Living Independently

This past August 17, Dr. Sanjay Gupta, the chief medical correspondent for CNN, described the Community Choice Act as making hospitals accessible for wheelchairs. What has really angered activists that have worked since 1990 for this progressive idea to our Medicaid system is that Gupta, rather than being silent about what he knows nothing about, filled CNN air time with misinformation.

If you did have to give a sound byte on CCA, it would be “Medicaid reform to end the institutional bias.” It is almost more intriguing how Sanjay Gupta came up with his mischaracterization, but since August 17^th ADAPT has waited for a correction.

ADAPT assumes the reason CNN pays Dr. Gupta so much is because they expect him to clearly understand issues dealing with health care in the US. Last summer, when Americans were working diligently to understand the components of the health care reform bill Gupta’s comment to “make hospitals accessible for wheelchairs,” shows a clear lack of analysis in his specialty.

ADAPT has created a video basically asking Sanjay Gupta and CNN’s Vice President for Legal affairs, David Vigilante, to do their jobs. If American’s are to trust CNN and Gupta, they must recognize when their work has failed or analysis is poor. ADAPT is asking that on April 1^st, you call David Vigilante and ask him to keep his promise of an on-air correction. CNN will be on all day today, and on April Fools’ Day. Can you trust CNN?

ADAPT video (cc): http://www.adapt.org/freeourpeople/atlanta09/gupta/gupta10g.swf

David Vigilante

david.vigilante@turner.com

404-827-2600

ADAPT, Around the country, System Change ADAPT, Video

Randy Alexander of ADAPT

It didn’t start out as part of the new Health Care Reform Bill, but for years ADAPT has worked to end the Institutional bias in America’s Medicaid system. ADAPT activists across the nation are celebrating the Community First Choice Option that is part of the Health Care Reform Bill that Congress passed Sunday March 21.

Twenty years ago with the signing of the Americans with Disabilities Act, ADAPT activists began to work to end the Medicaid bias that supported facilities and institutions but failed to help someone to stay in their own home or live and work in the community. Early on ADAPT called to redirect 25 percent of Medicaid funding away from institutions for support at home. In 1996, when 90% of Medicaid was funneled into expensive nursing homes, ADAPT engineered Newt Gingrich, then the House Majority Leader to introduce the Community Attendant Services Act, CASA.

A few U.S. states understood the logic and cost savings of the idea and begin to offer more home and community based services through state waivers of the federal Medicaid requirements. Rather than channeling all the federal funding into the for-profit nursing home industry, some progressive states “waived” the institutional requirement and provided home and community based services that allowed people to stay at home at a much lower cost to the state.

ADAPT worked for national legislation and Sen. Tom Harkin introduced MiCASSA, the Medicaid Community Services and Supports Act, to finally give Americans a real choice to live in their own home. While many states inched into providing more waivers, the nursing home industry blocked the national legislation to hang on to as much of the public funding as possible. With a nursing home in every county in the US, the institutions, money and old-boy lobbyists were able to prevent Americans from having choices in long-term Medicaid.

But in 2003 following ADAPT’s Free Our People March from Philadelphia to Washington DC, the Queen Mary began to turn. States were offering waivers for about 30% of long-term Medicaid care, and state budgets were reflecting the savings. Congress adopted “Money Follows the Person” legislation in 2006 that took the funding section of MiCASSA and gave incentives for states to provide home and community options to expensive institutions.

Nadina LaSpina of ADAPT

ADAPT’s work is not done. Federal law that requires equality is just not enforced, mostly the 1999 Supreme Court Olmstead decision. This ruling reinforced the fact that inappropriate institutionalization was discrimination; a type of discrimination unique to people with disabilities.

ADAPT has begun the Defending Our Freedom Campaign to make the federal government responsible for enforcing our rights. The Defending Our Freedom also asks grassroots people with disabilities to document their struggles to secure home and community based services.

Defending our Freedom Blog.

Around the country, System Change ADAPT

Rollie Heath at the Boulder town hall meeting

Last week at the Rollie Heath town hall I had a chance to ask for his support on the payday loan legislation HB 1351. His response in short was that he agrees with the spirit of the legislation and would like to end the “churning” of payday loans; however, “the payday credit rate,” he said, “is just too low at 36% for the business to exist in Colorado.”

Sen. Heath obviously believes that some “payday industry” should exist in our state and the industry has convinced him that they cannot continue to provide credit with a 36% cap on annual interest. Many people do believe that there is a social need, as well as a reasonable market for small short-term loans. Some see the 36% cap on payday loans as destroying the industry in Colorado, because no business could effectively service a small loan for that amount of money.

One of the differences in a payday loan is that the borrower does not have the option to pay down the principle. If you got a two week loan of $500, you would have to pay $575 two weeks later. There is no option to pay a portion of the principle to decrease the percentage owed. Likewise, to get around offering people a payment plan as the Colorado legislature intended, an individual is allowed to immediately take out another loan at the same amount. The result is that the two-week, short-term loan turns into a high-interest long-term loan. Many people, unable to pay the entire principle, end up paying the payday industry much more to service the loan than the value of the loan.

While most people would say that the payday spiral is bad, it is open and borrowers know what they are getting into when they get a payday loan. They argue that although it is not good practice, it obviously fills a needed gap in credit that is not provided by traditional banks and credit unions. At the hearing two weeks ago in front of the house judiciary committee, opponents of HB 1351 highlighted the jobs that could be lost because of the bill.

It was the CPWD, Bridges out of Poverty group that noticed the harmful impact of payday loans. By focusing on the interest rate, the Colorado legislation has missed the trappings of the payday loan industry that the CPWD group found most troubling. It is not the rate, but the payday loan practices that make the industry a detriment to our community and stagnates low-income residents move from poverty. Over three-quarters of the loans are “churned” or created by the payday loans themselves.  Moreover, the borrowers’ inability to pay down the principle makes the payday loan a reoccurring two-week barrier to real credit for people who need a short-term loan.

Before the Colorado legislation that deregulated lending and created the current large payday industry in Colorado, there were some short-term loans in our state. What Senator Heath points out is that there is a need for these short-term loans, and fixing the interest rate does not fix the troubling payday loan practices. Without addressing the problems of payday loans, the legislation does not seem to have strong support and will likely not get through the Colorado Senate as it stands now.

The Boulder town hall

- Tim Wheat

System Change Payday

Tomorrow the Colorado Statewide Independent Living Council (SILC) is meeting to work on the Statewide Independent Living Plan, Colorado Issue Briefs and typical statewide business that effects people with disabilities in Colorado. The Colorado Statewide Independent Living Council is a body that is appointed by the Governor to orchestrate the vision of Independent Living services for all Coloradoans with disabilities. The meetings are open to the public.

The Agenda and location of the upcoming SILC meeting.

Colorado SILC Members 2008

The Colorado Statewide Independent Living Council collaborates to foster systems change by responding to issues from the disability community. The SILC promotes respect for independence and self-determination resulting in full inclusion of people with disabilities as equal citizens of Colorado.

Currently there are 10 Centers for Independent Living (CILs) around the state. The Center for People with Disabilities is one of about 400 Independent Living Centers nationally. The SILC website has a county by county breakdown of service areas on a Colorado map. Map of Colorado Independent Living Centers.

The SILC works with the Independent Living Centers and the Colorado Division of Vocational Rehabilitation to develop and write a three year plan of goals for increasing access and independence for people with disabilities. This plan, called the SPIL, is submitted to the Rehabilitation Services Administration (federal government) and it details how funds will be distributed and services will be provided through Centers for Independent Living in Colorado.

The Colorado SILC has begun a series of “Issue Briefs” describing what it means to have a disability in Colorado. The Issue Briefs take advantage of current state survey information to show how disability impacts things like employment, health care and emergency planning in Colorado. SILC Issue Briefs.

SILC website: http://www.coloradosilc.org/

Colorado Independent - newsletter: http://www.coloradosilc.org/admin/cindex.htm

The current Colorado State Plan for Independent Living: http://www.coloradosilc.org/resources/orientation/spil08.pdf

-tw

Around Colorado, Independent Living SILC