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Avaleht / Albumid / Märksõna HCFA - Health Care Finance Admin. 4
ADAPT (628)
Edition USA/Colorado ADAPT seeks home care for all by Kerri S. Smith A national disabled persons’ advocacy organization based in Denver has launched a campaign aimed at moving people from nursing homes to home care. American Disabled for Attendant Programs Today (ADAPT) has at short-term goal: to re-direct 25 percent on the government's annual nursing home care budget. That money—estimated at $5.5 billion federal money and $5.5 billion from state coffers-would fund a national home care program instead. Under the ADAPT proposal, nursing home residents whose care is covered by Medicare or Medicaid could live at home. The government would pay home are attendants to care for them, rather than paying the facility. ADAPT spokesperson Mike Auberger said the group seeks “the ultimate demise of the nursing home system," and contends that paying an attendant to provide home care for a person usually costs less than nursing home care. In theory, the ADAPT plan would spend government money more efficiently-the same money would be used to care for more people who need assistance. The government is not enthusiastic about the idea, and a local nursing home industry spokesperson said ADAPT's demands are unrealistic. Auberger said Health and Human Services secretary Louis Sullivan declined to meet with ADAPT representatives. "We've been going back and forth with them, and the outcome is he doesn't meet with radical groups," Auberger said. And Arlene Linton, executive director of the Colorado Health Care Association (CHCA), said moving nursing home residents out of facilities “would isolate many of them from the community. “They'd also be without the 24-hour-care and rehabilitative services provided in nursing homes," Linton said. CHCA is the local branch of the American Health Care Association, which represents the nursing home industry. Linton added that ADAPT "is talking dollars, not people. Some residents have outlived their family and friends, and need the support a nursing home offers." A national campaign to publicize ADAPT's proposal began Jan. 15. Members demonstrated at government offices (including Health Care Financing Administration offices) and nursing homes in 24 cities. Auberger said media coverage was minimal, due to the Persian Gulf Crisis. Locally, ADAPT representatives demonstrated in Lakewood at Bethany Care Center. In the mid-'70s, the facility was operated by different owners and was known as Heritage House. Conditions at that time sparked a 13-year lawsuit over nursing home residents’ rights. The Federal Omnibus Reconciliation Act (OBRA) of 1988 also addressed quality of life issues for nursing home residents. The bill became effective Oct. 1, 1990. ln 1974, former Heritage House residents joined with Denverite Wade Blank and others to form the Atlantis Community, a local home care agency that currently cares for 135 people in Denver and Colorado Springs. Later, Atlantis Community leaders founded ADAPT. The group mobilized the civil rights movement for disabled persons, and ultimately affected the way nursing homes are inspected and regulated nationally. Auberger claims many current nursing home patients don't require intensive medical care, and "end up there only because they're out of money or their families can't care for them." Linton said CHCA met with ADAPT representatives twice to discuss the attendant proposal, "but they rejected our request to form a task force to find common ground." While Linton endorses home care as “a part of the long-term care continuum," she called the ADAPT proposal “robbing Peter to pay Paul. "We cannot support the concept of lowering funding for nursing home patients, to set up another funding to attendant services," Linton said. “We need new, additional funding for that." Recent federal budget cuts may make additional funding unlikely, at least in the near future. Atlantis and ADAPT are determined, however, and they are prepared for a long campaign.
ADAPT (641)
DISCLOSURE JULY-AUGUST I991 From Coast To Coast ADAPT Battles For Home Attendant Care by C.I. Zander Photo by Tom Olin: Two protesters in wheelchairs curl forward with arms raised to their faces as police or security tip them back on their back wheels. The person in the front (possibly Barb Guthrie) has a bumper sticker on the side of the chair that reads "I support my country." Capiton reads: ADAPT protestors being removed from HHS entrance in April action. “Almost everywhere we go, we meet somebody who has a friend or relative who's disabled — a brother, a cousin, a father or mother. That's why people support us. That's why they believe in what we are doing." Danny Saenz of ADAPT (American Disabled for Attendant Programs Today) was talking about the recent string of direct actions which has taken them from Baltimore to Washington to Dallas to Chicago and back to Washington again. ADAPT's primary issue: put Medicaid money into direct home attendant care of the disabled and get them out of nursing homes. ADAPT 's primary target: HHS Secretary Dr. Louis Sullivan, also known as “Lonesome Louie" and “Dr. No" because whatever ADAPT asks for, he refuses. “All we want is a meeting. . ." “All we want is a meeting," says Saenz, who is from the Austin, Texas ADAPT chapter. “But he always finds some excuse.” Tom Olin of Tennessee Adapt adds: "When we were in Washington recently, we thought that we had a meeting with Sullivan. But HHS went back on their word. So we closed down their building." Adapt members blocked the exits of the Health and Human Services building and forced guards to close it down for two hours on June ll. Police were reluctant to make arrests not only because it is bad publicity for them to be seen carrying off the disabled but also because most police stations do not have adequate care facilities. Tuesday, June 11, may go down as the biggest day in ADAPT's history for more reasons than the shutting down of HHS. Members began early at the American Health Care Association Convention where Sullivan was scheduled to speak. AHCA is a particularly galling organization to ADAPT because it is a lobbyist for the nursing home industry which receives billions in federal and state money for healthcare that ADAPT leaders describe as "inadequate," “wasteful” and “sometimes criminal." ADAPT estimates that over 1.5 million disabled could be moved from nursing homes to attendant home care if the Medicaid benefits were the same or comparable. Getting To Sullivan Although many ADAPTers got into the Hyatt Hotel where the AHCA convention was being held, security forces were able to head them off and lock the auditorium where Sullivan was scheduled to speak. All except for one person. She was able to sneak in and got down to the front of the room in her wheelchair. When Sullivan started his lecture, she also began speaking and gesturing to the audience, asking why Sullivan supported the agenda of nursing homes instead of the agenda of the disabled themselves. Several security police carted her off but ADAPT had, once again gotten Sullivan's attention. Eventually, Sullivan snuck out of the hotel, reputedly through the back kitchen entrance. But, even then, several ADAPT members caught up with him at his expensive limo and shouted their demands for a meeting at him as he drove away. Then ADAPT moved over to the HHS building where they blocked entrances and closed doum the building for a few hours. As National People's Action had done on their April visit, a few people got past the guards to some upper floor offices. But, of course, Sullivan was “not there." To cap off the day, ADAPT met with Senator Kennedy's staff to talk about the proposed health care bill. “We called for a meeting when we were here before in April," says Olin. “But they said they didn't know who we were. So we told them to just watch the news on TV and they’d see us.” What Kennedy’s staff and many other Washingtonians saw on TV then were another two direct actions which included blocking the HHS parking lot and the busy Baltimore intersection in front of the Social Security and Health Care Funding Administration building. ADAPT members said they wanted to illustrate what happens when they are locked in nursing homes. “It’s the same kind of feeling —— you can't leave when you want to. You need my permission," said Mike Auberger of Denver's Atlantis Community afterwards. “I’m sympathetic. . ." "I'm sympathetic to all these folks not able to get home, but this is a really minor inconvenience compared to the inconveniences suffered by those in nursing homes," said protester Nate Butler. A Washington Post photo showed ADAPT members lying down in front of police cars in a scene reminiscent of civil rights demonstrations of the 1960s. Some federal workers were irritated but many expressed sympathy for ADAPT’s views. Other ADAPT actions this spring included cornering Sullivan in Chicago on May 14 and, again in Dallas on May 22 at the President's Committee on Employment of People with Disabilities Conference. ln Dallas, according to the June issue of Incitement, ADAPT’s national newsletter: “(Sullivan) began his talk, and, slowly and silently, one by one, ADAPT members dropped to the floor and began crawling toward his podium, waving the proposed meeting dates in the air. Though he tried to ignore us, Sullivan stumbled over his words several times. in the end, a sea of bodies lay on the floor before him. . -" Sullivan's staff repeatedly says they won‘t meet with "radical" `groups`, but ADAPT leaders believe that this is just an excuse to avoid them. They note that Sullivan has plenty of time to meet with big money `groups` and lobbyists but that he ignores community-based `groups` whether they are "radical" or not. One of ADAPT's strongest arguments for reallocating Medicaid nursing home funds to a home attendant care system is financial. Leaders believe that, in the same way that health insurance administration costs eat up money that should go to the people who have the medical problems, nursing homes end up making large profits while the disabled suffer. Auberger says that nursing homes’ care costs are in the range of $30,000 to $60,000 a person a year but home care is in the $15,000-30,000 range. Auberger himself receives home care that averages about $2,000 a month. "Not only is it cost effective," he concludes, “it‘s the right to dignity and freedom of choice." The bottom line for ADAPT is the redirection of 25% of the $23 billion that Medicaid currently spends on nursing homes to community-based attendant services programs. While some states have adequate home care services, most do not. So ADAPT believes the primary change must come through the allotment of federal funds. “The nursing home industry is a billion-dollar industry — they give political contributions to politicians who protect their interests," says Lillibeth Navarro, an ADAPT member from California. “This is going to be a difficult struggle. But because our cause is right, because it touches practically everybody, we will prevail." For more information on ADAPT programs, call 303 733-9324 in Denver, or S12 4420252 in Austin, Texas.
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TUESDAY April 30, 1991, THE SUN, BALTIMORE, MARYLAND VOL 308, NO. 141 Photo by The Sun, Bo Rader: A line of people in wheelchairs (and two people standing with them) sit facing forward and sideways across a road. At least four lanes of traffic are blocked behind them as far back as you can see. Group includes Dennis Schreiber from DARE in Chicago, Albert from Long Island, possibly Barb Wesolac in the pink jacket, and Pat Puckett in a green jacket. Caption reads: Disabled protesters stop traffic. More than 125 handicapped activists blocked traffic at the intersection of Security Boulevard and Woodlawn Drive in Baltimore County for more than three hours yesterday afternoon to demand more funding for at-home care for the disabled. The group plans to resume its protest today at the Health Care Financing Administration in Woodlawn. (Article on Page 4D]
ADAPT (671)
Photo by Tom Olin: A woman with thin arms (Diane Coleman) sits holding a sign that reads "attendant services not lip service" and she looks off to her right. Her head is about waist height to a beefy police officer who stands looming beside her looking down with a hostile expression, his had on his hip. Behind them is some kind of barrier and a couple of other protesters. [This article starts on ADAPT 694 and continues on 678 and 670, The entire text of the article is included here for easier reading, but descriptions of the pictures are included on the pages the pictures appear on. 694 is just a picture and the headline of the story.] Title: ADAPT Activists and nursing home operators face to face: We will not stand for it any longer. Let our people go. You operators want to pretend it’s complicated. You raise a-lot of pseudo-issues to disguise the fact that it’s all about your money and your power. You want to pretend you’re trapped in this business, that union contracts prevent such and such... that legal liability prevents so on and so forth... We don’t want to hear any of that. It’s not complicated. It’s very simple. You will let our people go. >> We were arrested the first day, lots of us. They never expected us to come close to their hotel, the place where members of the American Health Care Association were staying while they held their convention across the street. Yes, they knew we were coming to Orlando. They briefed the locals, had the police waiting. So it was all set up in advance, cops on the rooftops, a police booking operation in the basement of the convention center. They were all set to cage us up for daring to interfere. They thought they had it covered. They were smugly going about their business, expecting only a minimum of trouble for a couple of hours. The intensity there — anyone driving by could feel it. The tons of security, the A.C.H.A. people retreating inside the hotel, aghast. It was like: “How dare they spoil our party!” The first wave of arrests was meant to stop us at all costs, keep us out of the convention. That first day, they thought they’d arrested all the “leaders.” But with ADAPT, when folks get arrested, other folks fill in and we just keep going. We will not be moved. It was our intent to send the message that nursing homes have one and a half million Americans locked up. We want the nursing home operators to be publicly accountable for that. Here we are, people who look like the folks the operators lock up at their home facilities. They’re on vacation, but they can’t escape. We are people with disabilities. We are everywhere. The operators were inside having seminars on how to manage the disruptive patient. We were outside holding a seminar with the press on the economics of managing people in nursing homes. Every place the A.C.H.A. people went they had to confront ADAPT people who had been in nursing homes. They can talk all they want about how homelike it is. We know better, firsthand. We are focusing the attention of the Bush administration through U.S. Health & Human Services Secretary Louis Sullivan and the whole Health Care Financing Administration. We are focusing public attention on the nursing home operators, the nurses, the families, everybody who had anything to do with our people being locked up. This will be a long struggle; we’re prepared for that. Five or ten years, a long struggle. Unless people like ADAPT are willing to stay focused and targeted, people in nursing homes and state schools are going to be forgotten all over again. We may not win at every action, but we will win the cumulative victory. We make people think about nursing homes. They don’t want to think about that. Put them away, put it out of mind, put it somewhere else. I want to say to people who say they don’t like ADAPT tactics: Do you really want our people out? Or are you sitting home saying, “Oh, those nursing homes shouldn’t do that!” How many people are going to get free because you hold that opinion? What are you doing about it? People are turned off by the arrests, by our confrontational style. “I’m not going to do ADAPT-style confrontations” — we hear that a lot. If you don't want to be on the front lines but you do want to help, there’s plenty to do: raising dollars so we can get to our actions, working with people in your community to make these issues known, forming your own group, bringing some attention to the issues in your own home town. We sure would welcome your help. ADAPT puts the edge on it, sets the margin. This is as far as we go, this is all we will take. We will not be moved. This article is taken from a conversation with Bob Kafka of ADAPT in Austin. The photographer is Tom Olin of ADAPT in Cumberland Furnace, Tennessee. You can reach ADAPT people at either of these telephone numbers: Colorado 303-733-9324 Texas 512-442-0252