[NYAPRS Enews] CBS: People With Disabilities Question Candidates

[Matt Canuteson]

NYAPRS Note: The Nov. 4th election is right around the corner, remember,
if you are using an absentee ballot, it needs to be postmarked by
October 28th in order to be counted.

Because this election year is so very important to all New Yorkers with
disabilities, we need to consider what steps are needed to ensure that
our community gets out record numbers at the polls.

We made a huge effort to ensure that people were registered to vote in
the election, and in that process learned most of our community is
registered.  

However, being registered is only half the battle, ensuring that people
have transportation and access to the polls is the next step to ensuring
a huge turnout for people with psychiatric disabilities.

Many NYAPRS members are actually providing transportation of the people
they serve to the polls, something we are encouraging programs to do. 

 

People With Disabilities Question Candidates

McCain, Obama Campaigns Discuss Issues That Matter Most To Those With
Disabilities

Jim Mullen CBS October 14th 2008 

 

People with disabilities are interested in the same campaign issues as
everyone else, but there are few others about which many people with
specific needs feel strongly. 

 

CBS 2 Disabilities Reporter Jim Mullen asked people with disabilities
what they wanted to know from the candidates. We asked what the Barack
Obama and John McCain's respective campaigns to supply written answers
to questions on those issues. 

 

Typically, the candidates can be seen talking about the economy, foreign
policy, and of course, each other. But disabilities issues rarely come
up as a subject, and those affected by them want that to change. 

 

"We are a part of the mainstream community, and we should be factored
in," said Gary Arnold. 

 

Among the most significant concerns for those with disabilities are
jobs. Unemployment is estimated at 70 percent or more for the disabled. 

 

"I want to know what the candidates are going to do about employment
issues and discrimination," said Sam Martarano. 

 

Both candidates are strong supporters of the new amendments to the
Americans with Disabilities Act. The ADA protects the civil and
employment rights of the disabled. 

 

Obama would also reinstate an executive order to require the federal
government to hire more people with disabilities. 

 

Housing is also a major concern. "There's a lot of accessible,
affordable housing for people," said Monica Heffner. 

 

Obama "supports examining additional approaches to increase accessible
affordable housing, and would ensure federal housing programs for the
disabled are sufficiently funded." The McCain camp says the senator has
dealt with affordable housing "as it relates to disabled veterans...
following the Gulf War, he developed a program to ensure housing loan
benefits for war veterans." 

 

Arnold added, "A very significant issue is access to long-term care." 

 

The Community Choice Act would give people with disabilities the choice
to receive services in their own home, or in a small community setting,
rather than in institutions. Obama is a co-sponsor of the act, and
McCain would support the program as long as it's financially sound and
the federal government can afford it. 

 

There are other questions we posed to the McCain and Obama campaigns.
Here is where they stand on: 

 

Autism: The combating autism act of 2006 requires the U.S. Secretary of
Health and Human Services to develop and implement a strategic plan for
research, screening, intervention and education. 

 

McCain: "John McCain is a co-sponsor of the Combating Autism Act of
2006. John McCain believes this legislation will increase awareness and
public screening of autism spectrum disorder, and will promote the use
of evidence based interventions and also create centers for research." 

 

Obama: "Barack Obama supports the Combating Autism Act which was signed
into law in December 2006. As a U.S. Senator, Obama has worked to fully
fund the Combating Autism Act. And, as president, Barack Obama will work
toward full funding of the Combating Autism Act and work with Congress,
parents and ASD experts to determine how to further improve federal and
state programs." 

 

 

The Americans With Disabilities Restoration Act: This proposed
legislation would revise the ADA's definition of disability to extend
protections beyond restrictions imposed by recent supreme court rulings,
especially for people whose impairments are fully or partially managed
by medications or assistive devices. This would, for example, apply to
someone who is not totally blind, but "legally" blind, or someone not
totally deaf, but still hard of hearing. 

 

McCain: "John McCain supports this legislation. In 1990, John McCain was
a co-sponsor of the landmark 1990 ADA. He believes that Congress must
assume responsibiltiy in clarifying and strengthening the law in light
of the U.S. Supreme Court's recent interpretations of the ADA." 

 

Obama: "Barack Obama was a co-sponsor of the ADA Amendments Act, which
President Bush just signed into law. The ADA Amendments Act restores the
original intent of Congress to protect the civil rights of all Americans
with disabilities. But this entire process shows why we need judges who
will honor the intent of the ADA and similar laws designed to protect
the civil rights of all Americans. Senator Obama has pledged to appoint
just this type of judge." 

 

 

The Mental Health Parity Act of 2007: This bill would require health
plans that provide coverage for serious mental health issues is provided
on the same terms as other illnesses. For example, parents of mentally
ill children often struggle to pay for health services not covered by
their insurer. 

 

McCain: "John McCain supports the Mental Health Parity Act of 2007. He
believes mental health is a necessary component to physical health in
all aspects of our daily lives." 

 

Obama: "Barack Obama is a co-sponsor of this legislation. Indeed, he is
a long-time supporter of mental health parity legislation on both the
federal and state levels. For example, Obama helped pass Illinois'
mental health parity law as a State Senator." 

 

 

A permanent post dedicated to disabilities policy: This calls for the
creation and appointment of a permanent assistant to the president for
disability policy at the White House 

 

McCain: "John McCain needs look no further than to his vice-president
Sarah Palin. She will be the first VP to raise a special needs child.
Her connection to the disabled and special needs families throughout
this nation is personal and compelling. You will find no greater
advocate." 

 

Obama: "Barack Obama supports the idea of creating a permanent position
of an Assistant to the President on Disability Policy in the White
House." 

 

In answering CBS 2's questions, the McCain campaign was represented by
Illinois State Rep. Jim Durkin, and the Obama campaign was represented
by Communications Director Justin DeJong.

 

http://cbs2chicago.com/jimmullenreports/candidates.disabilities.issues.2
.840054.html

 

 

 

Election 2008: Long-Term Care? Huh?

Liza Berger McKnight's October 10, 2008

 

As time winds down to the 2008 presidential election, it's fair to ask
which candidate would best improve the lives of those in the long-term
care field. 

 

Lots of luck.

 

With Nov. 4 just days away, candidates Barack Obama and John McCain have
offered only vague outlines of long-term care policies, leaving big
question marks in the minds of those in the industry.

 

"It's extremely difficult to honestly assess what each candidate means
to long-term care in general and nursing home facilities in particular,"
said Alan Rosenbloom, president of the Alliance for Quality Nursing Home
Care, in late August. "At this point, neither has a detailed plan and
neither platform offers much ... You see broad declarations of political
goals and objectives and not a lot of specifics."

 

It seems reasonable to deduce certain attitudes from the candidates'
general views on healthcare, but long-term care experts still hedge. 

 

"Generally speaking, the Republicans look at market-oriented solutions
and the Democrats look at government programs," said Dave Hebert, chief
lobbyist for the American Health Care Association. "That's not
necessarily a hard and fast rule, but that has been a hallmark of the
Democratic and GOP solutions in the past. But it's a new world and the
old solutions won't work anymore. Whoever is president will have to look
at private and government programs."

 

Providers, for their part, are not so interested in whether the
solutions lie in the government or the private sector. At this point,
they would settle for a dialogue. Specifically, they want to talk about
integrating the topic of long-term care into general healthcare reform,
and discussing a new payment system, as well, as the clock seems to be
ticking for Medicaid, long-term care's largest payment source.

 

"People tend to bifurcate it," Hebert said of long-term care and
healthcare. "They look at acute care and post-acute care differently.
Given the amount spent on Medicaid and Medicare, they should look at
long-term care." 

 

Both the American Association of Homes and Services for the Aging and
the American Health Care Association have submitted financing reform
proposals to the nominees. AAHSA has proposed a broad-based national
insurance trust that would provide a daily cash benefit for people
needing assistance with two or more activities of daily living. 

 

AHCA's plan calls for a "personal responsibility requirement" that
requires individuals to either purchase a long-term care policy or
dedicate funds into qualifying long-term care savings vehicles dedicated
for future long-term care costs. 

 

Whether these programs will receive public airing is anyone's guess, but
it seems pretty clear that healthcare will be on the table for
discussion. It will be up to long-term care providers to grab a seat. 

 

"The odds are good we will see a serious healthcare reform debate over
the next four years, regardless of who wins the election," Rosenbloom
said. "The inference I draw from that is it is important for us, the
provider community, to assure that when that debate happens, there is
serious consideration given to long-term care."

 

And even though the candidates' plans are short on specifics, there are
some encouraging signs for reform from both camps. Both candidates and
their parties address the importance of information technology and
Medicaid and Medicare payment reform. Also, last month the candidates
dispatched advisers for a long-term care symposium given by Genworth
Financial Inc. While they didn't expand on candidates' positions, they
acknowledged that long-term care is a vital healthcare issue. 

 

Obama's Plans

Obama has addressed the need to expand long-term care options, including
home care; paying caregivers a fair wage; and training more nurses and
caregivers to work in long-term care. (See his Web site
www.barackobama.com.)

 

The Democratic party platform also talks about closing the "doughnut
hole" of the Medicare Part D prescription drug program. The hole
represents the gap in coverage between $2,250 and $5,100 in costs in
which seniors must pay for their drugs solely on their own. 

 

Perhaps of most interest to providers, the platform mentions a need for
long-term care finance reform. It is the first time that a Democratic
platform has mentioned long-term care financing, according to AAHSA.

 

The Obama campaign gave assurances that the Democratic nominee is
thinking about it. 

 

"Long-term care is definitely on his mind," said a spokeswoman for the
campaign who declined to be named. 

 

One sign Obama could be serious about long-term care reform is the
Community Living Assistance Services and Supports (CLASS) Act of 2007, a
bill he sponsored this year. The legislation would establish a national
insurance program to pay for those with long-term care costs. Voluntary
payroll deductions of $30 per month would finance the program. Benefit
eligibility would kick in after five years of program contributions.

 

The legislation "is a close relative of the long-term care financing
plan that AAHSA's financing cabinet came up with a year ago," said
Barbara Gay, director of advocacy information for AAHSA. "They are like
first cousins. We take that as a promising sign." 

 

Last month, however, Gay expressed concern that Obama had not "connected
the dots," still considering the legislation a disability policy and not
a long-term care issue. 

 

McCain's Message

Republican nominee McCain also touched on "seniors" issues, though not
as much as his rival. McCain has hit upon the need to move away from
institutional care. He has expressed his support for Cash and Counseling
and the Program of All-Inclusive Care for the Elderly (PACE). The
programs allow seniors to receive a monthly stipend to spend as they see
fit, whether it be hiring workers or purchasing care-related services
and goods. 

 

Web site www.johnmccain.com talks about reforming the payment systems in
Medicaid and Medicare to "compensate providers for diagnosis, prevention
and care coordination."

 

The Republican platform also speaks about finding new ways to allow
seniors to stay in their homes. 

 

"This is true not only with regard to Medicaid, where we spend $100
billion annually on long-term care, but also for those who do not
qualify for that assistance," according to the platform. 

 

Interestingly enough, it is the first time since 1996 that the platform
hasn't called for private long-term care insurance, according to AAHSA.

 

A spokesman for the McCain campaign was reached repeatedly for comment
but had not responded to questions by press time. To Gay's knowledge,
McCain has not introduced long-term care-related legislation in the last
Congress.  

 

Speaking in Specifics

While the candidates' ideas might sound promising, experts caution that
the devil is in the details.

 

The candidates "both have a desire to expand access to the uninsured. I
think that's a laudable goal," said Robert Kramer, president of the
National Investment Center for the Seniors Housing & Care Industry. "The
question is how are we going to pay for it?"

 

If finding funding means cutting Medicare, "long-term care could pay the
price for expanding healthcare coverage to the uninsured," he said.
"These are some of the tough questions in front of the candidates."

 

One of the problems with the current payment system is it is a "silo"
method, he added. It becomes dangerous policy to cut one because of its
effect on the other. 

 

"We have payment silos and you may only look at Medicaid or Medicare or
private pay or managed care, but basically it's that payer mix that
allows most nursing homes to stay open. If you lose sight of that, you
may enact some very bad policy," Kramer said.

 

Along these lines, it's worth keeping in mind that the next president's
ideas are only one part of the equation. While his views would be
important, how Congress votes and performs will be equally, if not more,
important. 

 

"When all is said and done, a good portion of long-term care policy will
continue to come from Capitol Hill," Hebert reminded. "The
administration always has a bully pulpit, but at the end of the day,
there is the old saying, 'The president proposes and Congress
disposes.'" 

 

Change Ahead

The possibility for healthcare reform may be more real than it's ever
been. People seem to be clamoring for change from all corners-even from
the business community. That is a contrast to the early 1990s, when
then-First Lady Hillary Clinton crafted a healthcare overhaul that
failed.

 

"I think since that time, there has been a growing realization that
companies in this country have become less competitive with companies
from countries whose governments do provide health benefits that
citizens have, so, in reality, our companies are bearing a burden that
their international competitors don't have," AAHSA's Gay said.

 

So what about long-term care? It may just be the toughest nut to crack
in the healthcare system-particularly the financing angle-which is why
no one may want to touch it.

 

But the next occupant of the White House might not have a choice. With
the first baby boomers turning 65 in 2011, a caregiver shortage
worsening, and pressure continuing to build on Medicaid and Medicare
funding, long-term care might finally have its day.

 

http://www.mcknights.com/Election-2008-Long-Term-Care-Huh/article/119472
/

 

 

 

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