Disability Rights and the ACA

Leading Disability Rights Groups File Amicus Brief Defending the Affordable Care Act in Supreme Court Case WASHINGTON, DC – The American Association of People with Disabilities, the  Disability Rights Education and Defense Fund, the Judge Bazelon Center for Mental Health Law and 16 other leading disability rights organizations, represented pro bono by law firms Dentons and Baker Hostetler,  filed an amicus brief with the US Supreme Court highlighting the crucial health care protections that Congress provided for people with disabilities in the Affordable Care Act (ACA). The ACA prevented people from being denied coverage or charged more due to pre-existing conditions and made coverage of needed services available and affordable to millions of people with disabilities for the first time. In March, the Supreme Court agreed to hear the case, formerly known as Texas v. US and now known as California v. Texas, which it will hear in the fall. The case involves a challenge by Texas and other states to the constitutionality of the ACA’s “individual mandate” to have health insurance. Texas argues that the mandate is unconstitutional and that the entire law must be struck down. The Bazelon Center, the Disability Rights Education and Defense Fund, and the ACLU were also counsel on the amicus brief. “It would be a dark day for people with disabilities if the Court were to eliminate the ACA,” said Ted Kennedy Jr., chair of the board of the American Association of People with Disabilities.  Maria Town, AAPD’s CEO, added, “For disabled people, the ACA has meant not only the opportunity to get needed healthcare, but also independence and, in many cases, the difference between life and death.” “Congress clearly intended to provide protections for people with disabilities and would not have intended that the whole law be struck down even if one part of it was found invalid,” said Jennifer Mathis, Director of Policy and Legal Advocacy at the Bazelon Center for Mental Health Law. “With the ACA, Congress advanced the United States along the long road of ensuring healthcare equality for people with disabilities of all ages,” said Silvia Yee, Senior Staff Attorney for the Disability Rights Education & Defense Fund. “Our brief establishes how striking down the entire law thwarts the intent of Congress, deprives disabled Americans and their families of the health coverage they need to live full, productive and healthy lives in their communities, and hurts the entire nation.” Contacts: Bazelon Center for Mental Health Law: Amy Weiss, 202-203-0448, amy@weisspublicaffairs.com  American Association of People with Disabilities: Keri Gray, 202-521-4310, kgray@aapd.com Disability Rights Education and Defense Fund: Lawrence Carter-Long, 510-644-2555 x. 5256, lcarterlong@dredf.org

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Stimulus Checks and Medicaid

Long-Term Care Residents, 

Medicaid and 

Stimulus Checks

1. Will stimulus checks affect a resident’s Medicaid eligibility?
   
   The IRS defines the stimulus checks as tax rebates that will not be counted as income or resources for 12 months from receipt. If funds are unspent after 12 months of receipt, the unspent funds will be counted as a resource. Medicaid is automatically extended for all current Medicaid eligible individuals. Anyone who currently has benefits will not be denied during this period. Medicaid spending rules still apply as these funds will fall in a “look-back period.” KEEP ALL RECEIPTS of EXPENSES, especially for purchases of over $200.
   
2. Examples of allowable spending
• Dental care, sitter care, assistive device not covered (e.g. battery oxygen device)
• Tablet, phone, TV, WIFI, reading material
• Clothing, shoes, hygiene supplies, haircuts
• Minifridge, snacks
• Burial contract with funeral home (not a burial insurance plan)
• Personal non-medical outings transport
• Expenses to move to community (if planned)

3. Will the stimulus check count as applied income?
   
   No. As a tax rebate, the individual stimulus check will not be calculated as applied income. A person’s applied income amount will not be changed by the payment.
   
4. Medicaid rules for spending:
   
• Cannot give cash to friends, family, charity, churches
• Must spend in 12 months
• Must spend on an allowable asset or for resident care or quality of life
• Do not spend on services covered by Medicare and Medicaid

Residents and Families, 

More information about the Stimulus Check can be found:
https://www.irs.gov/newsroom/economic-impact-payments-what-youneed-to-know 

Stimulus checks are expected to start being distributed April 17, 2020. It will be sent the same way as social security checks are currently sent for persons receiving SSA and SSI-D. Action is only required by a resident who does not receive SSA or SSI-D, and who did not file a tax return in 2018 or 2019. They can check the link above for instructions. Full vendor residents who do not receive either SSA or SSI-D can register at this link: https://www.irs.gov/coronavirus/non-filers-enter-payment-info-here 

Make sure all new purchases are 

1. Marked with the resident’s name. For clothing, mark inside of collar or waistband. 
2. Put on the resident’s inventory sheet with the facility, in case it is lost. 
3. Allowable by Medicaid. Have the facility’s business office check with a Medicaid representative BEFORE purchasing. 
4. Supported with receipts. Give a copy of all receipts to the business office. Any expense over $200 will likely need to be explained to Medicaid when renewing your application.

This information is provided by the Tennessee Ombudsman Program – advocates for long-term care residents. PHONE# 615.253.5412. Website: https://www.tn.gov/aging/our-programs/long-term-care-ombudsman.html 

Disability Integration Act Update

We only need 14 more Senate cosponsors to have a majority of Congress cosponsoring DIA!
Yesterday, Senator Mazie Hirono (HI-D) became the 36th cosponsor of the Disability Integration Act (S.117) in the Senate!  Including Senator Schumer – who is the sponsor of the bill – we have a total of 37 Senators cosponsoring DIA!  To secure a majority of the Senate (51), we only need 14 more Senate cosponsors.

We already have a majority of the House of Representatives cosponsoring DIA, so that means we only need 14 Senate cosponsors to have a majority of the entire Congress cosponsoring the bill that gives people with long term service and support disabilities an enforceable statutory right to live in freedom.

Who do we still need in the Senate?
We are focused on securing Senate Democrats – who should support our civil right to live in freedom and a bill introduced by Senate Minority Leader Schumer (NY-D).  We also need Senate HELP Committee members so we are also targeting Republicans on the HELP Committee. Here is the list:

• Alaska : Senator Lisa Murkowski (Republican/HELP Committee)
• Arizona : Senator Kyrsten Sinema (Democrat - the only Democrat from Arizona not cosponsoring DIA)
• California : Senator Dianne Feinstein (Democrat)
• Hawaii : Senator Brian Schatz (Democrat and the only member of the Hawaii delegation not cosponsoring DIA)
• Indiana : Senator Mike Braun (Republican/HELP Committee)
• Kansas : Senator Pat Roberts (Republican/HELP Committee)
• Kentucky : Senator Rand Paul (Republican/HELP Committee)
• Louisiana : Senator Bill Cassidy (Republican/HELP Committee)
• Maine : Senator Susan M. Collins (Republican/HELP Committee)
• Nevada : Senator Jacky Rosen (Democrat/HELP Committee - the only Democrat from Nevada not cosponsoring DIA)
• New Hampshire : Senator Jeanne Shaheen (Democrat and the only member of the New Hampshire delegation not cosponsoring DIA)
• New Mexico : Senator Martin Heinrich (Democrat)
• New Mexico : Senator Tom Udall (Democrat)
• North Carolina : Senator Richard Burr (Republican/HELP Committee)
• Ohio : Senator Sherrod Brown (Democrat - the only Democrat from Ohio not cosponsoring DIA)
• Oregon : Senator Ron Wyden (Democrat)
• South Carolina : Senator Tim Scott (Republican/HELP Committee)
• Tennessee : Senator Lamar Alexander (Republican/HELP Committee)
• Utah : Senator Mitt Romney (Republican/HELP Committee)
• Virginia : Senator Mark R. Warner (Democrat)
• Virginia : Senator Timothy Kaine (Democrat/HELP Committee)
• Wyoming : Senator Michael B. Enzi (Republican/HELP Committee)

Of course, EVERY cosponsor helps move us forward!  For more information on current DIA cosponsors, go to: www.c4ci.org

The Impact of the Coronavirus Underscores the Importance of DIA

We have seen the news reports about the coronavirus being in nursing facilities and the deaths that it caused.  As reported in the New York Times, “The mortality rate is shocking,” said Mark Parkinson, president and chief executive of the American Health Care Association. He said the death rate might well exceed the 15 percent that had been reported in China for people aged 80 and older.
https://www.nytimes.com/2020/03/10/us/coronavirus-nursing-homes-washington-seattle.html

The reason this is “news” is because those deaths are part of a bigger news story.  The reality is that illnesses in fact circulate throughout nursing facilities and kill the residents.  When 11 children died in a New Jersey nursing facility, most people didn’t hear about it.
https://www.northjersey.com/story/news/watchdog/2019/02/27/wanaque-center-for-nursing-and-rehabilitation-failures-contributed-adenovirus-deaths/2952837002/

While people are being advised to avoid cruise ships and large groups, people with significant long term service and support disabilities often have no choice but to go into a nursing facility or other institution where they are kept in tight quarters and always at risk.  It isn’t a small number of folks.  Right now, over 2 million people are in nursing facilities and other institutions.  As American life changes in response to the coronavirus, we need to address the fact that disabled and elderly people continue to be forced into institutions where they are at risk.  There is no doubt that if the residents of the Life Care Center in Washington State or the Wanaque nursing facility in New Jersey were able to be supported independently, they would have been at far less risk of dying.

For a number of years, disability rights activists have been framing the fight for the Disability Integration Act as a fight for Life and Liberty.  The outbreak of the coronavirus reminds us that this isn’t just rhetoric.  The freedom of people with disabilities – young and old – is literally a matter of life and death.
 

How to wear a face covering

Face Coverings Recommendations from the CDC

A significant portion of individuals with coronavirus lack symptoms (“asymptomatic”) and that even those who eventually develop symptoms (“pre-symptomatic”) can transmit the virus to others before showing symptoms. This means that the virus can spread between people interacting in close proximity—for example, speaking, coughing, or sneezing—even if those people are not exhibiting symptoms. In light of this new evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission. Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.  

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the cloth face covering without assistance. The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance. 

How to Wear Cloth Face Coverings  

Cloth face coverings should--

• fit snugly but comfortably against the side of the face  
• be secured with ties or ear loops 
• include multiple layers of fabric  
• allow for breathing without restriction  
• be able to be laundered and machine dried without damage or change to shape 

Do I still need to stay at least 6 feet away from people if wearing a cloth face covering? 

Yes. Wearing cloth face coverings is an additional public health measure people should take to reduce the spread of COVID-19. CDC still recommends that you stay at least 6 feet away from other people (social distancing), frequent hand cleaning and other everyday preventive actions. A cloth face covering is not intended to protect the wearer, but it may prevent the spread of virus from the wearer to others. This would be especially important if someone is infected but does not have symptoms. View CDC’s guidance on how to protect yourself. 

Should cloth face coverings be washed or otherwise cleaned regularly? How regularly? 

Yes. They should be routinely washed depending on the frequency of use. 

How does one safely sterilize/clean a cloth face covering?  

A washing machine should suffice in properly washing a cloth face covering. 

How does one safely remove a used cloth face covering?  

Individuals should be careful not to touch their eyes, nose, and mouth when removing their cloth face covering and wash hands immediately after removing. 

The CDC resources used for this announcement are provided below: 

• For more information from the CDC on face coverings and how to make your own, https://www.cdc.gov/coronavirus/2019-ncov/downloads/DIY-cloth-face-covering-instructions.pdf 
• To access Cloth Face Coverings FAQs, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-faq.html  

Additional resources on face coverings:  

• For information on when and how to use masks; https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks 
• For information on how much protection face masks offer, https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-mask/art-20485449