CONSOLIDATION OF SUPPORTED EMPLOYMENT PROGRAMS
FOR PEOPLE WITH DISABILITIES
DBPC is issuing this revised position on consolidating Supported Employment (SE) programs in response to Governor Pataki's proposal to move Vocational and Educational Services for Individuals with Disabilities (VESID) and the Commission for the Blind and Visually Handicapped (CBVH) to the Department of Labor (DOL). This is NOT what DBPC had in mind. DBPC does not propose the relocation or consolidation of any agencies. We ask that Supported Employment programs be fully consolidated--including those now overseen by OMRDD, OMH, CBVH, and VESID--with one uniform set of definitions, regulations, and reports, and solely administered by VESID. DBPC opposes the Governor's proposal. DOL does not have the necessary knowledge or experience to provide services to people with disabilities. They have traditionally focused on short-term services, which are very different from the complex array of ongoing services needed by people with a wide variety of disabilities. And the Governor's plan does not truly consolidate anything; it simply physically moves two of the four agencies to a different location.
67% of people with disabilities are unemployed and therefore dependent on government-funded income supports. At this time of fiscal crisis, New York must make better use of programs that can reduce such dependence.
Supported Employment (SE) programs do this for people with disabilities by providing concrete supports for finding and retaining jobs. However, New York's administration of these programs is inefficient and redundant. Depending on the disability, SE services are available through VESID, CBVH, OMH and OMRDD. Each agency has its own set of regulations, definitions of disability, and documentation requirements, which often conflict with one another, resulting in confusion and unnecessary duplicative paperwork for providers. Additionally, each state agency conducts its own fiscal and programmatic audits, wasting a great deal of time and resources of the state and provider agencies. New York State should consolidate all supported employment programs for people with disabilities under VESID, with significant involvement of consumers, advocates and providers. This would establish one set of regulations and requirements for all disability groups and streamline administration and service delivery, producing significant savings, some of which could support more services for consumers. VESID has the most expertise in providing SE services to people with all types of disabilities, and is the best choice to house these programs.
New York's funding priorities for sheltered vs supported employment also increase state spending by promoting, rather than discouraging, dependence. NY funds sheltered employment services for individuals at twice the rate it pays for supported employment, creating an incentive to keep people with disabilities in segregated workshops (which often pay sub-minimum wage) rather than transitioning them to integrated jobs with competitive wages that enable people with disabilities to reduce their use of government services and become productive taxpayers. Many sheltered employment programs have tried to transition from segregated to integrated competitive services. While their philosophies and policies have shifted, the funding mechanism has not changed, forcing them to maintain their better-funded segregated programs in order to survive. New York State should allow funds to follow consumers from segregated to integrated/competitive employment opportunities, creating incentives and adequate resources to serve New Yorkers with the most significant supported employment needs.
RECOMMENDATIONS:
- Oppose Governor Pataki's proposal to move VESID and CBVH to NYSDOL.
- Consolidate ALL supported employment programs for people with disabilities under VESID, with involvement of consumers, advocates and providers.
- Allow funds to follow consumers from segregated to integrated/competitive employment opportunities.
FISCAL IMPACT: BUDGET NEUTRAL - ANTICIPATE COST SAVINGS
REPEAL HOME CARE COST-CUTTING TARGETS
Each year, since at least 1995, the legislature has enacted so-called "cost-saving" targets that have required certain counties and New York City to save a specified amount of money in the state share of Medicaid costs for personal care and, in some years, certified home health care. The penalty for a district that failed to achieve the specified cost savings has been a dollar-for-dollar budget cut in the amount not saved. For example, in 1995 the cost-saving target for personal care was a $53 million cut from the State share of Medicaid, L. 1995 ch. 81 _ 93. The state share of Medicaid costs for Personal Care is only about 40% of the total cost of services, with 10% paid by the local districts and 50% by the federal government. In order to achieve the state's $53 million cost-cutting target, districts had to cut over $100 million in personal care expenditures. The 1995 legislation, which enacted the cost-cutting targets, was drafted in a way to put most of the burden of meeting the targets on New York City, along with Nassau, Rockland and Putnam counties. Since 1995, similar legislation has been enacted nearly every year, mandating cost-saving targets in varying amounts.
Existing targets must be repealed, and no further home care cost-saving targets must be enacted. First, the targets are not cost-effective because they target only community-based long-term care, while ignoring institutional long-term care costs. The targets force local districts to reduce home care costs - under threat of harsh fiscal penalties - even though home care cuts result in increased nursing home placements and costs. Medicaid nursing home costs in New York State increased by 11%to $5.1 billion from 1997 to 1999. note 2 In the same years, the cost of the combined Medicaid home care programs increased by only 8% to $2.5 billion. This failure to consider the effect of home care cuts on global long-term care costs is a gross fiscal error. Moreover, cutting home care causes ripple effects in other medical care costs, with increased medical and hospital costs for malnutrition and dehydration, fractures, and medical conditions exacerbated by lack of care.
In addition to not being cost-effective, the targets are illegal, violating the Americans with Disabilities Act (ADA) as interpreted in Olmstead v. L.C., 527 U.S. 581 (1999). Under the Olmstead decision, states must provide long-term care services in the community rather than in nursing homes when it is not an "undue burden" to avoid discrimination. The targets have led the affected local districts to cut home care services and make these services less accessible in certain parts of the state, forcing people into nursing homes in violation of the ADA.
RECOMMENDATION:
Repeal cost-saving targets that require certain counties and New York City to save a specified amount of money in the state share of Medicaid costs for personal care and sometimes home health care.
FISCAL IMPACT: BUDGET NEUTRAL - ANTICIPATE COST SAVINGS
VITAL PERSONAL CARE SERVICES
FOR PEOPLE WITH
ALZHEIMER'S DISEASE AND OTHER COGNITIVE IMPAIRMENTS
The State Department of Health and various local Medicaid districts have incorrectly interpreted state Medicaid law to permit them to deny personal care services needed by people with Alzheimer's disease and other cognitive impairments. This is the result, in large part, to a policy change in 1996 that defined personal care services solely as help with physical tasks, excluding the supervisory care of aides that had long enabled people with Alzheimer's disease and other types of cognitive impairments to remain safely at home. The state claimed that the exclusion of supervisory care of aides was needed for "safety monitoring" of a person with Alzheimer's disease. Although this was an abrupt departure from decades of practice in New York State, it was upheld by the United States Court of Appeals for the Second Circuit in Rodriguez v. City of New York, 97 F.3d 611 (2d Cir. 1999).
New York State must ensure that its Medicaid program does not discriminate against people with Alzheimer's disease or other types of cognitive impairments. Personal care services should be equally accessible regardless of whether the individual's need is caused by a cognitive impairment or a physical impairment. Denial of adequate personal care for people with Alzheimer's disease or other types of cognitive impairments will force them to be institutionalized even when care in the community is the most appropriate setting. Unnecessary institutionalization is not only contrary to longstanding state policy, but violates the Americans with Disabilities Act (ADA), as interpreted by the United States Supreme Court in Olmstead v. L.C., 527 U.S. 581 (1999).
Moreover, state law must be made consistent with the recent amendments of the Federal State Medicaid Manual by the Health Care Finance Administration (now called the Center for Medicare and Medicaid Services), which oversees the Medicaid program nationally. As amended in January 1999, the definition of "personal care" in the State Medicaid Manual clarifies that "An individual may be physically capable of performing ADLs and IADLs note 3 but may have limitations in performing these activities because of a cognitive impairment. Personal care services may be required because a cognitive impairment prevents an individual from knowing when or how to carry out the task. For example, an individual may no longer be able to dress without someone to cue him or her on how to do so. In such cases, personal assistance may include cuing along with supervision to ensure that the individual performs the task properly," HCFA State Medicaid Manual Section 4480 (Jan. 1999).
The state law should track this federal definition in order to ensure that personal care assistance is equally accessible, regardless of whether the individual's need is caused by a cognitive impairment or a physical impairment. The current definition of personal care services in the state social services law is general, stating that they are services of an aide "...as determined to meet the recipient's needs for assistance when cost-effective and appropriate...and when prescribed by a physician..." SSL 365-a (2)(e). It must be clarified that personal care services are those services that "meet the recipient's needs for assistance WITH ACTIVITIES OF DAILY LIVING AND HEALTH AND SAFETY NEEDS DUE TO HIS OR HER PHYSICAL OR COGNITIVE IMPAIRMENTS..." (Changes are in CAPITAL LETTERS)
RECOMMENDATION:
Mandate that personal care services be equally accessible regardless of whether the individual's need is caused by a cognitive impairment or a physical impairment.
FISCAL IMPACT: BUDGET NEUTRAL - ANTICIPATE COST SAVINGS note 4
INCORPORATE TITLES II AND III OF THE ADA
INTO THE NEW YORK STATE HUMAN RIGHTS LAW
The Americans with Disabilities Act of 1990 (ADA) is the most comprehensive law ever passed to protect the civil rights of individuals with disabilities. The ADA enables people with disabilities to participate more fully in their communities, compete effectively for jobs, travel, and gain access to the goods and services that most Americans take for granted. The New York State Human Rights Law includes some, but not all, of the ADA's protections for people with disabilities, causing needless confusion for government officials in attempting to comply with both statutes. Conforming the state statute to the ADA will clarify the obligations of government officials to take reasonable steps to ensure that their services, programs and activities are available to constituents with disabilities. Incorporating Titles II and III of the ADA into the New York State Human Rights Law will impose no new or additional requirements upon local government, since the local government is already responsible for complying with the provisions of the ADA.
The Assembly has passed legislation for the past several years that would clarify the scope of protections against discrimination on the basis of disability in the area of government services by incorporating Title II of the ADA into New York State's Human Rights law. Title II of the ADA prohibits discrimination on the basis of disability by public entities and certain transportation providers. State and local governments and any of their departments, agencies, or instrumentalities are required to make reasonable modifications to their policies, practices, and procedures that deny equal access to people with disabilities. State and local governments must ensure the program accessibility of their facilities.
Existing buildings need not be fully accessible, but their programs must be. Public entities must furnish auxiliary aids and services when necessary to ensure effective communication and may not place a special charge to cover the costs. They must eliminate unnecessary eligibility standards that deny people with disabilities an equal opportunity to enjoy their services. They may not refuse people with disabilities the right to participate in a service, program, or activity and must maintain these offerings in an integrated setting.
Title III of the ADA should also be incorporated into State statute. Title III covers the accessibility of public accommodations such as retail stores, restaurants, theaters, etc. Public accommodations must make any modifications that are readily achievable to allow people with disabilities the opportunity for equal use of goods or services offered. Several other states have already incorporated Title III language into their state laws and it is time for New York to do the same. This will impose no new or additional requirements upon businesses.
In 1997, New York State became a national leader by passing the Reasonable Accommodations Act, which reiterated ADA employment regulations as state law. It is time for the state to implement Titles II and III of the ADA and utilize the state's enforcement mechanisms through the Human Rights Law. This will bring state regulations into agreement with the ADA and assure people with disabilities full access under state law to all government programs and public accommodations.
RECOMMENDATIONS:
- Incorporate Title II of the ADA into the New York State Human Rights Law.
- Incorporate Title III of the ADA into the New York State Human Rights Law.
FISCAL IMPACT: BUDGET NEUTRAL
WAIVE STATE SOVEREIGN IMMUNITY TO ADA
AND SECTION 504 CLAIMS
New York should be a leader to our citizens with disabilities who seek equality and justice under the law. The United States Supreme Court decided in February 2001 that states are immune from claims brought under Title I of the Americans with Disabilities Act (ADA) by state employees with disabilities who have been subjected to illegal discrimination. Other courts have since found that states are immune from claims under Title II of the ADA, which covers all activities of state and local government, and from claims under Section 504 of the Rehabilitation Act, which prohibits discrimination on the basis of disability by recipients of federal funds. Although New York State and its agencies have previously been found by courts to have violated the rights of New Yorkers under the ADA and Section 504, millions of disabled New Yorkers can no longer seek redress for such violations.
The businesses, schools, cities, counties, towns and villages of New York State cannot violate the ADA or Section 504 without the prospect of being held responsible by a court of law for their actions. It is anomalous, unjust, and unfair that people with disabilities are fully protected by federal civil rights laws if confronted with discrimination by New York City, but have significantly less protection if confronted with discrimination by New York State. In June of 2000, the Assembly and the Senate both enacted resolutions recognizing the importance of the ADA in providing equal rights and opportunities to New Yorkers with disabilities. Last session, the Assembly passed legislation that would amend the Civil Rights Law to waive state sovereign immunity to claims brought under the ADA. Identical legislation was introduced, but never voted on by the full Senate. Both bills were strongly supported by our two largest public sector labor unions, PEF and CSEA. New York State must now reassume responsibility equal to that of its public and private entities and be held liable for discrimination against its citizens with disabilities.
We urge Governor Pataki and the Legislature to demonstrate their commitment to equal opportunity for all New Yorkers by restoring the protections against discrimination granted to people with disabilities under the ADA and Section 504, and eliminating this unjust and inequitable barrier to their enforcement. A law must be enacted waiving the state's sovereign immunity to claims brought against it under the ADA and Section 504. We can afford no less.
RECOMMENDATION:
Waive New York State's sovereign immunity to claims brought against it under the ADA and Section 504 of the Rehabilitation Act.
FISCAL IMPACT: BUDGET NEUTRAL
STATE REGISTRY OF AFFORDABLE, ACCESSIBLE HOUSING
Affordable, accessible housing is in great demand by people with disabilities. As the housing market has grown increasingly tight, the difficulty for people with disabilities to find affordable housing has mounted significantly. According to 1990 Census data, one out of every three New York renters cannot afford housing. The National Low Income Housing Coalition identified New York State as the least affordable state in the nation for one- and two-bedroom units in 1996 - 1998, and one of the least affordable states in 1999 - 2001. note 5 Beyond the creation of more affordable and accessible housing, the Disability Budget and Policy Coalition recommends that New York State create its own registry of affordable, accessible housing, similar to the one established in Massachusetts.
RECOMMENDATION:
Create a New York State registry of affordable, accessible housing.
FISCAL IMPACT: TO BE DETERMINED
SOURCE OF PAYMENT ANTI-DISCRIMINATION LEGISLATION
The New York State Disability Budget and and Policy Coalition strongly supports legislation that would ban housing discrimination on the basis of tenants' source of income. Given the shortage of low-income housing, it is very difficult to find affordable housing. The need for wheelchair accessibility in affordable apartments makes finding suitable living arrangements next to impossible. With affordable and accessible housing in such short supply, landlords must be prohibited from denying an applicant the ability to rent a unit based solely on the prospective tenant's means of payment for the apartment. The fact that the applicant receives government assistance cannot be grounds for a landlord's refusal to rent a unit.
Banning source of payment discrimination protects citizens most in need to find the most suitable housing arrangement possible. This discrimination is also making it harder for people trying to transition from welfare to work, and for working families with low or modest incomes. Twelve other states currently prohibit "source of income/payment" discrimination or Section 8-discrimination.
RECOMMENDATION:
Ban source of income/payment discrimination in order to protect New York's most in need citizens to find the most suitable housing arrangement possible.
FISCAL IMPACT: TO BE DETERMINED
ELECTION REFORM: ACCESSIBLE POLLING SITES AND VOTING MACHINES
In 1999, the Office of New York State Attorney General Eliot Spitzer teamed up with advocates on Election Day and evaluated the accessibility of polling places statewide; almost every county had problems. Months later, in February 2000, a Federal Court decision mandated that counties be responsible for ensuring the accessibility of polling sites.
During the last presidential election, "53 million Americans with disabilities watched as inequities in our fundamental right to vote unfolded across the nation. The situation in Florida was a microcosm of what the disability community has been experiencing--and demanding change about--for years." note 6 Luckily, the federal Help America Vote Act of 2002 (HAVA, or "The Act") provides potential solutions to many--though not all--of the problems people with disabilities have long endured.
on Election Modernization released the report Voting in New York in the 21st Century, containing recommendations for modernizing the State's election process. This non-partisan Task Force examined the current methods of voting and administering elections in New York and recommended alternatives that could be implemented to improve the process.
In addition to enacting the Task Force's recommendations, we must also fully utilize the opportunity that the Help America Vote Act presents, and improve upon its provisions.
RECOMMENDATIONS:
- Ensure that New York conforms to all the provisions of the Help America Vote Act (HAVA) and take full advantage of all federal funding promulgated for machine modernization, voter and poll worker education, a statewide registration system, and improved provisional voting systems.
- Implement the recommendations regarding access found in the New York State Task Force on Election Modernization report, Voting in New York in the 21st Century.
- Amend New York State Election Law 4-104. Specify that counties are responsible for guaranteeing the accessibility of polling places and provide mandated accessibility standards to ensure consistent access along exterior paths, entrances, interior paths and for the machines themselves.
- Eliminate the "full face ballot" requirement so that more of the modern voting machines will comply with State requirements.
- Eliminate the fee for non-driver's identification cards.
- Provide matching funds to counties for accessible voting machines and assist communities applying for federal money pursuant to HAVA. Provide a matching fund program for counties over a period of five years to assist them in making their voting machines accessible to all citizens. Funds would be provided to counties that can verify that the exterior paths, entrances, interior paths and the machines themselves are fully accessible.
FISCAL IMPACT: TO BE DETERMINED
EXPANSION OF SCRIE TO PEOPLE WITH DISABILITIES
The Disability Budget and Policy Coalition urges New York State to expand the Senior Citizens Rent Increase Exemption (SCRIE) program to include people with disabilities, making them eligible for the senior citizens' tax abatement for rent-controlled and rent-regulated property. In order for people with disabilities to lead independent lives, they need safe, affordable, and accessible housing. Yet, in New York City and the surrounding suburbs, this goal has become increasingly difficult in recent years, as New York State continues to experience an affordable housing crisis of tremendous proportions. According to recent statistics from the Census Bureau, one in four households in New York City spend more than half its income on rent.
RECOMMENDATION:
Expand the Senior Citizens Rent Increase Exemption (SCRIE) program to include people with disabilities.
FISCAL IMPACT: TO BE DETERMINED
NOTES:
NOTE 1: According to the most recent available figures, New York's total weighted average annual per-capita cost for all forms of nursing facility services is $78,110. The state's total weighted average per-capita cost for all forms of community-based services typically provided to nursing-home-eligible people is $13,754.
NOTE 2: Source: NYS Dept of Health Office of Medicaid Mgt., On-Line SURS Information Retrieval System, Medicaid Reference Statistics Federal Fiscal Years 1997-1999, Dollars, Services, & Recipients by Age, Aid Category & Geography (October 2000)
NOTE 3: ADLs are "activities of daily living" such as eating, bathing, dressing, toileting, transferring and maintaining continence. IADLs are "instrumental activities of daily living" including personal hygiene, light housework, laundry, meal preparation, transportation, grocery shopping, etc. HCFA State Medicaid Manual Section 4480 (Jan. 1999)
NOTE 4: People with Alzheimer's disease and other types of cognitive impairments who are denied home care must be placed in nursing homes at a higher cost than home care.
NOTE 5: Housing Policy paper found on the website of the Neighborhood Preservation Coalition of NYS - www.npcnys.org
NOTE 6: The Independent (A Publication of the Capital Distric Center for Independence, Inc.) 12/00 Volume 2, Issue 3
Got Questions?
Local Senators
Thomas Libous
(518) 455-2677
James Seward
(518) 455-3131
Leadership
Governor George Pataki
(518) 474-8390
Senate Majority Leader Joseph Bruno
(518) 455-3191
Deaf News
Linda Land
by Linda Greeno
FREE WORKSHOPS FREE WORKSHOPS FREE WORKSHOPS
I love free workshops but I love workshops even if they cost me money. I love to learn and improve myself for better service for the Deaf community.
Sarah Schiffler from Rochester coordinates a grant and sets up workshops for community interpreters in private practice. The interpreters can be hearing or deaf to be able to attend the free workshops fairly close to our hometown.
Workshops can teach interpreters to be better communicators and more knowledgeable about Deaf Culture. They can improve your life as an interpreter, to be the best interpreter you can possibly be.
These workshops are for interpreters, both deaf interpreters and hearing interpreters. But sadly, very few interpreters from Broome County and surrounding areas have taken advantage of these FREE workshops. There are many interpreters who could benefit from FREE training to learn and improve their skills for working with the Deaf community.
Deaf people have a right to get a good/skilled interpreter. I personally want an interpreter who seeks out current "best practices" and skill-refining training of the type that these free workshops provide. More interpreters in this area need to reassess their priorities.
All jobs require annual training. Interpreters in private practice need to make sure they make it part of their business practices and cost of doing business to get their annual training. Get FREE training while you can!
How many of you remember working with an interpreter who uses no facial expressions? Do you remember an expressionless interpreter who doesn't talk, but looks like a robot? How often do you as a Deaf consumer have to change your signing style because the interpreter can't understand everyday Deaf use of ASL? How often do you as a Deaf Consumer tell them, "Go get some training!"?
Sadly, the grant will expire at the end of July. Will the grant be renewed? Sarah will report how many people want to attend the workshops. If the government doesn't feel enough people were interested in the free workshops they will not bother to continue funding the project. That will hurt those of us who do take advantage of the free workshops. After July, Certified interpreters and interpreters who want someday to be certified may not be able to attend workshops for free. They will have to pay to attend workshops to be able to improve their skills or earn the credits needed to keep their certifications.
Don't lose this free opportunity!
Deaf Calendar
Southern Tier Deaf Club
Bowling Tournament
March 21 - 23, 2003
Deaf and Hearing People Welcome!
March 21, 2003
Welcome Bowlers and Fans
Open House
Holiday Inn Ballroom
7:00 pm to Midnight
Refreshments Provided
FREE Admission!!!!!!
March 22, 2003
Men's & Women's Team Events
Midway Lanes
11:00 am and 2:00 pm
Buffet Dinner
Welcome Bowlers and Fans
Holiday Inn Ballroom
6:00 pm to 8:00 pm
March 23, 2003
Single & Double Teams
Midway Lanes
9:00 am to ???
