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The Memphis Center for
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10/31/98, 10:51 am

Memphis ADAPT is off to the nation's capitol to get alternatives to nursing homes. But that is not all that is going to DC. We are taking a complaint letter to John Wodatch of the Department of Justice, alleging that Tennessee continues to illegally segregate people with disabilities in institutions.

Tennessee has not taken the first steps to providing citizens choices to nursing homes. We asked the Director of TennCare to show us the federally required self-evaluation. We even sent her a Freedom of Information Act Request for the document that is to be available to show the public that they are not wasting our tax money.

TennCare did not respond. We know that they didn't show us the self-evaluation because they are have funneled all our tax dollars into the nursing home industry's pockets.

Tennesseans want choice.

We are coming back from Washington with the means to make Governor Don Sundquist and his fat-cat nursing home buddies provide home and community-based options and, most critically, to stop the inhuman segregation of Tennesseans in institutions.

Disabled demand options to nursing homes

It is going to be great meeting with 600 of our brothers and sisters in this struggle. Many friends and neighbors do not see how this effects the whole disability community. To discrimination that faces the poorest and most isolated actually impacts the whole country, not just people with disabilities; however, we have to bring the message to everyone because it is so clear to our community, and our experience with disability.

Tennessee spends 96% of public funding for long-term care on nursing homes, and other institutions.

"To power that can free our people is in Washington," said national organizer Mike Auberger, "ADAPT is here to let the American public know that 2 million individuals incarcerated in nursing homes is unconscionable." To federal government spends over $40 billion tax dollars through Medicaid to nursing homes and other institutions. Nationally, 80 percent of all Medicaid dollars paying for long-term care go to institutions, while a mere 20 percent supports people living in their communities.

To 1990 Americans with Disabilities Act (ADA) requires that states provide services to people with disabilities in the most integrated setting, but Tennessee has not taken the first steps required by the federal-civil rights law. Recently, ADAPT won concessions from the Department of Justice and Health Care Financing Administration, to support the ADA's mandate to provide the "most integrated setting" in services. In the coming week in Washington, the group plans to push the envelope still further and convince the uncommitted.

Making the choice available by getting health care bureaucracies to support the " most integrated setting" mandate is what the week long action is all about. To action is part of ADAPT's Campaign for REAL Choice. This Campaign builds on past work, such as a recent action in Memphis where ADAPT occupied the Tennessee Governor Sundquist's office for over 24 hours. ADAPT, which played an instrumental grassroots role in pushing through the Americans with Disabilities Act, is fighting to change a climate that favors nursing homes over people.

More than 500 organizations support MiCASA, ADAPT's bill in Congress --the Medicaid Community Attendant Services Act -- introduced by U.S. House Speaker Rep. Newt Gingrich, R-Ga., in June 1997. To bill garnered 76 co-sponsors from both sides of the aisle in the 105th Congress, and a Congressional Hearing on the bill was held in March. ADAPT organizers anticipate its reintroduction early in the next session.

Under Medicaid, nursing homes are a mandated service and attendant care is not. It is a state's option to apply for a Medicaid Waiver. Many states fail to use a waiver because of a cumbersome bureaucratic process and the powerful nursing home lobbies. Oregon has gone the furthest, de-institutionalizing more than half their disabled citizens, young and old, since 1982 when a budget crisis forced bureaucrats to look for ways to save state government from bankruptcy. Officials there found they could serve three people in the community for every one person in a nursing home. Ann Koci, Medicaid Director for Kansas, testified before Congress earlier this year that her state's home and community programs saved Kansas $24.5 million in 1996.

"This is beyond an issue of human dignity, it's about publicly traded corporations making money off disabled folks' bodies," said Stephanie Thomas of Texas ADAPT. "Enough excuses -- no more pilot projects. We will no longer tolerate the segregation forcing us into nursing homes and other institutions."

Oct. 31, 1998

Dear Mr. Wodatch:

Please regard this letter as a formal complaint against the state of Tennessee for violation of Title II of the 1990 Americans with Disabilities Act.

Specifically, our complaint states that the State of Tennessee when they did their self-evaluation of nursing home, institutional, and community-based services did not ensure that individuals with disabilities received services in the most integrated setting appropriate to their needs and have not taken adequate steps to address this issue. This violates the ADA regulations for self-evaluation and integration.

Because of the national significance of this problem we ask the Department of Justice to investigate this complaint directly.

Thank you,
Tim Wheat
ADAPT

Copy to: Donna Shalala, Secretary
US Dept of HHS
200 Independence Ave SW 615F
Washington, DC 20201

Marie Chretian
Regional Manager US Dept of HHS
Office for Civil Rights
Federal Center
61 Forsyth ST S.W.
Atlanta, GA 30323

Oct. 8, 1998

Dawn Russell
1633 Madison Avenue 
Memphis, TN 38104

Wendy Long
Acting Director of TennCare
TennCare Bureau
729 Church ST
Nashville, TN 37247

Dear Dr. Long,

The 1990 Americans with Disabilities Act (ADA) is one of the most important civil rights achievements. HHS Director of Medicaid and State Operations, Sally Richardson, has attempted to clarify the impact of recent ADA cases related to State Medicaid plans in a letter of July 29, 1998, to all State Medicaid Directors.

That letter points out that States are required to do a self-evaluation to ensure that "...policies, practices and procedures promote rather than hinder integration." The evaluation that the letter refers to is part of the State of Tennessee's ADA Title II requirements [28 CFR §35.105].

I would like a copy of the required self-evaluation as it relates to Medicaid funding of long-term care in Tennessee. Although the same federal law that requires the self-evaluation also directs that it be available for public inspection. I am including a Freedom of Information Act Request to insure your office of my genuine need for the requested material. Please respond to this request by Oct. 21, 1998.

Furthermore, to the extent that the Tennessee Medicaid program has not fully completed the self-evaluation, the letter from Ms. Richardson asks that the disability community be included in the process. Please indicate how the disability community assisted in generating the current self-evaluation, and what further assistance you may need.

Sincerely,

Dawn Russell
Governors Advisory Council on Long-Term Care

Enclosure

Oct. 8, 1998

Dawn Russell
1633 Madison Avenue 
Memphis TN 38104
(901) 726-6404

Wendy Long
Acting Director of TennCare
TennCare Bureau
729 Church ST
Nashville, TN 37247

Re: Freedom of Information Act Request

Dear Dr. Long

This is a request under the Freedom of Information Act, 5 U.S.C. Sec. 552. I request that a copy of the following documents be provided to me:

Tennessee State Medicaid Programs Self-Evaluation as required by 28 CFR §35.105

In order to help to determine my status to assess fees, you should know that I am an organizer of Tennessee ADAPT, a non-profit organization that works to end the segregation of people with disabilities. Governor Sundquist has appointed me to the Long-Term Care Advisory Council as the representative of ADAPT. I desire a copy of the Tennessee State Medicaid Programs Self-Evaluation as required by 28 CFR §35.105.

This request is made for a scholarly or scientific purpose and not for a commercial use.

Because the documents requested are required to be available for public inspection, I expect a response to my request without delay; but no later than October 21, 1998.

I request a waiver of all fees for this request. Disclosure of the requested information to me is in the public interest because it is likely to contribute significantly to public understanding of the operations or activities of the government and is not primarily in my commercial interest.

Thank you for your consideration of this request.

Sincerely,

Dawn Russell

The Memphis Center for Independent Living
1633 Madison Avenue, Memphis, TN 38104
(901) 726-6404 v/tty (901) 726-6521 fax
mcil@mcil.org 

MCIL is a United Way of the Mid-South member Agency

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