New Senate Bills Address Economic Access for People with Disabilities

Senator Tom Harkin (D-IA)

Senator Tom Harkin of Iowa recently introduced bills in the U.S. Senate to promote economic independence for people with disabilities. 

The bills address access to housing, transportation, and exercise and call upon the U.S. Access Board to develop new accessibility guidelines and standards in each of these areas. They are based on findings from an investigation by the Senate Health, Education, Labor, and Pensions (HELP) Committee into economic and employment issues faced by people with disabilities.

"To address the economic barriers Americans with disabilities still face, I am introducing three new bills as part of an 'Access for All' agenda to help them achieve the economic success necessary to be independent and lead full and fulfilling lives in their communities," stated Harkin who chairs the HELP Committee. "Today's report makes clear that even as more people with disabilities seek to enter the workforce, there are still too many barriers preventing them from becoming economically independent. When these Americans are not part of the workforce, they are much more likely to be stuck in poverty with no way of getting ahead."

The "Universal Home Design Act" would require certain accessibility features for single family homes and townhouses that are built or purchased with federal financial assistance. These include universal design features that would be established by the Access Board to ensure access to entrances, interior doors, environmental controls, and at least one indoor room, bathroom, and kitchen space. The bill also would create the Office of Accessible Housing and Development within the Department of Housing and Urban Development.

The "Accessible Transportation for All Act" would require access to taxi services and ban discrimination based on disability by taxi companies and drivers. It would authorize competitions to create affordable and accessible taxi and car designs, require states to develop strategic plans to increase the availability of accessible cabs, direct the Access Board to issue accessible taxi standards and service standards, establish a new tax credit for access improvements undertaken by taxi companies, and create an Accessible Taxi Board at the Department of Transportation.

The "Exercise and Fitness for All Act" would require access to exercise and fitness equipment at gyms, heath clubs, colleges and universities, and other facilities, including treadmills, step machines, stationary bikes, rowing machines, weight machines, and circuit training and strength equipment. The Access Board would be tasked with developing new accessibility guidelines for such equipment within 18 months of enactment.

According to the HELP Committee report, people with disabilities often cannot participate in the workforce due to a lack of access to reliable transportation and to affordable housing, and they continue to report discriminaton in the workplace, including wage inequality. The findings also address other economic issues and barriers faced by people with disabilities. 

Further information, including a summary of the introduced bills, is available on the Help Committee website.

Celebrate DSP Recognition Week

Direct Support Professional (DSP) is a nationally recognized position whose objective, according to Volunteers of America, is “to support developmentally disabled individuals in their development of basic living and social skills with the primary goal of integrating them into the community to the best of their ability.” These supports include personal care, daily living, and realization of personal goals, medical assistance and community inclusion.

This week, beginning Sept. 7, 2014, is National Direct Support Professionals Recognition Week. Join InterHab in recognizing the commitment and achievements of exceptional DSPs, and expressing our gratitude for their significant contribution to communities across Kansas.Show your thanks this week for all the challenging work DSPs do, day in and day out.

Davis advocates thorough exam of KanCare

Democratic candidate for governor says Medicaid provider, recipient concerns should spur review

House Minority Leader Paul Davis,
Courtesy of KHI News Service

By Andy Marso
KHI News Service
Sept. 2, 2014

TOPEKA — House Minority Leader Paul Davis, the Democratic candidate for governor, said Tuesday that if elected he would order a "top-to-bottom" review of KanCare.

Republican Gov. Sam Brownback spearheaded KanCare, which places the state's 400,000 Medicaid recipients under the administration of three private insurance companies, also known as managed care organizations (MCOs).

The governor has said the program is on track to meet its goal of saving the state $1 billion over five years through care coordination without cutting services, eligibility or provider payments.

But health care providers who serve Medicaid recipients have complained of later payments since the switch, and Davis said he's hearing from nursing homes, hospitals, doctors and home health agencies that are becoming financially strapped.

"It's causing a lot of cash flow problems for health care agencies across the state, and I think it's further proof this is just not working very well," Davis said. "What I want to do when we come into office is really take a top-to-bottom look at the KanCare program."

The Brownback campaign referred questions to the Kansas Department for Health and Environment, which administers the KanCare contracts for the three managed care companies: Amerigroup, Sunflower State Health Plan and United HealthCare.

Sara Belfry, a spokeswoman for KDHE, said the state is working with the companies to smooth claims processing. But she said some of the problems lie with the health care providers submitting the claims.

"Individual providers continue to struggle with some aspects of their billing," Belfry said via email. "We are making every effort to assist them. KDHE continues to work with all MCOs on provider payment issues that arise. We believe KanCare is working better and more efficiently for the people it serves than (the) old Medicaid system."

While some payments are delayed, Belfry said claim denials have been cut in half since fiscal year 2008 and now are around 15 percent.

Meanwhile, Belfry said the Medicaid recipients are seeing health care improvement under KanCare versus the previous state-run fee-for-service plan.

She highlighted $1.6 million in newly covered adult dental care, a more than one-third increase in primary care physician usage between 2012 and 2013, and a 4 percent drop in emergency room utilization in the same time frame. For recipients of home- and community-based services, who were added to KanCare this year, ER visits are down 27 percent, she said.

"The KanCare model encourages consumer-centered care at the right time and right amount with more flexibility to address individual situations than ever existed in Kansas Medicaid before KanCare," Belfry said.

Davis said he's "not necessarily against managed care" and that it can work well under some circumstances, but the provider complaints suggest KanCare is "clearly not working very well right now."

If elected, Davis said his administration would consult with medical providers and Medicaid clients to "find out what's working and what's not working."

Officials from KDHE told legislators that in 2013 none of the three managed care companies met the goals for timely claims payment that the agency set in the contracts the companies signed.

Representatives from the companies, which lost more than $100 million in the program's first year, have said the state's goals are aggressive but that they are committed to meeting them.

Belfry said the managed care companies paid 99.98 percent of "clean claims" within a month of receiving them, but the state is shooting for 100 percent.

"All three KanCare contracts require that the MCOs pay providers within 30 days of a clean claim being submitted, and the state is very serious about ensuring providers are paid promptly," Belfry said.

Davis also said Tuesday that it is important for the state to have an inspector general for the KanCare program, but he questioned whether the current position, housed within KDHE, provided enough independence to act as a proper watchdog.

He also questioned the administration's previous choice to appoint Rep. Phil Hermanson, who resigned before going through a Senate confirmation hearing.

"Clearly the last person they put forward was not qualified for the job, and I hope we can find somebody for that job who is well-qualified," Davis said.

Davis said he had no names in mind.

Belfry said KDHE is setting up interviews with candidates for inspector general.

Keen Umbehr, the Libertarian candidate for governor, also has been critical of KanCare.

See the original story here.