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主頁 / 相冊 / Washington DC, Sept. 2006 25
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Tennessee Needs The ... Community Choices Act of 2006 In Tennessee, facilities receive the lion's share of the long-term care budget. Washington, the state next to Tennessee in total population, has state waivers that provide citizens with Home and Community Based Services rather than forcing them into costly institutions. [ADAPT logo] The nursing home industry dominates long-term care funding in Tennessee resulting in poor care to fewer people at a greater public cost. Washington, with a much smaller federal Medicaid match serves over 70 thousand people with its long-term care Medicaid program, most in the community. Tennessee serves fewer than 40 thousand and almost exclusively in expensive and undesirable institutions. www.adapt.org
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[Headline] ADAPT Has Victories with Initial HUD eeting By Cassie James After our month long campaign to get HUD Secretary Jackson to live up to his previous commitment to meet with ADAPT regarding the ACCESS ACROSS AMERICA proposal, 15 ADAPT representatives met with HUD Secretary Jackson on Monday May 15, 2006. The feel was positive after the meeting, with Jackson, three of his Assistant Secretaries and several other key HUD staff. The three areas Secretary Jackson agreed to are important steps in moving forward on implementing ACCESS ACROSS AMERICA. Jackson agreed to: 1. Send a Secretary Directive encouraging Housing Authorities to help with Money Follows the Person. 2. Host a meeting with CMS and ADAPT at the table so we can assure we are all on the same page in this goal and moving forward on areas that are in our power to help create this pool of vouchers. 3. Meet with ADAPT three times a year to discuss progress on ACCESS ACROSS AMERICA and other issues such as the modification program that could help modify existing units for people with disabilities. ADAPT Power! If we continue the pressure with congress, HUD, and CMS we can make this happen!
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[Flyer with text 'The crime of disability' and a drawing of a person holding onto bars on a window, and with their left foot chained to a ball in the corner. Text on the bottom reads 'If being old and disabled isn't a crime, why are more than three million of us locked up?']
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[Headline] Catholic Entities Back Bill To Help Disabled Avoid Nursing Homes WASHINGTON (CNS) The U.S. Conference of Catholic Bishops and two other national Catholic organizations have backed proposed federal legislation that would enable many people with disabilities to live in their communities instead of in nursing homes. The legislation would help those with disabilities use Medicaid resources to choose independent living, with reliance on community-based services, over Medicaid-funded institutionalized care. In a joint letter to key House and Senate sponsors of the bill, the heads of the USCCE Committee on Domestic Policy, the Catholic health Association of the United States and the National Catholic Partnership on Disability urged passage of the Medicaid Community-Based Attendant Services and Supports Act, known as M3CASSA. "With the services that MiCASSA would make available, more people with disabilities will be able to move from institutional care to lives of independence in their communities," the Catholic leaders said.
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[Headline] Money Follows the Person By Stephanie Thomas November 1st was the deadline for states to apply for the federal Money Follows the Person Rebalancing initiative. It's our understanding 37 states applied. Grants, totaling $890 million, were awarded to 17 states in January 2007: AR, CA, CT, IA, IN, MD, MI, MO, NE, NH, NY, OH, OK, SC, TX, WA, WI. Twenty one other states have been asked by the Centers for Medicaid and Medicare Services, CMS, to clarify how their plan to rebalance long term care with their proposals. CMS is taking the rebalancing part of this initiative very seriously. The Congressional Budget Office (the same office that gave MiCASSA such a lousy cost estimate) estimates 100,000 people will get out. We should celebrate gaining movement toward real choice and community services. Money Follows the Person has the opportunity to being to tear down the walls of the institutional bias. States could see they can give flexibility so people have real choice in where they get their long term care, and it doesn't have to cost more money overall. So what now? Well, there is more we can do make use of the momentum we have going. First of all, if your state didn't apply this is an excellent opportunity for an Olmstead suit. They've had years to get it together and now the Feds have handed them a great tool to give people choice. If they couldn't even be bothered to apply there is real argument that they are not even trying to do what the Supreme Court said. Start identifying people who want out. Challenge your state to get them out. If your state didn’t apply, or did not get a grant, now is the time to actively remind them that you don't have to have this grant to do MFP. There is not any reason they cannot move the money from the nursing home / institution to the community under the current rules and regulations. States can and are doing it with no federal assistance! Targeted Case Management (TCM) is a Medicaid program that can be used to pay for identifying and coordinating services for folks transitioning out of institutions. This is a link to a good article on TCM: http://www.hcbs.org/ files/ 29/ 1440/ targeted-casemanagementSPAO41404.doc As former CMS Administrator said about MFP: "States have NO MORE EXCUSES.” Second, if your state GOT a grant but you aren’t crazy about the whole plan, don't worry. This is round one. MFP is definitely made for a "do it, fix it" approach. Once states are approved they have to do something called a Demonstration Operational Protocol (DOP) Basically, it's a more detailed plan of how the state will use the grant. (Hint: it's also a plan of how they can make MFP an ongoing part of long term care.) They won't get their grant money unless their plan is approved by CMS, and they have 3-12 months to do it in. It has to include all policies, operating procedures and an evaluation plan. CMS is encouraging states to have all the stakeholders (this means you too) to be involved, and section 6071(1) of the Deficit Reduction Act requires it. For more information on the DOP you can go to the CMS website or email: bob.adapt@sbcglobal. Let's celebrate MFP as a real advance in freeing our people. Then let's put it to good use. And of course we must renew the push for MiCASSA: The Community Choice Act.
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[This page continues the article from Image 1669. Full text is available on 1669 for easier reading.]
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[This page continues the article from Image 1669. Full text is available on 1669 for easier reading.]
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"It was obvious that HUD was making a decision not to send a letter as they promised," said Randy Alexander of Memphis. ”Jackson said they would inform Housing Authorities about setting a priority [for people leaving institutions], and the only reason for a delay seems to be that they now do not want to simply write the letter.” Ten minutes after leaving the "ADAPT Hotel," activists marched three blocks to the front of the menacing HUD building entrance. A delegation led by Jose Lara, Barbara Toomer and Bruce Darling of ADAPT was quickly led inside to negotiate, while hundreds of activists chanted and sang non-stop in the rain. The ADAPT team soon walked out of the meeting when the bureaucrats were not receptive. But the Assistant Secretary Kim Kendrick apparently did not want to see how the mass of ADAPT would react to the news; a second round of discussions was arranged with HUD. "We told them that we have been waiting for so long for the letter, and they were not going to do anything,” said Jose Lara of El Paso. "So we decided to leave. That was when they said ‘No, no, wait. We can deliver the letter.'” ”The Deputy Secretary came out to talk to us and said the letter would be there November first,” said Barb Toomer of Utah, who negotiated with HUD. "So, you know, if you trust them, the letter will be here. If things go the way have in the past, the letter won't be here and next time the letter doesn't come, it ain't gonna’ be much fun.” Shortly after HUD submitted, ADAPT was back in line and in the streets, headed east to the RNC headquarters. Soaked but invigorated by the success, Cassie [unreadable] of Philadelphia summed up the experience with HUD: "Well, I think we got the slow wheels of HUD turning again - I think it is ADAPT that keeps everything moving. They said HUD would put out the letter, but they couldn't get it out very quickly. But we upped the ante, and now the letter will be out in November." [Subheading] Day Five: Friday, A Diary of ADAPT’s visit to legislative offices. I wake up startled just after 8:00 am. I am still groggy from staying up so late and from the general exhaustion from the ADAPT Action yesterday. The alarm did not go off, and my girlfriend did not call; I guess I just got up because I did not want to miss any of the action. To get to all of the congresspersons offices, ADAPT had split up into groups of about 50 and spread out to the various security checkpoints at all of the House and Senate Office buildings. Once inside, the [image] [image caption] Teams gather in the Hart Building. Photo by Tim Wheat [text resumes] to the hotel conference room where the Full ADAPT contingent was gathered to announce that CPD would write a letter supporting the Medicaid Community Attendant Services and Supports Act (HR. 910, S 401.), ADAPT’s primary federal legislation proposal known as MiCASSA, and send it to all the bill’s co-sponsors. Day two was more of the same, with a long, slow march in a steady drizzle, the battle cry of ‘Go, go, go." and the stampede into the ornate lobby of the Capitol Hilton hotel. To my left was a potted fern and to my right was a mahogany colonnade supporting the mezzanine terrace from which worried men and women in business suits looked down on the packed lobby. Some of us wore cow costumes to add theater to the chant “WERE NOT YOUR CASH COW!" This time, ADAPT demanded a meeting with America’s Health insurance Plans CEO Karen lgnagni. AHIP, the trade association tor many of the nation’s managed care organizations, was targeted because as states start handing over long-term-care programs to private managed -care providers, quality and eligibility standards might suffer. ADAPT wants private insurers to guarantee that, among other things, people with disabilities wilI be offered self-directed community-based services as the first long-term-care option. After about two hours, ADAPT leader Mike Oxford read over a bull horn a letter signed by lgnagni agreeing to meet within 30 days. The day-three march was much shorter and wetter, culminating at HUD headquarters. Below the we come sign above the front door, a line of stern-looking guards stood behind yellow police barricade tape. Two ADAPT leaders were allowed to enter and meet with Assistant Secretary for Fair Housing and Equal Opportunity Kim Kendrick. hen AD PT leaders met with HUD Secretary Alphonso Jackson in May, he agreed to write the nation’s Public Housing Authorities, asking them to designate a number of Section 8 housing vouchers for Medicaid-eligible persons leaving she ters, nursing homes and other institutions. But the letter was never sent. Kendrick promised to get the letter out by November 1st. The marchers then continued to the headquarters ot the Republican National Committee, where people in wheelchairs occupied nearly every square foot of the lobby and spilled out onto the porch and sidewalk outside the entrance. After about an hour, ADAPT received a commitment in writing for a meeting before the end of the year with Ken Mehlman, the RNC chairman. ADAPT wants the RNC to endorse MiCASSA and Access Across America. The next night, at the final large group meeting, it was announced that the youth leaders had received a return call from Jim Ailing, president of U.S. operations tor Starbucks. According to youth summit organizer Sarah Watkins, the group received an apology and an offer to work with Starbucks‘ access specialists to address problems at the local store and others in the franchise. After meeting with ADAPT, NCPD sent a letter supporting passage of MiCASSA to the co-sponsors in both the House and Senate. ADAPT got a commitment from Kim Kendrick, HUD’s assistant secretary for Fair Housing and Equal Opportunity, to make sure her boss, HUD Secretary Alphonso Jackson, keeps his promise to contact the PHAs about designating Section 8 vouchers for Medicaid-eligible people With disabilities who are coming out of shelters, nursing homes and other institutions. ADAPT conducted their first youth summit, prior to the ADAPT action and put emphasis on this area throughout the Week. Furthermore, there were many notable young advocates that attended the action. A fax was sent by ADAPT, thanking Republican National Committee Chair Ken Mehlman for passing MFP, While also occupying the GOP offices to get a meeting with him. ADAPT Wants Republican support for two additional measures that will assist states in successfully implementing MFP, namely Access Across America, the housing initiative that Will assure that people with disabilities have adequate housing as they leave nursing homes, shelters and other institutions and MiCASSA, which would remove the institutional bias from Medicaid.