Why Little Rock?

National ADAPT focuses on Arkansas to demand all US states choose the Community First Choice Option

By Tim Wheat

National ADAPT felt it was important to make the point in Arkansas that people with disabilities demand for the Community First Choice Option is a bipartisan benefit to US states. Although it is part of the Affordable Care Act, it may be optioned independently and adds a six percent incentive to state Medicaid programs.

Failing to choose the Community First Choice Option not only keeps state residents isolated in expensive undesirable institutions, but it fails to take advantage of the cost-savings of home and community services in addition to the Medicaid enhanced rate. State funding for long term services and supports for seniors and people with physical disabilities is institutionally biased in Arkansas with 69.7% of Medicaid funding going to nursing facilities.

“That is pathetic,” said Mike Oxford, and organizer from Kansas. "Seniors and people with disabilities don't want to be forced into nursing facilities, but that's what the state is doing. This is not about spending more money, it is about reprioritizing so that funds that are currently spent on nursing facilities to fund services and supports that allow individuals to move out of these institutions or to avoid institutionalization altogether," Oxford said.

ADAPT supports Medicaid reform to make the system more efficient and effective and prevent US states, who administer the federal Medicaid program, from forcing people into institutions to balance the state budget. ADAPT holds that implementing real Medicaid reform, which restrains spending while promoting the independence and freedom of people with disabilities, is the most cost-effective use of state public money.

ADAPT proposes expanding community-based services, expanding consumer-directed services, de-medicalizing services, eliminating wasteful bureaucracy and taking advantage of "re-balancing" funding. Advocates point out that estimates show the state of Arkansas would save money by making this change and implementing the Community First Choice Option. CFCO is a federal Medicaid program that gives seniors and people with disabilities a real alternative to institutional placement and provides extra federal funding to do it.

Home And Community - Based Services (HCBS) allow people with disabilities to remain in their own homes. HCBS programs often suffer because states cannot make cuts to institutional care, but they can cut the optional Medicaid services. This institutional bias in the federal Medicaid law keeps public funds flowing into expensive institutions although most people would prefer to remain at home.

MCIL asks Sen. Alexander to support the CRPD

The Memphis Center for Independent Living delivered a letter asking for Senator Lamar Alexander to support the Convention on the Rights of People with Disabilities. The letter was signed by about twenty-five people to show their support and the support of the disability community for International respect for the civil rights for people with disabilities.

Josue Rodriguez, Mary Wooldridge and Michelle Ivery

The CRPD is a symbol of US strength and leadership in the world and advances our shared ideal and national power. It is based on the world leading Americans with Disabilities Act that this country passed nearly twenty-five years ago and extends basic civil rights to people with disabilities.

“I’m glad we didn’t just email the Senator,” said Michelle Ivery, whose name is the top center of the letter, “I believe now he knows we care and will follow through. All those people who signed the letter know that it got to Senator Alexander.”

MCIL provided this letter as one way that the community can show their support for the CRPD, also called the disability treaty. The treaty was signed by the US in 2009 and must be ratified by the US Senate. Senator Tom Harkin, who introduced the Americans with Disabilities Act in the Senate nearly twenty-five years ago, said that he will work to get the treaty to the Senate floor this session.

American businesses support ratification of the CRPD, including the U.S. Chamber of Commerce, the U.S. Business Leadership Network, and the Information Technology Industry Council. Many U.S. companies including IBM, AT&T, Adobe, and JP Morgan Chase support ratification.

Josue Rodriguez, Tim Wheat and Michelle Ivery took the letter to Sen. Lamar Alexander’s office today. Mary Wooldridge, the Constituent Services Representative took the letter and posed for a photograph with those delivering the letter. Following delivering the letter, the MCIL group visited the coffee shop Qahwa to have brunch.

ADAPT And Arkansas:

An overview of some important ADAPT Actions from the 1990s

By Tim Wheat

Brenda Stinebuck of Arkansas ADAPT

When ADAPT rolls into Little Rock next week it is important to know that the natural state has seen and heard of ADAPT before. Although National ADAPT has never been to Arkansas, local and regional actions have set the stage for the upcoming ADAPT Action.

“When I was at Mainstream, ADAPT was active and closely linked to the center,” said Richard Petty, the former Executive Director at Mainstream the Center for Independent Living in Little Rock. “ADAPT was able to take actions not best taken by the Center and the Center provided organizational support to ADAPT. Mainstream organized several national trainings for Arkansas ADAPT members. Diane Coleman, Shell Trapp and other ADAPT trainers came to Arkansas with Mainstream’s support.”

At the end of 1991, Governor Bill Clinton of Arkansas was preparing to run for US President. ADAPT reports in the INCITEMENT that the Presidential Candidate had made a statement that people have a civil right to live outside a nursing home.

But on December 12, 1991 the Arkansas Department of Human Services issued a memo that the state would limit personal care services to 50 hours per month and freeze other state programs that would keep people out of expensive institutions. Governor Clinton and the Arkansas Legislature were looking for ways to cut the state budget and looked to cut state programs that would save Arkansas money pushing people into costly federally funded institutions.

In this time before Olmstead, Money Follows the Person and the Community Choice Option, advocates had few tools to counter the cuts to the Arkansas Medicaid program. People with disabilities in Arkansas turned to the streets and adopted the ADAPT tactics that had been successful in making public transportation accessible. ADAPT Nationally and pivoted their focus to personal attendant programs and reforming Medicaid. ADAPT grassroots activists were asking for 25% of the current Medicaid funding for institutions to be diverted to provide attendant care to help people remain in their own homes and live and work in the community.

This was also before CASA, MiCASSA, the Community Choice Act and the Community Integration Act.

Sixteen activists occupied the private office of then Governor Bill Clinton on December 30, 1991. Arkansas ADAPT’s main demand was that the state stop the Medicaid cuts that were outlined in the Department of Human Services memeo. The group also asked for the state to develop a comprehensive long-range plan for home and community-based services and to apply for Medicaid personal assistance services waivers.

ADAPT marches in Harrisburg PA

Arkansas ADAPT was led by Dr. Terry Winkler, who was the first wheelchair user to graduate from medical school at the University of Arkansas. He teamed up with activist Verlon McKay, a veteran and others in the disability rights community including Richard Petty of Mainstream and Bonnie Johnson the head of the Arkansas Disability Coalition. Others present included Glennis Sharp, Adrian Horton, Mattie Jones, and Janice Winkler.

“I was chained in the office with Winkler, McKay and fourteen other activists,” recalls Richard Petty. “We stayed there until the early hours of the morning of December 31. The action was ended with a conference call with Governor Clinton (who was out of State at the Renaissance event in South Carolina) and discussions with Acting Governor Jim Guy Tucker, who was present in the office with the chained ADAPT members. Diane Coleman and Bob Kafka coached the activists by phone throughout the action.”

Arkansas ADAPT had slipped into the governor’s office while admiring the state Christmas tree. They secretly wound a long bicycle chain on themselves and inside the office to emphasize the fact that they would not leave until their demands were met.

“The action resulted in a signed written agreement in which the State agreed to roll back Medicaid cuts that would have forced thousands into nursing homes,” said Richard Petty. “They agreed to develop a comprehensive long range plan for home and community-based services, and agreed to make application for Medicaid waivers for personal assistance services.”

Two years later, INCITEMENT points out that ADAPT was at the Arkansas Capitol to enforce that agreement made with Gov. Clinton.

Twenty years ago last month, ADAPT struck out at a regional target in Fort Smith Arkansas. ADAPT activists from Arkansas, Texas, Oklahoma and Kansas occupied the offices of Beverly Enterprises, the largest nursing home corporation in the nation at the time. Beverly owned or leased over 800 nursing homes and had profits of nearly $90 million.

Randy Alexander, a long-time ADAPT activist got fired-up about ADAPT tactics during the Beverly Enterprises action in 1994. He remembers meeting Bob and Stephanie but had to leave with his ride home before meeting many of the others from Kansas, Oklahoma and Texas. He says he had just spent two years in an institution in Hot Springs after an injury.

“I was stuck in that damn institution. I had to fight to get out of there,” said Randy from his farm in rural Mississippi. “When ADAPT came along it was like saying a big ‘fuck you’ to the nursing home industry and Beverly Enterprises. I was all in.”

ADAPT asked to speak with David Banks, the Chief Executive Officer of Beverly and demanded that ADAPT’s proposal to redirect 25% of Medicaid institutional funding to attendant care be discussed at the upcoming AHCA Convention. At the time the main target for National ADAPT was the massive, well-funded nursing home industry lobby: The American Health Care Association.

Banks got the meeting but the lobby reneged on their member’s agreement and actually sued ADAPT to try to prevent the demonstration in Clark County Nevada that year. David Banks agreed to survey accessibility at Beverly facilities and he wrote a letter supporting a national attendant services program.

“It is my commitment that Beverly Enterprises will support a national attendant services program so that people with disabilities, old and young, will have real alternatives to institutionalization,” wrote David Banks the CEO of Beverly Enterprises.

In September of 1997, Verlon McKay organized an ADAPT hit on President Clinton speaking at the 40th anniversary of the Little Rock Nine at Little Rock’s Central High School. He said it was hypocritical to celebrate inclusion when the school remains inaccessible to people with disabilities. The real irony was that for the Little Rock Nine to get into the school and to the podium where President Clinton spoke, they had to build ramps.

The ADAPT members shouted down the President, but were not removed from the accessible seating a long way from the front steps. President Clinton paused at one point in the speech and looked up from his written comments where he had just talked about the Little Rock Nine not being able to learn “...in simple peace.”

“Speaking of simple peace,” directing his comments to the ADAPT Activists, “I'd like a little of it today.”

But ADAPT did not give the President any peace; Verlon and Arkansas ADAPT, supported by some Memphis ADAPT members continued to shout about the hypocrisy and rain on Clinton’s parade.

“I planned to be at the inaccessible Little Rock Central High School where Bill Clinton was going to talk about inclusion,” said Randy Alexander. “But traffic and police held me up and I never got there.”

Randy now lives a half-mile from a dilapidated care home at the Tubby Creek Farm he runs with Josephine. He jokes that the facility closed because he moved in. Randy may have started out with Arkansas ADAPT, but he has lived in Texas, Tennessee and now Mississippi. The farm takes all of his time but he still has a hope to join ADAPT for an action soon.

“My first action was against Greyhound in Hot Springs Arkansas. I didn’t get arrested,” said Randy, “but I got so excited that the other ADAPTers had to drag me off of the bus.”

Arkansas has been involved in much more and many things since the first ADAPT actions in the 1990s. National ADAPT members always must remember our roots and the struggles that our community faced years ago. For the natural state, this may be the first National ADAPT Action, but it is in the long tradition of people with disabilities speaking up, speaking out and taking to the streets to FREE OUR PEOPLE!

More photos of my visit to Tubby Creek Farm.

Medicaid Expansion is for working families

Local business is shouldering the cost of uninsured workers

By Tim Wheat

Medicaid expansion will not only bring billions of dollars of health care into the state of Tennessee, it will also improve the health care coverage of working families. While traditional Medicaid covers critical health care needs for people below the federal poverty level, the expansion aims at providing health coverage to those Tennesseans above the poverty level.

While Medicaid is intended to provide some health care for those who have fewest resources and the lowest income, the Tennessee Governor is not refusing federal funding of the current program. Governor Haslam has refused to expand Medicaid to citizens who make too much to qualify for the traditional program and have an income is above the federal poverty level.

“It is so important for people and policymakers to understand that the people harmed by the coverage gap are working people,” said Ron Pollack, executive director of Families USA. “They are not people who are looking for handouts, or welfare recipients.”

The US Department of Health and Human Services states that Medicaid Expansion would cover a family of four with an annual income less than $33,000 and a single adult income below $16,105. Families USA reported that 34,000 food service workers and 31,000 construction employees would be the leading employment sectors impacted by the Medicaid Expansion. The report also finds 112,000 Tennesseans working in Sales, Transportation, Maintenance, Office and Production that would benefit from the Medicaid Expansion.

The expansion to these employers means healthier workers and less work time lost without an investment in employer-paid insurance. It is not only state’s poor that are losing out on Medicaid Expansion, it is the business community that must shoulder the cost of uninsured workers. This cost is in addition to the $2.6 Million-a-day that taxpayers are losing out on by Governor Haslam’s procrastination on the Medicaid Expansion.