Weekly Advocacy Monitor

WhAM!

Volume 6, Issue 2 Ÿ January 14, 2008

Editor's Note:

NCIL has some very exciting new opportunities available on our website, with more to come in the near future. If you have not already, check out our Job Openings, new information on this year's Annual Conference including our Call for Proposals, and our 2008 Fundraising Campaign.

You can also now apply for funding to bring an IL Net training to your area, or search all of ncil.org from the homepage!

1) What's Happening in the Nation's Capital?. 2

2) National News. 2

CCA to be Heard in the House January 16^th, 2008. 2

75% Rule Undermined, More Progress Expected This Year 3

PARITY: Researchers Stress Importance Of Out-Of-Network Benefits. 4

Voting Rights Issues Clash with Federal Priorities as Election Heats Up. 5

House Releases 21^st Century Communications / Video Accessibility Act 7

Including People with Disabilities in Emergency Preparedness Activities. 8

3) State News. 9

SKIL Annual Meeting Update. 9

"Patients in Peril 2008" 9

Disability CIL Tackling Youth Incarceration, Seeking Input 10

4) Announcements. 10

MFP Rebalancing Demonstration Stakeholder Teleconference. 10

Working Life: Towards a Lifestyle of Employment For All 11

1) What's Happening in the Nation's Capital?

Source: Kaiser, CQ Daily

The House returns from recess on Tuesday, while the Senate continues convening only for pro forma sessions for one more week. Federal Reserve Chairman Ben Bernanke appeared before House Budget to discuss the near-term outlook for the U.S. economy. He predicted no recession for the near future.

Presidential Candidates are campaigning in Michigan for the January 15^th primary. Due to legal battles between states, Obama and Edwards will not be allowed to campaign in Michigan or have their names appear on the ballot. Michiganders should note that typical write-in rules do not apply in this case and that they must vote "uncommitted" in order to effectively vote for either of these two candidates.

January 19: Nevada Caucuses, South Carolina Republican Primary

January 26: South Carolina Democratic Primary

January 29: Florida Primaries

This week House Committee work will include:

CCA Hearing! The House Energy and Commerce Health Subcommittee will hold a hearing on the Community Choice Act entitled, "Medicaid's role for Americans with Disabilities." 10 am, Wednesday, 2123 Rayburn.

The Ways and Means Social Security Subcommitteewill hold a hearing on the effects of Social Security provisions affecting some public employees and other workers and their families who face hardships in retirement, or in the event of disability or death. 10 am, Wednesday, 1100 Longworth.

2) National News

CCA to be Heard in the House January 16^th, 2008

The Community Choice Act of 2007 will be heard in the House Energy and Commerce Subcommittee on Health January 16^th at 10:00am EST in room 2123 Rayburn House Office Building. The hearing is titled "Helping Families with Needed Care: Medicaid's Critical Role for Americans with Disabilities" This hearing will keep the momentum going for passage of CCA and focus on long term services and supports.

If you can come to Washington DC to attend the hearing, it will show legislators this is an important issue to the disability community! If you have an ADAPT orange T-shirt, wear it for solidarity. This hearing will also be accessible via webcast.

Contact members of the House Energy & Commerce Subcommittee on Health and ask them to attend this hearing. A complete list of Subcommittee members can be found online. It is critical members come to the hearing. Tell them the institutional bias in this country must end. Too many people are locked away in nursing homes away from their family, friends and community. It's time for change.

Please contact them, let them know why you care, and ask them to support the Community Choice Act, H.R. 1621. This is a national problem and together we can create a national solution. The House Energy and Commerce Committee is one of the "committees of jurisdiction" for the CCA in the House, and will play an important role in its passage.

For more information contact Judy R. Roy at: bhamilc1@bellsouth.net or Elizabeth Leef at 202-207-0334 ext. 1015; email elizabeth@ncil.org.

75% Rule Undermined, More Progress Expected This Year

The President recently approved the new Medicare, Medicaid, SCHIP Bill, S. 2499. Although the primary focus of the bill was to avert a 10% Medicare physician payment cut in 2008, the bill also addresses CPR's rehabilitation priorities.

Medicare's 75% Rule: The legislation will permanently freeze implementation of the 75% Rule at the 60% level as well as allow comorbid (occurring at the same time) conditions to continue to count toward meeting the rule's threshold. Additionally, the bill requires that HHS study beneficiary access to inpatient rehabilitation services and make recommendations for classifying inpatient rehabilitation hospitals and units. These 75% Rule provisions are completely inline with CPR's priorities and constitute a huge victory for CPR Members (including NCIL) and other stakeholders who worked to educate legislators about the importance of access to rehabilitation and its impact on independent living!

However, many issues of importance to the disability community were not addressed in this bill, including the Medicare Independent Living Act (or elimination of the "in-home rule"), Ending the Medicare Waiting Period Act, or acknowledgement that competitive bidding programs for durable medical equipment can impact access to equipment necessary for people with disabilities to live independently. NCIL will continue to advocate for the rights of people with disabilities and consumer control.

Lawmakers To Address Unfinished Policy Changes in Legislation This Year
Source: Congressional Quarterly

"Lawmakers are planning to address Medicare, SCHIP and Medicaid policy changes they had hoped to make last year in new legislation that would stop a 10% cut to Medicare physician fees scheduled to take effect June 30. CongressDaily reports, "With health care emerging as a top issue with voters, the election year might put increased pressure on lawmakers to present at least a few new health policies," although some proposals could draw veto threats.

Senate Finance Committee Chair Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) "want to explore Medicare changes that did not make it into last year's physician pay fix bill because time ran out". Those changes include measures supported by the Bush administration, such as health information technology requirements and proposals on mental health parity and genetic nondiscrimination. Committee members also might try to rewrite rules regarding Medicare Advantage plan marketing after the Bush administration last year rejected a proposal that would have given states more flexibility in regulating

the plans.

In addition, lawmakers are "likely to respond to the administration's latest attempts to stop states from expanding Medicaid eligibility" beyond 250% of the federal poverty level. A Baucus aide said the senator is planning to closely watch HHS this year to make sure its actions are consistent with the law.

Sen. Olympia Snowe (R-Maine), who negotiated SCHIP legislation that President Bush vetoed twice, said she hoped the Bush administration would be more willing to work with Congress this session. She said, "The administration has failed to recognize the way to achieve results for uninsured children is through building legislative consensus, not executive fiat"."

NCIL encourages members to talk with your elected representatives. If they do not hear from you, you cannot expect them to advocate for you! Pick up the phone and help advance disability rights in this critical area!

PARITY: Researchers Stress Importance Of Out-Of-Network Benefits

Source: Health Affairs, by Chris Fleming

Congress is on the verge of passing legislation mandating that health plans cover mental health (MH) and substance abuse treatment to the same extent that they cover other medical and surgical treatment. In a study published December 18 on the Health Affairs Web site, researchers say that passage of either the Senate or House version of this legislation would constitute a major improvement over the current 1996 Mental Health Parity Act, which only guaranteed equal annual and lifetime payment limits. However, the authors also warn that parity legislation could actually reduce access to MH treatment for some patients if it does not facilitate treatment by providers outside insurers' networks.

The study finds that, in 2005, only a minority of mental health providers in the national capital area participated in networks affiliated with the Federal Employees Health Benefit (FEHB) program, Medicare, Medicaid, or private insurance coverage. Only 38 to 49 percent of the area's psychiatrists, psychologists, and social workers were members of any network. Participation in FEHB networks was limited to approximately one-third of clinicians, and only 44 percent of FEHB patients received MH care from network clinicians.

"Our study shows that even in an area relatively rich in mental health resources such as Washington, D.C., and its surroundings, plan networks are not equipped to meet the full need for mental health treatment," said lead author Darrel Regier, executive director of the American Psychiatric Institute for Research and Education (APIRE). "Maintaining the out-of-network option is essential to ensuring access to treatment."

The version of parity legislation passed by the Senate would allow plans to vary the types of mental disorders covered under parity and to drop out-of-network MH coverage altogether if they decide that offering such benefits is not in their best interest, Regier and his colleagues say. In contrast, the parity bill moving through the House would require plans to cover all mental disorders and to cover out-of-network MH treatment at the same levels as other out-of-network treatment.

Voting Rights Issues Clash with Federal Priorities as Election Heats Up

Supreme Court Hears ID Case

Just as the 2008 election shifted into high gear, the Supreme Court took up a voting rights case Wednesday that could affect the outcome in some close contests this year and well into the future.

At issue: whether states may require voters to show a state government-issued ID or passport at their polling places. Crawford v. Marion County Election Board and Indiana Democratic Party v. Rokita, which concern the constitutionality of an Indiana statute mandating that in-person voters produce government-issued photo identification. The Court considered the burden that the law places on voters and the state's justification for the law, namely that photo IDs are needed to prevent vote fraud by those who are not legal voters, such as felons, noncitizens or nonresidents. Neither the Defense nor the Prosecution have been able to produce a witness affected the new law thus far. The Supreme Court is expected to rule on this case before July.

After receiving comments and support from the membership, the NCIL Voting Rights Task Force developed NCIL's Voting Rights Guiding Principles, which oppose ID requirements that pose a barrier to voting for people with disabilities.

Homeland Security Retreats from Facets of 'Real ID'

Source: Washington Post, by Spencer S. Hsu (Excerpted)

The Bush administration is easing its demand for tough national standards for driver's licenses, acting at the behest of state officials who say the "Real ID" plan is unworkable and too costly, officials familiar with the new policy said.

…In a recent meeting, DHS policy official Richard C. Barth told state officials to expect Real ID's price tag to fall by "billions of dollars" as DHS eases previous demands that the new licenses be renewed every five years, that expensive, tamper-resistant materials be used to create the ID cards, and that each state develop its own document verification systems, those officials said.

…Timothy Sparapani, senior legislative counsel for the American Civil Liberties Union, said DHS is weakening the program in a desperate bid to keep it alive. The ACLU and conservative libertarian groups that oppose Real ID view it as a de facto national ID with Orwellian implications. Eight states have passed legislation to opt out of the program, nine others have passed resolutions in opposition, and more will consider doing so this winter.

"DHS is doing back flips in order to get states to say they are complying with Real ID," Sparapani said. "It was flawed in principle from the beginning, and DHS is attempting a 'Hail Mary' pass to try to coerce and convince states that what they are doing under existing statutes is acceptable."

…In 2005, Congress passed legislation mandating Real ID to standardize information that must be included on licenses, including a digital photograph, a signature and machine-readable features such as a bar code. Under the law, states also must verify applicants' citizenship status, check identity documents such as birth certificates, and cross-check information with other states and with Social Security, immigration and State Department databases. The new licenses must include features to thwart forgery and fraud, and drivers born after 1935 will have to present birth certificates or passports to obtain them.

…Congress approved $40 million in grants to states to cover some of the expenses this year. By comparison, the National Governors Association wants $1 billion next year as a down payment for states' start-up costs. Read this article in full.

Take Action: Tell NCIL Your Voting Experiences!

Following up on last year's voter survey, The NCIL Voting Rights Task Force is seeking feedback from people with disabilities about their experiences voting - both positive and negative. Please send your polling place experiences to Task Force Chair Kathy Hoell at khoell@cox.net or to NCIL Policy Analyst Deb Cotter at deb@ncil.org Thank you for your participation. Don't forget to check out NCIL's Vote 2008 to read Presidential Candidates' responses to NCIL questions, learn more about the candidates, register to vote and more!

House Releases 21^st Century Communications / Video Accessibility Act

On December 21^st, 2007, the U.S. House of Representatives released a draft bill, the long-awaited "Twenty-first Century Communications and Video Accessibility Act." This proposal is a dramatic and comprehensive step forward for consumers with disabilities. It proposes to amend the Communications Act - the main statute that impacts the telephone and video programming industries - to add new consumer protections that will ensure people with disabilities do not get left behind as telephones and television programming increasingly rely on digital and Internet Protocol (IP) technologies. The proposals will allow greater numbers of people with disabilities to live independently and to enjoy new electronic gadgets and devices that most takes for granted.

See the draft bill (PDF only)

See a summary of the bill (Word)

Immediate Action Steps! To help pass these simple communication fixes that will bring communications into the 21^st century for people with disabilities, please send letters as soon as possible to the following House members who are the leadership of the House Energy and Commerce Committee. Make sure to ask them for sponsorship of the legislation.

John Dingell (D-MI), Chairman, House Energy and Commerce Committee, Room 2328 Rayburn House Building, Washington, DC 20515.

Ed Markey (D-MA), Chairman, House Subcommittee on Telecommunications and the Internet, Room 2125 Rayburn House Office Building, Washington, DC 20515.

Ranking Minority Members: Joe Barton (R-TX), Room 2109 Rayburn House Building, Washington, DC 20515.

Fred Upton (R-MI), Room 2322A Rayburn House Office Building, Washington, DC 20515.

Also send letters to your own representatives if they are members of the House Subcommittee on Telecommunications and the Internet, which will review the bill first. View a list of subcommittee members and their addresses. Snail mail is preferred. Please send copies of your letters to: COAT, c/o of AAPD, 1629 K Street NW, Suite 503, Washington, DC 20006, Attn: J. Simpson.

Your letter could help make sure that there really is 21^st century electronic communication for people with disabilities! NCIL is a member of the Coalition of Organizations for Accessible Technology (COAT). COAT advocates for legislative and regulatory safeguards that will ensure full access by people with disabilities to evolving high speed broadband, wireless and other Internet protocol (IP) technologies. COAT consists of over 160 national, regional, state, and community-based organizations dedicated to making sure that as our nation migrates from legacy public switched-based telecommunications to more versatile and innovative IP-based and other communication technologies, people with disabilities will not be left behind. Check out their website. If you are interested in accessible assistive technology and want to be an active member of the NCIL AT Subcommittee, please contact John Nousaine or Elizabeth Leef.

Including People with Disabilities in Emergency Preparedness Activities

On January 3^rd, NCIL policy staff joined the Consortium for Citizens with Disabilities (CCD) Task Force on Emergency Management and the National Council on Disability (NCD), to meet with officials from the Department of Homeland Security Federal Emergency Management Agency (FEMA), including Disability Coordinator Cindy Daniel, to discuss Top Officials 4 (TOPOFF 4), the nation's fourth terrorism preparedness exercise, which was conducted the week of October 15^th, 2007 and involved top officials in federal, state, and local government, as well as representatives from the international community and the private sector - over 15,000 people! NCIL policy staff and CCD members emphasized the need for increased inclusion of, response to, and collaboration with the disability community during this exercise. NCIL Policy staff has been invited to a follow-up briefing by the Interagency Coordinating Council (ICC) and FEMA regarding the two-day policy level Long Term Recovery Tabletop Exercise held in December 2007 and the After Action Conference, to be held in January, 2008.

On January 8^th and 9^th, NCIL participated in the National Organization on Disability's Special Needs Technical Assistance Conference, addressing the emergency preparedness needs of individuals with all types of disabilities.

Individual NCIL Members interested in working on these policy issues are encouraged to join the NCIL Emergency Management Task Force by contacting Norm Smith at projectfreedom1@aol.com.

3) State News

SKIL Annual Meeting Update

Kansas

There was a large crowd in attendance for SKIL's Annual Meeting December 7^th, 2007, in Parsons, Kansas. Following dinner, Executive Director Shari Coatney presented each board member a caricature created by local artist Skip Smith, who also created a portrait of the keynote speaker Andrew Imparato, President and Chief Executive Officer of the American Association of People with Disabilities, based in Washington, D.C. In his address, Imparato spoke of political power and the need to work together, especially during this election cycle. Imparato said that one way everyone can help is to get involved with increasing voter registration and turnout, and pay attention to events even in off-election years. AAPD, the largest cross-disability membership organization in the United States, was founded in 1995 by former Kansas Senator Bob Dole and some of those instrumental in passage of the Americans with Disabilities Act. Imparato said that as people age, more attention will be paid to accessibility issues.

A number of people were recognized at SKIL's annual meeting. The John Spillman Sprit of Independence Award went to Linda Roberts, The Proving by Doing Award went to Ron Waun, The President's Youth award went to Jessica Schwartz, The Bobby Carter Planned Giving Award went to the Jock's Nitch, The Gary Cantrell Radio Excellence Award went to Lynn Meredith and the Marty Wooten Advocacy Award went to Larissa Cervantes.

"Patients in Peril 2008"

District of Columbia Protection and Advocacy released the document, "Patients in Peril 2008", which outlines serious deficiencies and "inexcusable lapses" in care at St. Elizabeth's Hospital, including the deaths of seven people with psychiatric disabilities in 2007, The Inclusion Daily Express reports. Given the highly publicized recent national push to strengthen involuntary commitment standards (such as those by the State of Virginia and the L.A. Times), advocates should use such information to inform Americans that abusive and neglectful institutions are more than a relic of an ancient past and that lowered civil rights protections for people with mental illnesses will not be negotiated, let alone tolerated while such inexcusable and barbaric conditions persist.

Interested individual NCIL members are encouraged to join NCIL's Violence and Abuse Task Force to address policy issues on violence and abuse against people with disabilities, including mental illness. If you are interested in working on this Task Force, please contact one of the co chairs: Leslie Myers or Roberta Sick. Read the Report in Full (PDF). Contact ULS for alternative formats.

Disability CIL Tackling Youth Incarceration, Seeking Input

Denver

"The Disability Center for Independent Living in Denver is working closely with Lookout Mountain Youth Services to help transition youth with mental illness / substance abuse issues who have been incarcerated for minor offenses. We are working with one program director at Lookout to develop an eight week curriculum to provide independent living skills training, WRAP training, and a course on substance abuse and HIV/AIDS. We begin working with youth while they are still incarcerated and will be providing mentors upon release: youth who have experienced what they have experienced and can act as role models of success. There are two goals of the program: help guide the youth upon release to a "constructive approach to their independence" - oftentimes the sudden responsibility of independence after being incarcerated for a year or two leads to problems and recidivism. The second goal is to create a bond with the youth while still incarcerated so that they will stay with our program for at least a year after being released. Will keep you all up-to-date on the results we achieve. Any input from NCIL members would be appreciated."

4) Announcements

MFP Rebalancing Demonstration Stakeholder Teleconference

Source: CMS

The Centers for Medicare & Medicaid Services (CMS) cordially invites you to attend a national teleconference to hear about the core components and the current status of the MFP Rebalancing Demonstration. ADAPT believes that the organization "Voice of the Retarded" will be on the call to dismantle efforts to expand MFP, and they encourage the disability community to join and reiterate the need for Money Follows the Person.

As you may know, the MFP Program is the largest demonstration ever offered by Medicaid. The MFP Program is providing States with $1.75 billion in funding to promote community-based healthcare services as viable alternatives to institutional care. It is designed to help States transition people from institutions back into the community where they can preserve their independence, maintain ties to family and friends, and enjoy a better quality of life. The details for the teleconference are as follows:

Date: Thursday, January 17, 2008

Time: 3:00 - 4:30 p.m. (EST)

Call-in Number: 1-888-793-1765

Passcode: Stakeholders

This teleconference has been specifically designed for the informational needs of consumers, their families, and advocacy groups living in or representing the specific MFP Demonstration States. Participation is limited to these key stakeholders in the MFP demonstration States. If a MFP Demonstration program is operating or is planned for your State, this teleconference will provide you with important information about the program.

We encourage you to forward this message to local and regional chapters of your advocacy organizations or stakeholder groups, operating in the MFP Demonstration States, as this is a great opportunity to hear more details about the current status and core components of the MFP Rebalancing Demonstration. After a 45 minute presentation by the CMS MFP team, the teleconference will be open for your questions and comments. No pre-registration is required.

If you have any questions, please do not hesitate to contact Cathy Cope (410-786-8287), John Sorensen (410-786-5933) or Carey Appold (410-786-2117).

TASH Webinar Series:

Working Life: Towards a Lifestyle of Employment For All

Session 1: Challenges & Opportunities in Expanding Integrated Employment
Monday, January 28, 2008

Session 2: Discovery and Profiles
Monday, February 4, 2008

Session 3: The Customized Planning Meeting & Development of a Representational Portfolio
Monday, February 11, 2008

Session 4: Interest-Based Negotiation for Customized Employment
Monday, February 25, 2008S

Times for all Webinars: 1:30pm- 3:00pm Eastern; 12:30pm - 2:00pm Central; 11:30am - 1:00pm Mountain; 10:30am - 12:00pm Pacific

Click here for further details and registration. Co-Sponsored by Institute for Community Inclusion (ICI) UMass-Boston and AP.

Weekly Advocacy Monitor

WhAM!

Volume 6, Issue 6 Ÿ February 11, 2008

Editor's Note:

The NCIL offices will be closed February 18^th as staff celebrates President's Day and the next edition of the WhAM! will be released February 19^th. February 25^th NCIL offices will remain open but the majority of staff will be conducting the 2008 Disability Policy Summit in Washington, D.C. The following edition of the WhAM! will be released Monday, March 3^rd.

Correction: In last week's edition of the WhAM, we incorrectly identified Representative Howard McKeon as a Democrat from California. He is in fact a Republican.

1) What's Happening in the Nation's Capital?. 2

2) National News. 3

2009 Budget Update: President Bush Maintains 2008 IL Cuts. 3

House Passes Extension of Mental Health Parity Law.. 5

Heritage Foundation Releases Blatant Misrepresentation of ADA Restoration; Fox News Tows Line, Manipulates America's Best Intentions. 6

3) Announcements. 8

Was Your Tuesday Super? Tell NCIL about Your Voting Experience. 8

4) Additional Resources. 9

IL Funding Sample Letter and Talking Points. 9

1) What's Happening in the Nation's Capital?

Source: Kaiser, CQ Daily

Predictably, the President's $3.1 trillion budget was coolly received by the Democratic Congress when it was released last Monday, and even some Republicans were less than enthralled. Democrats blasted Bush's proposed five-year freeze in domestic discretionary spending and proposals to save billions from Medicare and Medicaid. They said the budget relied on faulty assumptions and the omission of numerous expenses - including future war funding - in order to show a balanced budget by 2012. A House Appropriations release said, "the president's budget is a dreary and irresponsible re-run of those we have seen for the past eight years - missed opportunities, misplaced priorities, and fiscal fairy tales."

Unlike last year, Democrats have no illusions about negotiating with Bush on domestic funding or somehow forcing him to accept more spending than he has proposed. Bush, with the support of most congressional Republicans, was able to use veto threats last year that forced Democrats to adhere to his limit for discretionary spending. As a consequence, there has been talk of delaying completion of this year's appropriations process until after the elections, or even into next year when a new president will be in office. Of course, if Democrats did that, Republicans would criticize the move and almost certainly try to make it an election-year issue, along with their crusade against earmarks. Bush on Friday made clear he will again take a hard line with Congress, saying he will veto any appropriations bill that exceeds the amount he requested for that bill.

Budget hearings flood the calendar this week, with the House and Senate attempting to cram in about two dozen hearings related to the 2009 budget. Agency and department heads will appear before a spate of committees to articulate their funding needs. Representatives from the departments of Defense, State, Treasury, Health and Human Services, Housing and Urban Development, the Interior, Veterans Affairs, and Transportation will each make appearances at separate hearings.

In the Senate, Federal Reserve Chairman Ben Bernanke, SEC Chairman Christopher Cox and Treasury Secretary Henry M. Paulson will appear together to testify on the state of the economy before the Senate Banking, Housing and Urban Affairs Committee. This same Committee will then vote on draft public housing legislation.

The Judiciary Committee will mark up legislation regarding "mentally ill offenders" (S 2304) and hearings on the nominations of James Randal Hall to be U.S. District Judge of Georgia, Richard H. Honaker for Wyoming, Gustavus Adolphus Puryear IV for the Middle District Tennessee, and Brian Stacy Miller for the Eastern District of Arkansas. Read important NCIL information on the pending confirmation of these radical judicial nominations!

The Health, Education, Labor and Pensions will hold a hearing on ways to address healthcare workforce issues for the future. The Finance Committee will hold a hearing on oversight of marketing and sales of private Medicare plans.

In the House, the Ways and Means Health Subcommittee will hold a hearing on Medicare provisions with CMS Administrator Kerry Weems. The Appropriations Labor-HHS-Education Subcommittee will hold a hearing on "social and economic burdens of disease, injuries and disability," and the Oversight and Government Reform Domestic Policy Subcommittee will conduct a hearing on "Medicaid's response to systemic problems linked to lack of public access."

2) National News

2009 Budget Update: President Bush Maintains 2008 IL Cuts

February 4^th President Bush sent his fiscal year 2009 Budget Request to Congress, his last such request before leaving office on January 20^th, 2009. Once again, the President's priorities are clear. His $3.1 trillion Budget Request proposes draconian cuts in health and human services programs, which would negatively affect the lives of millions of people with disabilities, children, older Americans, and low-income families while allowing billions of dollars in insurance industry subsidies to continue.

All Advocates should understand that the U.S. Constitution gives the funding power to the representative branch of government. Congress (the House of Representatives) must initiate and approve funding measures, and you can influence the funding process. NCIL stands ready to lead this charge.

Overview: Among other things, the President would:

ž Cut mandatory spending programs by $16 billion in 2009, $208 billion over the next five years, and $619 billion over 10 years;

ž Cut Medicare. In response to the arbitrary 45% cap created in the Medicare Modernization Act, the President's budget proposes legislation to reduce Medicare spending by $556 billion over the next 10 years and more than $10 trillion over the next 75 years;

ž Increase budget deficits and a record federal debt. This budget proposes making tax cuts to the wealthiest Americans permanent. The White House expects the deficit to reach $410 billion in 2008, just short of the record set four years ago. In fiscal year 2009, which begins on October 1^st, 2008, the budget gap is projected to be $407 billion;

ž Protect insurance industry profits. Once again, private insurers in Medicare will collect $150 billion over ten years in taxpayer-supported subsidies while reporting record profits due to the privatization of Medicare, and;

ž Privatize Social Security. The President's budget proposes spending $30 billion in FY 2009 and $647 billion over the next 10 years to create Social Security private accounts.

The Stakes are High for Independent Living Services: The Independent Living Program provides services to individuals with disabilities to maximize their independence and productivity and to help them integrate into the mainstream of American society.

State Grants Part B program awards formula grants to States to expand and improve independent living services and to support the operation of Centers for Independent Living. The President proposed funding Part B at $22.2 Million.

Centers for Independent Living Part C program makes competitive grants to support a network of consumer-controlled, nonresidential, community-based centers that provide a broad range of independent living services. The President proposed funding Part C at $73.3 Million, maintaining the 2% across-the-board FY 2008 funding cut to both Parts B and C for FY 2009. This proposed funding takes IL back to FY 2004 levels, as outlined in the funding chart below.

Funding History:

Federal Funding Feud Ensues: Ladies and Gentleman, the federal funding feud has begun and your help is needed to demand that Congress represent you and your funding priorities this time around. The House and Senate Appropriations Subcommittees will review the proposal, holding hearings and other public meetings. With the nation engaged in a prolonged war overseas and increased attention on homeland security, domestic spending remains flat funded. Given inflation, among other factors, this level funding is essentially a cut to IL funding. NCIL will need your support in garnering funding for persons with disabilities to fully integrate and participate in society. Click here for more information on the President's Budget Request for the Department of Education's Office of Special Education and Rehabilitative Services, including Independent Living.

Take Action: Tell Congress to increase funding for Independent Living, and consumer-directed services for people with disabilities! Use the sample letter and talking points included in this edition of the WhAM! under Additional Resources.

If your Representative serves on the House Labor, Health and Human Services, and Education Appropriations Subcommittee or the Senate Labor, Health and Human Services, and Education Appropriations Subcommittee, your calls and faxes will influence the outcome of the budget debate and appropriations process in the coming months. If you are affiliated with a Center for Independent Living in one of these Appropriators' Districts (either of the Subcommittees above, or the full Appropriations Committee in the House or the Senate) please contact your Senator and Representatives!

NCIL cannot stress strongly enough the importance of reaching out to these Members. Please invite your Member of Congress to visit your CIL, to show Appropriators directly the importance of the Independent Living Program by connecting constituents (voters) with the appropriations process and to put a face on the IL Program. If you would like more information about inviting your Member of Congress to tour your CIL and/or need assistance doing so, please do not hesitate to contact Deb Cotter, NCIL Policy Analyst at (202) 207-0334, ext. 1008 or Deb@ncil.org (with "Congressional Visit" in the subject line.)

House Passes Extension of Mental Health Parity Law

Source: CQ Today

The House passed legislation Thursday that would extend a mental health benefits law for another year as lawmakers prepare a broader parity measure for floor consideration. Passed by 384-23, the temporary measure would extend a 1996 law that bans health plans that offer mental health coverage from setting different lifetime or annual dollar limits for such treatment than those imposed for treatment of other illnesses.

A broader mental health parity bill sponsored by Patrick J. Kennedy, (D-RI), would expand mental health regulations and require plans offering mental health benefits to make them equal in cost and scope to any medical or surgical benefits offered. It includes provisions that would require insurance coverage of certain mental health conditions.

The 1996 law does not require insurers to offer coverage for any mental health conditions. "We want to get full parity, which means we want to get the real bill that extends full coverage of mental illnesses to all health insurance plans, just as we would expect health insurance plans to cover the rest of our body - cancer, diabetes, everything else," Kennedy said. "We shouldn't expect any less for mental illnesses."

Frank Pallone Jr. (D-NJ,) said, "In spite of the 1996 law and widespread recognition that mental illness and substance abuse are treatable illnesses, there still exist glaring inequities between health insurance coverage for mental health and that for other medical conditions. As we all know, these inequities can have dire consequences for friends, families and society in general." The bill also contains a provision to collect back taxes owed by doctors and hospitals by docking Medicare payments to them. The bill would compel Medicare's hospital and physician programs to participate in the Federal Payment Levy Program, which collects back taxes by withholding federal payments.

Heritage Foundation Releases Blatant Misrepresentation of ADA Restoration; Fox News Tows Line, Manipulates America's Best Intentions

Lies! Slander! And the worst part is, these people know what they're doing. It seems strong opposition to the Restoration Act is growing, and it looks like we're going to have a battle on par with that fought to pass the original ADA. Brace yourselves, advocates! The powers that be are against the ADA, as you will read below, and will say and do anything to advance their materialistic interests. We must do everything possible to counteract this type of blatant misrepresentation and manipulation of our voices, our people, and our civil rights. Nothing about us without us!

Heritage Foundation: Congress and The Disabled - More Harm Than Help

Source: Fox News, by James Sherk

Do you have less than perfect health? Need contact lenses or eye glasses? Under legislation before Congress, the government would consider you disabled. It sounds ridiculous. It is. But that rarely stops Congress. The proposed ADA Restoration Act has powerful supporters on Capitol Hill, including the majority leader of the House of Representatives, and it could easily become law.

The bill's stated purpose is to strengthen protections for disabled Americans provided by the Americans with Disability Act (ADA). Unfortunately it would go far beyond this goal, classifying virtually every American as disabled and weakening the protections the government provides the truly disabled.

Congress passed the Americans with Disability Act in 1990 with the noble goal of ensuring that disabled Americans could participate in public life. The Act prohibits discriminating against the disabled, and it requires employers to make reasonable accommodations for disabled workers.

Intending to help the truly handicapped, Congress defined the disabled as those with "a physical or mental impairment that substantially limits one or more major life activities." The act also exempts individuals who take corrective measures that mitigate their impairment, such as prescription lenses for a nearsighted employee.

The ADA has had mixed success. It has helped many disabled workers integrate into the workforce. Unfortunately, because it made employing disabled workers expensive and laying them off difficult, the act has discouraged businesses from hiring handicapped employees in the first place. Studies show that the well-intentioned ADA has actually reduced the number of disabled Americans with jobs.

Now many members of Congress want to expand the scope of the Americans with Disabilities Act to cover almost every American. The ADA Restoration Act would remove the phrase "that substantially limits one or more major life activities" from the legal definition of disability. Anyone with any physical or mental impairment, no matter how minor, would become legally disabled. Take your pick: Heartburn. Stress. Insomnia. Occasional shortness of breath. Headaches. Tennis elbow. Heck, the flu, for that matter. If the ADA Restoration Act becomes law the government would consider every American with imperfect health - which means almost every American - disabled.

The bill even specifies that if you aren't suffering from your impairment now, you are nonetheless disabled. It doesn't matter if you can take steps to mitigate your disability, such as taking medication to reduce your cholesterol level. Under this act, you are still disabled.

Unfortunately, this bill is more than absurd. The ADA Restoration Act would actually undermine the protections afforded to genuinely handicapped Americans.

The original Americans with Disabilities Act was designed to put qualified but disabled workers on a level playing field with everyone else. However, society doesn't have unlimited resources to accommodate everyone who wants assistance. Expanding the concept of disability to cover everyone will divert resources from those who truly need and deserve assistance.

The ADA, sensibly, only requires employers to make reasonable accommodations for disabled workers. The government doesn't require businesses to go bankrupt if they cannot accommodate the needs every disabled employee. If every worker qualifies for job reassignments to accommodate their "disability," then fewer truly disabled individuals will be able to obtain job reassignment as a reasonable accommodation.

The law would not even allow employers to give higher priority to individuals with more pressing disabilities. Instead employers would have to assign accommodations on a first-come, first-served basis, with no regard to the severity of the disabilities.

Consider a manufacturer with two positions on the assembly line where workers can perform their job while sitting down. If one employee claimed disability because of a sore knee, and another because of a sprained ankle, they could insist on those positions as reasonable accommodation to their disability. If a paraplegic then applied to work, the employer could not legally move one of those employees to a position that required standing, making room for the new applicant. Instead he would have to turn the genuinely handicapped worker away because there would no longer be any reasonable accommodation possible.

If every new hire is legally disabled, it becomes next to impossible to prove that a genuinely disabled worker was discriminated against. Any company could simply point out that it hired a different disabled worker who it also could not discriminate against.

When everyone is special, no one is. Calling all workers disabled once again tilts the playing field against those with genuine handicaps. Washington is filled with absurd ideas, but the ADA Restoration Act goes beyond absurd - to harming the very individuals it's intended to help.

James Sherk is the Bradley fellow in labor policy at The Heritage Foundation (www.heritage.org; contact Mr. Sherk and investigate his funding sources at http://www.heritage.org/about/staff/jamessherk.cfm ).

3) Announcements

Was Your Tuesday Super? Tell NCIL about Your Voting Experience

In the wake of Super Tuesday's Presidential Primaries in 22 states, there have been several news stories about voting irregularities across the country. The NCIL Voting Rights Taskforce is interested in hearing about the accessibility of your voting experience. Send your story to Deb Cotter, NCIL Policy staff by email deb@ncil.org and to Taskforce Chair Kathy Hoell at khoell@cox.net.

4) Additional Resources

IL Funding Sample Letter and Talking Points

If calling through the Capitol Switchboard, (202) 224-3121, once connected with the Representative's office, ask to speak with the staff person who handles Labor, Health and Human Services Appropriations issues and send any materials, including faxes to this staff person.

[DATE]

The Honorable [FIRST LAST NAME OF REPRESENTATIVE]

United States House of Representatives

Washington, DC 200515

Sent via Facsimile: (202) 225-[###]

Dear Representative [LAST NAME]:

I am writing to voice my concern about President Bush's proposed budgets cuts to programs that enable people with disabilities to participate fully in the American dream. For too long, programs such as the Independent Living Program have been cut or flat funded because of ill conceived budget priorities in Washington. The fact is that Independent Living services such as those provided by [NAME CENTER FOR INDEPENDENT LIVING] in [CITY, STATE] have been very effective in integrating people with disabilities in my community by promoting self sufficiency and providing skills and training that people with disabilities need to live independently.

Centers for Independent Living (CILs) are non-profit community-based entities that are funded under Title VII, Chapter 1, Part C of the Rehabilitation Act of 1973, as amended. There are 334 federally funded CILs and an additional 100 that operate solely on state and local funding. These Centers serve people with disabilities in all but five Congressional Districts.

CILs provide advocacy, information, peer counseling, and independent living skills training to people with all types of disabilities - promoting, supporting, and encouraging independent lifestyles in community-based settings, not costly nursing homes or other types of institutions. Last year, CILs prevented 28,000 people from entering nursing homes and helped nearly 2,800 people out of nursing homes into community-based settings.

Indeed, Centers for Independent Living have historically helped countless numbers of people move from such restrictive environments, saving the state and federal government millions of dollars as well as facilitating employment and tax paying opportunities. Yet, in spite of the success of the program, we find ourselves dramatically cut with each passing year. The President's Budget Request proposes to flat fund the Independent Living Program Part B (State Funded Centers) at $22.2 Million and Part C (Federally Funded CILs) at $73.3 Million maintaining the nearly 2% across-the-board cut in Fiscal Year 2008 - and further reducing IL's ability to assist people with disabilities, including veterans returning with significant disabilities such as Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI).

A few years ago the national budget for CILs reached $75 million, while serving thousands of people with disabilities. Now we find ourselves at FY 2000 funding levels. Since 2005, our budgets have been slashed by 5% while the demand for services continues to increase.

I look forward to hearing your response. Please feel free to contact me if I can provide you with any information at [GIVE YOUR DIRECT PHONE NUMBER AND EMAIL]. Additionally, Deb Cotter, NCIL Policy Analyst is my representative in Washington; please feel free to contact her for further information by phone (202) 207-0334, ext 1008 or email deb@ncil.org.

Thank you for your consideration.

Sincerely,

[FULL NAME]

[POSTAL ADDRESS]

[PHONE]

[FAX]

[EMAIL]

Weekly Advocacy Monitor

WhAM!

Volume 6, Issue 8 Ÿ March 03, 2008

1) What's Happening in the Nation's Capital?. 2

2) National News. 3

NCIL Disability Summit and Congressional Briefing Update. 3

NCIL Leaders Engage CMS Directly on Targeted Case Management, Etc. 4

Leavitt Says HHS Will Not Withdraw Controversial Case
Management Rule. 5

Disability Claims Backlog Will Last Five Years [Minimum] 6

Obey Claims Congress Will Wait for Next Administration if Bush
Officials Refuse To Compromise on HHS Funding. 6

3) State News. 7

AFGE, Women's and Fair Practices Survey for Workers with Disabilities. 7

State Ordered to "Help Disabled": Federal Judge Gives Health Cabinet a Week to Make Changes; Receives Federal Approval for New Waiver 7

OIG Finds Continued Lack of Supplier Compliance with Requirements. 8

1) What's Happening in the Nation's Capital?

The House and Senate Budget Committees plan to mark up their 2009 budget resolutions this week. Democrats criticized Bush's budget for failing to assume any war costs beyond 2009, and for counting increased future revenues that would occur if more taxpayers are allowed to be hit by higher taxes under the alternative minimum tax. Yet Democrats will likely use similar assumptions to bolster their budget. To achieve a surplus in 2012, Bush also assumed that domestic discretionary spending would freeze in the future and that substantial savings would be carved from mandatory programs, particularly Medicare. Democrats won't go along with those proposals, but will assume that many of Bush's tax cuts expire or are offset by other revenue-raisers, generating substantial revenue in the last couple years of the budget's five-year budget window. Work on the budget will spark another fiery debate over Bush's tax cuts - specifically, whether they should be extended or allowed to expire.

House Science and Technology Investigations and Oversight Subcommittee will finally hold a hearing on FEMA and toxic trailer homes, an issue NCIL has been pursuing for some time (1:00pm Wednesday, 2318 Rayburn).

The Senate Judiciary will mark up legislation on "mentally ill offender treatment" (S 2304), and will vote on the nominations of:

ž Brian Stacy Miller to be U.S. District judge for the Eastern District of Arkansas

ž James Randal Hall to be U.S. district judge for the Southern District of Georgia

ž William Joseph Hawe to be U.S. Marshal for the Western District of Washington

ž John A. Mendez to be U.S. District judge for the Eastern District of California, and

ž Stanley Thomas Anderson to be U.S. District judge for the Western District of Tennessee (10:00am Thursday, 226 Dirksen).

The issue of accepting these controversial judicial nominations in an election year is extremely important to NCIL. Click here to review the NCIL position on these nominations and join the grassroots movement to protect our civil rights!

2) National News

NCIL Disability Summit and Congressional Briefing Update

On February 25^th, NCIL held its first-ever Disability Summit. Thirteen national organizations joined the Board of Directors to review NCIL's Spring 2008 Policy Priorities and identify areas in which we can collaborate to effect positive change. Transportation and housing were areas where the participating organizations shared similar goals and were very willing to collaborate and share best practices and innovative ideas. Other issues discussed included ADA Restoration and civil rights, healthcare and The Community Choice Act, Independent Living and Reauthorization of theRehabilitation Act.

Discussion grew lively around the issues of consumer control, disability-friendly language, and the nature of a truly cross-disability grassroots organization. Although we did not agree on all of these issues, NCIL remains committed to our principles and those of our membership. Although we endeavor to pursue and increase collaboration, we also remain steadfast and committed to never compromise our values. The principles of consumer control, independent living philosophy, and grassroots political power remain the core of our organization.

The Summit was preceded by an extremely productive NCIL Board Meeting, several Hill visits, and meetings between NCIL leadership and CMS; as well as transportation stakeholders.

These events were followed by NCIL's 2^nd Annual Congressional Briefing, an opportunity for members of the House and Senate, as well as their staff, to be introduced to the 2008 Policy Priories set by our membership. The NCIL Board of Directors led the presentation, explaining NCIL, the Independent Living Program, and each of our priority issues and corresponding legislation. The audience of nearly 50 people listened intently and the majority stayed long after the presentation to meet with NCIL Board members, staff, and other stakeholders and advocates from the disability community.

Last week's events were a milestone for NCIL and we would like to thank those that participated. Our first Disability Summit was a sincere effort to promote areas of collaboration and we look forward to pursuing this effort further with all organizations and advocates working to secure the civil and human rights of Americans with disabilities.

NCIL Leaders Engage CMS Directly on Targeted Case Management, Etc.

February 25^th NCIL members went to the U.S. Department of Health and Human Services, where the Centers for Medicare & Medicaid Services (CMS) is housed, to discuss three issues: new Targeted Case Management rules, changes to Durable Medical Equipment (DME) availability, and Money Follows the Person (MFP) demonstration grants and Centers for Independent Living.

The NCIL PAS Committee called for a meeting with the CMS Administrator for NCIL Representatives attending the winter NCIL Board Meeting, Disability Summit, and Congressional Briefing the week of February 23-26 in Washington DC.

Jeff Hughes (NCIL Rehab Act Subcommittee Chair from Oklahoma), Tim Sheehan (NCIL Regional Representative Chair from Wisconsin), Billy Altom (Executive Director of APRIL and NCIL Member-At-Large), and NCIL Policy Analyst Elizabeth Leef met with:

ž Kerry Weems, Administrator of the Centers for Medicare & Medicaid Services (CMS)

ž Dennis Smith, Director of the Centers for Medicaid and State Operations (CMSO)

ž Gale Arden, Director of the Disabled and Elderly Health Plan Group within CMSO

ž Laurence Wilson, Director of the Chronic Care Policy Group in the Center for Medicare Management (CMM)

ž Robin King, Director, Office of External Affairs (OEA)

ž Mary Worstell, Director, Partner Relations Group (PRG) in OEA

ž Tracy Self, Director, Division of Partnership Relations in PRG, and assorted CMS staffers.

Regarding Targeted Case Management, Dennis Smith asked NCIL for real time information on transitioning people from institutions to the community. The new rules cut the number of days that can be reimbursed for work completed to transition an individual from an institution to the community from 180 to 60 days, seriously compromising the work of Centers for Independent Living. NCIL explained how unrealistic the new time frame was considering constraints around transition, including the costs of upfront money for rent, utilities (especially when there is no credit history), transportation (major problem in rural areas), the lengthy wait for Section 8 vouchers and accessible, affordable, integrated housing, as well as follow-up services. Dennis Smith said he was willing to revisit TCM spending or explore new ways to identify and fund those services under a different or new category other than TCM if we could show how much time, effort and money it takes to serve consumers who want to transition out of institutions. NCIL told Mr. Smith that we stand ready to work with CMS.

NCIL reported that Money Follows the Person (MFP) is working in some states, such as Kansas, while other states, such as Oklahoma, are ignoring the state plans they developed. CMS does not have the ability to follow up on approved plans to make sure states are fully implementing the approved plan.

Kerry Weems asked NCIL to help CMS investigate suppliers not living up to expectations by monitoring the 10 cities where CMS demonstration sites will go live in July 2008, then prepare for the additional 70 demonstration sited that will launch in 2009. NCIL was told competitive bidding will not affect vendors in rural areas. Administrator Weems suggested calling 1-800-Medicare to file complaints, as this creates a pathway to the regional offices. Every time someone calls 1-800-Medicare, the CMS Ombudsman tracks the phone calls by issue and gets a sense of where specific problem areas are. If the call center doesn't respond, CMS can track the date, time, location, and usually the operator, to see where training is lacking and attempt to improve the situation. The conversation flow was friendly and discussions will continue. NCIL will be contacting CMS to continue dialog on Targeted Case Management and Durable Medical Equipment. Please see the article below for updates on the growing movement to stop Targeted Case Management rules from taking effect.

Leavitt Says HHS Will Not Withdraw Controversial Case Management Rule

Source: BNA, by Steve Teske

Health and Human Services Secretary Michael O. Leavitt February 27^th indicated he has no intention of withdrawing a controversial Medicaid rule governing targeted case management, saying the rule will prevent states from financially gaming the program.

In testimony before the House Budget Committee on the Bush administration's fiscal year 2009 budget blueprint, Leavitt said states are using "fee-based contingency consultants" to get more Medicaid money via targeted case management services. The consultants are paid to increase Medicaid reimbursement, Leavitt told the committee, a practice that he said HHS is determined to stop.

'I Have to Push Back.': "We believe states are using ambiguities to unfairly increase" their share of Medicaid funding, Leavitt said in response to a question from Representative Lloyd Doggett (D-TX). The consultants "have no incentive but to push, push, push, push" for more funding, he added. "If I'm running a program of integrity, I have to push back." Read this article in full.

Disability Claims Backlog Will Last Five Years [Minimum]

Source: Congressional Quarterly Budget Tracker

A Social Security Administration official Thursday said the agency has about 750,000 disability case appeals pending before administrative law judges, about twice as many as 10 years ago - due partly to budget cuts in previous years.

Social Security Commissioner Michael Astrue told House appropriators that the backlog should drop to 683,000 cases by the end of fiscal 2008, thanks to a budget increase Congress provided this year. The agency will still be unable to process a claim faster than nine months, on average, before 2013, he said at a House Labor-HHS-Education Appropriations hearing. People seeking disability payments wait, on average, more than 500 days for their claims to be resolved. Many become sicker, lose their homes or even die while waiting, according to advocates. The situation has angered many lawmakers, though Congress's cuts to Social Security's administrative account over the years helped create the problem.

House Appropriations Chairman Obey noted that Astrue independently requested $76 million more from Congress in fiscal 2009 than President Bush had sought for the agency. Astrue said the difference was caused in part by differences in SSA and OMB cost estimates, and the true difference was more like $20 million, which he called "marginal." Astrue last year was sworn in for a six-year term that expires January, 2013. Obey also chairs the Labor-HHS-Education subcommittee. Read the Social Security Inspector General's Testimony.

Obey Claims Congress Will Wait for Next Administration if Bush Officials Refuse To Compromise on HHS Funding

Source: Kaiser

Congress will wait until next year to pass the fiscal year 2009 Labor-HHS-Education appropriations bill in the event that the Bush administration does not agree to negotiate on the legislation, House Appropriations Committee Chair David Obey (D-WI) told HHS Secretary Mike Leavitt during a Labor, HHS, Education and Related Agencies Subcommittee hearing on Wednesday, CongressDaily reports. During his opening remarks, Obey said, "It would be good if we could work things out because, if we don't, the administration will simply be

a bystander".

Obey said that he would prefer to negotiate with administration officials to pass the bill this year. However, he added, "If they refuse to sit down with us, then the president has taken himself out of the game, and we'll wait for an adult." In addition, Obey said, "This can be a wasted eight months, or we can get something done." Last year, "the president refused to compromise -- his way or no way -- and the year was wasted," he said, adding, "This year we can wait until we have another president". Obey said that he expects the next president "will be flexible".

In response, Leavitt said that he and the administration "look forward to working with Congress, states and all our other partners to carry out the initiatives President Bush is proposing." During his testimony, "Leavitt stuck to his position that he was at the hearing to defend the president's blueprint, not negotiate it" (CongressDaily).

3) State News

AFGE, Women's and Fair Practices Survey for Workers with Disabilities

Washington, D.C.

NVP for Women and Fair Practices is taking the challenge to hold the federal and D.C. governments accountable for their treatment of employees with disabilities and their failure to remove barriers to equal employment opportunities. Please help us evaluate their treatment of workers and right these wrongs!

If you would like to help, please complete this survey and contact your District Women's and Fair Practices' Coordinators or the Women's and Fair Practices Departments' staff.

State Ordered to "Help Disabled": Federal Judge Gives Health Cabinet a Week to Make Changes; Receives Federal Approval for New Waiver

Source: Lexington Herald Leader, by Sarah Vos

Kentucky

A federal judge has given the state one week to begin implementing sweeping changes to the state's community-based services for people with mental retardation and physical disabilities. The deadline means the Cabinet for Health and Family Services will have to allocate more money to the programs, said Marsha Hockensmith, assistant director of Kentucky Protection and Advocacy. Read article in full.

Kentucky Medicaid Receives Federal Approval for New Waiver (Source: Kentucky Cabinet for Health and Human Services). Kentucky's Medicaid program has received approval from the Centers for Medicare and Medicaid Services (CMS) to start a new waiver program to better serve individuals with acquired brain injuries in community settings. In his proposed budget, Governor Steve Beshear included funding of $6.5 million in fiscal year 2009 to serve 50 individuals and $18.7 million in fiscal year 2010 to serve 150 additional individuals. These funds would cover the state's share of the new program.

The waiver will serve Kentucky residents age 18 and older with acquired brain injuries (ABI). It provides an alternative to institutional care for individuals who have reached a plateau in their rehabilitation level, and require maintenance services to avoid institutionalization and live safely in the community. Read this article in full.

OIG Finds Continued Lack of Supplier Compliance with Requirements
California, [Source: Office of the Inspector General, excerpted]

Inspector General Daniel R. Levinson announced today that the Office of Inspector General (OIG) for the Department of Health and Human Services issued another report on durable medical equipment, prosthetics, orthotics, and supply (DMEPOS) suppliers' compliance with Medicare requirements. The report, "Los Angeles County Suppliers' Compliance with Medicare Standards: Results from Unannounced Visits," found that problems persist.

OIG inspected 905 suppliers to assess their compliance with certain Medicare standards. Although these suppliers must comply with more than 20 standards encompassing numerous requirements, OIG focused on four easily observed rules requiring that each supplier: (1) maintain a physical facility, (2) be accessible during reasonable business hours, (3) have a visible sign, and (4) post hours of operation.

OIG found that 115 of 905 suppliers (13 percent) did not maintain a physical facility or were not open during unannounced site visits. Another 79 suppliers (9 percent) were open but did not meet at least one of the two additional requirements for the standards we reviewed. Finally, we found that an additional 124 suppliers (14 percent) met the requirements for the standards we reviewed, but their claims had in common an atypical characteristic.

Click here for the full release (including photos of supply companies not accessible at their addresses on file) (PDF only).

Weekly Advocacy Monitor

WhAM!

Volume 6, Issue 11 Ÿ March 24, 2008

1) What's Happening in the Nation's Capital?. 2

House and Senate Approve Fiscal Year 2009 Budget Resolutions. 2

2) National News. 3

Social Security Prepares to Re-launch Ticket to Work Program; Summit Energizes Advocates and Beneficiaries. 3

PAS & Healthcare Committee Update! 4

3) State News. 5

West Virginia 'Lunatic Asylum' Angers Advocates. 5

4) Announcements. 6

Benefits to Work Calculator Upgraded. 6

Walgreen's Shows Successful Business Model, Not Charity, Employing People with Disabilities 8

NCIL Request for Proposals: Aging and Disability Communities Collaboration. 8

International Conference on Self-Determination. 9

1) What's Happening in the Nation's Capital?

Both the House and Senate are currently on a two week recess in their districts and will not return until March 31^st.

House and Senate Approve Fiscal Year 2009 Budget Resolutions

Both Houses of Congress narrowly adopted their versions of the fiscal year 2009 Budget Resolution (BR). The House adopted its Resolution on March 13^th, by a vote of 212 to 207, mostly along party line. The Senate voted 51 to 49 at 2 a.m. on March 14 to adopt its version. Despite support from the three remaining Presidential candidates, all of whom are Senators, a one year moratorium on earmarked spending was shot down convincingly in both Houses. There are several major differences in the Budget Resolutions, outlined by section below.

Domestic Spending. Both bills would spend more money on domestic spending than the White House budget. The Senate would spend $21.8 billion over the Bush Administration request and the House Resolution would provide $3.5 billion more than the Senate for domestic spending. The House would allow for $25.4 billion for non-emergency discretionary spending.

Medicaid Regulations. Senator Charles Grassley (R-IA) ultimately did not offer an amendment imposing restrictions on the budget resolution's reserve fund for moratoria on Medicaid regulations.

A "Sense of the Senate" Concurrent Resolution (S. Con. 70), offered by Budget Committee Chairman Kent Conrad (D-ND) on behalf of Finance Committee Chairman Max Baucus (D-MT), to "express the sense of the Senate that Medicaid administrative regulations should not undermine Medicaid's role in our Nation's healthcare system, cap Federal Medicaid spending, or otherwise shift Medicaid cost burdens to State or local governments and their taxpayers and health providers, or undermine the Federal guarantee of health insurance coverage Medicaid provides" did pass.

Reconciliation Instructions. The Budget Resolutions differ in reconciliation instructions given to committees of jurisdiction to reshape entitlement spending. Reconciliation is the usual procedure used to modify entitlement spending such as Medicaid, Medicare, and Social Security. The House bill instructs the Ways and Means Committee to produce $750 million in savings over the next six years from entitlement programs. These savings would be used to prevent a looming ten percent reduction in Medicare payments to physicians. The Senate Resolution has no reconciliation instructions.

FY 2001 & 2003 Budget Cuts. During debate on the Resolutions, the Senate spent considerable time debating the fate of the Bush budget cuts enacted in 2001 and 2003, many of which are set to expire in 2010. Specific action on these cuts is expected to be delayed until next year.

Lifespan Respite. The Senate passed an amendment by unanimous consent reserving $53 million for Lifespan Respite. Currently Lifespan Respite, although authorized, has no funding. Senate Lifespan Respite champions Senators Hillary Clinton (D-NY) and John Warner (R-VA) offered the amendment. While this amendment does not guarantee an appropriation for the program, it is an important step in the process and signals support to appropriators as they craft spending bills.

Education. An amendment offered by Senator Bernie Sanders (I-VT) that would have added $10 billion to IDEA funding as well as other increases to human services programs was defeated by a vote of 43 to 55.

The House and Senate will attempt to reconcile the differences in these bills in April. For more information about the federal budget and appropriations process, visit the Library of Congress or contact Deb Cotter, NCIL Policy Analyst by email at deb@ncil.org or by phone at (202) 207-0334, ext. 1008.

2) National News

Social Security Prepares to Re-launch Ticket to Work Program; Summit Energizes Advocates and Beneficiaries

In preparation for the implementation of the Ticket to Work and Work Incentives Improvement Act of 1999, final regulations are due to be released this month. NCIL is working with the Social Security Administration (SSA) to "relaunch" the Ticket Program, which provides Social Security Disability Insurance (SSDI) and Supplemental Security Insurance (SSI) beneficiaries with an opportunity to enter or reenter the workforce.

March 10-13th, NCIL policy staff joined SSA officials and other partners working to implement the program at a Ticket Partners Summit in Louisville, KY to strategize about fully implementing the forthcoming final Ticket regulations. Although some individuals with disabilities have successfully left the Social Security disability programs for work by taking advantage of TTW, the Ticket program has been more limited than disability advocates had expected. At last week's Summit, SSA met with representatives of state Vocational Rehabilitation, other rehabilitation service providers and employment networks, businesses, Work Incentives Planning and Assistance Programs, Protection and Advocacy Systems, beneficiaries, and NCIL. The goal was to stimulate more interest and to share opportunities for improved cooperation. NCIL continues to help implement the program by encouraging Centers for Independent Living (CILs) and Statewide Independent Living Councils (SILCs) to consider becoming Employment Networks, which enter into contracts with SSA to assume responsibility for the coordination and delivery of appropriate employment, employment activities, and other support services under the Ticket to Work Program. Final regulations are expected to further improve the mechanics of the Ticket program. Ticket to Work has created an "Employment Network Revenue Estimator" that CILs and SILC can use to calculate the advantages in becoming an Employment Network!

For more information, including the benefits of becoming an Employment Network, please visit: www.ssa.gov/work. NCIL Policy Analyst Deb Cotter can put you in touch with the appropriate Ticket to Work staff to discuss the application process, and address specific questions. Please feel free to contact Deb by phone at (202) 207- 0334, ext. 1008 or email, deb@ncil.org. Please see related stories below, "Benefits to Work Calculator Upgraded" and "Walgreens Shows Successful Business Model, Not Charity, Employing People with Disabilities"

PAS & Healthcare Committee Update!

The PAS Committee is hard at work tackling issues such as the Community Choice Act (CCA). S. 799 by Senator Tom Harkin (D-IA) now has 20 co-sponsors and the House bill, H.R. 1621 by Representative Danny Davis (D-IL) has 82 co-sponsors! The Congressional Budget Office is still working on scoring the legislation. Stay tuned for breaking news!

New Harmful CMS Regulations: The PAS Committee is doing a lot of work around CMS rules and regulations on targeted case management and other issues important to the disability community. The PAS Committee encourages all NCIL members to call their elected legislators to support H.R. 5173 by Representative Ellison (D-MN) and S. 2578 by Senator Norm Coleman (D-MN) to temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services. Yet another bill on this issue, H.R. 5613, was just introduced by Energy & Commerce Chairman John Dingell (D-MI), which would prohibit CMS from taking action to implement the regulations until April of 2009. These regulations include CMS limiting Medicaid payments for targeted case management services, rehabilitation services, school-based transportation and outreach services, governmental providers, provider taxes, and hospital outpatient services.

Universal Healthcare: The Healthcare Committee continues to discuss Universal Health Care coverage and the status on pending supportive legislation. This Committee is also working on:

ž Accessible Healthcare: If you are tired of falling off exam tables or not getting quality healthcare, support Promoting Wellness for Individuals with Disabilities. S.1050 by Senator Harkin (D-IA) has 3 co-sponsors and H.R. 3294 by Representative Nita Lowey (D-NY) has 6 co-sponsors.

ž Elimination of the In-Home Rule: If you are tired of being trapped in your home because your current wheelchair isn't designed for outdoor use, support the Medicare Independent Living Act, H.R. 1809 by Representative Langevin (D-RI), which has 40 co-sponsors, and S. 2103 by Senator Bingaman (D-NM), which has 10 co-sponsors. This legislation would eliminate the "In-Home Rule".

ž Ending the Medicare Waiting Period: If you are finally entitled to SSDI but now have to wait two years for health coverage when you need it right now, call or write to your elected Representative and ask them sign onto the Ending the Medicare Waiting Period Act by Representative Green (D-TX). H.R. 154 has 29 co-sponsors and S. 2102 by Senator Bingaman (D-NM) has 12 co-sponsors.

Assistive Technology: The Assistive Technology Subcommittee submitted a Thank you letter on March 14th to Representative Ed Markey for introducing the Twenty-First Century Communications and Video Accessibility Act. This legislation will ensure that individuals with disabilities have access to emerging Internet-based communications and video programming technologies in the 21st century.

If legislation is important to you, call your elected federal representatives and let them know how you feel. Congress must be reminded on a regular basis about our issues because of the large volume of requests the congressional offices take daily. Don't let your issue go by unnoticed. As Anita Koddick says, "If you think you're too small to have any impact, try going to bed with a mosquito in the room." For more information, please contact Elizabeth Leef at elizabeth@ncil.org or 2020-207-0334.

3) State News

West Virginia 'Lunatic Asylum' Angers Advocates

Source: AOL News, AP, by Vicki Smith

It is an intriguing and provocative name that translates to Web hits, phone calls and tour tickets - the Trans-Allegheny Lunatic Asylum. The new owners of this former mental institution in Weston, W. Va., have opened it up for tours. "It's not a freak show," one owner said.

It is a title, to some, that acknowledges history by recreating it, readopting one of the many names previously held by the long-vacant, 19th-century West Virginia mental institution known most recently as Weston Hospital.

But mental health advocates and a marketing expert say the new owners of the massive Gothic Revival hospital have gone too far, denigrating the suffering of former patients and reopening wounds with planned events like "Psyco Path" dirt bike races on the grounds. They say words like "lunatic" and "retarded" have gone the way of "colored" and "Negro" - and should never be resurrected.

"It's like turning back the clock to a time we don't want to go back to," says Ann McDaniel, executive director of the Statewide Independent Living Council, one of several advocacy groups to object. "I think they could still do what they want to do without being offensive."

Scott Miller, director of Mountain State Direct Action Center in Lewisburg, says one former patient burst into tears after seeing the name on a sign. "It's not just that I'm a liberal and I think it's not a good idea. It's seeing people physically hurt," he says. "That's about all I needed to know."

Rebecca Jordan, whose family now owns the 307-acre (124-hectare) complex, sees things differently. "This part of history is vital, and you cannot bury what you don't like," she says. "Should we take down the Holocaust museum? Should we completely deny all that happened because it's not favorable? Because it might hurt a few feelings?"

The daily tours that began last week, $10 to $30 depending on duration, focus on serious issues such as the evolution of mental health care, the Civil War, the Great Depression, even architecture. "Not one person who has gone through this place and taken the tour has said that one thing was offensive," Jordan says. "It's not a freak show." Read the article in full.

4) Announcements

Benefits to Work Calculator Upgraded

During the Ticket to Work "Partners' Summit," Bryon Mac Donald conducted a demonstration of the Disability Benefits 101 Calculator. The World Institute on Disability has upgraded and launched a new 2.0 version of its Benefits to Work Calculator, which shows California beneficiaries how their benefits might change when taking a job, changing jobs or starting a business. The improved online calculator tool allows workers and job seekers to plan ahead with new features for more personal and real-life planning. Users can now compare new job offers and their impact on benefits and health coverage. Bryon, who serves as chair of the NCIL Employment / Social Security Subcommittee, received praise from the several dozen participants who stayed late into the evening to talk with him about the improved design of the calculator, and more specifically, about getting calculators for their states - stay tuned!

DB101 also launched the newsletter Employment Matters, news and views from DB101, to share related information on changing times, topics, programs and resources. DB101 visitors can subscribe via the newsletter tab on DB101.

The revamped website features revised sections on the Earned Income Tax Credit, Individual Development Accounts, and the Work Opportunity Tax Credit. All new features are in English and Spanish.

Recently DB101 launched the Plan for Achieving Self Support (PASS) Calculator. Social Security's PASS program can help you set aside money to fund a career goal. DB101's PASS Calculator provides estimates on how setting up a PASS might affect your finances, and can help you decide if the PASS program is something you want to explore further.

Other calculators include the Medi-Cal for the Working Disabled Calculator, which estimates whether you can access health coverage through Medi-Cal's 250% Working Disabled Program. DB101's School and Work Calculator helps youth aged 14 to 18 navigate and plan for important benefit changes that may occur at age 18.

If you are leaving a job or have left one recently, and expect to start your next one within a year, DB101's Job-to-Job Calculator can show you what might happen to your income and health coverage during the gap.

Work and Benefits Calculators are easy to use, screen reader accessible and in plain language (English and Spanish). They are completely confidential. The DB101 team designed these calculator tools for and with people with disabilities and their families, as well as service providers and the employers who work with them. In developing the new tools, the design team received and used input from benefits planners and beneficiaries using public and private benefits.

A contract with the Social Security Administration allowed DB101 to complete the calculator tools by the end of this year. The calculators are the result of pioneering design and development support since 2002 from the California Department of Rehabilitation, the Employment Development Department, the California Health Incentives Improvement Project, the Community Technology Foundation of California, and The California Endowment. Key design partners are Eightfold Way Consultants, Berkeley, California, and ECONorthwest, Portland, Oregon. For more information, visit www.db101.org or contact Bryon MacDonald by phone (610) 251-4304, TTY (620) 208- 9496, or email bryon@wid.org.

Walgreen's Shows Successful Business Model, Not Charity, Employing People with Disabilities

One of the highlights of the above- mentioned Ticket to Work Partners Summit was the keynote address by Walgreens Vice President Randy Lewis, who spoke about Walgreens' new Distribution Center in Anderson, SC, where 42% of the 250 employees are people with cognitive and/or physical disabilities. Mr. Lewis, whose son has Autism, spoke of the benefits the universally designed distribution center had for all of its employees and how the integrated workforce has helped increase morale and educate non disabled workers about the contributions people with disabilities can, and want to make by securing employment. Walgreen's is participating in the Ticket to Work Program serving as an Employment Network. Mr. Lewis reiterated that the Distribution Center is just a start, a baby step toward integrating the workforce. He continues to meet with business leaders to promote the inclusion and accommodation of people with disabilities in the workforce and, during the question and answer period, acknowledged that Walgreen's needs to do more to hire people with disabilities in their retail stores throughout the country in entry level and professional positions. This would go a long way in showing American consumers the benefit of hiring qualified people with disabilities. News clips about Walgreen's effort, visit:

ABC: Walgreens Gives Hope to Disabled Workforce

NBC: Walgreens program puts the 'able' in disabled: Drugstore chain mainstreams handicapped workers at new S.C. facility

Please note that although the second article has text, neither video is closed captioned. Feel free to contact your local ABC or NBC affiliate about making their news clips accessible.

NCIL Request for Proposals: Aging and Disability Communities Collaboration

A Request for Proposals was released March 14^th for collaboration between independent living advocates and the aging community. Grants will be awarded to CILs, SILCs or associations for independent living centers to develop exemplary plans for collaboration, education and exchange of information and resources among the independent living community, the aging community, and ADRCs. For more information, please contact Elizabeth Leef at elizabeth@ncil.org or 202-207-0334.

International Conference on Self-Determination

On May 27-29, 2008 at the sophisticated Detroit Marriott Renaissance Center, the International Conference on Self-Determination will serve a much different purpose than most other conferences. It's designed to be a combination of a few very short presentations, but mostly panel discussions and roundtables organized by topic with a diversity of moderators and cross-disability panel members rather than a single focus presentation by a particular individual or organization. Each session is organized across disabilities. Please check out the electronic brochure. To request multiple brochures for distribution at upcoming meetings and events, please email info.icsd@gmail.com .

The time has come to move forward for self-determination for all. Please join us for this unique conference opportunity.

Weekly Advocacy Monitor

WhAM!

Volume 6, Issue 13 Ÿ April 7, 2008

1) What's Happening in the Nation's Capital?. 2

2) National News. 3

House Science Committee Investigates CDC Formaldehyde Research and FEMA Response 3

Federal Court Holds Individual Entitled to State Payment of Full-Time Home Care. 3

Medicaid Rules Faulted at Energy and Commerce Hearing. 5

Kennedy, Domenici work on Parity Compromise; NYT Readers Wax Philosophical on Practical Issue 6

Medicare Acts to Reduce the Number of Yearly Drug Plan Reassignments Among Low-Income Beneficiaries 8

3) State News. 8

Taxi Commission Acts to Bring First Accessible Taxis to District 8

4) Announcements. 9

NYLN Hosts National Teleconference, "Many Voices, One Vote!" 9

NIDRR and Partners Release Resource Guide on Emergency Management 10

Autistic Self Advocacy Network Announces Launch of International Chapter 10

1) What's Happening in the Nation's Capital?

Source: CQ Budget Tracker

Hearings on the future of Iraq are plentiful next week, several of which feature testimony by both the U.S. Ambassador to Iraq and Gen. David Petraeus. Secretary of Defense Robert Gates and Joint Chiefs of Staff Chairman Michael Mullen will appear before the Senate Armed Services Committee to talk about future U.S. involvement in Iraq.

Appropriations hearings continue next week, with Secretary of State Condoleezza Rice, Attorney General Michael Mukasey and Secretary of Agriculture Ed Schafer all making appearances before different panels to talk about the funding needs of their departments.

A "Who's Who" of economists and budget experts Wednesday expressed frustration with what they called a failure of the political establishment to address future fiscal problems that will be caused by expanding "entitlements".

Numerous panel members said the public and politicians aren't responding because, unlike the current housing credit crisis, the problem is not immediate and won't manifest itself until years down the road. Congressional Budget Office Director Orszag questioned whether an alternative approach is needed to complement the current message, focusing on dramatic inefficiencies that exist in the healthcare system

The (very conservative) Heritage Foundation's Stuart Butler said it is critical to continue educating the public about fiscal problems so policymakers can "get public permission to act." A regular participant in the Fiscal Wake Up Tour, he told the audience at the subsequent CRFB dinner that the foundation "is going to be like no foundation you've ever seen before" and would "focus on educating, activating, and stimulating action." "Stay tuned," he said.

Not all budget forum panelists supported proposals for a fiscal commission or task force to recommend comprehensive solutions that Congress could vote on, similar to a military base closing commission, with former lawmaker Kolbe raising questions. "We're talking not about the selection of what physical infrastructure in the Defense Department should be closed . . . we're talking about reordering the entire economy." Kolbe also said that having some commission present a comprehensive recommendation and requiring a single up-or-down vote by Congress raised Constitutional questions and "is a very frightening thought in many ways."

In both the House and Senate, in several Committees and Subcommittees, legislators will hold hearings on the current credit and financial crisis. A House Ways and Means Panel will look at extending unemployment benefits due to the current state of the economy. The Senate Transportation-HUD Subcommittee will hold a hearing on the Federal Housing Authority's role in addressing the housing crisis. The Senate Banking, Housing and Urban Affairs Committee will hold a hearing on proposals to mitigate foreclosures and restore liquidity to the mortgage markets.

Chairman Christopher Dodd and the Committee's ranking Republican, Richard Shelby, were given a deadline of midday Wednesday to devise a compromise to offer as a substitute amendment to current housing legislation. Speaker Nancy Pelosi called publicly for a White House summit on the economy with House and Senate Democrats and Republicans.

2) National News

House Science Committee Investigates CDC Formaldehyde Research and FEMA Response

On Tuesday, April 1st, the House Science Committee held the hearing, "Toxic Trailers: Have the Centers for Disease Control Failed to Protect Public Health?" at which Sierra Club Toxics Program Analyst Becky Gillette testified, reporting on the negative health effects of formaldehyde in trailers provided by the Federal Emergency Management Agency to people who evacuated and lost their homes to Katrina, Wilma and other natural disasters. Read more about the hearing, including testimony from the Sierra Club and the Centers for Disease Control and Prevention at the House Science Committee website.

On Friday, April 4th, NCIL Executive Director John Lancaster and Policy Analyst Deb Cotter met with Ms. Gillette and NCIL Housing Subcommittee member Mary Lamielle to discuss opportunities for the Housing Subcommittee to work with the Sierra Club to reduce formaldehyde and other toxic chemicals. As NCIL members know, the NCIL Housing Position Paper addresses the issue of Multiple Chemical Sensitivity and the promotion of affordable, accessible, integrated, and safe housing for people with disabilities.

Federal Court Holds Individual Entitled to State Payment of Full-Time Home Care

Source: BNA, Volume 13 Number 65

Editor's Note: This article was not modified to reflect NCIL's appreciation for respectful language toward disability. Contact BNA to let them know how you feel.

The Illinois Department of Public Aid must fully fund the full-time nursing care needed by a disabled individual in his home because it is an appropriate setting and because it will not cost the state more than it would have to pay to keep him hospitalized, a federal court ruled March 26 (Radaszewski v. Maram, N.D. Ill., No. 01-cv-9551, 3/26/08).

The U.S. District Court for the Northern District of Illinois ruled that Eric Radaszewski and his mother, Donna, were entitled to judgment in their lawsuit brought under Section 504 of the Rehabilitation Act and Title II of the Americans with Disabilities Act. The court ordered the state to provide the full-time care required by Radaszewski's handicap, which the court said stemmed from brain cancer, a stroke, and subsequent medical treatment that left him with impaired physical and mental functions.

The failure to accommodate Radaszewski's handicap violated the two laws because he was entitled to reside in an appropriate community-integrated setting and because accommodating his disability would not otherwise disrupt the provision of Medicaid services to other individuals, the court ruled. The court issued its decision on remand from a September 2004 appeals court decision that found the trial court had, in an earlier ruling, dismissed his claims prematurely.

The U.S. Court of Appeals for the Seventh Circuit in that decision ruled that Eric was entitled to pursue claims challenging decisions by the Illinois Department of Public Aid, and its director, Barry S. Maram, not to pay for the full-time nursing care he alleged was necessary. The appeals court found dismissal was inappropriate because Eric might be able to demonstrate at trial that the cost of medical services he needed at home would be comparable to the costs of his receiving the high level of attention he would need in a skilled nursing facility or hospital.

At trial on remand, the plaintiffs made just such a claim. To support their claim, they presented evidence that accommodating his handicap by providing, in his home, the full-time nursing care he required would be less expensive for the state than if it was required to pay for full-time hospitalization. The court rejected the state's claim that he was entitled to only $4,593 per month, an amount that the court said would have paid for barely five hours per day of the nursing care he required.

'Fundamental Alteration' Defense Rejected: The court found that Illinois was required to provide community-based treatment for disabled people like Eric as long as such treatment was appropriate, as long as Eric desired community placement, and as long as it did not require the state to "fundamentally alter" the nature of its program or services. The state did not contest that community-based treatment was appropriate.

Although the state asserted a "fundamental alteration" defense, the court found it was unavailable under the circumstances. If Eric was placed in an institution, the state would be required to provide the necessary level of care with "constant monitoring and continuous skilled assistance in accomplishing basic bodily functions," the court said. "The services that Eric requires and presently receives at home are, in substance, the services that would be required in a hospital," it added.

"The unrebutted evidence clearly shows that the cost of caring for Eric in the proper institutional setting--a hospital--would be substantially greater than the cost of allowing Eric to remain in the community and receive the same proper treatment and health care," it continued. Thus, it concluded, "Illinois has not demonstrated that providing the requested accommodation to Eric would impose an unreasonable burden on the state or fundamentally alter the nature of its programs and services." The court's decision is available online at the BNA website (PDF).

Medicaid Rules Faulted at Energy and Commerce Hearing

Source: CongressDaily, by Fawn Johnson

Editor's Note: NCIL supports this bill as one of several proposed fixes to new Medicaid rules that threaten independent living and transition initiatives nationwide. The National Governor's Association has written to Congress asking them to put a stop to CMS' new regulations. Please reach out to members of the Energy and Commerce Committee who have not already signed on.

Members of the House Energy and Commerce Committee today [April 4^th] skewered a series of Medicaid regulations that states claim would cost them at least $50 billion over five years. Energy and Commerce Chairman John Dingell and Rep. Tim Murphy, R-Pa., have introduced legislation to place a one-year moratorium on seven regulations. The bill faces hurdles, including a $1.6 billion cost that must be offset and possible Senate opposition. Four of the regulations addressed in the Dingell/Murphy bill are under a moratorium that expires in the summer. The Senate budget resolution includes language to maintain that moratorium for another year, but it is not clear if it will act on the other three. During a break in the hearing, Energy and Commerce Health Subcommittee Chairman Frank Pallone (D-NJ) said one option for moving the legislation would be to attach it to another must-pass bill. "But we haven't made any decisions," he said.

At the hearing, Dingell said, "When one reviews how [Centers for Medicare and Medicaid Services] dealt with comments submitted on the regulations, it appears that there was no intention of working with the states or other beneficiary groups to find common ground." Dingell cited thousands of comments CMS has received protesting the rule. Only a handful of communiques to CMS "contained a positive comment," Dingell noted, quoting the agency directly. Murphy agreed with many committee Republicans who do not support his bill that CMS should put a stop to Medicaid waste, fraud, and abuse. But the "disabled and infirm" served by Medicaid "should not be bearing the burden" as policymakers seek solutions, he said. As a psychologist, Murphy said he has personal experience with the program. "I'm not sure any of us understand the system, even in the administration," he said.

CMS Medicaid and State Operations Director Dennis Smith told the subcommittee the Dingell/Murphy bill would thwart the administration's efforts to "apply fiscal accountability in Medicaid. ... As currently written, [the bill] would not simply delay implementation of these regulations, but it could jeopardize policies and interpretations that predate these regulations," he said. Galen Institute President Grace-Marie Turner said lawmakers should "work with administration" on amending the rules "rather than block them completely." GAO Acting Director on Health Issues James Cosgrove said his investigators found that in the past several years, some states had overpaid providers to draw more federal matching funds, and then secured rebates from the same providers. But under questioning, from Dingell, Cosgrove said GAO had issued no recommendations regarding the specific topics addressed in the seven Medicaid regulations.

Kennedy, Domenici work on Parity Compromise; NYT Readers Wax Philosophical on Practical Issue

Source: Kaiser

Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) and Sen. Pete Domenici (R-NM) have proposed a new set of cost offsets to the House version of a mental health parity bill (HR 1424) that passed in March, CongressDaily reports. The offsets are part of a compromise parity measure that was sent to the House during the spring recess.

Both the House and Senate have passed parity bills that would cost about $3 billion over 10 years. The House measure, which includes more requirements for what mental health services must be covered by insurers, would offset its costs through rebates paid by drug makers to state Medicaid programs and implementing a "controversial" proposal to prevent doctors from referring patients to physician-owned hospitals, CongressDaily reports. The additional House requirements and the two offsets are opposed by business interests. The Senate bill (S 558), which was created with input from business interests, has received their support.

Rep. Patrick Kennedy (D-R), a lead sponsor of the House bill, declined to comment on specifics of the Senate recommendations but said, "We're in discussions to work out a compromise that maintains as much of the integrity of the House bill, while trying to pass something that will make it through the Senate." He added that the Senate is "being a great help" by suggesting "other pay-fors," noting, "the pay-fors that we used in the House are frankly not going to fly in the Senate, and everybody acknowledges that."

Give-and-Take: Rep. Kennedy said he is ready for a "give-and-take" conversation regarding several provisions of the House bill that would not be accepted by the Senate. According to CongressDaily, the House bill includes a mandate that health insurers cover all conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, though many in the Senate would not accept such a mandate. Rep. Kennedy said other provisions, such as out-of-network parity and medical management, are seen as necessary by the House. Rep. Kennedy noted that the House position has been strengthened by several committee votes, as well as the floor vote on the bill. An aide for Sen. Kennedy said Senate sponsors of the bill could potentially concede some House requests (Johnson, CongressDaily, 4/2).

Letters to the Editor: The New York Times on Wednesday published letters to the editor responding to a March 30 opinion piece by columnist Sarah Kershaw. According to Kershaw, mental health parity "raises all sorts of tricky questions," such as, "Is an ailment a legitimate disease if you can't test for it?" It continued that "scientific advances may go a long way to help the parity cause" because the "biological and neurological connection lends strength to the notion that mental illnesses are as real and as urgent as physical illnesses and that there may, at long last, even be a cure in this lifetime, or the next." Kershaw wrote, "And if you can cure something, you can treat it, and there is a finite quality to that treatment - and its costs" - which could make insurers "more willing to pay for it." However, the piece concluded, "[I]n the halls of Congress, at least, the mind-body problem is far from resolved, particularly when it is uncertain who the next president will be" (Kaiser Daily Health Policy Report, 3/31).

Summaries of the letters to the editor appear below.

ž Carolyn Robinowitz: "Mental illnesses are real illnesses that can be accurately diagnosed and effectively treated, with success rates that rival treatments for heart disease and cancer," according to Robinowitz, president of the American Psychiatric Association. Robinowitz writes that the "'mind-body problem'" Kershaw references is "not murky," noting that "the brain is part of the body, and mental illnesses have clear physical as well as behavioral indicators." The letter continues, "Research shows that parity can be achieved without a significant increase in cost," concluding, "It's time to end discrimination in health insurance coverage" (Robinowitz, New York Times, 4/2).

ž George Northrup: The "case for mental health parity does not depend on resolving the age-old question of the mind-body relationship," because an "equally good reason to favor parity is that it would encourage therapy for millions whose untreated conditions" result in lost work productivity, accidents and neglected health, Northrup, president-elect of the New York State Psychological Association, writes. He adds, "While some conditions are indeed chronic (as in medicine), a large body of research supports the overall effectiveness of mental health treatment," noting that Kershaw's "generalization that mental illness typically 'never ends'" applies to "a small subset of those with emotional problems" (Northrup, New York Times, 4/2).

ž Richard Gomberg: "Research has shown that many psychiatric diagnoses are at least as reliable and valid as medical diagnoses," according to a letter to the editor by Gomberg, a psychiatrist and a former congressional fellow working on mental health policy for the late Sen. Paul Wellstone (D-MN). In addition, "the idea that treating an illness is justified only when it can be tested for, would show up on autopsy or can be cured would be news to the millions of Americans" with chronic conditions that "would not fit those criteria," he writes. Gomberg adds that it is "not true that 'mental illness never ends'" because the "suffering of mental illness can be effectively treated." He concludes, "I feel extremely fortunate to be practicing medicine in Massachusetts, where we have a mental health parity law that allows me to offer my patients appropriate and compassionate care" (Gomberg, New York Times, 4/2).

Medicare Acts to Reduce the Number of Yearly Drug Plan Reassignments Among Low-Income Beneficiaries

Source: CMS

April 1^st, the Centers for Medicare & Medicaid Services (CMS) issued a final regulation that could allow nearly one million Medicare beneficiaries with limited income and resources to remain in the Medicare prescription drug plan in which they are enrolled without having to pay a premium.

"It's important that we provide stability and predictability in the prescription drug program, particularly for the beneficiaries who receive Medicare's extra help," said CMS Acting Administrator Kerry Weems. "By changing the method that we use to determine the benchmarks for the low-income subsidy, we are able to ensure that there will continue to be a wide choice of zero-premium plans available to these beneficiaries." The rule will be available online at the CMS website (PDF). View the entire Press Release. Please see related story below.

3) State News

Taxi Commission Acts to Bring First Accessible Taxis to District

Source: DC Taxi Commission

The District of Columbia Taxicab Commission (DCTC) today asked for applications for up to $200,000 in grant funds to bring of wheelchair-accessible taxicabs to the District, one of the few major cities without such service. The District funds were authorized in the Wheelchair-Accessible Taxicab Promotion Fund Act of 2007 sponsored by Councilmember Jim Graham.

"We are determined to bring wheelchair-accessible cabs to our streets as quickly as possible," said Leon J. Swain, chair of the Taxicab Commission. "We invite all qualified parties to apply for these funds."

"Wheelchair accessible taxis promote employment, tourism and the overall freedom for people with disabilities," said Eve Hill, director of the Office Disability Rights. "There is a large unmet demand for wheelchair-accessible cabs from residents, visitors and businesses. These funds will help meet this demand."

A wheelchair-accessible taxi works just like a traditional cab does - no prior reservations are required nor are there eligibility restrictions.

The District funds will help taxicab companies meet the funding match required for the approximately $1.65 million in federal funds in the New Freedom program administered by the National Capital Region Transportation Planning Board (TPB) of the Metropolitan Washington Council of Governments (COG). Questions about New Freedom should be directed to Beth Newman, bnewman@mwcog.org, 202-962-3253 or Wendy Klancher (email) or at www.tpbcoordination.org.

The DCTC invitation is separate from the New Freedom application. Applications for the District funds are to be submitted to the DC Taxicab Commission: 2041 Martin Luther King Ave, SE, Ste 204, Wash, DC 20020; Attn: Ms. Sherry Tillman. The deadline is Thursday, April 17, 2008, 3:00 p.m. eastern time. Download the Download the Request for Applications (RFA) for D.C. grant money.doc.

4) Announcements

NYLN Hosts National Teleconference, "Many Voices, One Vote!"

Please join The National Youth Leadership Network (NYLN) for a national teleconference and webcast on Tuesday, April 15, 2008 at 8:00PM Eastern; 7:00PM Central; 6:00PM Mountain; 5:00PM Pacific and 2:00PM in Hawaii.

Are you ready to vote in the 2008 election? Are you ready to show Washington and the nation, the power of the disability vote? If so, this is the event for you!

Join to learn more about: the process of voting, ways to register to vote, voter registration tips, accessibility at the voting booth, and how to become an informed voter.

Also, you will receive information on: the history of people with disabilities and the right to vote, statistics on voting and people with disabilities, voting legislation (laws that affect people with disabilities), and the importance of people with disabilities using the right to vote.

Help youth with disabilities catch the power of the disability vote!

To sign up, go to http://www.nyln.org and click the teleconference link at the bottom of the screen. After you register, you will receive the toll free number and the link to the website in your email. Please call 1.866.480.6565 if you have questions. This teleconference and webcast is supported by Independent Living Research Utilization (ILRU) in conjunction with NYLN. The opinions and views expressed are those of the presenters and no endorsement should be inferred.

NIDRR and Partners Release Resource Guide on Emergency Management

Source: NIDRR

The National Institute on Disability and Rehabilitation Research is pleased to announce the release of a new online publication: Emergency Management Research and People With Disabilities: A Resource Guide. This resource guide is the culmination of cooperative efforts by NIDRR, the Department of Education, the Research Subcommittee of the Interagency Coordinating Council on Emergency Preparedness, and Individuals with Disabilities (ICC), and the New Freedom Initiative Subcommittee of the Interagency Committee on Disability Research.

The guide provides a listing and description of research projects funded by the federal government and nonfederal entities, research recommendations that have come out of conferences on emergency management and disability, and a bibliography of relevant research publications. It is our hope that this guide will facilitate the development and implementation of a nationwide research agenda on emergency management and people with disabilities, so that we can develop a strong evidence base about the best ways to ensure the safety and security of people with disabilities in emergency and disaster situations.

Autistic Self Advocacy Network Announces Launch of International Chapter

Source: ASAN

The Autistic Self Advocacy Network is proud to announce its first international chapter, the Autistic Self Advocacy Network - Australia (ASAN-AU). With the founding of this chapter, ASAN will be able to expand current efforts to ensure the full representation of the autistic community in autism and disability public policymaking as well as continue efforts to broaden access to the autistic culture and neurodiversity movements on a global scale. The introduction of this new chapter makes ASAN the first truly international autistic self-advocate organization engaged in public policy and social change advocacy. This new chapter, the first of many internationally, will enable ASAN to share resources and expertise, thereby increasing the capabilities of the autistic self-advocate movement as a whole. ASAN looks forward to working with our Australian brethren to ensure that the promise of "Nothing About Us, Without Us," is fulfilled worldwide.

Weekly Advocacy Monitor

WhAM!

Volume 6, Issue 15Ÿ April 21, 2008

1) What's Happening in the Nation's Capital?. 2

2) National News. 2

Senator Urges Agencies, Congress to Hire Employees with Disabilities. 2

SAVE THE DATE: Feel the Power of the Disability Vote! 4

Bush Names SBA Chief to Replace Jackson as HUD Secretary. 4

New Medicaid Regulations and Power Chairs: a Reality Check. 6

Making the Case to Increase 504's Housing Accessibility Requirements. 7

House Hearing on Workforce Diversity: Disability Absent from Discussion. 8

3) State News. 9

Travelers with Disabilities Sue Detroit Airport Authority, Northwest Airlines. 9

4) Announcements. 9

FY 2008 Real Choice Systems Change and ADRC / Area Aging Grant RFP.. 9

1) What's Happening in the Nation's Capital?

Source: CQ

The House considers several measures under suspension of the rules, including a bill requiring the use of plain English in government communications that explain how to file taxes or obtain government benefits or services; legislation to halt outsourcing of IRS tax debt collections and to authorize grants to states to provide a paper trail for electronic voting this November. The House and Senate will consider farm legislation after passing a one-week extension of the current farm law; as well as legislation to address the credit crisis in the student loan market.

The Senate will consider a bill that would make technical corrections to the 2005 surface transportation law; resumes consideration of a motion to proceed to a highway funding revisions bill; and continues work on highway funding; and will debate a motion to consider a bill tightening employment discrimination laws.

The President met with Pope Benedict XVI in the Oval Office; later hosts a dinner with Mrs. Bush in honor of the Pope.

In the House, the Energy and Commerce Committee will hold a full committee mark up of the Protecting the Medicaid Safety Net Act of 2008, which would extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009 (see related articles below). The Veterans' Affairs Committee Health Subcommittee will hold a hearing on health-related legislation for veterans, the Veterans Disability Benefits Claims Modernization Act of 2008.

In the Senate, the Appropriations Committee Defense Subcommittee will hold a hearing on Defense Department medical programs. The Special Committee on Aging will hold a full committee hearing entitled, "Caring for Our Seniors: How Can We Support Those on the Frontlines?"

2) National News

Senator Urges Agencies, Congress to Hire Employees with Disabilities

Source: Govexec.com, by Alyssa Rosenberg

The federal government must hire more people with disabilities to meet its obligation as a model employer, said Sen. Richard Durbin (D-IL) in a Monday lecture at New York Law School.

"We should show employers by example why it makes good sense to hire and promote people with disabilities," he told students and professors during the fourth annual Tony Coelho Lecture in Disability Employment Law and Policy in New York.

Durbin cited a January 2008 report from the Equal Employment Opportunity Commission on the federal employment of people with disabilities. That report found that there were only 90 people with targeted disabilities, which include blindness, deafness and mobility loss, in senior pay grades in the federal government. Overall, EEOC concluded, the federal government employs fewer people with disabilities now than it has at any point during the last 20 years. The Illinois Democrat also noted that Congress was equally far behind in its efforts to hire people with disabilities.

"Congress, we should look at ourselves," he said. "We honestly don't know how many people with disabilities work in Congress. In the Senate, each office is its own little kingdom. There is no central effort to engage more people with disabilities."

Durbin has two disabled staffers in his office, and Coelho, who authored the 1990 Americans with Disabilities Act when he served in the House, said Durbin has vowed to push his colleagues to commit to adding 10 people with disabilities to the Senate staffs each year. The House already has a similar commitment in place. Hiring more people with disabilities is important, Durbin said, because it allows companies and the government to tap a largely ignored talent pool of motivated, efficient workers at relatively low cost.

Another recent study found that disabled workers consistently scored as well or slightly better on performance reviews than their able-bodied counterparts. They also took fewer scheduled and unscheduled days of leave. The average cost of accommodating a disabled worker was $313, and the most commonly requested accommodation was a flexible schedule, according to the report, prepared by DePaul University researchers, the Illinois Department of Commerce and Economic Opportunity, and the Chicagoland Chamber of Commerce.

"When millions of Americans with talents and skills [that] our nation desperately needs are shut out of the workforce, you don't need a Ph.D. in economics to tell that's bad for the economy," Durbin said.

The best way to improve the federal government's hiring practices is not through legislation, he said, but via a change in culture and through presidential initiative, such as the one President Bill Clinton announced in 2000 to hire an additional 100,000 federal employees with disabilities.

"I'm talking about a president with the principles and the standards to inspire that," Durbin said, before suggesting that Sen. Barack Obama (D-IL) whom he has endorsed, would be that kind of president. "I don't want to promise that he would sign any [executive order to replicate Clinton's initiative]; that's beyond me," Durbin said. "Knowing him, though, I bet if I talked to him, he would do it. Durbin acknowledged that it would take time for the federal government to change attitudes about disabled employees, but said outstanding examples already exist.

"Who would believe that a few months after being shot down and losing her legs that [Tammy Duckworth] could run for Congress and run the [Illinois Department of Veterans Affairs]?" Durbin asked. "Her husband is deployed. She is living by herself as a double amputee. As she does that, she dispels the myth that being a double amputee means that it's over."

TAKE ACTION: Have Your Organization Sign Petition Calling for Hearing on Federal Employment of People with Disabilities

Despite Federal law mandating the hiring of people with disabilities by the Federal government, less than 1% of the 2.6 million Federal workforce are people with "targeted disabilities". NCIL and AAPD have launched an effort to convince Congress to hold oversight hearings on this issue to hold government agencies accountable for their inaction and non-compliance. We strongly urge your organization to sign onto our letter urging House Oversight and Government Reform Committee Chairman Henry Waxman (D-CA) to hold a hearing on the employment of people with disabilities in the Federal government.

For background information, contact NCIL Policy Analyst Deb Cotter by phone (202) 207-0334, ext. 1008, or email deb@ncil.org and please see NCIL's Fact Sheet on the Schedule A Hiring Authority.

SAVE THE DATE: Feel the Power of the Disability Vote!

On July 26, 2008, the18^th anniversary of the Americans with Disabilities Act, several national, state, and local disability organizations, including NCIL, will host a Presidential Candidate Forum in Columbus, OH. The event, entitled "Feel the Power of the Disability Vote," will be an opportunity for the disability community's voice to be heard and have their questions answered. Stay tuned for further details!

Bush Names SBA Chief to Replace Jackson as HUD Secretary

Source: CQ, By Libby George

President Bush said Friday he will nominate Small Business Administration chief Steve Preston to lead the Department of Housing and Urban Development.

If confirmed by the Senate, Preston will follow the scandal-plagued tenure of Alphonso R. Jackson in a post that is central to the administration's plans to combat home foreclosures.

Jackson announced his resignation in March amid allegations of cronyism, corruption and political favoritism that brought demands from key lawmakers that he step down. Friday was his last official day on the job, and the White House did not want to leave the agency without a designated successor. "The department requires strong leadership at a time when our housing market is experiencing a time of uncertainty," Bush said of Preston. "He knows how to tackle a problem, devise a solution and get results. That's exactly the kind of person I was looking for. He will play a central role in addressing out nation's housing problems."

HUD is a central player in the administration's plans to address the subprime mortgage mess that has rippled through the economy and left millions with ruined credit and no homes. The White House has advocated several ways to help floundering homeowners, most of them centering on the Federal Housing Administration, a Depression-era agency that falls under the department's jurisdiction. Bush is no doubt hoping Preston will be able to restore relations between HUD and Congress as the administration continues to press for final action on an FHA overhaul (HR 1852, S 2338) that could enable the agency to help more borrowers refinance into government­-insured loans.

Preston, who has led the SBA since Senate confirmation July 11, 2006, faced controversial challenges in that post; one of his key accomplishments, according to one senior administration official, was to revamp the Disaster Assistance Program, which was struggling to respond to the 2005 Gulf Coast hurricanes.

Prior to assuming his post at SBA, Preston was executive vice president of the ServiceMaster Company, where he also served as chief financial officer. During the first half of Preston's private sector career, he was a senior vice president and treasurer of First Data Corporation, and an investment banker at Lehman Brothers.

Confirmation Outlook: A leading Senate Democrat was initially skeptical of Preston. "The president's choice has no apparent housing background, which raises questions," said Senator Christopher J. Dodd (D-CT), chairman of the Banking, Housing and Urban Affairs Committee, whose panel will hold Preston's confirmation hearings. "Nevertheless, I look forward to learning more about Mr. Preston and his qualifications for this important job at this trying time in our nation's economy."

But others took a "wait-and-see" approach. "I look forward to meeting Mr. Preston and having a candid discussion on his plans to restore the tarnished reputation of HUD and meet the needs of the people and communities it serves," said Senator Patty Murray (D-WA) who chairs the Appropriations subcommittee with jurisdiction over HUD and was a leading critic of Jackson.

New Medicaid Regulations and Power Chairs: a Reality Check

Source: Mark Sheperd (edited)

What changes has CMS made this past year and a half? It all began November 15, 2006, but really started Jan 2007, when all power wheelchair payments made by Medicare were reduced by 27%. July 1, 2008, the same power chairs will be reduced again by 19%. This additional payment cut by CMS is a result of Medicare's National Competitive Bidding (NCB) program.

REALITY CHECK: If a consumer received a chair before these dates, a supplier would have been paid, let's say $8,000, for example. For a consumer to be given that same chair today the dealer will receive $5,840. After July 1^st, because complex rehab is now bid competitively, the amount will go down to $4,730.40.

So the BIG question is, will a consumer get the same quality chair? When you look at the cold hard economics, it is impossible to imagine. Most likely, a chair of lesser quality and fewer features will be provided, because of the dramatically reduced payments. How can a supplier purchase, service and provide to a consumer the same quality chair and features with these dramatic reimbursement reductions? Consumers will get a wheelchair but it will not be comparable.

While Medicare went into competitive bidding saying that consumers would receive the same quality products and services, it's not possible. With 2 serious power wheelchair reimbursement cuts since January 2007 amounting to over $3250.00 on a basic $8000 chair, this outcome is not likely.

The Domino Effect: Private Insurance

It's important to know that most other insurers base their payments off of the amount that Medicare pays, which means that the dealer will be receiving less than the $4,730.40, even from private insurance companies. Again, consumers will receive products that will not be of the same quality and features as they received previously from Medicare or Private Insurance.

Are People Eligible for Dual Medicare and Medicaid hurt by this regulation?

Medicaid is different in each and every state, however; few if any pay the Medicare price, and in most cases they can not pay more than the amount that Medicare pays. The head of Medicaid policy in Ohio says they will set their payment at about 20 to 25% below the Medicare rate! Now Ohio dealers will receive (for the $8,000 chair of a year and a half ago) a grand total of $3,547.80 as full payment for the item. Remember that "DUAL Medi-Medi" can not pay more than this amount; nor can the dealer collect additional money from the consumer, and must accept this amount as payment in FULL!

"Under the Medicare program a consumer (who is not dual eligible) can choose to do an upgrade and pay for "deluxe" features and options". This Regulation has "Cost Shifted" payment to the consumer if they want to receive the exact chair they have today, or they must accept a much lesser chair.

CONCLUSION: Wheelchair technology advancements over the past 2 decades have made incredible leaps offering consumers amazing functional features and options allowing them to live a more independent, productive life. Medicare provides consumers only the features and options that are medically necessary for them "In the Home". With the two new reduced "complex rehab payment rates," consumers will receive inferior equipment and decreased services than previously. We are at a serious turning point for the worse. This is criminal. Equally bad is that third-party (private) insurers base their payment on Medicare. Is it time for you to voice your concern?

NEXT STEPS: What can you do?

• Tuesday, April 22 - Participate on the CMS CONSUMER CALL and voice your Power wheelchair concerns! Tuesday, April 22, 2008; 2:30- 3:30 p.m. EDT. Topics: update on competitive bidding program for durable medical equipment, prosthetics, orthodics, and supplies (DMEPOS). Policy experts will be available to answer questions. Call-in procedures: dial (toll-free) 800-475-0456 (please call in 15 minutes before the session begins). Pass code: NMTP

• Tuesday, April 22 - Participate in NCART's "Healthcare Industry Call-in Day" by contacting your two Senators and the Representatives from your state! Help make 1000+ calls to Congress in support of Obtaining an Exemption for Complex Rehabilitation and Assistive Technology Products (HR 2231). Tuesday, April 22, 2008. Consumers of complex Rehab need access to quality products and providers! Visit http://www.ncartcoalition.org/. In the bottom left corner, enter your zip code to find senators and representatives in your area). Take a minute to log your calls on the NCART website.

• What CMS Wants You to Know (PDF)

Making the Case to Increase 504's Housing Accessibility Requirements

From Steve Gold: Increasing Section 504's Minimum 5%/ 1%/ 1%; Information Bulletin #244

In earlier Information Bulletins, we explained that HUD's regulations for Section 504 of the Rehabilitation Act require that a minimum of 5% of housing units (which receive federal financial assistance) must be accessible to persons with mobility disabilities and another 1% each for persons with hearing and visual disabilities.

The "5%1%/1% minimum" was established in 1988 when HUD promulgated its Section 504 regulations and has never been revised or updated. This minimum is no longer in tune with current statistics or data.

We need to request and demonstrate to HUD that it must increase the 5%/1%/1% for accessible housing in all federally funded programs (HOME, CDBG, and public housing) in your geographic area. There is a federal regulation that authorizes this increase. 24 Code of Federal Regulations section 8.22 (c), states that HUD "may prescribe a higher percentage [than 5%] ... upon request... by any affected recipient ... or agency ...based upon demonstration to the reasonable satisfaction of HUD of a need for a higher percentage ... based on census data...."

Here's how we can demonstrate the need for a higher percentage of accessible units than 5%/1%/1% so that your local Section 504 minimum requirements will more accurately reflect the number of persons with mobility disabilities who require accessible units. Go to http://factfinder.census.gov, click on data sets, then the 2006 American Community Survey, select your geographic location, then click on Subject Tables, then disability characteristics. Read this Information Bulletin in Full.

House Hearing on Workforce Diversity: Disability Absent from Discussion

On March 27, the House Oversight and Government Reform Subcommittee on Administration Oversight, Postal Service, and Federal Government Operations held a hearing on "Managing Diversity of Senior Leadership in the Federal Workforce and Postal Service" to examine the views of various governmental and non-governmental officials on the "Senior Executive Service Diversity Assurance Act" (H.R. 3774 and S. 2148). This legislation, which NCIL supports, would provide for greater diversity within, and improved policy direction and oversight of, the Senior Executive Service (SES). Employees in SES serve in the key positions just below presidential appointees. While both bills include disability, no one on the panel and none of the Representatives at the hearing mentioned the lack of people with disabilities in the Federal government, which hovers below 1% of the 2.6 million Federal workers. To read more about the hearing, including testimony, visit the Subcommittee website.

TAKE ACTION: Tell Congress to Support Increased Federal Employment of Qualified People with Disabilities! Contact your Senators and Representative to urge them to cosponsor and support the Senior Executive Service Diversity Assurance Act H.R. 3774/S. 2148. For more information, contact NCIL Policy Analyst Deb Cotter at (202) 207-0334 or deb@ncil.org.

3) State News

Travelers with Disabilities Sue Detroit Airport Authority, Northwest Airlines

Michigan; Source: AP (edited for respectful language)

Northwest Airlines and the Wayne County Airport Authority have been accused of discriminating against physically passengers with disabilities. A federal lawsuit filed in Detroit on behalf of five plaintiffs alleges violations of federal laws, including the Americans with Disabilities Act. It says Metro airport and Northwest dropped passengers with disabilities to the floor, failed to provide boarding assistance and damaged wheelchairs. The suit seeks no monetary damages.

The Detroit News and Detroit Free Press reports Northwest spokeswoman Michelle Aguayo Shannon says the airline was "disappointed" in the filing of the lawsuit. Airport spokesman Michael Conway says providing service to disabled passengers is something the airport authority takes seriously.