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8/14/98, 5:49 pm
A lot has been going on at the Center this week:
ADAPT responds to Sundquist's comments.
Last in the U.S. in Nursing Home options is NOT "doing a good job."
by Dawn Russell
of Memphis ADAPT
Governor Sundquist's remarks yesterday concerning long-term care in Tennessee demonstrate how he is getting nothing done for Tennessee and promises to keep our state unprepared for the coming rise in long-term care needs.
The Governor said that continuing his inaction and persisting in exclusively funding nursing homes is doing a "good job." Janet Reno however recently directly told state governments that:
"... We believe that states have an obligation to provide services to people with disabilities in the most integrated setting appropriate to their needs. . . . Many individuals with disabilities are being placed in nursing homes or other institutional settings even when they don't really need to be there."
Tennessee long-term care must be consistent with the civil rights initiative of the Americans with Disabilities Act. The ADA requires that government services be provided in the "most integrated setting." The U.S. Supreme Court has ruled that providing services only in a nursing home is "illegal discrimination." [Helen L. v. DiDario]
The pilot programs have simply been used as a delay to real action in the past. Successful models exit in almost every other state, yet the nursing home lobby insists on bureaucratic delays and protection of their monopoly of Medicaid money. Under Menke's direction, the council is to provide "a comprehensive and detailed plan to guide long-term care for all Tennesseans," has mutate into coordination of "a patchwork of services."
For example, the Shelby County waiver, found to be cost effective compared to nursing home care by the Sundquist administration, was never pursued beyond the pilot stage. The waiver, burdened by senseless restrictions, was to serve 400 people but it has never reached its potential. Sundquist, the planning council, and the nursing home industry are now purposing new delays, and ignoring Tennessee's need for action.
I feel as an advisory council member that our purpose is to be a rubber stamp to add to the illusion that the governors administration is working hard to change the long-term care system in Tennessee. Reports show that Tennessee is 49th in the U.S. and the Governor says he is doing a good job.
Dawn Russell
ADAPT
Back to the top of Aug. 14 MCIL Journal
The dispute with The Public Eye and ADAPT goes back a long way. Deborah wrote the restaurant about access problems back in October of 1994. Of course, The Public Eye should have been accessible by July of 1992.
Back in 1994 The Public Eye claimed that making the restaurant accessible was not "readily achievable." The Public Eye whined that they just could not afford to make alterations like every other business in town. The Americans with Disabilities Act does not require alterations that will bankrupt business, it merely calls for accessibility when it can be accomplished.
The ADA, however, does not allow them to use the "we are poor businessmen" excuse forever. The law sets priorities and states accommodations are to be made "when readily achievable."
The Public Eye has waved this excuse around for too long. They have not set priorities and worked to make the restaurant accessible. The Public Eye has not taken the first step to making the restaurant accessible. Eight years of inept business does not excuse The Public Eye from their responsibilities to all Americans.
The continual resistance is an important issue with the ADA. The thrust of the civil rights law for people with disabilities is that the community will become more and more accessible. The legislation was not so sweeping or unforgiving that it would force companies out of business. The ADA requires upgrades when they are possible, with clear priorities.
Back to the top of Aug. 14 MCIL Journal
HISTORY OF THE PUBLIC EYE'S INCOMPETENCE
Dear State Medicaid Director:
Enclosed is the Health Care Financing Administration (HCFA) Civil Rights Compliance Policy Statement which expresses our Agency's commitment to ensuring that there is no discrimination in the delivery of health care services through HCFA programs.
We have committed ourselves to full compliance with the requirements contained in this policy statement. As our partner with the administration of the Medicaid program you likewise are obligated to comply with those statutory civil rights laws. As stipulated in the policy statement, these laws include: Title VI of the Civil Rights Act, as amended; Section 504 of the Rehabilitation Act, as amended; the Age Discrimination Act of 1975, as amended; the Americans with Disabilities Act of 1990 as amended; and Title IX of the Education Amendments of 1972. The Office of Civil Rights of the Department of Health and Human Services has previously advised HCFA that detailed implementation regulations for the Rehabilitation Act of 1973, as amended, are located at 45 Code of Federal Regulations, Part 85. Nancy-Ann Min DeParle, the Administrator of HCFA, has asked that I share this policy statement with you and that you do likewise with health care providers and all others involved in the administration of HCFA programs. Equal access to the health care services provided for persons eligible for HCFA-funded programs, including Medicaid and the Children's Health Insurance Program, is fundamental to our success. Thank you for your cooperation in this matter.
Sincerely,
/s/
Sally K. Richardson
Director
Enclosure
cc:
All HCFA Regional Administrators
All HCFA Associate Regional Administrators for Medicaid and State
Operations Lee Partridge American Public Human Services Association
Joy Wilson National Conference of State Legislatures Jennifer
Baxendell National Governors Association National Alliance of State
and Territorial AIDS Directors Association of State and Territorial
Health Officers
Back to the top of Aug. 14 MCIL Journal
HEALTH CARE FINANCING ADMINISTRATION (HCFA) CIVIL RIGHTS COMPLIANCE POLICY STATEMENT
The Health Care Financing Administration's vision in the current Strategic Plan guarantees that all our beneficiaries have equal access to the best health care. Pivotal to guaranteeing equal access is the integration of compliance with civil rights laws into the fabric of all HCFA program operations and activities. I want to emphasize my personal commitment to and responsibility for ensuring compliance with civil rights laws by recipients of HCFA funds. These laws include: Title VI of the Civil Rights Act, as amended; Section 504 of the Rehabilitation Act, as amended; the Age Discrimination Act of 1975, as amended; the Americans with Disabilities Act of 1990, as amended; and Title IX of the Education Amendments of 1972, as well as other related laws. The responsibility for ensuring compliance with these laws is shared by all HCFA operating components. Promoting attention to and ensuring HCFA program compliance with civil rights laws are among my highest priorities for HCFA, its employees, contractors, State agencies, health care providers, and all other partners directly involved in the administration of HCFA programs.
HCFA, as the agency legislatively charged with administering the Medicare, Medicaid and Children's Health Insurance Programs, is thereby charged with ensuring these programs do not engage in discriminatory actions on the basis of race, color, national origin, age, sex or disability. HCFA will, with your help continue to ensure that persons are not excluded from participation in or denied the benefits of its programs because of prohibited discrimination.
To achieve its civil rights goals, HCFA will continue to incorporate civil rights concerns into the culture of our agency and its programs, and we ask that all our partners do the same. We will include civil rights concerns in the regular program review and audit activities including: collecting data on access to, and the participation of, minority and disabled persons in our programs; furnishing information to recipients and contractors about civil rights compliance; reviewing HCFA publications, program regulations, and instructions to assure support for civil rights; and working closely with the Department of Health and Human Services (DHHS), Office of Civil Rights, to initiate orientation and training programs on civil rights. HCFA will also allocate financial resources to the extent feasible to: ensure equal access; prevent discrimination; and assist in the remedy of past acts adversely affecting persons on the basis of race, color, national origin, age, sex, or disability.
DHHS will seek voluntary compliance to resolve issues of discrimination whenever possible. If necessary, HCFA will refer matters to the Office for Civil Rights for appropriate handling. In order to enforce civil rights laws, the Office for Civil Rights may: 1) refer matters for an administrative hearing which could lead to suspending, terminating, or refusing to grant or continue Federal financial assistance; or 2) refer the matter to the Department of Justice for legal action.
HCFA's mission is to assure health care security for the diverse population that constitutes our nation's Medicare and Medicaid beneficiaries; i.e., our customers. We will enhance our communication with constituents, partners, and stakeholders. We will seek input from health care providers, states, contractors, the DHHS Office for Civil Rights, professional organizations, community advocates, and program beneficiaries. We will continue to vigorously assure that all Medicare and Medicaid beneficiaries have equal access to and receive the best health care possible regardless of race, color, national origin, age, sex, or disability.
Nancy-Ann Min DeParle Back to the top of Aug. 14 MCIL Journal
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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