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April News
NGA Announces Medicaid Reform Task Force Members
WASHINGTON — The National Governors Association (NGA) today announced the
formation members of a Medicaid Reform Task Force. The task force will work
with the Administration and Congress to strengthen and modernize the
state-federal health care program for low-income and disabled individuals.
The task force will be co-chaired by Kentucky Gov. Paul Patton, NGA's
chairman, and Idaho Gov. Dirk Kempthorne, NGA's vice-chairman. Members
include Florida Gov. Jeb Bush; Indiana Gov. Frank O'Bannon; Connecticut
Gov. John Rowland; Iowa Gov. Tom Vilsack; Maryland Gov. Robert Ehrlich;
Missouri Gov. Bob Holden; North Dakota Gov. John Hoeven; and New Mexico
Gov. Bill Richardson. ...
The task force will work to fashion an agreement that is based on NGA's
Medicaid reform principles, which are contained in a new NGA policy that
was adopted last month at the NGA Winter Meeting. They include:
- The Medicare and Medicaid programs are interrelated and any change
made to Medicare, whether to strengthen its solvency, address its
financing, or for other purposes, should be considered in conjunction with
reforms to Medicaid.
- The federal government should assume full responsibility for the acute, primary, long-term,
and pharmaceutical care of the dual eligibles, individuals who are enrolled
in the Medicare program, but because of their low-income, are also eligible
for the Medicaid program.
- It is also unacceptable for Medicaid to be the only long-term care
program in this country. Other sources of coverage, whether federal,
employer-based, personal, familial, or community-based, must be developed.
- States must have greater ability to manage the Medicaid program
with respect to eligibility, benefits, cost-sharing, and coordination with private sector insurance.
- Medicaid reform proposals that provide states broader
Medicaid program authority should weigh fiscal and health policy
implications of the current financing structure, or an alternative
approach.
- Efforts to reduce fraud and abuse by Medicaid beneficiaries
and providers are essential to safeguarding limited health care resources,
but any effort to develop error rates to measure state performance should
be strongly opposed.
- To the extent possible, all current waivers shhould be replaced
with clear statutory authority.
- The federal government should pay 100 percent of the cost of any
new Medicaid mandates imposed under an act of Congress, federal regulation, or court decision based on federal laws and regulations.
- The federal cap on the commonwealths and territories should be
removed and a federal contribution for commonwealths and territories should
be implemented that is comparable to that of the states.
The Task Force convened for the first time today by conference call and the
governors agreed to devote significant time and energy to developing a
consensus and work aggressively to enact changes to the program during this
congressional session. The Governors will speak by conference call on a
weekly basis and will come to Washington D.C. as required to meet with
Administration officials and members of Congress.
Source: Darlene Howard, Office for Civil Rights, Region V, US Dept of Health & Human Services; 3/20/03, 312/353-5946 voice, 312/886-1807 fax, 312/353-5693 TDD
Congress Considering Medicaid/SSI Cuts
Please contact the following Senators IMMEDIATELY and ask them to oppose
any cuts to Medicaid and other entitlements such as SSI in the final Budget
Resolution conference report. Ask these Senators to tell their leadership
that they will not vote for a final Budget Resolution that includes cuts to
Medicaid.
All of the Senators listed below voted last week for a
Sense of the Senate amendment to provide states with $30 billion of
temporary fiscal relief, including a temporary increase in the FMAP.
Obviously, large cuts in Medicaid move in the opposite direction of any
increase in FMAP.
Background: The House-passed Budget Resolution included an estimated $92
billion in Medicaid cuts and $2 billion in cuts to SCHIP. The Senate is
currently working on its Budget Resolution, which is not likely to contain
Medicaid cuts, but it is expected to turn its attention almost immediately
to approval of the final budget agreement with the House. The House and
Senate leadership are meeting to decide on the contours of the final budget
agreement.
Timeline: The Budget Resolution is on a very fast track and final action on
the conference report (i.e. the agreement between the House and Senate) may
be completed by Thursday, March 27th. Therefore, immediate action is
needed to contact your Senators. All Senate offices can be reached at
202/224-3121.
TIER ONE: Collins (R-ME), Fitzgerald (R-IL), Frist (R-TN; Majority Leader), Grassley (R-IA, chair of Finance), Smith (R-OR), Snowe (R-ME), Specter (R-PA)
TIER TWO: Bayh (D-IN), Bond (R-MO), Campbell (R-CO), Cochran (R-MS), Coleman (R-MN), DeWine (R-OH), Dole (R-NC), Domenici (R-NM), Hatch (R-UT), Lugar (R-IN), Murkowski (R-AK), Nelson (D-NE)
TIER THREE (Senators who voted for Sense of the Senate but are unlikely to vote
against the Budget Resolution if it has Medicaid cuts.): Alexander,(R-TN); Bennett (R-UT), Brownback, (R-KS); Bunning (R-KY); Burns (R-MT); Chambliss (R-GA); Cornyn (R-TX); Graham (R-SC); Hagel (R-NE);
Hutchison (R-TX); Roberts (R-KS); Stevens (R-AK); Talent
(R-MO); Voinovich (R-OH); Warner (R-VA)
 Find your senator's e-mail address
Source: Liz Savage, Consortium for Citizens with Disabilities, 3/25/03
Source: Justice For All Moderator
House Budget Cuts
Friends,
We have some good news and some bad news. FIRST THE BAD NEWS: Potentially
devastating budget cuts ($93 billion over 10 years from Medicaid and $2
billion from SCHIP) are included in the federal budget resolution passed by
the House of Representatives on March 20th. The Senate, which is working on
its version of the budget resolution as we write this message, does not
include Medicaid or SCHIP cuts (or cuts to any other important low-income
programs).
Once the Senate finishes its work, the next step will be a House-Senate
conference committee to work out the differences between the two versions.
Our best guess is that Congress will work quickly, possibly completing
action on the budget by early April.
National groups will meet soon to discuss this crisis and to figure out
what Medicaid advocates should do. We will keep you informed. The most
important first step is to call your Senators - tell them to talk to
Senator Nickels so that the conference committee does not report out any
cuts to Medicaid and SCHIP.
AND NOW THE GOOD NEWS: The Senate took up a "Sense of the Senate"
resolution. This resolution says that it is the sense of the Senate that,
as money becomes available, no less than $30 billion should be given to the
states, and at least half of this money should go towards a temporary FMAP
increase. This resolution passed overwhelmingly, 80-19. This is a huge and
sweeping victory. However, a Sense of the Senate is not binding, and there
will still be work to do in making sure that the Finance Committee
designates money for fiscal relief. Still, this is an important first step
and a strong though symbolic gesture of support for the bill.
We'll keep you updated as the situation develops.
Source: Families USA, 3/21/03
House Bill Proposes Limit on Nonprofit Advocacy Rights
Act now! If passed, this proposed
legislation will limit the advocacy rights of nonprofits.
We encourage you to write a letter to the House Subcommittee on Education
and Workforce (Illinois Representatives Danny Davis and Judy Biggert are
members) encouraging members to vote against this legislation.
Less than a week ago, Rep. Michael Castle introduced a bill (HR 1350) to
reauthorize a law that requires the education of disabled children, called
Individuals with Disabilities Education Act (IDEA). Buried in the proposed
legislation is language reminiscent of the 1996 Istook amendments that
would have restricted the advocacy voice of nonprofits.
At this time, the provision only addresses grants going to nonprofits that
provide training and information to parents of children with disabilities.
The Castle provision would make a nonprofit that does any type of "federal
relations" no matter how little and no matter whether it was paid for with
private dollars ineligible for these parent center grants. Moreover, a
nonprofit would be prohibited from receiving these grants if a board member
or a paid staff serves on the board of another organization that engages in
any "federal relations."
Two other factors add to the troubling nature of this provision. First,
"federal relations" is not defined. The proposal specifically prohibits
lobbying at the federal level on disability education issues, but adds that
"federal relations" would also disqualify the organization from receiving
grants. So "federal relations" must go beyond federal lobbying. We cannot
imagine what type of federal government interactions would not be
considered "federal relations."
Second, it has been reported that a House staffer indicated that this model
might be applied to all Part D grantees under IDEA. This would mean a much
broader set of nonprofits would be affected. It is clear that this is the
slippery slope. If good for these grantees, why not for others? The
nonprofit community stood together during the Istook fight, even when there
were attempts to carve out certain types of nonprofits. This Castle
proposal may require the same type of unified voice from the nonprofit
sector raising objections.
The bill will be considered by the House Committee on Education and the
Workforce. The first stage will be a mark-up in the Subcommittee on
Education Reform, which is chaired by Castle. A date for the Subcommittee
mark up has not yet been set.
We strongly urge you to let the Subcommittee members know of your concern
about this provision. To facilitate, OMB watch has created a sample letter that you can modify and send to all Committee Members. One button from the web site will send the letter to all Committee Members.
Subcommittee on Education Reform:
Republicans (11): Mike Castle, Chairman (DE), Tom Osborne, Vice Chair (NE), Jim Greenwood (PA), Fred Upton (MI), Vern Ehlers (MI), Jim DeMint (SC), Judy Biggert (IL), Todd Platts (PA), Ric Keller (FL), Joe Wilson (SC), Marilyn Musgrave (CO)
Democrats (9): Lynn Woolsey, Ranking Minority Member (CA), Susan Davis (CA),
Danny Davis (IL), Ed Case (HI), Raśl Grijalva (AZ), Ron Kind (WI), Dennis Kucinich (OH),
Chris Van Hollen (MD), Denise Majette (GA)
 Sample letter
 The Subcommittee staff is also taking comments directly.
It is also helpful to call Congressional offices: (202) 224-3121
Please feel free to contact me if you have any questions.
Ruth A. Cardella
Donors Forum of Chicago
208 S. LaSalle, Suite 740
Chicago, Il 60604-1006
312.327.8941
Source: Donors Forum Advocacy Network, 3/27/03.
IDEA Reauthorization
The House Subcommittee on Education and Reform of the Committee on
Education and the Workforce has introduced two pieces of IDEA legislation.
One is a full-scale IDEA bill, and the other is a bill concerning private
school vouchers, the subject of the report we co-authored with People for
the American Way and announced in RRN #20. There will be more "companion"
bills to come in the next weeks. We are reviewing both bills in detail,
and we will bring you our analyses next week.
Improving Education Results for Children with Disabilities Act
IDEA Parental Choice Act of 2003:
Rep. Jim DeMint (R-SC) and House
Education and the Workforce Chairman Rep. John Boehner (R-OH) introduced
this measure on March 20, 2003. This bill does just what we suspected it
would do: proposes to allow local public school districts to use federal
IDEA funds to give partial "scholarships" for use in private schools,
including those that are faith-based. The funds may also be used for
tutoring and other private services for students in schools deemed to be
failing. At this writing, we have seen only the House press release but
not the bill itself.
The DREDF/People for the American Way report on the Florida program used as
a model for this bill: Jeopardizing a Legacy: A Closer Look at IDEA and
Florida's Disability Voucher Program.
Special Education Teacher Shortage Bill:
Rep. Joe Wilson (R-SC) has
introduced legislation to address the growing shortage of special education
teachers by dramatically expanding federal student loan forgiveness for
Americans who teach math, science, or special education in disadvantaged
schools. The Wilson bill was originally proposed by President and Mrs.
Bush, and is included in the President's FY2004 budget proposal.
Join the RNN
Earlier Briefings
Source: Disability Rights Education and Defense Fund's IDEA Rapid Response
Network (RRN) 3/21/03.
Mental Health Code Legislation
I was very pleased with the way things turned out last week in Springfield
with regard to the bills filed by Sen. Watson to lower the commitment
standard and to make it easier to medicate people involuntarily. I have
attached the compromise language that all the parties worked out on all the
issues, which will be added as a floor amendment to Senate Bill 199,
replacing everything else in the bill. Senate Bills 198 and 1062, also
filed by Sen. Watson, will fall by the wayside.
The most important thing from my perspective is that the commitment
standard did not change — the language that was added made no substantive
changes to that standard but just expanded upon the existing law. The same
is true for the part of the bill dealing with the deterioration issue and
court approved medications in the amendments to the forced medication
section of the Mental Health Code.
With regard to the elimination of jury trials in medication hearings, we
did not object for 2 reasons. First, Illinois is the only state which
permits jury trials in medication hearings. Second, juries are more
likely to approve petitions for forced medication than judges are.
I did not feel very strongly one way or the other about adding the
definition of mental illness. This definition is the current law in
Illinois anyway under an Illinois Supreme Court decision several years ago
and actually adds some good language at the end. We left it in and figured
the psychiatrists would tell us if the definition should be changed or
should be kept out of the Mental Health Code entirely.
There was another significant attempt to change the law that was ultimately
kept out of the attached amendment. The primary proponent of the original
bill wanted to change the law so that an individual could be taken into a
psychiatric hospital without notice and kept there for 96 hours for an
emergency psychiatric exam, rather than the 24 hours
permitted under current law. Other parties to the negotiations thought
this was too long and everyone agreed on 48 hours as a compromise. But I
would not agree to expand this time period at all; I would actually like to
see it reduced. Since we were not able to reach a unanimous agreement,
there will be no change in the current law.
One final point: We all agreed to the proposal (which is not attached
because it is too long) to waive all court filing fees for commitment
petitions and petitions for involuntary medications. This was not a
particularly important issue to me or several of the others and we left it
in.
This amendment should get added to the bill and be approved by the Senate
with no problems. The bill would then get a new sponsor in the House and
go to committee there. Since all the major players on these issues
participated in the negotiations (the original proponent who was a
constituent of Sen. Watson, NAMI, Mental Health Association and us), this
amended bill ought to pass out of the House as well with no significant
changes. But one never knows about these things - anything can happen. I
will keep you posted.
Source: Kevin Irvine, 3/24/03
New Work Trends Survey!
Today the John J. Heldrich Center for Workforce Development released a new
survey in its Work Trends series addressing misconceptions among the
nation's employers about hiring workers with disabilities, and the need for
policies promoting opportunity in the workplace. Please visit our new web
site to check out the survey and to sign up for our new, improved, and
expanded web newsletter (it will offer more national news, voices, and
findings).
Survey
Source: Margaret (Maggie) Roffee, US Dept. of Labor
Lifetime Affliction Leads to a U.S. Bias Suit
By Steven Greenhouse
ORTHPORT, Ala. — Samantha Robichaud was born with a dark purple birth mark
covering her face, and she has felt the sharp sting of discrimination ever
since.
"As a child, I was always exiled," Ms. Robichaud said. "No one wanted to
play with me. Kids were scared that if they touched me it would rub off."
In school, Ms. Robichaud (pronounced ROW-buh-shaw) remained an outcast
because of her birthmark, known as a port wine stain.
"I was never in the social scene, never with the cheerleaders or football
crowd," she said. "The big joke was the guys would dare each other to make
a date with me. Then some good-looking guy would go out with me and break
my heart. Then everyone giggled about it."
Ms. Robichaud is 32 now, married and the mother of two, and well past
worrying about schoolyard cruelty. Her struggle now is to obtain a measure
of justice in a lawsuit that charges her former employer, a McDonald's
restaurant, with treating her as shabbily as some grade-school children
did.
In early March, the Equal Employment Opportunity Commission filed a federal
lawsuit in Birmingham, 60 miles away, accusing the McDonald's franchisee of
violating the Americans with Disabilities Act by refusing to promote Ms.
Robichaud to manager because of how she looks. The franchisee, R.P.H.
Management, denies the accusation.
About one in 3,000 children are born with port wine stains, caused by
dilated capillaries under the skin, but Ms. Robichaud's doctors said hers
was one of the worst they had ever seen, and untreatable by laser surgery.
Sometimes, she acknowledged, people derisively call her an alien.
In August 2000, Ms. Robichaud took a job at a McDonald's restaurant here,
down Highway 43 from her high school. "I let them know when I was hired
that I would be seeking a management position, that I would not want to be
on the bottom of the totem pole forever," she said.
From 4 a.m. to 2 p.m. each day, she worked the grill, rushing hundreds of
Big Macs and Egg McMuffins to the drive-through window and front counter.
Eager to move up, she sought to master all the skills of running a
McDonald's, learning how to stock the restaurant and working the counter
and drive-through window when co-workers were out sick.
In her five months at McDonald's, she said she grew frustrated when some
workers hired after her were promoted to manager. Ms. Robichaud, who was
making $5.75 an hour, said she occasionally asked her superiors why she had
not been promoted and was told she needed more experience and should learn
to do some tasks faster.
One day, in January 2001, she said, opening the restaurant with the shift
manager, the manager complained of health problems and voiced concern that
there was no one suitable to replace her if she was out sick.
"I asked her, 'Why don't you train me to be a shift leader?'" Ms. Robichaud
said. "She said: 'I'm tired of telling you a bunch of lies and coming up
with a bunch of different excuses. You will never be in management here
because I was told you would either make the babies cry or scare the
customers off.'"
Ms. Robichaud was stunned. "I felt as if someone just slapped me upside the
head," she said, tears filling her eyes. "It hurt."
A talkative woman, with a knack for telling stories, she insisted that she
got along well with the customers and especially the children, often joking
with them about what toys were in their Happy Meals.
After the rebuff over a promotion, Ms. Robichaud said, she decided she
would "stop giving 150 percent."
"I had the willingness to do whatever it took to move up," she said. "And
then someone says, 'No matter what you do, no matter what you put in,
you're not going to go anywhere.' How would that make you feel?"
The next day, Ms. Robichaud said, the shift manager criticized her for
working slower than usual, saying she had developed a morale problem. Ms.
Robichaud was so upset that she clocked out and went home. She never went
back, considering herself forced out.
The next day, she contacted the E.E.O.C., which concluded that she had been
improperly discriminated against. After months of efforts to reach a
settlement with the franchisee, the commission filed suit on March 7,
seeking unspecified compensatory and punitive damages.
"This is no different from a whole line of cases in which employers said,
'We can't hire someone who's black for this kind of position because our
customers would be uncomfortable,'" said Sharon Rennert, acting director of
the commission's Americans with Disabilities Act division. "That's illegal
discrimination, and it's no different here." ...
This disabilities act lawsuit is unusual because commission officials
acknowledge that Ms. Robichaud is not disabled — she can walk, talk and
work as well as most people. But the lawsuit relies on a part of the law
that protects workers regaarded as having a disability, and Ms. Robichaud
asserts that McDonald's viewed her as having a disability that disqualified
her from becoming a manager.
"This is an important case," Ms. Rennert said, "because this is a qualified
person, an individual who met all the requirements to work at this
McDonald's, who showed enthusiasm, a desire to improve herself, and yet for
all her efforts, all the employer could see was this facial disfigurement.
The employer was making a mountain out of a molehill."
But several experts on the disabilities law who represent
management asserted that Ms. Robichaud's case faced an uphill battle
because of a 1999 Supreme Court decision interpreting the Americans with
Disabilities Act. The court defined a covered disability as one involving a
substantial limitation of a major life activity. The court added that the
limitation had to involve more than one particular job. ...
The case may boil down to whether Ms. Robichaud can demonstrate that
McDonald's, by not wanting to place her in a visible job, was excluding her
from a broad range of jobs.
"This is exactly the type of discrimination that those of us who helped
enact the A.D.A. expected the law to address," said Chai Feldblum, a
Georgetown University law professor who helped draft the disabilities act.
"But given the way the law has been interpreted, it's uncertain whether a
court will rule that this woman should get a remedy under the law."
If the federal courts dismiss her case, lawyers say, Ms. Robichaud will
have no other legal remedy.
Since the lawsuit was filed, Ms. Robichaud has appeared several times on
television, where she has sought to spread the teachings of "Beauty and the
Beast" and the lessons her mother sought to instill in her — it is beauty
inside that counts.
"You can be Miss America, but if you're ugly on the inside, your beauty
doesn't mean anything," Ms. Robichaud said. "The beauty needs to come from
the heart."
Source: The New York Times, 3/30/03
Asset-building Bills in Congress
Congress soon will consider two crucial bills — Savings for
Working Families Act and Assets for Independence Act — that would
significantly increase funding for Individuaal Development Account (IDA)
programs. IDA programs in Illinois and throughout the country have helped
thousands of families learn how to manage their money, save regularly, and
reach their goals such as owning a home, starting a business, and going to
college. ...
The Savings for Working Families Act (S.272) would authorize
$450 million to match savings of IDA participants. The bill, introduced on
January 30 as part of the Charity, Aid, Recovery and Empowerment Act, has
broad bipartisan support. The Assets for Independence Act, enacted in 1998
(PL 105-285,USC S.604), is the largest funding source for IDA programs.
The bill is up for both reauthorization and appropriation.
Research shows that, given the right opportunities and
incentives, even very low-income people can and will save. In a typical
IDA program a nonprofit organization provides financial education and
support to low-income savers, who make deposits into special savings
accounts called IDAs. Public or private funds, or both, match individual
deposits, helping savers reach allowable asset goals. ....
The Center administers, in partnership with the IL Dept. of
Human Services and private institutions, the FLLIP IDA program through
local nonprofit organizations in Moline, Wheaton and Champaign. Over 25
people already have graduated and made their asset purchases since the
program was launched in September 2001. Banks that have contributed
$20,000 or more to the FLLIP IDA private matching funds include Allstate,
Charter One, Fifth Third and Guaranty Bank. The Center is seeking an
additional $40,000 in private contributions to complete its fund-raising
for the FLLIP IDA program.
For more information, visit the site, or
Dory Rand [312/263.3830, x.228].
See also: the CFED site.
Source: Illinois Welfare News, March 2003.
Health Care Justice Act
The Health Care Justice Act of 2003 (HB 2268, SB 1430) is a
process to achieve universal health care. It is not one specific plan to
achieve universal health care; it requires the creation of a bipartisan
Health Care Reform Commission by Sept. 1, 2003, to oversee the gathering of
public input and recommendations for a universal access health care plan.
The Commission and its operations will fall under the Dept. of Public
Health.
For more information:
IL Campaign for Better
Health Care, or call at 217/352 5600 or 312/913 9449.
Free Tax Preparation
The City of Chicago is co-sponsoring free tax preparation
sites with the IRS, Tax Assistance
program, Tax Counseling Project, and CEDA.
Bring the following documents:
- All 2002 W-2 and 1099 forms
- Social Security cards for all household members
- Copy of 2001 tax return
For heating assistance, also bring :
- Proof of income from all household members for past 30 days
- Current heat/electric bills
- Rental agreement with monthly rental amount
- If TANF recipient, Medical Eligibility Card
For site locations and hours, call 311, or 711
for TDD users.
I Love Literacy!
After nearly two years of discussions and negotiations between
the two national literacy
organizations — LVA and Laubach Library — a new organization has been
born, ProLiteracy Worldwide. To celebrate its creation, ProLiteracy iis
sponsoring a series of regional symposia for literacy practitioners in
Florida, Texas, California and Illinois.
In Illinois, the conference will be April 23rd and 24th. For
further information, call LVA-Illinois at 312/857 1582.
ADA Pride and Progress
On July 22nd, 2003, the IL Dept. of Human Services (in
cooperation with numerous state agencies and councils) will celebrate the
13th anniversary of the signing of the Americans with Disabilities Act at
the James R Thompson Center, 100 W Randolph in Chicago from 10 am to 3 pm.
There will be an art exhibit with 200 works, some informational workshops,
an ADA Help table, etc.
For more information, call 312/793 0034 voice, 312/793 3597
tty.
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