Did everyone survive April Fools Day?  I didn't.  Got to the the T on Friday and realized I left my glasses at home.  Walked back up the hill, into the house....and felt the glasses in my pants pocket.  Getting old is tough.

Following this theme I'm going to direct your attention to the Editorial and the Demand letter included in this issue.

Look for a special on Emergency Preparedness later this week and one on Health Care Reform & Managed Care for Dual Eligibles soon.

I recently discovered a web site that offers free software that allows a person to control a compute uses one's eyes.  I've certainly heard of this, but here's an opportunity to try it yourself: 

Camera Mouse. 

April 1, 2011

Via Hand Delivery

Mark Reilly

Chief Legal Counsel

Office of the Governor

Commonwealth of Massachusetts

State House

Boston MA 02133

Re:     Violations of Title II of the Americans with Disabilities Act

Dear Mr. Reilly:

I represent the Disability Policy Consortium ("DPC") and its members, many of whom are Deaf and rely on American Sign Language to communicate.  Carol Hilbinger and Alan Gifford are two DPC Board members who are Deaf. The Massachusetts State Association of the Deaf (MSAD) is also being represented by the DPC in this letter.  Mr. Gifford is the President of MSAD.

DPC is an organization of disability rights activists who share a common goal of equal opportunity for all individuals with disabilities.  DPC has over 1,200 members from more than 270 Massachusetts cities and towns and an additional 1385 "friends".  Some DPC members are deaf or hard of hearing.

DPC is committed to fostering understanding and support through advocating and educating for each individual's quality of life, including the ability to live independently in whatever community one may choose.

DPC's mission is to promote inclusion, independence, and empowerment by guiding statewide development of policies that ensure that programs and services enable people with disabilities to participate in the political, economic, and social mainstream of the Commonwealth of Massachusetts.

The Massachusetts State Association of the Deaf is a statewide advocacy organization whose members are Deaf or Hard of Hearing.   MSAD was founded in 1975.  Its mission is to advocate for the rights of, and to serve the needs of the Deaf and hard-of-hearing individuals in Massachusetts.   It is to advocate and protect the rights of deaf and hard of hearing in order that they can fully participate in the civic, educational, social, cultural, and economic life of the Commonwealth and to further enhance the quality of life for deaf and hard of hearing people living in Massachusetts.

The Disability Policy Consortium has been proactively requesting accommodations in many aspects of emergency preparedness since 2006.  In May 2010 we filed a Title II ADA complaint with the Department of Justice regarding the lack of interpreters present during announcements of public officials during the MWRA water crisis that began on May 1, 2011.

We attempted to reach the Communications Office of the Governor numerous times during the fall of 2010.  Our attempts were not successful.  In fact, we have not had a direct conversation or correspondence from anyone in Massachusetts state government.  The case (#331216) is still open with the U.S. Attorney's Office.

The Americans with Disabilities Act ("ADA"), a federal statute, says that states "are required to make reasonable modifications in policies, practices, and procedures that deny equal access to individuals with disabilities". Specifically, state "governments must ensure effective communication with individuals with disabilities...Where necessary to ensure that communications with individuals with hearing, vision, or speech impairments are as effective as communications with others, the public entity must provide appropriate auxiliary aids...such services or devices as qualified interpreters...".[1]

The DPC does not believe that providing American Sign Language Interpreters would result in a fundamental alteration in the nature of a service, program, or activity or will create "undue financial and administrative burdens"[2] to the Commonwealth.

On March 27, 2011, the Massachusetts Commissioner of Public Health held a press conference at 2 PM (DST) to announce the result of testing Massachusetts drinking water for radiation from nuclear fallout from Japan.  Commissioner John Auerbach was accompanied by one individual at the platform.  He was not accompanied by a qualified American Sign Language Interpreter.

The above press conference directly violates 28 CFR §130.160 (d) (1), which "requires the public entity to take such steps as may be necessary to ensure that communications with applicants, participants, and members of the public with disabilities are as effective as communications with others".[3]

It is the goal of the DPC, MSAD, Ms. Hilbinger, Mr. Gifford, DPC and MSAD members to correct ADA violations and bring entities into compliance with the ADA and all federal disability laws and regulations.  Therefore, we propose that before the parties begin what is sure to be expensive litigation for the Commonwealth, we seek to amicably resolve this matter.  However, if you fail to reach a settlement agreement with the Disability Policy Consortium, Massachusetts State Association of the Deaf, Ms. Hilbinger and Mr. Gifford within 30 days from the date of this letter, the DPC. MSAD, Ms. Hilbinger and Mr. Gifford will pursue litigation against you in federal court to rectify your violations. 

To begin the process, we request that you respond to this letter within 30 days with an outline of the plan you intend to implement within an 30 additional days (May 31, 2011) that will effectively insure that communication access will be available at all emergency announcements, press events, or public addresses to the general public dealing with health and safety.   We will be pleased to meet with you to discuss reaching satisfaction on these accommodations to avoid litigation.

You should note that attorneys' fees and costs as well as injunctive relief are available to a prevailing plaintiff in an ADA action and not settling this dispute at this initial stage will result in far more expense than would be the case if we can resolve these issues amicably.

I look forward to hearing from you.

Very truly yours,

William F. Allan

Executive Director

FY12 Budget: Legislature Steps Up...Maybe   

By Kyle Cheney

STATE HOUSE NEWS SERVICE

STATE HOUSE, BOSTON, MARCH 31, 2011..... The House's top budget writer, Rep. Brian Dempsey, is in talks with Patrick administration budget officials to forestall, at least for the next three months, cuts to programs for disabled and elderly residents, Dempsey's office confirmed Thursday.

"We are actually in the process of setting up more meetings with the administration so that we can reach an amenable solution for everyone," said Colleen McGonagle, a Dempsey aide. "He's had initial meetings. Now, we're trying to go get deeper into the issue and talk with the administration and ... come to some solution because it affects so many people."

The negotiations led Rep. John Rogers to withdraw a budget bill amendment Wednesday that would have forced the Patrick administration to cancel proposed cuts for adult day health, adult foster care and other programs aimed at some of the most vulnerable Massachusetts residents.

"Chairman Dempsey approached me in the House chamber. We discussed the issue. He informed me that he is currently in good faith discussions with [state finance officials] about the issue and they're trying to reach an agreement," Rogers, a Norwood Democrat, said in a phone interview. "In that spirit, I agreed to withdraw the amendment, pending, hopefully, to reach a favorable resolution on the issue."

The state Division of Health Care Finance and Policy earlier this year proposed slashing more than $10 million from adult day health programs, adult foster care and day habilitation programs by cutting the reimbursement rates paid to those who provide care to elderly and disabled residents. But the agency put the cuts on hold this month, under pressure from advocates for the disabled and elderly, as well as lawmakers who support the programs.

Al Norman, executive director of Mass Home Care, an advocacy organization for the elderly, said the decision to delay the cuts was welcome but has kept the participants in those programs in limbo, unsure whether the governor will ultimately cancel or implement them.

"We just want somebody to tell us straight out, your programs are going to be cut or they're not going to be cut," he said. "If the governor vacillates, we will be in an unfortunate state of limbo."

A spokeswoman for the Executive Office of Administration and Finance did not respond to a request for comment.

Norman and other supporters of adult day health had encouraged lawmakers to file amendments to a spending bill wending its way through the Legislature, but lawmakers in each branch, acknowledging the ongoing discussion between lawmakers and the administration, pulled the amendments from consideration.

Proposals filed by Rogers, as well as Reps. Martin Walsh (D-Dorchester) and Jason Lewis (D-Winchester) were all withdrawn without notice during a Wednesday House session.

During a Senate session on Thursday, Sen. Patricia Jehlen (D-Somerville) also withdrew an amendment to prevent the cuts after the Senate's budget chief, Sen. Stephen Brewer (D-Barre), promised to place a phone call to the governor's top budget adviser, Secretary of Administration and Finance Jay Gonzalez.

"The administration has put the rate cut on hold. But that doesn't mean those rates won't be cut later in the fiscal year. This amendment would just ensure that those rates remain stable for the rest of fiscal 2011," Jehlen said.

Brewer said he had placed a recent call to Gonzalez but failed to connect with him.

"I'm told that [the administration] will make a decision on that very soon, but I do want to assure the lady that that phone call will be completed, perhaps as soon as this debate winds down," he said, adding he would "articulate our passion" against the cuts.

Jehlen responded, "With that understanding I will withdraw the amendment."

-END-

3/31/2011

Parting Words: Dr. Jean McGuire    

Thank you all for the many ways in which you have enriched my life in the work we have been doing together over the course of the last four years.  I am very appreciative of the challenges, support, and fun you have brought my way.  It is good work we are all doing and I look forward to continuing to see you on my new path.   

I will be joining the Center for Social Policy at UMass Boston on May 1.  Rosalie Edes is assuming the role of Acting Assistant Secretary.

Take care,

Jean

Jean Flatley McGuire, PhD

Assustant Secretary

Health Care Reform:  CMS on  ACOs

from Renal BizBlog - Keith Chartier

The Centers for Medicare & Medicaid Services has released the long-awaited proposed rules for Accountable Care Organizations (ACOs).

Click CMS Proposed Rules for ACOs to access the entire 429-page proposal.

"This proposed rule would implement section 3022 of the Affordable Care Act which contains provisions relating to Medicare payments to providers of services and suppliers participating in Accountable Care Organizations (ACOs).  Under these provisions, providers of services and suppliers can continue to receive traditional Medicare fee-for-service payments under Parts A and B, and be eligible for additional payments based on meeting specified quality and savings requirements," according to a summary of the rule, which will have a 60-day comment period.

To coincide with the release of the rule, CMS Administrator Donald Berwick, MD, MPP, wrote a perspective piece for the  New England Journal of Medicine. "The financial opportunity for an ACO to achieve shared savings will vary according to its initial tolerance for risk," he wrote. "Two different models are proposed. In the first model, ACOs earlier in their evolution can elect to assume a smaller share of upside gains but no risk of loss for 2 years and then transition in year 3 to accepting risk. In the second model, organizations that are willing to take on both upside gains and downside risk can qualify for a higher proportion of shared savings from the start."

Bay State Council of the Blind Resolution 2011-01 MCB Budget

WHEREAS, the Bay State Council of the blind, (BSCB) has historically advocated for the funding of crucial vocational rehabilitation and social rehabilitation services provided by the Massachusetts Commission for the Blind, (MCB); and

WHEREAS, due to the cumulative impact of state budget cuts in the past few years, MCB has found it necessary to lay off staff; and

WHEREAS, Governor Patrick has proposed a $450,000 cut in MCB's Community Services line item 4110-1000 for Fiscal 2012; and

WHEREAS, MCB Commissioner Janet LaBreck testified at a budget hearing in Fitchburg on February 18 that if this cut is implemented in the final budget, she intends to take all of it out of the Deaf-Blind Community Access Network, (DBCAN), which would eliminate this program; and

WHEREAS, the DBCAN program provides vital interpreter and guiding services to deaf-blind consumers which  allow them to perform tasks such as shopping, managing finances, going to doctors appointments and attending business meetings and social functions; and

WHEREAS, the elimination of the DBCAN would inflict stifling isolation upon a particularly vulnerable population;

NOW, THEREFORE: BE IT RESOLVED that the Bay State Council of the Blind, in convention assembled on this 27^th day of March, 2011 in Waltham Massachusetts asks the Massachusetts Legislature to restore the $450,000.00 MCB budget cut proposed by the Patrick Administration for FY 2012.

BE IT FURTHER RESOLVED that BSCB demands that the Commissioner of the Massachusetts Commission for the blind unless otherwise directed by the Legislature not inflict any cuts exclusively upon one program and that any cuts should be humanely distributed among the programs funded by the Community Services line item 4110-1000.

On the Calendar: Equal Choice Law

The Joint Committee on Elder Affairs will be holding an Oversight Hearing relative to the Equal Choice law.  (Options Counseling program) 

The hearing will take place on April 11^th at 1:00 p.m. in room B-1.  

• Vocational Rehabilitation/Employment
• Community Supports/Independent Living
• Advocacy