Wednesday, May 11, 2011

On TV, PWDs Are “Ratings Gold”

Two contestants on Dancing on Wheels on BBC

[By Suzanne Robitaille]

Every now and then the media writes an article about reality shows thatblend in people with disabilities. Favorites are American Idol contestant James Durbin, who has both Tourette and Asperger syndromes, and Luke Adams, the first Deaf contestant on The Amazing Race. While it’s great to see differently abled folk thrown into the crazy, shenanigan-lovin’ circus that is reality TV, it’s about time that producers began realizing the potential for PWDs to draw in top ratings all on their own.

There’s no finer person to lead this trend than Oprah Winfrey, who just crowned Zach Anner, a comedian who has cerebral palsy, as the winner of his own TV show on the Oprah Winfrey Network. Anner plans to travel the world in his wheelchair, cracking jokes about inaccessible palaces and how yoga looks a lot like how he puts on pants in the morning.

In a cable series on NBC’s Universal Sports, Take a Seat followed filmmaker Dominic Gill, who shared a tandem bike with 10 physically challenged partners during a cross-country trip. The network is innately familiar with physical disabilities as it sponsors and airs the Paralympics Games. Not to be outdone is TLC’s popular series Little People, Big World, which follows an Oregon family of little (and average-height) people as they juggle the social and physical challenges of living with dwarfism.

Across the pond, the Brits are fashionably early to this game. There’s BBC America’s Britain’s Missing Top Model, where all the models have a disability, yet, in the beauty industry, “an ounce of fat is a greater hurdle than a missing limb,” as The New York Times television critic Alessandra Stanley keenly notes. Dancing On Wheels is another BBC program where six couples compete for the Wheelchair Dance Sport European Championships – and some of them do a mean foxtrot.

And though it ended in 2009, BBC’s The Cast Offs was like Survivor for PWDs, where viewers rooted for a paraplegic, a dwarf, a blind person, a deaf person, a man with deformed arms and a woman with a facial condition to endure on a British island for 90 days. One reviewer called it “Lord of the Flies on crack.”

PWDs are now even creating their own web series on YouTube. One to check out is My Deaf Family, which is executive produced by Deaf actress Marlee Matlin (who also is a contestant in this season’s Celebrity Apprentice). A BBC Ouch! web series, My Big Fat Inclusive Wedding, asks disabled brides to recount the unique touches that made their days so special. Ouch! also hosts a fascinating web podcast between three disabled comedians in Australia, San Francisco and in London.

Since no one person with one type of disability can truly represent someone with a different disability, you can bet there’s gads and gads of PWD storytelling to explore on the tube. New Mobility Magazine said it best: PWDs “show the reality of life. The fullness of life. Add in the curiosity factor, and we’re ratings gold.”

TecAccess Trains Disabled Youth For Social Media Careers

Social media such as Facebook, Twitter and LinkedIn are transforming how businesses develop new products and improve services — and the need for tech-savvy people to run social media for companies is growing by leaps and bounds. At the same time, young people with disabilities like autism and other developmental or intellectual disorders are finding themselves underemployed. One possible solution: Put them to work in the social media field.

TecAccess, a provider of accessibility consulting services, has teamed up with the Virginia Department of Rehabilitative Services and non-profit American Epiphany for a pilot internship program to teach special needs young people to become social media specialists and land jobs in the corporate world, with the goal of helping them develop long-term successful careers.

“Corporate America is finally realizing what the kids have known for several years now….and want to jump on the social media bandwagon, says Debra Ruh, founder and CEO of TecAccess. “Our goal is to expose these young people to a work environment and teach them how to use skills they already have in an appropriate way that can pay huge dividends for the businesses that hire them,” says Ruh.

The first class got underway earlier this month, with students between ages 19 and 24 with disabilities ranging from autism and Down syndrome to attention deficit hyperactivity disorder (ADHD). Social media is a niche that can easily be filled by high functioning people with these types of disabilities, because it doesn’t require an as-intense level of social or customer interaction as other jobs might. The focus on information technology also appeals to many people with disabilities who have grown up with technology that helps them learn and communicate, and tend to be more tech-savvy as a whole.

Class instructors are already reporting progress. One of the interns with Aspergers’ who came into the first class was very hesitant and withdrawn, and didn’t connect with other members of the group, says instructor Chris Hagerman. The intern had difficulty speaking when asked a question in class, but she could write “furiously” and had no trouble reading her answers out loud. “There was much less pressure writing down her answer and then reading it to the class,” Hagerman says. “Now she can’t wait to get started.”

Long-time Richmond, Va., news anchor Andrea McDaniel is the founder of American Epiphany, a one-year-old 501(c)(3) non-profit that works to help writers create and promote stories that celebrate the vision of America’s Founding Fathers. McDaniel says media folks were early to jump on the social media bandwagon. Facebook and other tools are “the fastest ways of getting information out, as we just witnessed in Egypt [when long-time Egyptian President Hosni Mubarak stepped down],” McDaniel says.

For the state of Virginia, which recently received a warning from the U.S. Justice Department over the way the state treats its citizens with disabilities, the pilot internship program is an affordable solution to bringing more training programs to the community for people with disabilities. The Virginia Department of Rehabilitative Services helped develop the course curriculum and has provided ongoing support.

Monday, May 2, 2011

Employers Gird for Disabilities Act Changes

Amendments to the Americans with Disabilities Act that take effect on May 24 are intended to make businesses focus on accommodation. An attorney explains what owners should expect and do

Recent amendments to the Americans with Disabilities Act widen the range of disabilities and shift the burden of proof from employees to business owners in labor disputes, says Jeff Nowak, a labor and employment attorney at Franczek Radelet in Chicago. The new regulations issued last month by the U.S.Equal Employment Opportunity Commission were mandated by the ADA Amendments Act of 2008 and will take effect on May 24. In fiscal year 2010, there were 25,165 disability discrimination charges filed with the EEOC, up from 21,451 charges in fiscal year 2009.Nowak says employers will have to spend more in the future to accommodate disabled employees and assign staff to handle impairment requests. He spoke recently to Smart Answers columnist Karen E. Klein. Edited excerpts of their conversation follow.

Karen E. Klein: How do the amended rules compare to the original Americans With Disabilities Act of 1990?

Jeff Nowak: The amendments were enacted on Sept. 25, 2008, and became effective on Jan. 1, 2009. The law made a number of significant changes to the definition of "disability" under the Americans with Disabilities Act (ADA). Congress approved the final regulations drafted by the EEOC on a bipartisan vote and they were published last month.

As originally enacted, the ADA defines someone with a disability as one who has a physical or mental impairment that substantially limits one or more major life activities. Individuals also may be protected by the ADA if they are regarded as having a disability, such as HIV, or having a record of a disability, such as alcoholism.

What does the amended law change?

It did nothing to change that basic definition. However, since the ADA took effect, the courts have construed the definition in a relatively narrow fashion. So a court could dispose of a case alleging discrimination by finding that the individual was not actually disabled.

The amendments make sweeping changes in the manner in which these terms now are construed. The final regulations include specific language that says the term "disability" should be broadly construed to the maximum extent permitted by the terms of the ADA.

The message from Congress and the EEOC for business couldn't be any clearer: Stop focusing on whether someone is disabled and focus on the potential discrimination and reasonable accommodation.

These new regulations list certain impairments that the EEOC says will virtually always be found to be a disability. What are those conditions?

They include deafness, blindness, autism, cancer, cerebral palsy, diabetes, epilepsy, and major depression. It's not a per se list, stating that every one of these conditions will always be considered a disability, but it went nearly that far.

What's interesting about this list is the EEOC has always taken the position that you have to conduct an individual assessment to see what the person can or can't do before you make a determination of disability. For instance, I can't assume that diabetes is a disability until I make an assessment of the employee's disability. Now the burden is shifted to the employer to prove it does not constitute a disability.

Certainly if someone is blind or in a wheelchair with cerebral palsy, there's not much dispute that they're disabled.

(story continued here)

Tuesday, April 26, 2011

Income at Risk: Unemployment Slows For Some, But Not People with Disabilities, Allsup Finds

Rising Social Security disability applications begin to stabilize; financial strains continue for many people with disabilities and their families
Belleville, Ill. – April 20, 2011 – During first quarter 2011, the unemployment rate for people with disabilities continued to significantly outpace the unemployment rate for other workers, according to the quarterly Allsup Disability Study: Income at Risk.Allsup is a nationwide provider of Social Security Disability Insurance (SSDI) representation and Medicare services.
The Allsup study shows people with disabilities experienced an unemployment rate approximately 60 percent higher than people with no disabilities for the first quarter 2011. Specifically, the unemployment rate for the first quarter averaged 14.9 percent for people with disabilities, compared to 9.3 percent for others, according to non-seasonally adjusted data from the U.S. Bureau of Labor Statistics (BLS).
Since the BLS began reporting unemployment rates for people with disabilities nearly three years ago, the lowest unemployment rate reported for people with disabilities was 11.1 percent, recorded in November 2008. In comparison, the highest unemployment rate for people with no disabilities during this time period topped out at 10.4 percent in January 2010.
“People with disabilities often face a significantly greater challenge in locating and maintaining employment,” said Paul Gada, personal financial planning director for the Allsup Disability Life Planning Center. “Their health conditions may make it difficult to continue working for extended periods of time, causing them to come in and out of the job market. As their conditions worsen, ultimately, hundreds of thousands find it is impossible to return to the work force.”
The BLS also reported that 45.5 percent of those individuals unemployed in March had been jobless for 27 weeks or more. This compares to 44 percent who had been jobless for 27 weeks or more during March 2010.
Number of New SSDI Claims Begins to Stabilize
The Allsup Disability Study: Income at Risk also shows that during first quarter 2011, the number of people with disabilities unable to work and applying for SSDI increased to 720,119, up just 1 percent compared with first quarter 2010. An estimated 1.8 million SSDI claims are pending in the Social Security review process with an average cumulative wait time of more than 880 days.
“It’s not easy to apply for Social Security disability benefits and many people experience significant financial hardship, including bankruptcy and foreclosure, while waiting years to receive their SSDI benefits,” Gada said.
Knowing if and when to apply for SSDI benefits are two important and complex decisions facing people with serious health conditions. “People with disabilities often wait longer than they should because they don’t understand the guidelines and their eligibility, and they haven’t sought the professional representation that could get them their benefits more quickly,” Gada said. “This can prolong their wait for the income provided by SSDI and add to their financial burdens.”
On the flipside, other individuals may be applying for Social Security benefits without meeting the guidelines. This further contributes to the delay experienced by those who do qualify for benefits.
SSDI Guidelines and Process
Generally, applicants are considered disabled by the Social Security Administration if:
  • They cannot do the work they did previously;
  • They cannot do any other work because of their disability; and
  • Their disability has lasted or is expected to last at least one year, or result in death.
To qualify for SSDI, a person also must have worked and paid into the program (via FICA payroll taxes) for five of the last 10 years and be under retirement age. Studies show that a 20-year-old worker has a 3-in-10 chance of becoming disabled before reaching retirement, according to the Social Security Administration. However, only a small percentage of people with disabilities qualify for SSDI.
Gada noted that the SSDI guidelines are intentionally stringent and the application process requires an extensive amount of paperwork. This includes completing an initial disability insurance application and, in most instances, a detailed activities of daily living questionnaire. Information is needed on the person’s work history and the impact of the disability on his or her day-to-day activities. A doctor must verify information and additional medical exams may be required if there is not enough information to make a decision.
“SSDI is intended to be a financial safety net for people who have paid into the system and have serious, long-lasting disabilities that prevent them from working. For these individuals, it truly is a lifeline, providing monthly benefits as well as earlier access to Medicare and protection for their retirement income,” Gada said.
Individuals uncertain of their eligibility for disability insurance benefits can contact the Allsup Disability Evaluation Center at (800) 279-4357 for a free evaluation.
Allsup also provides free financial resources and tools to help people with disabilities better manage their finances while awaiting SSDI benefits. This includes information on establishing a budget, managing debt and healthcare costs, and learning about resources to better address financial issues such as bankruptcy and foreclosure. These resources are available online at MyFinances.Allsup.com.
ABOUT ALLSUP
Allsup is a nationwide provider of Social Security disability, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers. Founded in 1984, Allsup employs nearly 800 professionals who deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. The company is based in Belleville, Ill., near St. Louis. For more information, visit www.Allsup.com.
The information provided is not intended as a substitute for legal or other professional services. Legal or other expert assistance should be sought before making any decision that may affect your situation.

Editor’s Note: Details on the first quarter 2011 Allsup Disability Study: Income at Risk are available at http://www.allsup.com/Portals/4/allsup-study-income-at-risk-q1-11.pdf

What to Expect at a Social Security Disability Hearing

What to Expect at a Social Security Disability Hearing

Disability appeal may mean a hearing before a judge is the next step
Belleville, Ill. – April 22, 2011 – Many applicants for Social Security Disability Insurance (SSDI) benefits wait several years for an in-person hearing before an administrative law judge. Now that the hearing date is finally upon them, what should they expect? Allsup, which has successfully represented more than 150,000 people for their SSDI benefits, offers the following information and advice.
SSDI is a federally mandated disability insurance program that taxpayers and their employers fund through payroll taxes. Social Security disability benefits provide monthly income to those who have experienced a severe disability and can no longer work for 12 months or longer, or who have a terminal condition. Claimants’ whose SSDI applications are denied can pursue a disability appeal and, eventually, reach the hearing level. This is when a hearing before an administrative law judge is required in order to decide the claim for Social Security benefits.
How should I dress? The first rule, says Edward Swierczek, an Allsup senior claims representative with more than 37 years SSDI experience, is to just be yourself. “There’s no need to wear a business suit to the hearing,” he said. “Don’t try to be too spiffy. Wearing nice casual clothes is always appropriate, but don’t overdo the casual look by wearing shorts or a halter top because that’s just not appropriate in a court of law.”
What happens in the hearing room? Besides the claimant and his representative, if he has one, people attending the hearing will include the administrative law judge (ALJ), an assistant who records the proceedings, and usually a vocational or medical expert, or both. A claimant may bring a friend or family member to testify on his or her behalf. But their testimony will have, in most instances, minimal impact, Swierczek said, because most ALJs will consider their testimony somewhat prejudiced in favor of the claimant. However, the testimony will certainly be considered.
The proceedings begin when the judge swears in the claimant and asks general questions for the record. These may include establishing the claimant’s name, date of birth and Social Security number. The ALJ also may ask the claimant for his height, weight and living arrangements.
Often, the ALJ will ask direct questions about how a disability affects the claimant’s daily life. A typical question is, “Can you go shopping?” According to Swierczek, this is where a representative may interject with questions of his own to help clarify the claimant’s physical limitations. “Although the claimant may reply, ‘Yes, I can shop,’ this may not be the complete answer,” Swierczek pointed out. “Because I know the complete details of the claimant’s situation, I may ask my own questions to ensure the ALJ has all the information he needs to make an informed decision.
“For example, although the claimant can indeed go shopping, my questions may reveal that because his disability prevents him from driving to the grocery store, he has to rely on a neighbor for a ride to the store. Then, after he’s in the store, he has to ride a motorized scooter up and down the aisles and get help from a store employee to reach items on the top shelf.”
What happens next? After questioning the claimant, the ALJ may question the vocational expert if there are any jobs in the national economy the claimant can perform. A question to a medical expert may be an inquiry if the claimant is physically or mentally able to perform that type of work.
Although there are exceptions, as a rule, hearings usually last about an hour or less. Three things can happen at the conclusion of an SSDI hearing:
The ALJ will close the record and the claimant will receive a written decision, which may take up to six months. This is the most common method of receiving the ALJ’s decision.
The ALJ will make a bench decision, announcing at the hearing that he is awarding SSDI benefits.
The judge may indicate that he’s awarding benefits, but that the claimant will have to wait for a formal notification.
Swierczek added that although SSDI hearings are often stressful for the claimant, they are not intended to be confrontational.
“Generally, most judges are understanding and patient,” he said. “Their job is to hear all the facts and get all the information they need to make a determination if the claimant is eligible for SSDI benefits. The big thing for claimants to remember is to relax, be themselves, and answer all questions truthfully and completely.”
Individuals who have questions about handling their disability appeal, may contact Allsup’s Disability Evaluation Center at (800) 279-4357 for a free SSDI evaluation.
ABOUT ALLSUP
Allsup is a nationwide provider of Social Security disability, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers. Founded in 1984, Allsup employs nearly 800 professionals who deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. The company is based in Belleville, Ill., near St. Louis. For more information, visit www.Allsup.com

Disabled, but Looking for Work

Disabled, but Looking for Work

BATESVILLE, Ark. — Christopher Howard suffers from herniated discs in his back, knee problems and hepatitis C. As a result, Social Security sends him $574 every month and will until he reaches retirement age — unless he can find a job.

Christopher Howard, 36, with his wife, Darlene. “I would feel better if I worked and made my own money,” he said.

Christopher Howard and his wife live on his $574 a month disability check from Social Security. He is confident he will find a job.
Though he has been collecting disability checks for three years, Mr. Howard, who is just 36, desperately wants to work, recalling dredging for gravel rather fondly and repairing cell towers less fondly.

“It makes me feel like I am doing something,” said Mr. Howard, a burly man with a honey-colored goatee. “Instead of just being a bum, pretty much.”

Programs intended to steer people with more moderate disabilities back into jobs have managed to take only a small sliver of beneficiaries off the Social Security rolls.

Yet, at a time when employers are struggling to create spots for the 13.5 million people actively looking for jobs, helping people like Mr. Howard find employment — or keeping them working in the first place — is becoming increasingly important to the nation’s fiscal health.

For the last five years, Social Security has paid out more in benefits to disabled workers than it has taken in from payroll taxes. Government actuaries forecast that the disability trust fund will run out of money by 2018.

About 8.2 million people collected disabled worker benefits totaling $115 billion last year, up from 5 million a decade earlier. About one in 21 Americans from age 25 to 64 receive the benefit, according to an analysis of Social Security data by Prof. Mark G. Duggan, an economist at the University of Maryland, compared with one in 30 a little over a decade ago. In Mr. Howard’s home state of Arkansas, the figure is one in 12, among the highest in the nation.

Along with monthly checks that are based on the worker’s earnings history, beneficiaries generally qualify for Medicare — otherwise reserved for those over 65 — two years after being admitted to the disability rolls.

There are several reasons for the increase in beneficiaries. Baby boomers are hitting the age when health starts to deteriorate, and more people are claiming back and other muscular-skeletal ailments and mental illnesses than claimed those as disabilities a generation ago. Lawyers who solicit clients on television and on the Internet probably play a role. And administrative law judges say pressure to process cases sometimes leads to more disability claims being accepted.

But given the difficult job market, some economists say they believe that an increasing number of people rely on disability benefits as a kind of shadow safety net.

The program was designed to help workers who are “permanently and totally disabled,” and administration officials say that it is an important lifeline for many people who simply cannot work at all.

But Social Security officials can take into consideration a claimant’s age, skills and ability to retrain when determining eligibility. So one question is: How many of these beneficiaries could work, given the right services and workplace accommodations? Social Security officials say relatively few.

Nicole Maestas, an economist at the Rand Corporation, has examined Social Security data with fellow economist Kathleen J. Mullen, and concluded that in the absence of benefits, about 18 percent of recipients could work and earn at least $12,000 a year, the threshold at which benefits are suspended.

Other economists say that even among those denied benefits, a majority fail to go back to work, in part because of medical problems and a lack of marketable skills.

“In an atmosphere in which there is a concern about fiscal problems, it’s always easy to point the finger at groups and say, ‘These people should be working,’ ” said Prof. John Bound, an economist at the University of Michigan, “exaggerating the degree to which the disability insurance program is broken.”

Even if claimants have more ambiguous medical cases, once they are granted disability benefits, they generally continue to collect. Of the 567,395 medical reviews conducted on beneficiaries in 2009, Social Security expects less than 1 percent to leave because of improved health.

The benefits have no expiration date, like the current 99-week limit for collecting unemployment. And because many people spend years appealing denials and building their medical case before being granted benefits, their skills often atrophy and gaps open on their résumés, making it more difficult for them to get back to work.

Beneficiaries, who also fear losing health care coverage, may view their checks as birds in the hand. “Even if you’re taking just $800 or $900 a month, that’s better than nothing,” said Bruce Growick, an associate professor of rehabilitation services at Ohio State University.

Shortly after Mr. Howard’s benefit checks started arriving, he received a four-by-six-inch card from Social Security informing him of services to help him return to work. Confused by the bureaucratic language and fearing the loss of medical coverage, he discarded it. When he called the local office, he said a staff member did not seem to know what his rights were or what help was available.

“I thought it is just better to get what we are getting,” he said.

In fact, Social Security offers disability beneficiaries some incentive to ease back into the work force. For nine months after starting a job, they can earn any amount without threatening their benefits. For another three years, if their income falls below $1,000 a month, they can immediately receive full benefits again. And they can keep Medicare coverage for eight and a half years after going back to work, something few beneficiaries may realize.
The earnings ceiling for those receiving disability checks from Social Security creates a “powerful disincentive to work.”

In 1999, Congress passed a law authorizing the Ticket to Work program, which offers beneficiaries practical help with a job search. Social Security also waives medical reviews for those who participate.

So far, the program has had little success. Out of 12.5 million disabled workers and those who receive benefits for the disabled poor, only 13,656 returned to work over the last two and a half years, with less than a third of them earning enough to drop the benefits.

A Social Security spokesman noted that some other beneficiaries had returned to work without using its Ticket to Work program. In 2009, 32,445 recipients left the benefit rolls because they were earning enough in jobs.

Officials say they have streamlined and simplified the Ticket to Work program. But even with more awareness, they say not enough people could go back to work to make a difference in the disability trust fund.

“We could make this program exponentially more successful and it wouldn’t be enough to dramatically improve the solvency picture,” said Michael J. Astrue, the commissioner of Social Security. “You do it because work — for people who can work — gives them dignity and improves their economic condition.”

In Batesville, a small manufacturing town about 80 miles northeast of Little Rock, Ark., Mr. Howard and his wife, Darlene, who is also out of work, scrape by on his monthly $574 check. They live in a garage behind the home owned by Mr. Howard’s parents. Inside the forest green shack, which has no running water, they have crammed some shabby furniture and a tiny galley kitchen.

Mr. Howard, who went to a community college for only six weeks and quit before becoming a certified nursing aide, landed work over the years through friends and family. One job was building and repairing cell towers in Illinois. In 2000, during a climb up a tower, Mr. Howard fell more than 20 feet before a pull cord stopped him. He quit on the spot, but ignored the back pain.

He moved back to Arkansas, met Ms. Howard and began working for a company that dredged the White River for gravel used to make asphalt and concrete. He operated 25- to 40-pound pumps, drove a forklift and repaired plant vehicles, earning $8.50 an hour, or about $22,000 a year with overtime.

The job kept him outside every day, and sometimes he fished for bass and trout on the way upriver. “I would still be doing that job if I could,” he said on a cool March afternoon as he sat in a booth at McDonald’s, sharing refills of Dr Pepper with his wife.

Six years ago, his working life came to a halt. While fixing a dump truck, he began vomiting blood. He was rushed to the hospital, where his gallbladder was removed, because of complications of the hepatitis C he had contracted from a tattoo in his early 20s.

Mr. Howard, who said he spent much of his 20s hanging out with the “wrong crowd,” admits he played a role in his poor health. “I was living pretty heavily on the weekends,” he said.

After the surgery, doctors determined he had herniated discs. He tried to go back to work but found he could not perform many tasks, like heavy lifting, and was dismissed.

His initial application for disability benefits was denied. He tried going back to work, hanging dry wall, but pain stopped him. Eventually, he hired a lawyer. After three years and three tries, he won benefits.

Last September, he met Shawn Blasczczyk, a coordinator of the Ticket to Work program with the White River Area Agency on Aging in Ash Flat, Ark., who had given a presentation at an employment office where Mr. Howard’s father worked. After learning he had some protections while searching for work, Mr. Howard decided to try.

Advocates for the disabled say Social Security makes lackluster efforts to promote the Ticket to Work program. All new beneficiaries should have an appointment to “talk to a benefits counselor about returning to work and how it will affect you,” said Lori Gentry, a care manager at the White River agency, a nonprofit that works with disabled beneficiaries. “I don’t think that is a whole lot to ask to get a monthly check.”

Some advocates recommend intervention before people receive benefits to try to help the disabled stay in jobs in the first place.

In a proposal for the Center for American Progress and the Brookings Institution’s Hamilton Project, Professor Duggan of the University of Maryland and Prof. David H. Autor, an economist at M.I.T., suggest that disabled workers be offered partial income support and services to remain in the workplace. Moreover, they advocate for employers to purchase mandatory disability insurance as they do unemployment insurance and workers’ compensation, giving them incentive to accommodate workers rather than send them to the federal benefit rolls.

Mr. Howard is bumping up against his limitations, only some of which have to do with his medical condition. Last September, Ms. Blasczczyk helped place him in a job driving seniors to doctors’ appointments, but he quit after six months because of the stress. Scrolling through job listings at McDonald’s on a recent afternoon, he noted that many required college degrees.

Still, Mr. Howard is confident he will eventually find some work. While searching, he and Ms. Howard, who is also applying for work, have quit smoking and are trying to eat healthier foods. They have joined Mr. Howard’s father in a Bible study group.

“I would feel better if I worked and made my own money,” he said. “Because that way when somebody who needs it even more than I do, the Social Security would be there for them.”

Thursday, April 21, 2011

Coordinated Care for People with Medicare and Medicaid

New flexibility for states to improve Medicaid and implement innovative practices
New rules will make Medicaid more flexible and efficient, helping states provide better care and lower costs

The U.S. Department of Health and Human Services (HHS) today announced four initiatives to give states more flexibility to adopt innovative new practices and provide better, more coordinated care for people with Medicaid and Medicare while helping reduce costs for states and families. The initiatives support the Obama administration’s work to make Medicaid more flexible and efficient and to address long-term cost growth. Several of the announcements also help implement provisions of the Affordable Care Act. Today HHS announced:

  • Fifteen states will receive federal funding to develop better ways to coordinate care for people with Medicare and Medicaid coverage, also known as dual eligibles, who often have complex and costly health care needs.
  • All states will receive increased flexibility to provide home and community-based services for more people living with disabilities.
  • All states are eligible to receive more money to develop simpler and more efficient information technology (IT) systems to modernize Medicaid enrollment.
  • A proposal by the state of New Jersey for flexibility to expand health coverage for nearly 70,000 low-income residents has been approved.

“Medicaid programs provide health coverage for millions of low-income Americans who otherwise would lack access to health care,” said HHS Secretary Kathleen Sebelius. “With these new resources and flexibilities, states will have new options to make their Medicaid programs work better for the people they serve, while helping lower their costs.”

Coordinated Care for People with Medicare and Medicaid

Under a new initiative funded by the Affordable Care Act, 15 states will receive up to $1 million each to develop new ways to meet the often complex and costly medical needs of the approximately nine million Americans who are eligible for both the Medicare and Medicaid programs, known as “dual eligibles.” The goal of the program is to eliminate duplication of services for these patients, expand access to needed care and improve the lives of dual eligibles, while lowering costs. The new Federal Coordinated Health Care Office, or the Duels Office, at the Centers for Medicare & Medicaid Services (CMS), was created by the Affordable Care Act to improve care for dual eligibles and will work with the states to implement the top strategies to coordinate primary, acute, behavioral and long-term supports and services for dual eligibles, improving quality and lowering costs.

The 15 states that will receive these funds are California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin.

“Beneficiaries who are in both Medicare and Medicaid can face different benefit plans, different rules for how to get those benefits and potential conflicts in care plans among providers who do not coordinate with each other,” said Donald M. Berwick, M.D., administrator of CMS. “This can be disastrous for those beneficiaries who are most vulnerable and in need of help.”

Helping People with Disabilities Live in their Communities

CMS proposed new rules today giving states new flexibility for their programs to help people with disabilities choose to live in their communities rather than in institutions. The proposed rules reduce administrative barriers for states seeking to help multiple populations, which may include seniors and/or people with different types of disabilities. They will also allow individuals to participate in the design of their own array of services and supports, including such things as personal care and respite services for caregivers.

“These long awaited rules will help people living with disabilities realize the promise of the ADA to live in the least restrictive environments possible for them—like their own homes,” said Henry Claypool, director of the Office on Disability at HHS. “With these new tools as well as incentives included in the Affordable Care Act, states, working closely with advocacy groups, beneficiaries, and other stakeholders, can more easily develop effective plans to improve options for people with disabilities. We hope states will take advantage of this new flexibility.”

The proposed rule, CMS-2296-P, can be found at www.ofr.gov/inspection.aspx.