponsor of the Genetic Information Nondiscrimination Act (GINA), which prohibits discrimination on the basis of genetic information by employers and health insurers. The Act also applies health information privacy regulations to the use and disclosure of genetic information.

Guaranteeing Health Care Coverage: Many people with disabilities do not seek work or leave the workforce
because they need the guaranteed health insurance that the federal government’s benefit programs provide. As a result, many stay on Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI),
which include Medicare or Medicaid coverage, rather than take a job that might jeopardize their health care
coverage. Barack Obama has pledged to sign universal health care legislation by the end of his first term in
office that will assure that Americans with disabilities will have quality, affordable, portable coverage that will allow them to take a job without fear of losing coverage. People with disabilities who lose their Medicare or Medicaid eligibility by taking a job, but still cannot afford coverage, will be provided a subsidy in order to
purchase coverage. Moreover, under the Obama-Biden plan, insurers will not be able to deny coverage on the
basis of pre-existing conditions.

Improving Mental Health Care: Mental illness affects approximately one in five American families.
Veterans returning from Iraq and Afghanistan are coming home with record levels of combat stress. The
National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100
billion per year. Barack Obama is a supporter of the bipartisan Paul Wellstone Mental Health and Addiction
Equity Act of 2007, and, as a state senator, Obama helped pass a mental health parity bill that requires coverage for serious mental illnesses to be provided on the same terms and conditions as are applicable to other illnesses and diseases. As president, Obama will support mental health parity so that coverage for serious mental illnesses is provided on the same terms and conditions as other illnesses and diseases. For veterans, Obama will improve mental health care at every stage of military service—recruitment, deployment, and reentry into civilian life.

III. INCREASING EMPLOYMENT RATE OF WORKERS WITH DISABILITIES
Increasing Executive Branch Hiring of Workers with Disabilities: Barack Obama and Joe Biden believe the
federal government should serve as a model for other employers in hiring and accommodating employees with disabilities. The federal government is the United States’ largest employer. Barack Obama and Joe Biden
believe the federal government must recruit, hire, retain and advance workers with disabilities. To achieve this end, Obama will reinstate Executive Order No. 13173 which President Clinton issued just before he left office. Executive Order No. 13173 failed to achieve its mandate of hiring an additional 100,000 federal employees with disabilities within five years. Obama will issue this executive order early in his first term and designate a senior White House official to assure that all federal departments and agencies meet the mandate. That official will also be responsible for integrating disability policy into major presidential initiatives. Obama will also ensure that all electronic and information technologies employed by the federal government are fully accessible to federal employees and members of the general public with disabilities, as required by Section 508 of the Rehabilitation Act. In that spirit, Obama has taken steps to make his campaign website consistent with Section 508 standards.

Effectively Implementing Section 503 of the Rehabilitation Act: Barack Obama will direct all of his
department and agency heads to bring their agencies into full compliance with all aspects of the Rehabilitation Act and adopt regulations which assure that result. Section 503 of the Rehabilitation Act requires the federal government and employers who are federal contractors to “take affirmative action to employ and advance in employment qualified individuals with disabilities.” Yet, affirmative action in employment for adults with disabilities is not enforced with goals and timetables like the affirmative action requirements for people of color and women found in Executive Order No. 11246 and its progeny. As a result, affirmative action under the Rehabilitation Act is largely ineffective. Barack Obama will direct his Secretary of Labor to make changes to the regulations implementing Section 503 so that they more closely resemble those implementing Executive Order No. 11246.

Providing Private-Sector Employers with Resources to Accommodate Employees with Disabilities:

Several large employers, such as Walgreens, CVS, and Marriott, have led the way by establishing systems for
recruiting, hiring, accommodating, retaining and promoting employees with disabilities. As president, Barack Obama will direct his Secretary of Labor, the Labor Department’s Office of Disability Employment Policy, and its Job Accommodation Network to bring together employers, employer associations, human resources professionals, disability advocates, service providers, and the labor movement to identify, promote, and disseminate best practices in accommodating workers with disabilities.

Encouraging Private-Sector Employers to Use Existing Tax Benefits to Hire More Workers with
Disabilities: The tax code already contains several provisions designed to encourage employers to hire
employees with disabilities, including the Disabled Access Tax Credit, a Tax Deduction for Architectural and
Transportation Barrier Removal, and the Work Opportunity Tax Credit. Yet, very few employers actually take
advantage of these credits. Barack Obama and Joe Biden will launch an aggressive effort to educate employers about these tax benefits so that more employers use them to hire greater numbers of employees with disabilities.

Establishing a National Commission on People with Disabilities, Employment, and Social Security: As
president, Barack Obama will announce the creation of a National Commission on People with Disabilities,
Employment, and Social Security which will include presidential appointees, congressional appointees and the Commissioner of the Social Security Administration and the Secretaries of Labor and Health & Human
Services as ex officio members. The President’s charge to the commission will include:

• Examining and proposing solutions to work disincentives in the SSDI, SSI, Medicare, and Medicaid
programs.
• Revisiting the Ticket to Work Act to assess how it can better provide SSDI and SSI beneficiaries with
the supports they need to transition into work.
• Considering opportunities to improve the results produced through the relationships between the SSDI
and SSI programs and the workforce investment and vocational rehabilitation systems.
• Examining the sufficiency of SSDI and SSI benefit levels in light of available work opportunities for
working-age people with disabilities.
• Determining the sufficiency of the “substantial gainful activity” level in the SSDI program and whether
it should be indexed to average hourly wages or some other measure.
• Studying programs that would help young people join the labor force rather than the SSI rolls.

Supporting Small Businesses Owned by People with Disabilities: Despite the challenges that individuals
with disabilities face in starting their own businesses, they are not currently considered “disadvantaged” for
purposes of federal contracting provisions that seek to aid disadvantaged business owners. Barack Obama and Joe Biden would direct the Small Business Administration to amend regulations under the Small Business Act that provide preferences in federal contracting to small businesses owned by members of socially and
economically disadvantaged groups to include individuals with disabilities.

Assuring Workers with Disabilities and Family Caregivers Get the Flexibility at Work They Need: Some
workers with disabilities are unable to take or keep jobs, or even to remain in the workforce, because they don’t have the scheduling flexibility to tend to their health care needs. Scheduling flexibility, including time off from work, can be an appropriate – even an essential – “accommodation” for many employees with disabilities. In addition, more than 50 million “family caregivers” provide support to older people or to people with disabilities.

These families spend an average of twenty-one hours per week caring for a relative with a disability or illness and paid thousands of dollars in extra out-of-pocket expenses, on average. These added responsibilities expose family caregivers to a substantially higher risk of physical and mental health challenges ranging from stress, alcohol abuse, and depression, to heart disease, high blood pressure, and arthritis. Approximately 60 percent of family caregivers are women, and more than half are employed. Family caregivers also need the accommodation of workplace flexibility to help them navigate work and caregiving while also struggling to pay their bills and maintain their households. To provide greater workplace flexibility, Barack Obama and JoeBiden will:

• Expand the Family and Medical Leave Act: The Family and Medical Leave Act (FMLA) provides
eligible employees of larger employers (i.e., 50 or more employees) with 12 weeks of unpaid leave to
care for a family member’s or their own serious health condition. Barack Obama and Joe Biden will
guarantee that millions more workers have access to FMLA leave by reducing the threshold for which
employers are covered from companies with 50 or more employees to those with 25 or more.

• Encourage States to Adopt Paid Leave: According to the National Partnership for Women and
Families, 78 percent of employees covered by the FMLA who have needed leave but have not taken it
report that it is because they could not afford to take unpaid leave. Of those employees who could not
afford leave, nearly 88 percent report that they would have taken leave if they had been able to receive
some pay while away from work. As president, Barack Obama and Joe Biden will initiate a 50-state
strategy to encourage all of the states to adopt paid-leave systems. Barack Obama and Joe Biden will
provide a $1.5 billion fund to assist states with start-up costs and to help states offset the costs for
employees and employers. Obama’s Department of Labor will also provide technical information to the
states on how to craft paid-leave programs consistent with their local needs.

• Mandate A Reasonable Amount of Paid Sick Leave: Half of all private-sector workers have no paid
sick days. The problem is worse for employees in low-paying jobs where less than a quarter receive any
paid sick days. But sick days can be critical for workers with disabilities. For example, employees with
cancer may need to attend chemotherapy sessions or seek other intermittent treatments for their physical
or mental impairments. Barack Obama will require that employers provide seven paid sick days per
year – which may be taken on an hourly basis – so that Americans with disabilities can take the time off
they need without fear of losing their jobs or a paycheck.

• Protect Against Caregiver Discrimination: Workers with family obligations often are discriminated
against in the workplace. This is a growing problem, as evidenced by the skyrocketing number of
discrimination suits being filed: there has been a 400 percent increase in the number of family
responsibility discrimination lawsuits in the last decade. Barack Obama and Joe Biden will prevent
family members from being discriminated against because of caregiving responsibilities. They will
commit the government to enforcing recently-enacted Equal Employment Opportunity Commission
guidelines on caregiver discrimination.

IV. SUPPORTING INDEPENDENT, COMMUNITY-BASED LIVING FOR AMERICANS WITH DISABILITIES

Assuring the Rights Affirmed in Olmstead v. L.C.: Barack Obama and Joe Biden believe we still have
considerable progress to make in ensuring that the rights affirmed to Americans with disabilities in the
Olmstead v. L.C. decision, which required states to place people with mental disabilities in community settings rather than in institutions when treatment professionals determine that community placement is appropriate. In addition to supporting the Community Choice Act of 2007 and the CLASS Act of 2007, they believes that we should further incentivize states to provide Americans with disabilities the ability to choose the most appropriate care for their individual needs. Barack Obama and Joe Biden believe the federal government should help states increase the supply of high-quality community-based settings for individuals with disabilities by providing additional grants for new communities and community expansions. And they believe the federal government needs to be diligent about making sure the states enforce the rights affirmed by the Olmstead decision.

Supporting the Community Choice Act and Direct Care Workers: Barack Obama and Joe Biden support
Senator Tom Harkin’s (D-IA) Community Choice Act of 2007, which would allow Americans with significant
disabilities the choice of living in their community rather than having to live in a nursing home or other
institution. The legislation would expand community direct care services, with the goal of ensuring highquality care for Americans with disabilities. The current shortage of community direct care attendants is related to shortages in other sectors of the economy – low pay, limited or no benefits and inflexible working hours.

Barack Obama and Joe Biden supports the Fair Home Health Care Act, which would extend minimum wage
and overtime protections to direct care attendants, and why he also supports raising the minimum wage and
providing these workers – along with all other Americans – access to high-quality, affordable health insurance.

They also believe that we should strengthen ties between community direct care settings and federal, state and local job training programs to ensure that individuals receive information about job openings.
Supporting the CLASS Act: Currently 10 million Americans require long-term care, and that number is
expected to increase to 15 million by 2020. These Americans are often forced to give up their homes or
communities in order to receive the care they need. Barack Obama and Joe Biden strongly support the
Community Living Assistance Services and Supports (CLASS) Act to create a voluntary, budget-neutral
national insurance program to help adults who have or develop functional disabilities to remain independent and in their communities. Employees would have the option of enrolling through monthly $30 payroll deductions.

Individuals over 18 who had contributed premiums for five or more years would then be eligible for benefits if they are unable to perform two or more activities of daily living (e.g., eating, bathing, dressing). Those benefits could be used for housing modifications, assistive technologies, personal assistance services, transportation or other supports to increase the ability of those with disabilities to find and keep jobs, and remain in their homes and communities.

Streamline the Social Security Approval Process: The Social Security Administration (SSA) has been
consistently under-funded, resulting in unconscionable delays in initial claims determinations and hearings for individuals applying for the Social Security Disability Insurance (SSDI) and Social Security Supplement
Security Income (SSI) programs. The SSA’s disability claims backlog has reached a record high of 755,000, up
from 311,000 in 2000. The average wait time for an appeals hearing averages 505 days and, in some cases, can exceed three years. Barack Obama and Joe Biden believe that it is unacceptable to have a system in
which individuals lose their homes or are forced to declare bankruptcy because the federal government cannot process their claims quickly enough. Barack Obama and Joe Biden are committed to streamlining the current application and appeals procedures to reduce the confusion that surrounds these important programs. As president, Obama will also ensure that the SSA has the funding it needs to hire judges and staff and to invest in technology to expedite final decisions. Obama supported the $150 million increase in the SSA’s budget that was vetoed by President Bush this year. As president, he will continue to work to ensure that the SSA has the resources it needs for hiring and to more effectively process its caseloads.

Protect Voting Rights: Americans with disabilities have the same right to cast their vote as every other
American. That means that all polling places need to be physically accessible and all voting equipment must
allow Americans with disabilities to vote with the same privacy and independence as other voters. Yet as of
last year, over one third of states still had not provided at least one machine that would allow voters with
disabilities to cast a ballot privately and independently. Barack Obama and Joe Biden believe that this is
unacceptable. They support fully funding the Help America Vote Act (HAVA) so that we can ensure all polling
places are accessible. An Obama administration would also assure better enforcement of federal disability
rights laws – from HAVA to the Voting Accessibility for the Elderly and Handicapped Act to the ADA – to
make sure the right of Americans with disabilities to vote is fully protected.

In addition, Obama forcefully opposes voter ID laws that require mandatory photo identification at polling
places, which would have the effect of disproportionately disenfranchising Americans with disabilities, more
than 3 million of whom lack a government-issued form of identification. Obama believes voter ID
requirements are unconstitutional. Obama led Senate opposition to national photo ID requirements and joined an amicus brief filed with the Supreme Court arguing that Indiana’s voter ID law violates the 24th Amendment, which prohibits any form of poll tax. In an Obama Administration, the voting rights of people with disabilities and all Americans will be protected with the full force of the law.

Amending the Medicare “Homebound” Rule: Barack Obama and Joe Biden support amending the Medicare
“homebound” rule so that those with disabilities have the freedom to leave their homes without fear of having their government benefits taken away. They believe that our Medicare policy must reflect the common sense notion that community engagement and support is a vital component of a meaningful life. They looks forward to amending the law to remove arbitrary measures of “acceptable” time away from home and further ensure that individuals do not have benefits removed unfairly.

Investing in Assistive Technologies: Barack Obama and Joe Biden believe we must use technology to make
community-based living a reality for more people with disabilities. They support the Fostering Independence
Through Technology Act, which offers 21st century solutions, such as home monitoring and communications technologies, to overcoming barriers for people with disabilities. In addition, amending the Medicare “Homebound” rule will assure that homebound people with disabilities are not denied certain vital assistive living technologies just because they might occasionally be used outside the home.

Protecting the Safety of Individuals with Special Needs: One of the most devastating aspects of Hurricane
Katrina was that most of the stranded victims were society’s most vulnerable members – low-income families, the elderly, the homeless, and Americans with disabilities. Too many states and cities do not have adequate plans in place to care for special-needs populations. Obama passed legislation to help states properly plan the evacuation of individuals with special needs. He and Joe Biden believe that this is only the first step in ensuring that the most vulnerable individuals in local and national emergencies are adequately safeguarded.

Supporting Americans Living with Autism Spectrum Disorders: More than one million Americans live
with an autism spectrum disorder (ASD), a complex neurobiological condition that has a range of impacts on
thinking, feeling, language, and the ability to relate to others. As diagnostic criteria broaden and awareness
increases, more cases of ASD have been recognized across the country. Barack Obama and Joe Biden believe
we need to research treatments and search for the causes of ASD. Obama has been a strong supporter of more than $1 billion in federal funding for ASD research on the root causes and treatments. Barack Obama and Joe Biden believes we must work to guarantee that Americans with ASD can live independent and fully productive lives and to assure that their families understand and are able to support a loved one with ASD. They will fully fund the Individuals with Disabilities Education Act to ensure that no child with ASD or any other disability is left behind. They will also fight to assure that the government and our communities work together to provide a helping hand to people with ASD and their families.

Obama has a long record supporting people with ASD. In the state senate, Obama sponsored legislation that
became law to create the ASD Program - a systems development initiative designed to promote the
implementation of evidence-based practices. And in the U.S. Senate, Obama is also a cosponsor of a measure that would expand federal funding for life-long services for people with ASD, authorizing approximately $350 million in new federal funding for key programs related to treatments, interventions and services for both children and adults with ASD.

Strengthen VA Specialty Care: Advances in technology have meant that the survival rate for U.S.
servicemembers is higher now than in any previous conflict. There will be a long-term need for strengthened
specialty care within the VA, including additional polytrauma centers as well as centers of excellence for
Traumatic Brain Injury (TBI), PTSD, vision impairment, prosthetics, spinal cord injury, aging, women’s health
and other specialized rehabilitative care. In the Senate, Barack Obama has supported the expansion of PTSD
and TBI centers of excellence and cosponsored an innovative bipartisan measure to encourage students
specializing in vision care and rehabilitation to work in the VA. As president, he will expand the number of
these centers of excellence and invest in specialty care.

Preamble:

As supporters of the National Agenda for Disability Rights, we affirm the following propositions and principles:

We assert that unintended barriers and intentional exclusion, deep seated prejudice and widespread institutionalized discrimination shut people with disabilities out of society and impoverish our lives.

We declare that these exclusionary practices restrict us far more than any medical, physiological or psychological condition or difference.

We call on our society to rectify this historic pattern of injustice by enforcing legal protections against disability-based discrimination and ensuring our right of equal access.

We affirm that the devices, services, and accommodations we require are not means of caring for those who are fundamentally dependent, but are alternative modes of functioning.

We assert our right to these modes as the means of both our individual self-determination and self-fulfillment, and out participation in and contribution to society.

We claim these protections and provisions, not as measures of charity, but as matters of civil and human rights.

We call upon our society to live up to its noblest ideals by guaranteeing citizens with disabilities equality of both opportunity and respect.

We envision a society that supports and celebrates the rich array of human differences by accommodating the myriad ways in which all people function.

We proclaim that ensuring justice, equality, and dignity to people with disabilities will strengthen the rights and respect accorded to all citizens by building a society truly pluralistic, democratic, and open to all.

Guided by these principles and representing America’s many diverse disability communities, we join in a cross-disability campaign to advance the rights and interests of Americans with disabilities.

Goals and Values:

Goal 1: Increase the availability of affordable, accessible, appropriate housing of their choice for people with disabilities in America.

Value Statement: We value availability, affordability, accessibility, appropriateness, and individual choice in housing. Appropriate housing depends on the needs of individuals and may include physical access, location of supportive services, flexibility of policies, availability of usable transportation, and other factors.

Goal 2: Increase availability and coordination of community-based, health, mental health, housing and other services of their choice for people with disabilities.

Value Statement: The disability community of America values, health care, mental health care, housing, transportation, and other services in their communities rather than in segregated settings. We value individual choice, self-determination, and range of options in these services, including the choice to decline services. We encourage creativity and effectiveness in development of service delivery systems.

Goal 3: Ensure availability and accessibility of public and private transportation mechanisms for people with disabilities.

Value Statement: The disability community of America values access to public transportation that meets our needs as a matter of course, rather than as a special favor. We value the integration of services to the disability community into the overall public transportation system.

Goal 4: Design and implement an effective and competitive education system for students with disabilities which includes appropriate integration and specialized services and supports.

Value Statement: The disability community of America values the integration of students with and without disabilities. The disability community values the provision of educational and supportive services that are appropriate for each maximizing integration and educational benefit.

Goal 5: Educate communities about disabilities and disability social history for the purpose of eliminating discrimination, implementing disability rights and increasing responsibility for disability rights.

Value Statement: The disability community of America values the understanding of and voluntary implementation of disability civil rights. We seek to preserve disability rights social history to foster an understanding of disability rights as basic civil and human rights.

Goal 6: Improve enforcement, stop restriction, and expand disability rights laws.

Value Statement: The disability community of America values the existing disability rights laws and the enforcement mechanisms in place to enforce them when voluntary compliance does not occur. The disability community opposes efforts to make enforcement more difficult or to limit protection.

Goal 7: Increase gainful employment of people with disabilities and reduce the disproportionately high level of poverty among Americans with disabilities.

Value Statement: People with disabilities are twice as likely to live in poverty as other Americans. The disability community of America values the opportunity to work and to be valued, paid, and recognized equally for our contributions to the workplace.

Goal 8: Increase responsiveness of government agencies to the needs of people with disabilities.

Value Statement: The disability community of America values the opportunity to participate meaningfully in, and benefit from, government programs and services and to have disability issues integrated in all levels of government.

Goal 9: Assure a system of universal health care that meets the needs of people with disabilities.

Value Statement: The disability community of America values health care that is accessible and readily available, that is flexible enough to meet the needs of people with various disabilities and health care needs, that treats the whole person, that values individual choice (including the choice to decline services), and that is available to everyone.

Goal 10: Develop a health care system that bases treatment on the needs and choices of the individual without bias.

Value Statement: The disability community values health care that does not discriminate on the basis of racial, ethnic, or cultural background or regarding the nature or severity of the person’s disability. Discrimination in this context includes lack of physical or communication access, denial of personal choice (including the choice to decline services), and denying services based on existing or possible future disability. The disability community values health care that facilitates independent living.

(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.

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.