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The Council for Disability Rights |
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July 2005
Evaluation of Section 811 and 202 Programs A recent congressionally mandated evaluation of Section 811 and 202 housing programs suggests that project size does not strongly influence either costs or service availability. The study finds that size plays a lesser role in project satisfaction than meeting disabled residents' needs, preferences, and requirements for supportive services. Researchers collected data on housing and services by speaking with state policymakers, interviewing project sponsors, making site visits to 50 projects in 10 metropolitan areas, and interviewing residents. Researchers found that priorities for these projects include locations in safe, desirable residential or mixed residential and commercial neighborhoods; an emphasis on independent living; use of community-based support services in lieu of onsite provision; and good relationships with local neighbors and businesses. Physical appearance of a project, including size, is a significant factor in local acceptance. A project that blends into the neighborhood is desirable. This evaluation underscores the importance of flexibility in project size, given cost and service accessibility; a project design that maximizes independence, privacy, and nterdependence of residents with community; and a need for further cost analyses and financing mechanisms to expand affordable housing for the disabled. The full report, Implications of Project Size in Section 811 and Section 202 Assisted Projects for Persons with Disabilities, is available in printed form for a nominal charge by calling 800/245-2691 or as a free download. Source:visitability-list@listserv.buffalo.edu, 7/13/05 DOJ Settles Disability Discrimination Lawsuit against Nevada Developers, Architects & Engineers WASHINGTON, D.C. - The Justice Department today announced a settlement agreement with three firms in Reno, Nevada, resolving a lawsuit that alleged disability related housing discrimination. The suit is the Department's first enforcement action in Reno concerning the accessibility requirements of the federal Fair Housing Act. "Cutting corners in the construction of new housing does not pay," said Bradley J. Schlozman, Acting Assistant Attorney General for the Civil Rights Division. "The design and construction requirements of the Fair Housing Act are clear and readily achievable in new construction. The Justice Department will continue to hold accountable those who have a legal obligation to provide accessible housing." According to the government's complaint, ERGS, Inc.; civil engineering firm CFA, Inc.; and an individual architect violated the Fair Housing Act by designing and constructing housing complexes in a manner that left them inaccessible to people with disabilities. The properties are Silver Lake Apartments and Sierra Sage Apartments on the outskirts of Reno. The Reno-based Silver State Fair Housing Council (SSFHC) brought suit first, after filing a complaint with the U.S. Department of Housing and Urban Development, with which the United States' lawsuit was consolidated. The agreement requires accessibility improvements to the apartment units and the complexes' common areas at an estimated cost of $1.67 million. The agreement also provides $27,500 in damages for the SSFHC and $250,000 to reimburse its attorney's fees and litigation expenses; establishes a $150,000 fund to compensate individuals injured by the inaccessible housing; and requires the payment of a $30,000 civil penalty. "Today's action is an excellent example of what can be achieved when the United States joins forces with a local housing group that shares the same passion for equal housing access. The Silver State Fair Housing Council has been advocating and educating for fair housing rights in northern Nevada since 1989. We are pleased to have partnered with them in this case to create more housing options for persons with disabilities to live where they want," said Daniel G.Bogden, US Attorney for the District of Nevada. Persons with disabilities who believe they may be aggrieved by the accessibility violations at Silver Lake or Sierra Sage should call 1-800-896-7743 to determine how they can file a claim for monetary damages. Since January 21, 2001, the Civil Rights Division has filed 161 lawsuits alleging discrimination in housing, including 73 based on disability discrimination and 34 based specifically on the Fair Housing Act's design and construction provisions that formed the basis of this lawsuit. 
The consent decree
Information on the accessibility requirements of the Fair Housing Act
Olegario "Ollie" D. Cantos VII, Esq., Special Asst to the Acting Assistant Attorney General
Civil Rights Division, US DOJ, 950 Pennsylvania Ave, NW, Room 5529, Washington, DC 20530 Voice: 202/616-7920 / TDD: 202/514-0617 / Fax: 202/307-2839 Source: Civil Rights Division, US Dept of Justice [voice:202/514-2008 / tty: 202/514-1888] Law on disabled targeted; State senator wants to stop frivolous lawsuits By Hank Shaw, Capitol Bureau Chief SACRAMENTO - A cottage industry of activist lawsuit-filers using the Americans with Disabilities Act as their weapon have cost California's business community millions in settled lawsuits - an act that a local legislator says enriches the activist at the expense of both the business and the disabled. In Stockton, one serial suit-filer settled a case against Union Safe Deposit Bank for $30,000. An ADA lawsuit also led to the closure of the 105-year-old restaurant On Lock Sam's; its owners said they were never given a chance to fix the problems. New owners reopened the restaurant in spring 2004. State Sen. Chuck Poochigian wants to stop frivolous ADA suits while protecting the right of the disabled to sue real violators. Disabled advocates say his legislation doesn't do what he wants it to do and have vowed to fight him in the Legislature. Poochigian's idea: Target California's all-but-unique law that lets people sue businesses violating the ADA for extra monetary sums, including attorneys' fees and punitive and other damages. Most states allow suits only for physical harm caused by violations. Poochigian, a Fresno Republican whose district includes part of San Joaquin County, wants to change the law to bar such "pain and suffering" lawsuits -unless the targeted business fails to fix the violation in four months. If property owners do make their businesses ADA-compliant, they cannot then be sued for punitive damages or attorneys' fees. The bill would not affect anyone physically injured because of an ADA violation."The bill protects the right of an individual who suffers a physical injury to get medical bills paid while limiting lawsuits for fees and punitive damages if property owners correct the problem," Poochigian said. At issue is the growing movement to curb California's love of lawsuits. Last month, the Tracy City Council voted to support similar legislation. And last fall, California's business community spent millions to support a ballot initiative limiting shakedown suits. It passed easily. The state Chamber of Commerce also backs Poochigian's bill. Jarek Molski of Woodland Hills is the type of serial litigant Poochigian wants to put out of business. Courts records show Molski filed 334 nearly identical lawsuits against businesses throughout California, alleging various ADA violations. According to court documents, the vast majority of the cases were settled, and none were tried on its merits. Molski was declared a "vexatious litigant" by a federal judge last December and must now receive approval from a judge before he files any future suits. Cheryl Bergan of the California Foundation for Independent Living said the judge's decision was the proper way to curb frivolous lawsuits. She said Poochigian's bill would actually discourage businesses from complying with the law before they get sued. Why bother spending the cash to become ADA compliant until someone in a wheelchair threatens to sue you, Bergan asked. "It's simply not fair that with a law that is 15 years old you should have to wait another 120 days or it's too bad, so sad for you," she said. ... She said her group will oppose Poochigian's bill when it is heard in committee next month. No one denies that many businesses do not fully comply with the federal law. It requires scores of special adjustments to improve access for people in wheelchairs or with other mobility problems. Toilet paper must be no more than 48 inches from the floor. The seat can't have a spring to keep it up. Bergan says she understands why some activist litigators - such as the one who sued Union Safe Deposit Bank in 2002 - travel around filing lawsuits: Even though some people might find the practice distasteful, it is one of the few ways to get businesses to comply with the law. Unlike most federal regulations, the ADA was designed to be enforced through litigation, Bergan said. So lawsuits - and the legal precedents stemming from them - are an expected byproduct of the law. "Access is as important as fire sprinklers or emergency exits," Bergan said. "But access is not treated as important, and this bill allows it to remain that way." Yet, all but a tiny fraction of ADA cases are brought to trial, so the precedents the writers of the law expected never fully developed. The result is that the realistic bounds of what's reasonable or not remain vague, leaving the door open for what Poochigian calls "predatory litigators." Poochigian says his bill would stop these people, leaving only legitimate lawsuits. "Ironically, this law that was originally designed to open doors for the disabled has forced some business to close their doors altogether," he said. "The Americans with Disabilities Act should be about providing access, not a payday for shakedown artists." The bill, SB855, is expected to be heard in the Senate Judiciary Committee on May 3. Source: RecordNet.Com
Details of the bill
Capitol Bureau Chief Hank Shaw [phone 916/441-4078]
Census Bureau Facts for 15th Anniversary of Americans with Disabilities Act, July 26, 2005 WASHINGTON, May 26 /U.S. Newswire/ — On this day in 1990, President George H.W. Bush signed into law the Americans with Disabilities Act, guaranteeing equal opportunity for people with disabilities in public accommodations, commercial facilities, employment, transportation, state and local government services and telecommunications. Population Distribution 37.5 million — Number of people age 5 and over in the civilian non-institutionalized population with at least one disability, representing 14 percent. These individuals fit at least one of the following descriptions: they are 5 years old or older and have a sensory, physical, mental or self-care disability; they are 16 years old or older and have difficulty going outside the home; or they are 16 to 64 years old and have an employment disability. By age and sex :
Further information on the "Population Distribution" data
Specific Disabilities
Further information on the "Specific Disabilities" data
Serving Our Nation
Questions or comments should be directed to the Census Bureau's Public Information Office [301/763-3030; fax 301/457-3670]
Ways to Celebrate the 15th Anniversary of ADA Mark_Johnson@shepherd.org, suggests;
For information about the Americans with Disabilities Act (ADA)
Access Currents: Volume 11,#3 May/June 05 Board to Hold Forums During Week of ADA Anniversary Events Among a number of programs and receptions planned by various organizations to mark the 15th anniversary of the Americans with Disabilities Act (ADA) on July 26th, the Access Board will hold several public forums on its work and goals under the ADA. These events will allow the public to provide input on shaping a new agenda and on specific Board initiatives. The meetings, which are free and open to the public, will be held at the Marriott at Metro Center in downtown DC. Public Hearing on Passenger Vessels (July 25,10:00 -12:00) The Board will hold a public hearing on access to passenger vessels on the morning of July 25. The public is invited to provide comment on materials the Board released in November on its rulemaking for access to passenger vessels, including draft guidelines for large vessels, such as cruise ships, and a notice outlining several different options on addressing access to smaller vessels, such as water taxis and excursion boats. This event follows similar hearings held in D.C. last January and in Los Angeles at the end of June.
For further information, contact Paul Beatty [202/ 272-0012(v), 202/272-0082 (TTY)]
The materials on passenger vessels, available for comment
Meeting on Promoting Education on Accessible Design (July 25, 1:30 - 4:30) An information meeting will be held later on the same day on a new Board initiative to promote accessibility in the education of architects, planners, and engineers. The Board seeks recommendations on ways this goal can be advanced through education curricula, design competitions, outreach to colleges, universities, and accrediting organizations, and other means.
For further information on this event, contact Jim Pecht [202/ 272-0021 (v), 202/272-0082 (TTY)]
Forum on Board Agenda and Services (July 26, 9:30 - 11:00) The Board will hold a public forum on its work developing and maintaining guidelines, sponsoring research, and providing information and services through its web site. This forum will provide an opportunity for the public to provide input on the Board's agenda for rulemaking, research, technical assistance, and training. Recommendations are sought on topics or issues that the Board should address through its work writing guidelines for accessible design, its research program, or other means, such as information meetings. The Board also seeks recommendations on new guidance and training materials and how this information and related services can be delivered most effectively to its various audiences, particularly through its web site. This is part of a program of seminars organized by the National Council on Disability (NCD) in cooperation with various Federal agencies. The full program, "The ADA: 15 Years of Making a Difference," includes an opening plenary session, five other ADA-related workshops in addition to the Board's session, and a closing session. For information on the full program, contact the NCD at 202/272-2004 (v) or 202/272-2074 (TTY).
For further information on the forum, contact Kathy Roy Johnson [202/272-0041 (v), 202/272-0082 (TTY)]
Board Unveils New Website; Seeks Input on Future Enhancements In June, the Board implemented a complete redesign and overhaul of its web site. The revised site features a new look and organization, improved navigational and search features, and additional on-line services. Visitors can now order Board publications through the site in addition to subscribing to the Board's newsletter or filing a complaint under the Architectural Barriers Act. The new site's design provides a portal page or "mini-homepage" for each of the Board's guidelines and standards, including those under development, which contain links to all relevant materials and related resources for easier one-stop shopping. The Board plans to develop new content and features for the web site in coming months. This next phase will explore ways in which guidance and training on the Board's design criteria and accessible design can be delivered most effectively through the site. A public forum to be held on July 26th will invite recommendations from the public on these and other web site features and on-line services. Courthouse Access Advisory Group to Meet in Chicago in August The Courthouse Access Advisory Committee will hold its next quarterly meeting August 4th and 5th in Chicago. The committee, which the Board chartered last fall, is exploring ways to address and promote access to courthouses, including courtrooms, which pose unique challenges to accessibility. At this meeting, members will review and assess considered design solutions and best practices. In addition, the committee will continue work gathering resources and planning outreach and educational initiatives. Presentations on courtroom platform lifts and on emergency egress are also on the agenda, along with planning for next year's meetings. The committee's members include designers and architects, disability groups, members of the judiciary, court administrators, representatives of the codes community and standard-setting entities, government agencies, and others with an interest in the issues to be explored. Committee meetings are open to the public. Courthouse Access Advisory Committee Meeting: Allegro Hotel, 171 West Randolph, Chicago, IL August 4th, 9 to 5 pm August 5th, 9 to 3 pm For further information, contact Elizabeth Stewart [202/272-0042 voice, 202/272-0082 (TTY)]
Supreme Court Rules that ADA Covers Foreign Flag Vessels In June, the Supreme Court ruled in a split decision that cruise ships, including those of foreign registry, are covered by the Americans with Disabilities Act (ADA). The case, Spector v. Norwegian Cruise Line, involved claims concerning barrier removal and discriminatory policies by a foreign-flag cruise line. The Court ruled that cruise ships fall within the ADA's definitions of "public accommodations" and "specified public transportation." On the question on whether the ADA applies to foreign-flag cruise ships, the ruling opinion upheld coverage of the ADA to the extent that it does not interfere with the internal affairs of a foreign-flag cruise ship. For example, discriminatory practices such as charging passengers with disabilities higher fares and special surcharges would be barred under the ADA since they have no bearing on a ship's internal affairs. Other requirements of the ADA, such as removal of barriers to access where readily achievable, would apply only to the extent that a ship's internal affairs were not affected. The decision notes that barrier removal would not be considered "readily achievable" where it conflicted with international legal obligations or threatened shipboard safety.
The full text of the ruling and dissenting opinions
New Voting System Guidelines Released for Public Comment In June, the Election Assistance Commission published new guidelines for voting systems that are available for public comment for 90 days. These guidelines, once finalized, will be available for states to use on a voluntary basis in complying with the Help America Vote Act of 2002. This law was enacted to prevent the types of ballot controversies that arose in the presidential election of 2000 and calls for methods to improve the usability and reliability of voting systems used in Federal elections. The law ensures that voting systems and polling places are accessible to people with disabilities and also covers ballot verification by voters, language barriers, and provisional voting. The new guidelines contain specific provisions for accessibility, as well as voting system usability, security, and privacy. Specifications address access to voting equipment for all types of users, including those with vision impairments. The Commission will hold public hearings on the guidelines during the comment period. The guidelines were drafted by a committee comprised of voting system specialists, election officials, persons with disabilities, and other stakeholders and interests, including the Access Board. This committee was set up under the law to prepare guidelines for the Commission's review. Board members J.R. Harding, EdD and James Elekes, MEd, MPA/ CPM represent the Board on this committee and on the Commission's Board of Advisors.
The draft guidelines and instructions for submitting comments
Research Completed on Access at Vessel Doors with Coamings Results are in on a study the Board sponsored on providing access at doors on various types of passenger vessels. Conducted by the US Dept of Transportation, this project explored ways to provide access at vessels doors with coamings or sills, which are used to prevent water infiltration. The results provide information on solutions to this issue which will supplement the Board's work in developing new guidelines for passenger vessels. The study results provide data that can be useful to vessel designers, operators, and inspectors in improving disability access without compromising the vessel safety provisions of the coamings at weathertight doors. In Phase I of the project, researchers examined governing safety regulations and developed several case studies examining the design and regulatory review of weathertight doors on certain types of smaller sized classes of vessels. In Phase II, researchers explored technical guidance and design solutions for weathertight doors that meet both U.S. Coast Guard regulations and the Board's accessibility guidelines.
The project report, "ADA Access to Passenger Vessels: Finding Safety Equivalence for Weathertight Doors with Coamings"
Doug Wakefield, Board's Section 508 Specialist, to Retire Doug Wakefield, the Board's expert on accessible information technology, retired from government service at the end of June. Wakefield joined the Board in 1998 to lead its work writing new standards for electronic and information technology under section 508 of the Rehabilitation Act. This law, as amended, assigned the Board the task of issuing new standards for covered technologies procured by Federal agencies. After these standards were issued in 2000, he provided technical assistance and training on them, conducting numerous sessions across the country. He also oversaw the development of related guidance material and represented the Board at various interagency and international forums on section 508 and accessible information technology. Prior to his work at the Board, he provided consultation on accessibility for employees with disabilities at the General Services Administration's Center on Information Technology Accommodation and before that ran his own consulting firm which specialized in adaptive computer equipment. Access Board Training The Board regularly provides training and briefings on its guidelines and standards at various events across the country. Often, these sessions are part of larger programs organized by different groups and associations. Sessions can be tailored to focus on particular areas of interest, such as specific types of facilities or spaces. Training is available on new guidelines the Board issued last July for facilities covered by the ADA and the Architectural Barriers Act (ABA). While it will take some time before these new requirements become mandatory as standards under the ADA, new ABA standards covering most of the Federal sector will take effect later in the year. Training is also available in areas to be addressed by future guidelines, such as outdoor environments and public rights-of-way. Besides programs on its facility guidelines, the Board offers training on design criteria for transportation vehicles, electronic and information technology, and telecom-munication products. For further information or to arrange a Board training, contact Peggy Greenwell, the Board's training coordinator, at training@access-board.gov or 202/272-0017 (v) or 202/272-0082 (TTY). Training Calendar
"Access Currents" is a free newsletter issued by the Access Board every other month by mail and e-mail.
Subscribe to Access Currents
Send questions or comments or call 800/872-2253 ext. 0026 (voice) or 800/993-2822 (TTY). Mailing address is 1331 F St NW, #1000; Washington DC 20004.
Source: The Access Board - May/ June 2005. Airport Security Survey If you have a disability and have recently taken an airplane trip, the Transportation Security Administration (TSA) would like to know about your experience with airport security. We are trying to reach as broad a sector as possible. Please take a few minutes to fill out this survey. Thanks for your help.
Take the survey
In order to assist persons with disabilities or medical conditions, TSA has developed guidelines with input from various disability-related groups and organizations. We then trained our airport screeners in the methodology needed to ensure effective, safe, comfortable, dignified, and respectful screening at all TSA security checkpoints. From May 23rd through August 23rd, 2005, TSA will be conducting a Persons with Disabilities and Medical Conditions Customer Satisfaction Survey. Source: Maureen McCloskey, National Advocacy Director, Paralyzed Veterans of America, 801 18th St. NW, Washington, DC, 202/416-7696, 202/416-7706 (fax) Leadership Exchange in Arts and Disability Network conference The LEAD network conference and training, sponsored by the John F. Kennedy Center for the Performing Arts, heads to Arizona this fall. WHAT: Leadership Exchange in Arts and Disability (LEAD) Conference and Training WHEN: September 29 to October 1, 2005 WHERE: Mesa Arts Center and Scottsdale Center for the Performing Arts, Arizona BONUS: Pre-conference workshop intensives, September 28, 1 -5 pm. Who will benefit from this professional development? Accessibility Managers, Liaisons and Coordinators Auditorium, Box Office and House Managers Outreach and Education Coordinators Guest, Patron and Visitor Services Managers New and experienced ADA/504 Coordinators or Managers University and College ADA/504 Coordinators or Managers Museum, Theater and Arts Center Administrators Marketing/Audience Development Directors (Special pre-conference "Demystifying the Disability Market") Volunteers and Board Members Conference activities :
All this for a reasonable price! Nonprofit arts organizations, university/ college staff and public arts agencies attend for just $125; send two or more team members and registration drops to just $95 per person. Pre-conference registration packages and one-day discount passes are also available. For more information and an accessible registration form, call 202/416-8727(voice) or 202/416-8728 (TTY).
Conference brochure and registration form
Huge costs for parents of disabled It costs three times as much to raise a disabled child compared to a youngster without a disability, according to a new report. The financial burden or looking after a disabled child leaves many families in debt and living in poverty, according to the report Ordinary Lives. Report authors New Philanthropy Capital (NPC) estimated that 5% of all children in the UK - around 700,000 - are disabled. They said that the combination of inability to go out to work and the higher cost of raising a disabled child resulted in a disproportionate level of poverty and debt in these families. The report showed that 55% of families with disabled children lived at the margins of poverty - more than four times the proportion of other households. It also found that 84% of these families were in debt, compared to only 47% of all households. Figures show that it costs an average of #8,300 a year to bring up a severely disabled child. The report said that the minimum essential budget from birth to the age of 17 was approximately #143,000 - with the largest proportion being spent on transport. This is at least three times more than the amount required to raise a child without a disability, the NPC said. Martin Brookes, head of research at NPC, said: "This is a huge social problem and there are some relatively simple changes the Government could make to the tax and benefits system to alleviate the problem. But money is only part of the problem. Many of these families also suffer from stress and social isolation and this is where charities can play a valuable part." The NPC, which advises donors to charities on how to give more effectively, said the most valuable thing that charities could do was provide emotional support and the opportunity for carers to take a break. But it said these charities were in desperate need of more funding to allow them to support more children and their families. Source: Cardiff UK (icWales), 7/6/2005 75% Rule Will Force People with Disabilities into Nursing Homes By Peter W. Thomas, Esq. Two weeks ago, Secretary of Health and Human Services Michael Leavitt dealt a serious blow to the disability and rehabilitation community by deciding to move forward with implementation of the so-called 75% Rule for inpatient medical rehabilitation. It is unlikely that anyone other than rehabilitation providers noticed. But the fact remains that the 75% Rule and other potentially deleterious policies impacting medical rehabilitation, such as local coverage determinations and outpatient therapy caps, are combining to force Medicare beneficiaries and other people with disabilities into nursing homes and less intensive settings of rehabilitation care. This decision could deprive people with disabilities access to the most medically intensive and appropriate rehabilitation services and, over the longer term, cause decreased levels of function and independent living. This article is intended to raise awareness of this gathering threat to Medicare beneficiaries and all Americans who may need intensive rehabilitation services. By choosing to implement the 75% Rule as it currently stands, Secretary Leavitt and the Centers for Medicare and Medicaid Services (CMS) will require inpatient rehabilitation hospitals to have 75% of their patients fall into one of 13 diagnostic categories, such as stroke, spinal cord injury, or traumatic brain injury. Rehab hospitals not meeting these criteria will lose the higher payments from Medicare associated with a more intensive rehabilitation setting. The policy was originally intended to cut down on inappropriate admissions to inpatient facilities, but will almost certainly have another effect as well: denying access to medical rehabilitation in favor of cheaper, less-intensive settings like nursing homes. The current 75% Rule began to be phased in starting July 1, 2004, where the threshold for admissions meeting the criteria was 50%; in 2005 and 2006, the thresholds are 60% and 65% respectively, with the final 75% threshold becoming effective starting July 1, 2007. Rehab hospitals provide specialized medical rehabilitation for persons who have had a significant impairment of function as a result of injury, disease or condition, and/or recovery from surgery or medical treatment. They provide close medical supervision coupled with an intensive rehab program to restore health status, function and independence in the home and community. Care is provided in a specialized setting by a team of health professionals that specialize in the medical, social and psychological aspects of rehabilitation. When compared with skilled nursing facilities, patients in rehabilitation hospitals usually stay for shorter periods of time and have better functional outcomes, but at a higher overall short-term cost. With dollar savings in mind, HHS is limiting the vast bulk of rehab hospital admissions to 13 categories based on medical condition so that, ostensibly, patients are not admitted if they can arguably receive their rehabilitation in a nursing home or other less intensive setting. The 13 conditions, however, fail to account for many patients who would clearly benefit from medical rehabilitation, have better outcomes, and ultimately go on to lead more independent lives in the community. The practical impact of the current 75% Rule is that people with disabilities will be admitted to inpatient rehab on a quota system. Rehab hospitals that are close to the quota will have their hands tied and will be unable to accept patients who may be clearly in need of intensive rehab but do not qualify under one of the 13 specified conditions. Though the conditions listed in the rule appear, at a quick review, to be an appropriate listing of conditions that encompass a broad enough spectrum to satisfy the 75% Rule, there are many examples of patients who will be excluded from admission to a rehab hospital under the current rule. Cancer patients undergoing chemotherapy can improve both motor and cognitive function. Patients who have undergone extensive cardiac surgery are scientifically documented to have decreased mortality, improved quality of life, and lower costs from cardiac-focused inpatient rehabilitation. Pulmonary rehabilitation stays as brief as 10 days have been shown to improve exercise tolerance and abnormal breathing relative to their condition. And very few people requiring joint replacements will be permitted access to the rehab hospital. The rule, however, has a trickle-down effect that restricts access to inpatient rehabilitation care for all people with disabilities. Simply explained, the 75% Rule is a classification tool for CMS to determine which hospitals treat typical rehabilitation patients and, therefore, deserve higher payments. The rule was never intended to assess the appropriateness of inpatient rehabilitation for specific patients. But the current 75% Rule operates as a medical necessity tool so that specific patients are being denied admission based on their diagnosis, not based on their need for intensive rehab care. Practically speaking, rehab hospitals are being forced to manage the mix of the patients they treat based on a payment rule rather than clinical judgment or rehabilitation need. The rule further creates a situation where access to inpatient rehabilitation is largely dependent upon the point in time that a patient arrives at the hospital, not whether that patient needs to be admitted. So the same patient might be admitted in September but not in March, depending on how many other patients a particular hospital has treated whose conditions may not be listed under the 75% Rule. Many Medicare beneficiaries are currently being denied access to inpatient rehabilitation, rehab programs are being curtailed, and rehab hospital closures will begin to occur soon. Rehabilitation provider capacity is being seriously degraded at the very time that demand, through the baby boom generation, is increasing. More people with disabilities will be going without inpatient rehab and being sent to nursing homes, outpatient therapy, home health care, or nothing. Although inpatient rehabilitation generally does cost more in the short term, a shorter length of stay and a more intense rehabilitation program usually produce better outcomes, which results in long term savings. The Problem Will Get Worse Before it Gets Better The 75% Rule will create greater restrictions in the coming years as the rule phases in and more and more rehab hospitals are forced to admit fewer and fewer patients, sending many people with disabling conditions into nursing homes and other less-intensive settings of rehab care. The impact on access to intensive rehab treatment could genuinely harm people with disabilities seeking to become as independent and functional as possible. This issue is not going away any time soon and legislative action may be the only solution. Training for Parent Leaders Do you want to inform parents about their rights under Special Education Laws? Do you want to help parents participate effectively in their child's IEP meeting and other special education meetings? Do you want to teach parents how to become effective advocates? Do you want to provide Special Education rights training to your own parent/community group as a volunteer trainer? The Family Resource Center on Disabilities' Parent to Parent Training Program will provide advanced-level training in 1) Advocacy & Negotiation and in One to One Assistance on August 13th; and in Outreach & Publicity and in Training & Communication on August 20th. The programs run from 9:30 am to 3:30 pm at FRCD's office at 20 E. Jackson Blvd., #300 in Chicago, IL 60604. The $10 fee includes lunch on both days. Participants who complete the training will receive free materials on the IDEA Rules, How to Organize an Effective Parent/Advocacy Group and Move Bureaucracies, and How to Get Services by Being Assertive (both published by FRCD), and other valuable materials. To participate in this workshop, you should have a basic knowledge of Special Education and be willing to be a volunteer trainer for at least one Special Education Rights training seminar for other parents in your community or at FRCD. Source: Family Resource Center on Disabilities, 312/939-3513 (voice) / 312/939-3519 (TDD). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
