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June 2005
Medicare improves Access to Power Chairs & Scooters The Centers for Medicare & Medicaid Services (CMS) today announced new national coverage criteria for mobility assistive equipment (MAE) including power wheelchairs and scooters. The new criteria, which are effective immediately, adopt a function-based determination of medical necessity. This determination looks at the ability of the beneficiary to safely accomplish mobility-related activities of daily living, such as toileting, grooming, and eating, with and without the use of mobility equipment such as a wheelchair. The national coverage determination (NCD) addresses the full range of MAE from simple canes and walkers to sophisticated power wheelchairs. "The steps we are taking today are part of our efforts to ensure that seniors who need mobility help will get it promptly, and that we are paying appropriately for mobility assistive equipment," said CMS Administrator Mark B. McClellan, MD PhD. "The new functional criteria reflect current medical practice and mean that beneficiaries will have the freedom to live better, more mobile lives, without needing to fit into a rigid 'bed or chair-confined' standard." The new coverage criteria are part of a larger three-pronged Modern Mobility Initiative announced in April 2004 focused on improving coverage, payment and quality of suppliers of power wheelchairs and other mobility aids. In addition to developing new coverage criteria, CMS has developed new billing codes that will take effect January 1, 2006, to reflect the variety of wheelchairs now on the market. CMS expects to issue new quality standards for suppliers in 2006. "This coverage policy ensures that a beneficiary's functional status and individual circumstances are considered so that the most appropriate technology for each beneficiary's personal needs is covered," said Barry Straube, MD, CMS's Acting Chief Medical Officer and Acting Director of the Office of Clinical Standards and Quality. "It is also consistent with the documentation of the functional needs of the patient that should be in medical records for our beneficiaries." CMS plans to issue additional guidance in the near future to help physicians and treating practitioners better understand the new coverage criteria and CMS's expectations about proper documentation in the medical record. Because the new functional criteria more explicitly refer to standard clinical evaluative methods, CMS expects that the medical documentation generated during the patient evaluation will more accurately be reflected in the beneficiary's medical record. It is CMS's intent that this will make the power mobility device coverage process more straightforward. "During the course of reviewing Medicare's policies for power mobility devices, CMS came to the conclusion that there are more accurate tools to root out fraud and abuse," said Kimberly Brandt, Director of CMS's Program Integrity Group. "The combination of the new NCD and the planned enhanced educational outreach by Medicare to physicians and treating practitioners, as well as to suppliers, will eliminate most honest billing errors. More accurate claim submission will allow CMS to better analyze claims data and focus claims review to target abusive billers." Source: Medicare News, CMS Office of External Affairs, 5/5/05. 
More information about these developments can be found online.
Curb ramp lawsuit partially settled Accessibility to disabled at issue in federal case By Liz Cobbs, News Staff Reporter The city of Ann Arbor may replace some curb ramps that do not comply with Americans with Disabilities Act standards, following a partial settlement of a federal lawsuit brought by an advocacy organization. Because the Ann Arbor Center for Independent Living's lawsuit is pending and a review of curb ramps will go back 13 years, it is not immediately known how many curb ramps are to be replaced and how much it will ultimately cost the city to replace them. The center claimed in its August 2004 lawsuit, assigned to U.S. District Judge John Corbett O'Meara in Detroit, that the city has failed to build curb ramps according to federal and state accessibility guidelines and standards. The lawsuit alleges the city's failure has resulted in unsafe sidewalks and intersections for people using wheelchairs, who are sometimes forced to travel in the streets. Among the issues still to be resolved is reaching an agreement with the Downtown Development Authority over fixing curb ramps downtown, said the center's attorney, J. Mark Finnegan of Ann Arbor. Assistant City Attorney Abigail Elias said it is the city's policy not to comment on pending litigation. In addition, Elias said, "the first consent decree and partial settlement speaks for itself." The consent decree and partial settlement is the document that details the partial resolution of the lawsuit. The document will be in effect over the next three years. The city stated in the document that by agreeing to the partial settlement, it is not admitting liability or waiving any defenses it might have to the lawsuit. According to the document, the city will give the center's attorneys a list of construction, alteration and resurfacing projects for 2005 and list intersections of streets, roadways, highways, sidewalks and paths that will be altered or resurfaced. By the end of the year, the city will give plaintiffs' attorneys a list stating whether curb ramps at intersections that were part of construction, alteration or resurfacing projects done from March 1, 1992, through Dec. 31, 1997, meet ADA standards. The city will also state which nonconforming curb ramps it intends to replace and which ones it intends to leave in place, the document said. The consent decree also calls for the city to provide the same type of list by Dec. 31, 2006, for projects done from Jan. 1, 1998, through Dec. 31, 2004. Before filing the lawsuit, representatives from the Ann Arbor Center for Independent Living approached the city about its claims that the city built curb ramps that do not meet ADA standards. In an August 2003 letter that is now an exhibit in the lawsuit, City Administrator Roger Fraser wrote to the center's president and CEO, James Magyar, that the curb ramps complied with all applicable regulations and guidelines. A follow-up letter written by Elias in October 2003 said the city followed the Uniform Federal Accessibility Standards rather than the ADA guidelines for its sidewalks and curb ramps. Source: Ann Arbor News (Ann Arbor, MI), 4/11/05 Tips for Leave-Law Compliance Navigating the various leave laws is one of the most difficult tasks an employer faces. When an employee requests leave, employers must ensure compliance with the Family Medical Leave Act, the Americans with Disabilities Act, and workers' compensation laws in their state. During a recent BLR audio conference, two employment law attorneys offered tips for employers on how to navigate through the maze of leave laws. Lindsey Urbina, who practices labor and employment law at the Miller Law Group in Larkspur, California, said employers should start by determining if the employee seeking leave is eligible for leave because of a "serious health condition" under the Family and Medical Leave Act (go here for information on FMLA eligibility). Since FMLA leave can run concurrently with workers' compensation leave, it is important to make this determination and designation as soon as possible to avoid having the employee return workers' compensation leave and then request an additional 12 weeks under FMLA, Urbina noted. If the employee has a serious health condition, the employer should determine if the condition qualifies as a protected disability under the ADA, according to Urbina. She said employers sometimes are surprised to learn that they may be required to offer leave to employees as a reasonable accommodation under the ADA (go here for more information on the ADA). The law requires employers with 15 or more employees to provide reasonable accommodation for otherwise qualified individuals with disabilities, unless it would cause undue hardship. Allen Kato, who is an attorney in the Litigation and Employment and Labor Law Groups of Fenwick & West, LLP, said that while the FMLA has a limit of 12 weeks of leave within a 12-month period, the ADA and state workers' compensation laws generally have no set cap on the amount of leave. Depending on the circumstances, intermittent leave may be required under all the applicable laws, the attorneys said. Kato and Urbina also addressed the reinstatement rights under the leave laws. Under FMLA, when the leave ends, employers must return employees to the same job or equivalent one in pay, benefits, and other employment conditions. In general, under workers' compensation law, employers must rehire employees only after they are released for full duty without restrictions. However, employers are barred from automatically refusing to rehire someone with a significant occupational injury that qualifies as a serious health condition under FMLA and/or an ADA-protected disability, Urbina noted. Under ADA, disabled workers usually have the right to return to work if they can carry out the essential functions of the job with or without a reasonable accommodation. Kato noted some "traps for the unwary." He said a growing number of employers are using return-to-work programs to lower workers' compensation costs, but these programs can run into conflict with the FMLA and the ADA. Kato reminded employers that they are prohibited from refusing to let an employee return to work out of fear that the employee will re-injure himself or herself and file new workers' compensation claims. To conclude, Urbina stressed the importance of:
When can you take a dog into a store? If it's a service dog, anytime you want One former owner of a Ballard convenience store lost a $21,000 judgment for denying a woman's access to his store. Joyce Fischer-Jones said she was emotionally disabled and has trouble leaving home without her dog "Sox" to calm her panic attacks. The Americans With Disabilities act doesn't give store owners much leeway. About the only time they can ask a service dog to leave is if it acts up, or lashes out. In another incident, Ravenna Alexander found herself talking to the police after an employee of a Money Mart check-cashing store called 911, complaining she brought a dog inside. "But he can't refuse because I have a dog, a service dog," Alexander said. "And that's what his exact words were: 'You can't be in here with a service dog, you can't be in here with your dog.' He wouldn't even acknowledge it as a service dog." Now it's the store that could be in trouble. Alexander said she needs the dog for anxiety, she even has documentation for her Labrador Retriever, Stitch. "All a business owner can ask is, 'Is this an animal that is providing a service because of a disability?' said Angela Dawson-Milton, of the Seattle Office for Civil Rights. "If they get a yes to that question, they have to allow the animal into the establishment." She said a service dog does not have to be marked or wear a harness or look like a service dog. She said many disabilities are not obvious. "The law says they don't have to come out and tell you what their disability is, or tell you anything more than 'I need it, for a disability,'" she said. The Seattle Civil Rights Office said it's getting about two to three complaints each month, a number that's been growing for the last year. Money Mart's corporate office in Victoria, BC issued a statement, saying the company "regrets the incident... that the dog was mistaken as a pet by a Money Mart employee and the customer was politely asked to leave the dog outside. "Money Mart has offered an apology to the customer and has reprimanded the employee involved." But if you're in the habit taking a pet into the store, and you tell the management it's a service dog when you don't have a disability, you would be the one in trouble with the law. Source: King5 (Seattle, WA) 5/6/05 HUD Section 811& FY2006 The Administration's FY 2006 budget proposes to end one of the most essential and cost-effective housing development programs ever administered by HUD — the Section 811 Supportive Housing for Persons with Disabilities program. Under the Administration budget, all funding for the development of new units of permanent supportive housing for people with the most severe disabilities would be eliminated. HUD's proposal would slash the Section 811 budget by 50 percent, and provides only the minimal funding needed to renew expiring Section 811 five year contracts for existing tenant-based vouchers and project-based subsidies. For more than 40 years, the Section 811 program (and its precursor the Section 202 program for persons with disabilities) has been dedicated to the development of new community-based supportive housing for the most vulnerable people in our society. The Section 811 program is the only HUD program that produces affordable and accessible permanent housing with supports for extremely low-income people with severe disabilities. The program has been the cornerstone of efforts to promote and expand community integration for people with disabilities whose housing and supportive services needs cannot be addressed through the private rental housing market. The Section 811 Supportive Housing Program The Section 811 Supportive Housing program provides affordable and accessible housing for people 18 years of age or older with severe disabilities, including physical disabilities, developmental disabilities, and people with chronic mental illness. Most Section 811 program participants live in supportive housing units developed and managed by non-profit organizations. Historically, HUD has used 75 percent of Section 811 funding to provide one-time capital funding and an essential monthly subsidy to help finance the development of fully accessible rental housing, including independent living projects, condominium units, and small group homes, many of which offer voluntary supportive services for people with severe disabilities. The non-profit Section 811 sponsors must agree to provide the housing to people with severe disabilities for a minimum of 40 years, an extremely cost-effective long term approach. For the past eight years, Congress has dedicated 25 percent of Section 811 funding to tenant-based vouchers that HUD has administered as the Section 8 Mainstream Housing Opportunities for Persons with Disabilities Program. Unfortunately, the Mainstream program has been grossly mismanaged by HUD since its inception in 1997. HUD's Section 811 Budget Request Instead of maintaining the Section 811 program's long standing commitment to production of new supportive housing units, the Administration's FY 2006 shocking budget request proposes to end the production component of the program. The Administration has recommended slashing Section 811 funding to a mere $120 million, an amount that will only support renewal of existing tenant-based and project-based subsidy commitments. This is a cut of $118 million from the FY 2005 budget. Because of this egregious cut, over 1,000 new units of supportive housing will not be available for people who currently live in institutions, nursing homes, homeless shelters, or who remain home with aging parents. This proposal not only flies in the face of disability policy but also is completely counterintuitive to the principles included in President Bush's New Freedom Initiative. The Section 811 Program: A Cost-Effective and Essential Program The Section 811 program is widely recognized in states and localities as a cost-effective supportive housing alternative to expensive institutional settings. Many states have relied on the Section 811 program to reduce the number of people with severe disabilities forced to remain in public mental health facilities, Medicaid funded nursing home beds, or public facilities for people with mental retardation and other developmental disabilities. Recent cost studies document the program's cost effectiveness:
Section 811 supportive housing production is also needed to address the serious and growing problem of aging parents who are still providing housing for their adult children (many who are now in their 30's and 40's). For example, over 700,000 people with developmental disabilities live at home with parents age 60 and over who do not know where their adult child will live after they die. Olmstead, the New Freedom Initiative and Accessible Housing The Section 811 Supportive Housing Program is critical to address the significant need for supportive housing in states participating in the Administration's New Freedom Initiative for People with Disabilities. Prompted by the U.S. Supreme Court's Olmstead decision and the Administration's Real Choice Systems Change Grant program, most states have identified a critical need to expand the development of supportive housing — including housing with a much higher degree of physical accessibility than is available in the private rental market. Some state plans (e.g. Virginia and Maryland) contain actual references to the need for additional Section 811 resources to support their goals of community integration for people with disabilities. It is both tragic and ironic that the production of Section 811 supportive housing units is being proposed for elimination at a time when states are actively working to expand this type of housing opportunity. Recommendation The Technical Assistance Collaborative, Inc. (TAC) encourages advocates to write to Congress and urge their representatives to increase Section 811 funding by at least $129 million in FY 2006 to restore the program to its FY 2004 funding level of $249 million. Congress should require that any funds not needed to renew existing Section 811 contracts be dedicated exclusively to the production component of the program so that new desperately needed supportive housing units can be created in 2006 and beyond. For many years, TAC has urged HUD and the Office of Management and Budget to adopt our recommendations to improve the Section 811 production program by eliminating outdated bureaucratic requirements that prevent the leveraging of additional capital funding that could make the production of Section 811 units even more cost effective. We have also gone on record that we cannot support any expansion of the tenant-based Mainstream component of the program at this time until: (1) HUD has documented that all Mainstream vouchers currently funded are being used by people with disabilities who can benefit from supportive housing; and (2) HUD has issued appropriate policy guidance to ensure that all future Section 811 funding is used solely for this purpose. For more inormation, contact Technical Assistance Collaborative, Inc. TAC is a national organization that works to achieve positive outcomes on behalf of people with disabilities or other special needs by providing state-of-the-art information, capacity building, and technical expertise to organizations and policymakers in the areas of mental health, substance abuse, human services, and affordable housing. 
Technical Assistance Collaborative
535 Boylston Street #1301, Boston MA 02116 phone 617.266.5657 / fax 617.266.4343 
e-mail
Source: Technical Assistance Collaborative Inc. National Council on Disability Calls for Immediate Changes in Emergency Planning for People with Disabilities WASHINGTON — The National Council on Disability (NCD) today released a report recommending immediate federal changes in emergency planning for people with disabilities. According to NCD chairperson Lex Frieden, Saving Lives: Including People with Disabilities in Emergency Planning, provides an overview of steps the Federal Government should take to build a solid and resilient infrastructure that will enable the government to include the diverse populations of people with disabilities in emergency preparedness, disaster relief, and homeland security programs. This infrastructure would incorporate access to technology, physical plants, programs, and communications. It also would include procurement and emergency programs and services." "NCD commends the Administration and those in leadership positions for the issuance of the July 22, 2004, Executive Order on people with disabilities and emergency preparedness. In addition, NCD acknowledges the work of the Department of Homeland Security (DHS) and the Federal Communications Commission (FCC) in their efforts to ensure that Americans with disabilities are included in the developing infrastructure." "All too often in emergency situations the legitimate concerns of people with disabilities are overlooked or swept aside. In areas ranging from the accessibility of emergency information to the evacuation plans for high-rise buildings, great urgency surrounds the need for responding to the concerns of people with disabilities in all planning, preparedness, response, recovery, and mitigation activities. The homeland security terrorist event of September 11, 2001, as well as the recent energy blackouts in the U.S. Northeast and Midwest and, more recently, the natural disaster hurricane events in Florida and the tsunami event of December 26, 2004, underscore the need to pay attention to the concerns raised in this report," Frieden concluded. The decisions the Federal Government makes, the priority it accords to civil rights, and the methods it adopts to ensure uniformity in the ways agencies handle their disability-related responsibilities are likely to be established in the early days of an emergency situation and be difficult to change if not set on the right course at the outset. By way of this report, NCD offers advice to assist the Federal Government in establishing policies and practices in these areas. This report provides examples of community efforts with respect to people with disabilities, but by no means does it provide a comprehensive treatment of the emergency preparedness, disaster relief, or homeland security program efforts by state and local governments. Key Findings Disaster management activities appear to have many access mistakes in common. People with disabilities frequently encounter barriers to physical plants, communications, and programs in shelters and recovery centers and in other facilities or devices used in connection with disaster operations such as first aid stations, mass feeding areas, portable payphone stations, portable toilets, and temporary housing. Many of these barriers are not new. Information and lessons learned are not shared across agency lines, and thus experience does not enlighten the development of new practices. Many accessibility lessons learned during previous disasters are not incorporated in subsequent planning, preparedness, response, and recovery activities. This should not be perceived as a post-9/11 problem. Segments of the disability community have reported problems in helping to develop and benefiting from emergency services over many decades. People with disabilities are left out of preparedness and planning activities. These activities include analyzing and documenting the possibility of an emergency or disaster and the potential consequences or impacts on life, property, and the environment. Key Recommendations
Source: NCD
Read the report : Saving Lives: Including People with Disabilities in Emergency Planning
ADA Celebration Each year, the Illinois Dept of Human Services along with other state agencies and councils sponsor a statewide event to commemorate the passage of the Americans with Disabilities Act of 1990 (ADA). This year's fifteenth anniversary celebration entitled, ADA Renew the Spirit, highlights the accomplishments of people with disabilities as it recognizes how state agencies and programs, and other organizations have worked to comply with this law, improving access to environments, programs, services and opportunities for people with disabilities. ADA Renew the Spirit will be held on Thursday, July 21, 2005, at the James R. Thompson Center, 100 West Randolph Street, (between Randolph & Lake and Clark and LaSalle Streets), Chicago, from 10 a.m. to 3 p.m. The Americans with Disabilities Act of 1990 Signed into law by President Bush on July 26, 1990, the Americans with Disabilities Act or ADA provides civil rights protections and equal access to environments, programs and opportunities for people with disabilities. Key areas covered by the act include employment (Title I); state and local governments (Title II); public accommodations including transportation (Title III); and telecommunications (Title IV). Title V covers "miscellaneous" situations. The latest Harris poll (2004) revealed that 54 million Americans — more than 20% of the population — have some form of disability. And of that number, many individuals may have multiple disabilities that can include physical, cognitive and developmental disabilities. Although some areas of access have improved, the unemployment rate among people with disabilities is the highest of all minorities reaching over 70%. The essence of the ADA and other disability-related legislation such as the Individuals with Disabilities Education Act (IDEA) is to ensure that people with all types of disabilities can share equally with their non-disabled counter parts in the American dream. Although progress has been slow, recognition of the ADA, as well as the potentials of people with disabilities has improved. Events like ADA Renew the Spirit assist in delivering a powerful message to the general public illustrating the positive aspects of disability. Accessibility Features In order to facilitate equal access to all event activities, the Illinois Dept of Human Services will provide reasonable accommodations — sign language interpreters, wheelchair access throughout the event space, on-site personal assistants (PAs), audio description of stage performances, informational materials in alternative formats such as Braille or large print. Other accommodations are available upon advance request. Exhibitors are also asked to provide printed materials in alternative formats. Event Components Overview ADA Renew the Spirit includes:
Each year, workshops are hosted at the ADA Celebration event focusing on various subjects related to the ADA. Workshops featured this year include:
Some of the workshops are typically broadcast, via telephone hookup to Illinois Department of Human Services, Springfield, IL to broaden their outreach. Arts & Access The centerpiece of the festivities is an extraordinary art exhibit featuring the works of artists with disabilities sponsored by the Department of Human Services, Little City Foundation and the Illinois Arts Council. Nearly 200 original paintings, drawings, sculptures, prints, photographs, and media works, including a live or taped web cast, will be showcased. The highlight of the exhibition will be a special hands-on Wearable Art demonstration by artists from Little City Foundation's Center for the Arts, and participants in attendance will get to take home a wearable piece of art. The art exhibit remains in the lobby of the James R. Thompson Center for a two week period from Monday, July 11th through Thursday, July 21, 2005. Live Entertainment In addition to its visual arts display, ADA Renew the Spirit will present a live entertainment venue featuring cross cultural and cross disability performers in the outdoor arena near the large sculpture of the Thompson Center. The show runs from 11:30 a.m. to 3:00 p.m. featuring such acts as lively bands, dance and musical performances such as Vision Quest, a rhythm and blues group from the Chicago Lighthouse. Organizational Exhibitors More than 50 exhibitors offering programs and services for people with disabilities will share information with event attendees, as well as illustrate how they continue to comply with ADA legislation. Both state and local government offices, as well as non-profit and other independent organizations are represented. Employment Match and an "Employment Match and Fair" will be held to match qualified pre-screened job candidates with disabilities with participating employers organized in tandem with Partners for Inclusive Employment (PIE). On July 21, 2005, job candidates with disabilities will be pre-screened and attend job readiness workshops to prepare for the "Employment Match and Fair" to be held on August 9, 2005. ADA Help Table A variety of resources and information related to the ADA are available to event participants and guests compliments of the Illinois Department of Human Services. Midwest Wheelchair Race & Run Marianjoy Rehab Center presents their fifth annual Midwest Wheelchair Race & Run, the largest sanctioned 10k wheelchair race in Chicagoland and the Midwest. The race is August 21st at Wheaton Warrenville South High School, Wheaton; start time at 7:30 AM. Register by August 7 and your fee is $20; after August 7th, the fee is $25. Proceeds from the event will support Marianjoy's wheelchair sports programs. The Race is for people of all abilities; winners will receive cash prizes. Source: Ablegram, Schaumburg Township Disability Services Office, May 2005.
For more information (or call 630/588.7856)
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