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Category: Action Alert

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CALL TO ACTION: We Need 12% FMAP (Federal Medicaid Assistance Payment) Increase

Urgent Action Needed from You!

From Julie Reiskin, Executive Director

Background:

  • The FMAP formula is designed so that the Fed pays a lesser portion of Medicaid costs in states with higher per capita income relative to the national average.  Colorado until recently was a wealthier state.
  • FMAP rates have a statutory minimum of 50% and a maximum of 83%. For FY2019, regular FMAP rates range nationally from 50% – 76.39%, with Colorado at 50% and states like MS, WV, AL, KY, and NM at greater than 70%,
  • That means for every dollar of expense, the State of Colorado and the Fed each chip in 50 cents, despite how the Coronavirus pandemic is impacting our economy right now.  Colorado has tourism as a big part of our economy.
  • At the same time, Medicaid membership increases as our economy takes a downturn, creating even more expense for the State.

Federal Response:

  • The Federal Stimulus package did include a 6.2% increase in FMAP for all states.
  • Colorado and most other states asked for and received needed flexibility from the federal government to help us cope with the effects of the pandemic. THIS JUST ALLOWS US TO DO THE ACTIVITIES BELOW BUT DOES NOT GIVE US RESOURCES TO ACTUALLY DO THESE THINGS:  Some of our requests include:
    • Not kicking people off of Medicaid during the crisis
    • Relaxing prior authorization requirements so people do not risk not getting essential services
    • Increased funds for supports like cleaning and sanitizing in nursing facilities, dialysis centers, etc.
    • Paying retainer payments to programs that are essential for our most vulnerable but that cannot operate during the crisis like adult day care programs
    • Allowing paid time off for some direct care workers so they do not come work with vulnerable people when ill.

Problem:

For Colorado to actually implement the most critical areas of flexibility requested, meet the needs of the Medicaid providers that include rural hospitals, personal care workers, people that provide direct support to those with cognitive disabilities, and other essential needs the FMAP needs to be at least 12%.   Therefore, we need our federally elected officials to actively fight for an increased FMAP in the next stimulus package currently in the work.  It must be at least 12%.  At the very least we need money that goes to the states to help with Medicaid costs.

This is NOT a partisan issue.  Medicaid Helps ALL of Colorado.   This could be a life and death issue for elderly and disabled Coloradans but will also affect many others including everyone who has either lost their job or has reduced hours.

WHAT TO DO NOW:

Everyone should contact BOTH Senators and the Representative for YOUR area.  You should say that you want the package to include 12% FMAP or any other way to get money to state governments and why you care about Medicaid.  Include that you are a voter, and know and speak to many other voters!!    Share this request with others.

Colorado U.S. Senators

  1. https://www.bennet.senate.gov/public/index.cfm/contact
  2. https://www.gardner.senate.gov/contact-cory/email-cory

Colorado U. S. Representatives

  1. CD 1 Diana DeGette https://degette.house.gov/contact  Denver
  2. CD 2 Joe Neguse https://neguse.house.gov/contact  Boulder to Ft. Collins and Eastern Mountains
  3. CD 3 Scott Tipton https://tipton.house.gov/contact Entire Western Slope and Pueblo
  4. CD 4 Ken Buck https://buck.house.gov/contact Northern Colorado including Greeley
  5. CD 5 Doug Lamborn https://lamborn.house.gov/contact Colorado Springs to Salida
  6. CD 6  Jason Crow https://crow.house.gov/contact Aurora to Centennial
  7. CD 7 Ed Perlmutter https://perlmutter.house.gov/forms/writeyourrep/  Most of Jefferson & Adams

Please get at least 5 other people to write –and ask them to do the same!

A map showing the congressional districts of Colorado.CD 1 Diana DeGette:  Denver  CD 2 Joe Neguse: Boulder to Ft. Collins and Eastern Mountains CD 3 Scott Tipton: Entire Western Slope and Pueblo CD 4 Ken Buck: Northern Colorado including Greeley CD 5 Doug Lamborn: Colorado Springs to Salida CD 6  Jason Crow: Aurora to Centennial CD 7 Ed Perlmutter: Most of Jefferson & Adams
Colorado Congressional Districts, 113th Congress

PART 3: URGENT AND IMPORTANT CCDC INVESTIGATION OF CSL PLASMA

Please see Part 1  and Part 2 for other important related information.

THE FOLLOWING PROVIDES AND EXPLANATION OF THE LEGAL BACKGROUND REGARDING DISABILITY DISCRIMINATION THAT MAY OCCUR BY PLASMA CENTERS, INCLUDING CSL PLASMA:

According to their website, CSL Plasma states the following with respect to “Who Can Donate?”

Anyone in good health, 18 or older, who weighs at least 110 lbs, have had no tattoos or piercings within the last 12 months, meets our eligibility and screening requirements, has valid identification and a permanent address is eligible to donate plasma.

To maintain high health standards, a member of our medical staff gives every potential donor a screening examination, and gathers medical history information. This is for the donor’s safety as well as the quality of the product that will be made from plasma, and we assure the utmost respect to donor privacy.

Both the requirements regarding “good health” and the required “screening examination” may very well discriminate against people with disabilities, even though they may have been put in place with the best of intentions. These phrases often serve as buzzwords for disability discrimination. For example, what does “good health” mean and who gets to decide? Also, as explained below, “screening examinations” may screen out letting people with disabilities donate plasma even when an individual’s disability has nothing to do with the ability to provide a plasma donation safely.

Plasma centers like CSL Plasma are places of public accommodation under the Americans with Disabilities Act (“ADA”) and the Colorado Anti-Discrimination Act (“CADA”) and are not permitted to discriminate on the basis of disability.[1] As such, CSL Plasma cannot refuse to allow you (if you are an individual with the disability) to donate and receive payment for doing so on the basis of disability except under very limited circumstances. If you have already contacted a CSL Plasma center in the past and have been denied the ability to donate plasma based solely on the basis of your disability or if you call now to try to make a donation, here are some key things to remember:

No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who ow/ns, leases (or leases to), or operates a place of public accommodation.[2]

Both Title III of the ADA and the CADA apply to the owners of public accommodations and/or businesses that lease a place of public accommodation or operate a place of public accommodation, although the CADA refers to “any person” who discriminates whereas the ADA only applies to entities that discriminate, not persons.[3] You should also be aware that Title III of the ADA prohibits an entity from engaging in contractual, licensing or other arrangements that result in discrimination on the basis of disability as well.[4] The CADA is intended to apply all of the same standards and defenses as the ADA.[5] As a result, it is possible, for example, that the CADA incorporates standards pertaining to contractual licensing and other arrangements that result in discrimination. Title III of the ADA prohibits many forms of discrimination some of which are very direct and others are much more subtle.

And now for some minutia or “getting in the weeds” of ADA Title III and CADA claims:

An individual or class of individuals on the basis of disability cannot be denied the equal opportunity to participate in plasma donation; nor can an individual or entity like CSL Plasma use “standards or criteria or methods of administration” that have the effect of discriminating on the basis of disability or perpetuate the discrimination of others (for example, a standard that prohibited all people who are blind or deaf or who have any other form of disability that is not specifically related to the individual’s ability to donate plasma).[6] Title III also prohibits imposing “application of eligibility criteria ” that screen out or tend to screen out an individual with the disability or any class of individual with disabilities from participating in plasma donation and prohibits failing to “make reasonable modifications in policies, practices or procedures” when such modifications are necessary to afford an individual with disabilities and equal opportunity to participate in plasma donation or due to a failure to “provide appropriate auxiliary aids and services” (like sign language interpreters if necessary for effective indication) in order to participate in plasma donation.[7] Modifications of policies, practices and procedures under Title III of the ADA may also include requiring that a plasma center not discriminate against an individual with the disability who uses a service animal.[8] Under the CADA, an individual with a disability has the right to be accompanied by a service animal and even a trainer of a or an individual with the disability accompanied by an animal that is being trained to be a service animal is permitted to have the service animal in or service animal in training in any place of public accommodation.[9]

In addition, plasma centers are required to be fully accessible to people with disabilities if they are newly constructed facilities under the ADA if they have been altered or renovated in a significant way, and they must remove architectural and communication barriers when doing so is readily achievable which means without difficulty or expense (like installing accessible parking spaces and ensuring that equipment and rooms are made accessible when doing so is not complicated or expensive).[10] The CADA also addresses design and construction issues with respect to the requirements that it be construed to apply the same standards and defenses available under the ADA reference above and also in its remedial provisions.[11]

For people with mobility disabilities, there is specific guidance issued jointly by the United States Department of Justice, Civil Rights Division, Disability Rights Section and the United States Department of Health and Human Services Office for Civil Rights (“Joint Guidance”). This guidance addresses requirements related to the accessibility of medical equipment and also the need to accommodate individuals with such disabilities. SeeAmericans with Disabilities Act: Access To Ethical Care for Individuals With Mobility Disabilities.” Here are just some examples that relate directly to this guidance as well as prohibitions set forth in the policies of plasma clinics regarding transferring individuals with mobility disabilities:

    • Question: I don’t want to discriminate against patients with disabilities, but I don’t want my staff to injure their backs by lifting people who use wheelchairs onto exam tables. If my nurse has a bad back, then she doesn’t have to help lift a patient, does she?

Staff should be protected from injury, but that doesn’t justify refusing to provide equal medical services to individuals with disabilities. The medical provider can protect his or her staff from injury by providing accessible equipment, such as an adjustable exam table and/or a ceiling or floor based patient lift, and training on proper patient handling techniques as necessary to provide equal medical services to a patient with a disability. (See Part 4 [of the document] for more information on this equipment.)

    • Question: What should I do if my staff do not know how to help a person with a disability transfer or know what the ADA requires my office to do? Also, I am unsure how to examine someone with spasticity or paralysis.[12]

To provide medical services in an accessible manner, the medical provider and staff will likely need to receive training. This training will need to address how to operate the accessible equipment, how to assist with transfers and positioning of individuals with disabilities, and how not to discriminate against individuals with disabilities. Local or national disability organizations may be able to provide training for your staff.[13]

Therefore, it might very well be considered discrimination on the basis of disability if a plasma clinic has a policy or standard that requires an individual who uses a wheelchair who wishes to donate plasma to be able to transfer herself to a device such as an examination table or chair used for plasma donation independently and without any assistance from the staff working at the plasma center.

Furthermore, it is very important that plasma centers do not discriminate on the basis of myths, fears, and stereotypes associated with disabilities as often occurs with respect to people with cognitive or psychiatric disabilities.[14] Therefore, if a plasma center prevented someone during its screening process from donating plasma because of fears or stereotypes related to the individual due to a condition that causes muscle spasms, seizures or psychiatric disorders, all of these actions may constitute discrimination under Title III. Likewise, if a plasma center refused to allow someone to be a plasma donor because the individual had a psychiatric disability based on a fear that the individual might attempt to donate plasma without having taken his or her medications might very well constitute discrimination on the basis of disability.

There are exceptions to all of the forms of discrimination that are prohibited under Title III of the ADA set forth above, but they are very limited. For example, if allowing the individual to donate plasma would cause an “undue burden to the plasma center, or if the individual somehow constituted a direct threat to the health or safety of others even if the behavior that caused that direct threat was related to disability and could not be accommodated reasonably, the plasma center may refuse to allow the individual to donate plasma. Even when a plasma center falls under the ADA provisions addressing newly designed and constructed facilities, there might be an exception for full and complete accessibility if it is structurally impracticable to make the facility accessible and in compliance with the requirements for the Standards for Accessible Design. There may be other disability-related reasons why an individual might not be able to donate plasma (for example, if an individual had some blood-related disease that would interfere with providing plasma, this might constitute an exception). Nevertheless, as said, the exceptions are very limited. As an example of the limitations on the exceptions, making a  determination as to whether allowing an individual with a disability to donate plasma constitutes an undue burden for the facility at issue, many considerations must be made like determining resources and capabilities of any parent company involved with the facility in question. Another example relates to the structural impracticability defense related to designing instruction. A public accommodation like a plasma center would have to prove that the conditions under which the facility was built made it almost nearly impossible to build it in for compliance with the ADA if it falls under the newly designed and constructed facilities provisions.

Therefore, as set forth in Part 1 of this Alert, please let us know if you have experienced discrimination on the basis of your disability by CSL Plasma, or, as set forth in Part 2 of this Alert if you wish to contact CSL Plasma and donate plasma, and you experience discrimination on the basis of disability as a result, please do contact Kara Gillon at the email address or telephone number listed in Part 1 of this Alert.

[1] 42 U.S.C. § 12181(7)(f) (defines “public accommodation” to include the office of a healthcare provider or other service establishment); Colo. Rev. Stat. § 24-34-601(1)(defines “place of public accommodation” to mean a place of business engaged in sales to the public and any place offering services, facilities, privileges, advantages, or accommodations to the public, including but not limited to any business offering sales to the public or public facility of any kind whether indoor or outdoor); Levorsen v. Octapharma Plasma, Inc., 828 F.3d 1227, 1234 (10th Cir. 2016) (holding that a similar plasma donation center is a public accommodation under the ADA).

[2] 42 U.S.C. § 12182(a); Colo. Rev. Stat. § 24-34-601(2)(a) (referencing the prohibition of discrimination on the basis of disability by any “person” defined elsewhere in the statute, Colo. Rev. Stat. § 24-34-301(5)(a), as including limited liability companies, partnerships, associations, corporations and other entities similar to those identified in Title III of the ADA).

[3] Id.

[4] 42 U.S.C. § 12182(1)(A)(i)-(iii).

[5] Colo. Rev. Stat. § 24-34-802(4); Colo. Code Regs. § 708-1:60.

[6] Id. §§ (b)(1)(A)(1) & (b)(1)(D).

[7] Id. §§ (b)(2)(A)(i)-(iii).

[8] 28 C.F.R. § 36 302(c)(1).

[9] Colo. Rev. Stat. §§ 24-34-803(1)(a) & (2)(a) & 24-34-804(1). Both the ADA and the CADA place some limitations on the use of a service animal (and/or under the CADA a service animal in training). 28 C.F.R. §§ 36.302(c)(2), (4), (5) (the animal must be in the control of its handler, the animal must be housebroken and public accommodations are not responsible for the care or supervision of service animals); Colo. Rev. Stat. § 24-34-803(4)(requiring that a service animal or a service animal in training must be under the custody or control of the individual wh the disability or the trainer).

[10] 42 U.S.C. §§ 12183 (applicable to new construction and alterations) & 12182(b)(2)(A)(iv) (applicable to the requirement of existing facilities — those designed and constructed before the enactment of the ADA — to remove structural and communication barriers when doing so is readily achievable).

[11] Colo. Rev. Stat. §§ 24-34-802(b)-(c).

[12] A similar analysis would be applied to a blood donation center or plasma donation center.

[13] The guidance provides direct contact information for the ADA Website and the US Department of Justice as well.

[14] 28 C.F.R. pt. 36, app. C at 706 (a person who is not allowed into a public accommodation because of the myths, fears, and stereotypes associated with disabilities would be protected under the ADA as would an individual who was denied services because the public accommodation feared a psychological condition constituting a disability might result in problems if the individual was not medicated properly).

⇐⇐Part 1                  ⇐ Part 2

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PART 2: URGENT AND IMPORTANT CCDC INVESTIGATION OF CSL PLASMA


Please see Part 1  and Part 3 for other important related information.

CCDC MEMBERS, IF YOU HAVE NOT ALREADY ATTEMPTED TO DONATE PLASMA TO CSL PLASMA (See all locations set forth in Part 1 of this Alert):

  • DO YOU NEED TO EARN MONEY? (Silly question, we know.)
  • DO YOU WANT TO SAVE LIVES BY HELPING YOUR FELLOW COLORADANS? (CCDC members are always the first responders when it comes to helping others.)
  • DO YOU WANT TO HELP CCDC WITH A DISABILITY DISCRIMINATION WITH AN INVESTIGATION BY DONATING PLASMA OR TRYING TO DO SO? (We need your help to determine what, if any, discrimination on the basis of disability is happening.)

What could be better than that? A trifecta. CCDC members and friends, would you like to earn up to 400 extra dollars per month[1] on an ongoing basis and provide an enormously needed service to help others in need? Why not donate plasma? Currently, plasma centers are designated as a “Critical Business” that will remain open for purposes of making donations under the current Colorado Order and PHO (see Part  1 of this Alert for links to these orders) as well as under the U.S. Department of Homeland Security’s Cybersecurity & Infrastructure Security Agency[2] because their services are needed desperately by those who need plasma. In addition, CSL Plasma advertises that it is taking extreme precautions to follow all COVID-19 protocols in order to ensure the safety of those of you who want to help others who desperately need donated plasma.[3] CCDC certainly wants to ensure that all of its members and our families, friends and colleagues stay safe and healthy. Finally, CCDC wants to make sure that CSL Plasma is not discriminating against people with disabilities and needs your help to investigate whether this is happening.

We all know everyone is struggling both with worries about their own physical health and the physical health of their friends and family, and we all are dealing with economic circumstances that also provide us all with a great amount of stress. For many, economic problems are enormous.   On top of the physical health and economic concerns that weigh heavily upon all of us, our current circumstances are affecting many people’s mental health as well.

One way we can all benefit others as well as earn some income during these stressful economic times is to donate blood and plasma. Because people are staying at home, they are much less likely inclined to provide needed donations of blood and plasma to those centers that will make it available for life-giving and life-sustaining procedures for so many people throughout our state.

Several recent news reports provide some examples regarding medical needs in Colorado, and plasma donations are needed now more than ever.[4]

CCDC is investigating CSL Plasma, because there is reason to believe that this entity is discriminating against people with disabilities and preventing them from donating plasma as a result. Even though people with disabilities want to do their part and help others as well as earn needed income in the process, they might be turned away from doing so for reasons resulting from disability discrimination that could very well violate the Americans with Disabilities Act (“ADA”), the Colorado Anti-Discrimination Act (“CADA”) and possibly other disability rights laws.

You can earn up to $400 for donations each month and help save other people’s lives in the process. Even though you might have already received or soon will be receiving a tax refund and/or a stimulus check, for many of CCDC members with disabilities, this additional money can really help especially those on lower incomes and those who are currently not working because of the pandemic. By doing so, you can provide a potentially life-saving service for so many people who are either hospitalized or have conditions requiring them to need plasma transfusions for reasons that may or may not be related to the current pandemic. This needed service for others can help CCDC members with disabilities with their needed extra income.

So, by donating plasma, you can serve three very meaningful purposes: (1) You can help yourself make it through these difficult economic times; (2) you can help others who so desperately need plasma to survive; and (3) you can help CCDC with its investigation regarding whether this plasma center is discriminating on the basis of disability. This is an extremely rare win-win-WIN situation!

So many CCDC members (many of home live on lower and fixed incomes) who have always stepped up to help others in need in the past have asked us at CCDC, “What else can I do to help fellow Coloradans during this horrible and unexpected crisis?” This is one more critical time and one more urgently needed way to help. This very well may be the most critical time we have ever seen with respect to all of us needing to help each other. Clearly, donating needed plasma will help others stay alive as we all work to help each other get through the pandemic together.

Furthermore, CCDC has become aware and is very concerned that the entity that runs these plasma centers may be discriminating against people with disabilities who want to serve others in helping to donate plasma. We have reason to believe that these plasma centers may be prohibiting many people with disabilities, solely on the basis of disability, from donating plasma.

As set forth in Part 1 sent earlier, please let us know immediately (1) if you have tried to donate plasma at one of the Colorado centers listed in Part 1 And available on the CSL Plasma website for Colorado locations, and, in doing so, if you have been denied the ability to donate plasma for a disability-related reason (the appropriate contact information and what information you should provide is all set forth in Part 1); or (2) if you would be willing to try to donate plasma to assist others and earn some income during these trying times.  You can find the plasma center near you in the state of Colorado and contact the facility of your choice if you would like to donate plasma. Their website provides other useful information you will need as well.

[1] Please keep in mind not every payment will be $400.00. That is the maximum amount an individual might receive for donating plasma in a given period of time. According to the CSL Plasma Frequently Asked Questions page:

You can get paid up to $400 each month by donating life-saving plasma. This is applicable for eligible, qualified new donors. Fees vary by location. In addition, you can also receive points (called iGive) for your donations. iGive points can be redeemed for extra cash deposited (loaded) right to your reloadable prepaid card. Check with your preferred CSL Plasma donation center to see if they are participating in any other special promotions.” In addition, The U.S. Food & Drug Administration (FDA) regulations state that the maximum frequency you can donate plasma is once in a two-day period – and, no more than twice in a seven-day period.

[2] See CSL Plasma Corona Virus page and Safe Passage letter; as stated in Part 1 of this Alert, CSL Plasma centers also fall under the “Critical Business” exception to the Stay at Home Order executed by the Colorado Governor and as described by the Colorado Department of Public Health and Environment in its implementation of the Order § III(C) which excludes businesses engaging in healthcare operations and provides a non-exhaustive list, including businesses like blood banks and other healthcare operations like plasma donation centers.

[3] CSL Plasma “Our Message to Our Donors.”

[4] See, e.g., “Denver man with rare disease is asking people to donate blood during the stay-at-home order,” Denver Post, https://www.thedenverchannel.com/news/coronavirus/denver-man-with-rare-disease-is-asking-people-to-donate-blood-during-the-stay-at-home-order (last visited Apr. 7, 2020); “Local family seeks plasma donor for life-saving COVID-19 treatment,” Fox31 Denver, https://kdvr.com/news/coronavirus/local-family-seeks-plasma-donor-for-life-saving-covid-19-treatment/ (last visited Apr. 7, 2020); “Colorado hospital calling for donors to help with experimental, ‘promising’ coronavirus treatment: Convalescent plasma treatment is being used at Children’s Hospital Colorado,” ABC News, https://abcnews.go.com/Health/colorado-hospital-calling-donors-experimental-promising-coronavirus-treatment/story?id=69951910 (last visited Apr. 7, 2020).

This three-part Alert will be followed by Part  3, the final installment of the Alert pertaining to the applicable law and how disability discrimination might occur related to those who wish to donate plasma. Part 1 sent earlier explains who to contact and what information you should provide if you feel you have experienced disability discrimination as a result of contacting CSL Plasma.

 

⇐Part 1                    Part 3⇒

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PART 1: URGENT AND IMPORTANT CCDC INVESTIGATION OF CSL PLASMA


Please see Part 2  and Part 3 for other important related information.

HAVE YOU EXPERIENCED DISCRIMINATION ON THE BASIS OF DISABILITY AND ATTEMPTING TO DONATE PLASMA TO A CSL PLASMA CENTER IN COLORADO BECAUSE OF YOUR DISABILITY?

For example, were you denied the opportunity to donate plasma and receive payment for doing so for a disability-related reason? If so, our Civil Rights Legal Program needs to hear from you as soon as possible. Please contact Kara Gillon at ccdclpa@ccdconline.org or (303) 660-8254. Email is best as the Colorado Cross-Disability Coalition (“CCDC”) staff are all following the current EXECUTIVE ORDER D 2020 024, AMENDING AND EXTENDING EXECUTIVE ORDER D 2020 017 ORDERING COLORADANS TO STAY AT HOME DUE TO THE PRESENCE OF COVID-19 (“Order”), entered April 6, 2020, as well as the UPDATED PUBLIC HEALTH ORDER 20-24 IMPLEMENTING STAY AT HOME REQUIREMENTS (“PHO”), dated March 26, 2020, and issued by the Colorado Department of Public Health & Environment. Most of us are working at home unless otherwise necessary. CCDC is permitted under these orders to have staff in the office, but we are working at home unless otherwise necessary.

WHAT DO WE NEED FROM YOU? We need to know as much precise information as possible which may include the following: (1) when you made the contact with any of the CSL Plasma Centers located in Colorado (the previous link provides all addresses and other necessary contact information, also listed below); (2) all reasons why you believe you were discriminated against on the basis of your disability; (3) who you talked to and when and what was said.

Leave a good time to contact you (again preferably by email) and your name, telephone number, email address and whether you are a CCDC member already.

If you would like to become a CCDC member, membership is free and can be extended to any individual who believes in social justice for people with all types of disabilities. You can become a member easily by logging on to the CCDC Membership Website Page. By becoming a member, you may elect to receive important information regarding all activities of CCDC which are especially important in light of the current pandemic.

This is Part 1 of three parts to be included in this Alert.

Part 2 of this Alert will provide you with information regarding whether you would be interested in being a plasma donor which accomplishes three important purposes: (1) Assisting individuals who are in desperate need of plasma donations received those donations during this time of crisis; (2) helping you obtain some additional needed financial resources during this economic crisis; and (3) assisting CCDC with its investigation of this issue and the possibility of disability discrimination.

Part 3 of this Alert will provide you with the legal background for the types of disability discrimination individuals might be experiencing as a result of attempting to donate plasma at CSL Plasma centers.

WE ARE CONDUCTING AN INVESTIGATION AND NEED TO HEAR FROM YOU AS SOON AS POSSIBLE.

Colorado CSL Plasma locations:

Arvada
11651 W 64th Ave Suite B1
Arvada, CO 80004
Ph: 303-425-9959
Fax: 303-423-6464
Mon-Fri 6:30am-7pm; Sat/Sun 7am-5pm
Map This Location
Donation Center Details

Aurora
690 Peoria St. Unit M
Aurora, CO 80011
Ph: 303-363-0095
Fax: 303-363-6732
Mon-Fri 6am-8pm; Sat 7am-3pm; Sun 6am-6pm
Map This Location
Donation Center Details

Colorado Springs
5506 N. Academy Blvd
Colorado Springs, CO 80918
Ph: 719-284-3258
Fax: 719-387-9767
Mon-Fri 7:30am-6pm; Sat/Sun 9am-3pm
Map This Location
Donation Center Details

Evans (Greeley)
3505 11th Avenue, Unit #1
Evans, CO 80620
Ph: 970-330-3558
Fax: 970-330-1807
Mon-Fri 7am-8pm; Sat-Sun 7am-7pm
Map This Location
Donation Center Details

Ft. Collins
1228 West Elizabeth Street, Suite D-3
Ft Collins, CO 80521
Ph: 970-484-2248
Fax: 970-484-2568
Mon-Fri 7am-7pm; Sat-Sun 7am-3pm
Map This Location
Donation Center Details

Grand Junction
2650 North Avenue
Grand Junction, CO 81501
Ph: 970-233-7947
Fax: 970-241-3511
Sun-Fri 6am-7pm; Sat 6am 5pm
Map This Location
Donation Center Details

Northglenn
11874 Washington St
Northglenn, CO 80233
Ph: 303-515-7621
Fax: 303-255-1471
Mon-Fri 6:30am-7pm; Sat-Sun 7am-5pm
Map This Location
Donation Center Details

 

Part 2⇒                         Part 3⇒⇒

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The Public Charge Rule Is Now in Effect Nationwide— What Does that Mean and What Can You Do?

Update: February 24, 2020 
From the Center for Public Representation

Today, the Department of Homeland Security’s discriminatory public charge rule goes into effect. The rule puts in place a new test for people who are applying for visas or green cards. It looks at people’s health, including whether they have a disability, and whether they have used or might one day use public benefits, including Medicaid-funded home and community-based services on which many people with disabilities rely because they are not covered by private insurance. This rule will have a disproportionate impact on people with disabilities and will discourage people already in the US from using critical public benefits to which they are legally entitled. Continue reading “The Public Charge Rule Is Now in Effect Nationwide— What Does that Mean and What Can You Do?”

Action Needed! SB 20-033: Allow Medicaid Buy-in Program After Age 65

SB 20-033: Allow Medicaid Buy-in Program After Age 65

By Julie Reiskin, Executive Director, CCDC

WILL ALLOW PEOPLE WITH SIGNIFICANT DISABILITIES WHO WORK USING THE MEDICAID BUY-IN TO CONTINUE WORKING AFTER AGE 65

Program: The Medicaid Buy-In for Working Adults with Disabilities (Buy-In) has been a path out of poverty for people with disabilities since 2014. By allowing people who have a disability and a job to buy into Medicaid and, if needed, long-term services and supports, individuals can earn up to 450% of the Federal Poverty Level while only counting 50% of their earned income. Best of all, there is no asset test. ALL OTHER paths into Medicaid carry a $2000 asset limit and strict earnings limits.  Continue reading “Action Needed! SB 20-033: Allow Medicaid Buy-in Program After Age 65”

The New Year Brings with it Reflections on the Past Year by Julie Reiskin

The New Year brings with it reflections on the past year, hopes for the year to come, resolutions to do better at something or perhaps a resolution to stop making empty promises to oneself.  Why do we celebrate the New Year?  Have we not had enough time off from work, enough to eat and drink, and enough time with family by now?   The reason we celebrate is the passage of time is something to celebrate –as a culture that is a blend of many different cultures, we celebrate survival. Continue reading “The New Year Brings with it Reflections on the Past Year by Julie Reiskin”

Action Alert: Tell Social Security No New Burdens for People with Disabilities!

African-American woman with gray hair
The Social Security Administration just announced that it wants to change its rules for people who get disability benefits, including SSI.  Most people would have to prove disability every two years. If Social Security moves forward with this proposal nearly two million people will be at risk of losing benefits over the next ten years.  These are people with severe disabilities who can’t work.

To read the original article, click here.

THE NEW RULES WOULD HURT PEOPLE WITH DISABILITIES.

  • Getting Social Security disability benefits is incredibly burdensome. It can take years to qualify, and the process is time-consuming and stressful.  The new rules would force people to start over just two years later.
  • Social Security makes mistakes. Social Security does not always follow the law for disability reviews, and people get cut off by mistake.  The new rules would make these problems worse.
  • More reviews would clog the Social Security system for everyone. People often wait two years or more for Social Security hearings.  The new rules would push more people into the system, creating long delays for people who need income urgently and cannot work.
  • There are not enough lawyers to help people. Without a lawyer, most people will not make it successfully through the review process. But many lawyers are not able to handle disability reviews, so people will go without the help they need.

TAKE ACTION!

This video is closed-captioned, you can turn them on.
 

What can you do?

Here are three things you can do to fight these new rules:

1. Submit Comments to Social Security.

Social Security is collecting comments on the new rules until January 17, 2020. It will have to read and consider every comment. Below is some sample language, but remember, your comment will be stronger if you personalize it with your own experiences and message.

Dear Social Security Commissioner Saul:

I am writing about the proposed Social Security rule that would make most people getting disability benefits to prove that they have disabilities every two years. I am very worried about the rule. I do not think it should go forward.

It can be very hard to get disability benefits. For some people it takes years, and it is a stressful and time-consuming process. More frequent disability reviews will create additional burdens for people with disabilities who cannot work and are struggling with income insecurity.

Even worse, Social Security often makes mistakes when reviewing disability, meaning there is an even greater chance that people who qualify for benefits will be denied and will go without the help they need. And pushing more people into disability reviews will slow down the system for everyone.

The new rule will put nearly two million people at risk of losing benefits over the next 10 years. This rule would hurt people with disabilities. Please do not go forward with the rule.

Sincerely,

2. Contact Your Congressperson.

Social Security has to follow the law when it issues the new rules. Congress can investigate whether the new rules fit with the law. Ask your Congressional Representative to look into the new rules. Click here to contact your Congressperson. Not sure what to say? Here is some sample language you can modify:

Dear Congressperson ___Last Name___,

I am writing about the proposed Social Security rule that would make most people getting disability benefits to prove that they have disabilities every two years. Please tell Social Security that it should not go forward with the rule.

It can be very hard to get disability benefits. For some people it takes years, and it is a stressful and time-consuming process. More frequent disability reviews will create additional burdens for people with disabilities who cannot work and are struggling with income insecurity.

Even worse, Social Security often makes mistakes when reviewing disability, meaning there is an even greater chance that people who qualify for benefits will be denied and will go without the help they need. And pushing more people into disability reviews will slow down the system for everyone.

The new rule will put nearly two million people at risk of losing benefits over the next 10 years. This rule would hurt people with disabilities. Please work with Social Security to make sure that the rule does not go forward.

Sincerely,

3. Spread the Word!

Social Security needs to hear from as many people as possible about the new rules. Please share this page with your friends and colleagues, and on social media.


CCDC COMMENTS

To download a copy of CCDC’s public comments by Julie Reiskin, ED, click here.

December 29, 2019

Docket Number SSA 2018-0026

These comments are on behalf of the Colorado Cross-Disability Coalition (CCDC). CCDC is a statewide social justice organization focusing on disability issues throughout Colorado. Over the past several years we have increased our focus on employment, encouraging employment and assisting people that want to transition from benefits to full employment to do so. The most successful tactic has been the creation of a very successful Medicaid Buy-In Program for working adults with disabilities.

We have also worked with and continue to work with our state Vocational Rehabilitation program to make improvements there. We have a long way to go. People with disabilities in Colorado who have full-time full-year jobs increased by approximately 3% from 2016-2018 (from about 26-29%). People with disabilities are still paid much less than our non-disabled peers. Because the economy in Colorado has been excellent, we have not seen how much of this gain is temporary.

What we know without question is that increasing punitive tactics and bureaucratic trickery to make benefit acquisition and retention more difficult has the opposite effect.

Our interest in employment is for many reasons:

  • Until we have reasonable employment levels we will not truly be fully integrated into all parts of the community.
  • The crushing poverty the disability community experiences can only be solved by increasing employment, both the number of people employed and by achieving pay equity for people with disabilities.
  • People with disabilities have a lot to add to the workforce. We have skills and talents and they should be used.
  • People with disabilities want to work.

We also see the need to redefine how we think about work. This is not solely a disability issue, some of the changes we seek are changes in the US workforce.

  • Work does not have to mean working 40 hours a week somewhere. Part-time work, the gig economy, and working from home are all reasonable options in the 21st century.
  • We must not look at receipt of benefits and employment as mutually exclusive. Many people will always need some level of benefits (both Medicaid and cash assistance) and they should be not only allowed, but supported and encouraged. This is a departure from the current policy where work is punished and people that attempt it are viewed with suspicion.
  • People that have been out of the workforce for several years or who have never been part of the workforce often need extensive support over many years to fully and completely reenter.
  • Some level of a cushion is needed when people are in between jobs. This will be more necessary when the economy changes. While everyone has this risk, people with disabilities are often more isolated, and less able to do temporary work, therefore, less able to survive the time between losing one job and getting a new job.
  • People with all types of disabilities and at all severity levels have value and can do something. This does not mean that all people that receive benefits could survive without those benefits.

It appears that SSA plans to spend $1.8 billion to save $2.6 billion over the next decade. As noted in the analysis, when people are terminated from payment this does affect others and this could create a chill effect and could discourage some people from applying for needed benefits.

While we appreciate the stated intention of helping people get back to work and agree that the longer one is out of the workforce, the more difficult it is to get back into the workforce, we believe SSA is missing the point. The analysis in the NPRM shows a lack of understanding as to why the return to work rate amongst SSA disability beneficiaries is so low.

As an organization run by and for people with all types of disabilities we have direct experience and understand why the return to work rate is so low. Many of us on staff are people that are or were SSA beneficiaries that have been able to get off or reduce our dependence on these benefits. Even with a very supportive employer and more knowledge of the system than most other beneficiaries, the process is excruciating. We assist hundreds of people each year to navigate these systems. The problems are caused by the system – not a lack of desire to work – and the NPRM does NOTHING to address the root causes.

We see the primary causes of failure to re-enter the workforce as follows:

Getting on Social Security or SSI

The process is horrendous. It is demoralizing, long, intense, and terrifying. Most people wait until they are desperate (unless they have a catastrophic event and are in a hospital with a social worker to assist) because people fundamentally do not want to give up work. Work is more than a paycheck. For many, it is an identity, a place that gives one self-worth, a place with social and emotional connections. Even financially because benefits always pay less than the paycheck left behind.

Even in the best-case scenario, the process can take upwards of six months. Usually, it is more like 2-3 years. During this time people are (incorrectly) advised that they should not work at all because social security will look at work negatively. While this is incorrect advice, there is a lot of nuance and documentation required to keep working while applying for benefits. During this time people must fill out form after form focusing on everything that is wrong, every deficit, every ailment, and problem. Nowhere in the application process does SSA provide the applicant space to document what one CAN do, rather than what one CANNOT do. It is a traumatic experience. We see people becoming so despondent during this process that they feel suicidal.

After going through this process once, people will do anything to avoid having to do it again. The safe move is to not even try to work. Even though SSI says they do not do a continuing disability review (CDR) if someone uses the Ticket to Work, they will do a CDR if there is work activity.

SSA Reaction to Work

When someone does try to work, even a little, SSA reacts with suspicion and accusation. People report work and receive letters that start with an accusation “We have information that you have worked” as if that is something bad. Recently someone who went through a disability determination process and was found completely disabled tried to increase work hours and was able to find part-time work for four hours a week at $12 an hour in a supported work environment. That caused a whole new review. Had this individual not had someone to fill out the numerous forms again, they would have stopped doing the additional work. This is not due to laziness or lack of interest in work but due to severe disabling anxiety and inability to understand how to do the paperwork.

Why can SSA not start these letters with “Congratulations…thank you for reporting your work? If one works, one must report monthly to the local SSA office. There is no online reporting and the fact that employers report to SSA anyway seems to be inadequate. They will frequently return documents saying that something was wrong, such as the SSN was written on the wrong part of the page. They ask for paystubs even though most pay is electronic. When people go in for a financial review (for SSI only) they are told they have to resubmit everything because the local office lost the paperwork.

We are regularly told the local offices do not have time to enter the information reported. This leads to overpayments (both legitimate and not) which is another barrier to work. Even if one proves the overpayments are not the fault of the beneficiary repayment may still be required. Often people end up in repayment situations because they did not understand how to do the complex paperwork to ask for a waiver (and sometimes did not understand that they could make such a request or appeal a determination of an overpayment). When one reports honestly and still is penalized, and this happens over and over again, one loses the will and sometimes the financial ability, to continue employment.

SSA needs to use additional resources to properly enter information reported and to properly match data reported by employers to reduce the need for individual beneficiaries to use an archaic paper reporting process. The tone of communications, nature of communications and process to report work activity is punitive and discouraging. When someone is already struggling with numerous barriers this is often the proverbial straw breaking the camels’ back. Other than a brochure called “Working while on Social Security and How We Can Help” there is no adequate assistance for beneficiaries trying to obtain or maintain paid employment. This brochure makes it clear that one can have SSDI or SSI and work, but the overwhelming belief is that work and receipt of disability benefits must be mutually exclusive.

Getting off benefits is complex

Assuming someone is willing to take the risk to try to get off of SSDI or SSI, one must be able to understand and comply with extremely complex regulations and reporting requirements. There is no universal, accredited, accurate benefits counseling. People have reasonable questions and need to know if they try to work how that affects all benefits, not just SSDI and SSI. They need to know how to keep Medicaid if they have significant medical needs. People rarely go from disability benefits to a job with health insurance. Moreover, for most disabled people private insurance is useless.

What we need is Medicaid, not insurance. Private insurance does not cover decent wheelchairs or long-term services such as personal care. Many states now have Medicaid Buy-In Programs for working adults with disabilities which is one of the few actual programs that do help people return to work. Every state program is different, each is at the whim of the state legislature, and some state programs are not actual incentives because the earning limits are so far below what one would need to survive, let along thrive, without benefits.

Moreover, these programs are usually disconnected from SSA. While health care is the biggest issue there are other considerations with other programs. If an individual resides in subsidized housing then knowledge is needed about how housing is affected. Even if someone is eventually able to pay market rent, in some areas finding an accessible unit might be impossible. Getting out of poverty requires a lot of planning so simply having more income may not translate into the ability to afford a move during the first year or even the first few years. Most people have to begin part-time and inch toward more hours.

Different public programs have different reporting requirements. People need to be given information in plain language what has to be reported to whom and how often. Having a universal reporting form, or figuring out information sharing would be incredibly helpful. Even SSA programs are not communicated well. 1619A and B are important and highly effective programs to help people on SSI keep their Medicaid. For many people keeping Medicaid is more important than the cash benefit. Between 1619 and the Medicaid Buy-In Programs, giving up the cash benefits may be possible, but only if it is done properly. People need to have a plan and many will need assistance in implementing the plan. Nothing in this proposal will help—adding more reporting only hinders any hope of getting off of benefits.

Many people have cyclical disabilities

The SSDI disability criteria is all or nothing. Once you earn money for 9 months, you are seen as no longer disabled. People that do well for a period and then crash are afraid to try. While there is the expedited reinstatement process it is not as seamless as it sounds. It does allow someone to get back on SSDI for up to 6 months while SSA evaluates the case. If the evaluation takes longer than 6 months – something common if a doctor has to be found, particularly in rural areas – this is not unusual. Looking at medical records is often a snapshot of a point in time. Even the 9-month trial work period can be broken up so someone could be considered able to return to work because in a period of several years they worked 2 or 3 months at a time on an annual basis. It need not be 9 continuous months. There is a big difference between being able to work 2 or 3 months with several months in between and being able to maintain consistent employment.

The proposed regulations appear to be targeting people with cyclical disabilities, such as many forms of serious mental illness. The fear of being under constant review can actually exacerbate the actual disability. The level of toxic stress caused by having one’s survival threatened can and will affect actual health outcomes. Again, letting people work when they can and forgoing benefits only when they are able work with an easy, non-punitive way to have benefits immediately restored when the person is not able to work consistently would accomplish the goal of having more SSI and SSDI beneficiaries employed. Forcing repeated reviews will not. Some employment, even if not consistent or permanent, would be preferable to none.

Returning to work is a process – not an event

Benefits are taken away too quickly. The simple evaluation of the 9 month trial work period is inadequate as mentioned above. It is easy to get a job, particularly in a good economy. What is harder is keeping the job. When people are out of the workforce for a long time, and in today’s fast paced world even a few years can be a long time, they lose both skills and endurance. Work norms change quickly. People returning to work after an absence need supports. Some will need social coaching, some will need to relearn (or learn for the first time) technology skills. Other than some vague references to “Ticket to Work” people are not told about available supports. Even though people on SSI or SSDI are supposed to be automatically eligible for federally funded Vocational Rehabilitation Services, this rarely happens. The process of applying for Vocational Rehabilitation and then implementing it can be many months.

The definition of disability itself is a huge problem and illustrates very outdated thinking. The ability to engage in SGA (which is not enough to live on in many parts of the country) is not a good indicator of disability. The all or nothing aspect of the definition is problematic. Telling people with obvious lifelong disabilities that they are no longer disabled also is a problem. Telling people that they are no longer eligible for certain cash benefits due to earnings (framed as a positive) would be preferable especially if there was a truly safe and easy way to get back on benefits.

The concept of a work incentive

It is a myth that people do not want to work. It is a myth that if you just take away the benefits people will go out and find a job. While some will find a job most on SSI or SSDI will not be able to keep it without a lot of support. If the system would focus on what people really need, add some flexibility and become less punitive, many more people would be able to successfully exit. Moreover, most so-called work incentive programs have been designed with no input from people with disabilities or our advocates. If SSA would work with people in the disability community in a meaningful way we could help design programs that might work. The programs created including the “Ticket to Work” are very complicated and tend to simply put money in the pockets of various service providers without real accountability to the disabled beneficiary.

Other Concerns with the proposal:

Timeframes

If there are going to be child re-determinations at set ages, this should be well communicated and parents should get information requests many months in advance. It appears these CDRs will be done at ages 1, 6, 12 and 18. We experience issues currently with the age 18 CDR because parents are not given the information and forms in advance. It can take months to get an appointment with a doctor. It can take time to get paperwork from schools and medical providers. At age 18, parents are dealing with a plethora of systems supporting the transition to adulthood. We recommend at least a full year and some support to get documentation together. The criteria are different before and after age 18 and there is no real explanation of the difference. This causes parents to send in what they have always sent in and then experience denials, causing appeals, because they used the wrong standards. This is different than actual ineligibility.

Medical Improvement

This can be a misleading concept. In the mental health evaluation standards in the “blue book” there is a component that grants disability when someone is doing well but that is due to the person being in a highly structured setting for more than a year. This allows for an evaluation of how someone looks based on the support that the person is receiving. Such an analysis should be done universally. It might not be a highly structured setting, but could be that with the demands of work, transportation, getting out and staying out daily, people look more functional (or less disabled) than they are. It is very concerning that SSA sees mental conditions like schizophrenia as non-permanent. Comparing schizophrenia to a broken leg is disingenuous. Moreover, people do not get disability from social security because they break a bone. Most people with schizophrenia have serious functional limitations that last a lifetime. In addition to the psychiatric and related cognitive issues, the medications they are required to take often cause physical disabilities. The same is true for some other serious mental illnesses.

Redeterminations

It is a myth that there are many people on SSI or SSDI that could easily or even at all just go to work. Many of the people targeted for the more frequent reviews will not be able to complete the detailed and exacting paperwork requirements without assistance. There is not enough assistance to go around and people in desperate need are likely to lose benefits simply due to failure to return the paperwork. Once denied they will need to appeal, and if they cannot find help doing this they will end up homeless or in dire situations. This is a particular issue for those with psychiatric disabilities or brain injuries. Forcing people with these limitations to go through reviews every two years is no different than telling someone who is paralyzed to walk up the stairs and if they can do that, they will receive their benefits. Yes, some will get jobs, but SSA has no data on how many will be able to keep jobs. These redeterminations are incredibly stressful and require a lot of work from the entire support system.

You also asked for comments on language that is unclear in any way.

This section appears aspirational. You say you will review cases in a specific amount of time unless you decide for a variety of reasons not to do so. You could simply say you will try to conduct a review of all nonpermanent impairments every three years, as resources allow.

f) Waiver of timeframes. We will review all cases with a nonpermanent impairment at least once every 3 years unless we, after consultation with the State agency, determine that the requirement should be waived to ensure that only the appropriate number of cases are reviewed. We will base the appropriate number of cases we will review on such considerations as the number of pending reviews, the projected number of new applications, and projected staffing levels. We will grant such waiver only after good faith effort on the part of the State to meet staffing requirements and to process the reviews on a timely basis. We may also consider the availability of independent medical resources. A waiver in this context refers to our administrative discretion to determine the appropriate number of cases to be reviewed on a State-by-State basis. Therefore, under certain circumstances, we may delay your continuing disability review longer than 3 years following our original determination or decision or another review. We would base the delay on our need to ensure that pending reviews and new disability claims workloads are accomplished within available medical and other resources in the State agency and that such reviews are done carefully and accurately.

The section quoted below could be shortened to say “We conduct continuing disability reviews to determine whether or not you continue to be eligible for benefits. Payment ends (but eligibility for some other services including Medicaid may continue) if you show that are you able to earn a specific amount of money without special conditions for at least 9 months.” It confuses people when you say that their disability ends because in many cases the person remains disabled, they just demonstrate that they are able to engage in substantial employment.

General. We conduct continuing disability reviews to determine whether or not you continue to meet the disability or blindness requirements of the law. Payment ends if the medical or other evidence shows that you are not disabled or blind as determined under the standards set out in section 1614(a) of the Social Security Act if you receive benefits based on disability or § 416.986 of this subpart if you receive benefits based on blindness. In paragraphs (b) through (f) of this section, we explain when and how often we conduct continuing disability reviews for most people. In paragraph (g) of this section, we explain special rules for some individuals who are participating in the Ticket to Work program. In paragraph (h) of this section, we explain special rules for some people who work and have received social security benefits as well as supplemental security income payments.

Finally, we believe the cost to the public is grossly understated. There are two areas of underestimation.

The cost to comply with the CDR

This is not just a matter of getting records from one doctor. Other evidence is required. This is going to further stress an already overburdened medical system, especially the mental health system. This will require other social service professionals to help people with the paperwork. It will add calls to crisis lines. It will increase medical and mental health visits as people struggle to comply.

When people lose their source of income they often end up in crisis

They must turn to food stamps, other forms of general assistance, etc. They rely on food banks and other charities. Many become homeless requiring services at shelters and others who live in public housing will stop being able to pay their portion of their rent. Once someone loses their housing, they are likely to incur numerous other costs. According to the National Alliance to End Homelessness in 2017 someone with long term or chronic homelessness costs the taxpayers more than $35,000 a year. This is double the average SSDI benefit and more than double the full SSI benefit. Most people with disabilities that lose their housing are not able to find new housing. Even if someone gets a job at the SGA level, they might not be able to retain their housing. If they lose their disability status they might also lose subsidies. If there is a break in benefits, even for a couple of months, most people will lose their housing. People on SSI are not allowed to save money. Most people on SSDI do not have the means to save and maybe on other programs that limit asset accumulation. Therefore people using these programs do not have the financial wherewithal to weather a couple of months without benefits. They certainly do not have the ability to find and move into new housing.

In summary, CCDC finds these proposed regulations to be bad public policy. It will not achieve the laudable goal of helping people with disabilities enter or return to work. It will increase the poverty of an already vulnerable population. It will add stress to an already overburdened social services system and cause needless suffering to thousands of voters with disabilities and their families. If there is any real intention to help people with disabilities return to work and escape poverty, SSA should work with the disability community to fix the work incentive programs already authorized in law, and bring forth proposals for improved legislation and regulation so that these programs can function appropriately.

We suggest that SSA withdraw this proposal and convene people with disabilities, including people using SSA work incentive programs and people who have successfully exited SSDI and SSI to better understand the needed elements for success.

Sincerely,

Julie Reiskin, LCSW
Executive Director

2019 Legislative Session Wrap Up

This was a busy session as is typical whenever there is a new administration and many new legislators.  Despite some unfortunate partisanship that caused delays,  the reading out loud of 2000 page bills, hearings that occurred during a blizzard, and overnight sessions some great work did get done that will benefit the people of Colorado including people with disabilities.

Before talking about the bills, I want to call out the amazing CCDC team that worked at the Capitol this year.

  • CCDC Board Co-Chair Josh Winkler showed his typical leadership working some bills very hard, following the budget, and mentoring some of our newer volunteer lobbyists. Other board members that participated in the process were Scott Markham and Dr. Kimberley Jackson.
  • Our volunteer lobbying team consisted of Francesca Maes, Michael Neil, Jennifer Roberts, Haven Rohnert, and Linn Oliver with help from Jennifer Remington, Auralea Moore, and Tim Postlewaite.
  • Valerie Schlecht did a fantastic job as our contract lobbyist for mental health issues and stepped up on several other issues as a volunteer. Dawn Howard our community organizer, AKA Cat Herder in Chief did a great job making sure everyone knew what was happening, where people were needed, etc.

CCDC wants to thank our many partners, in particular the Arc of Colorado, Arc of Aurora, Arc of Adams, the Colorado Center on Law and Policy, the Colorado Children’s Campaign, 9-5 Colorado, ACLU of Colorado, Colorado Senior Lobby, Disability Law Colorado, Colorado Common Cause, PASCO, and Accent on Independence Homecare amongst others.  We also want to thank Colorado Capitol Watch for a great product that made tracking the bills easier.

Because this was a year with many new legislators and many groups rushing to push through bills that had struggled in years past, many of which were bills we were going to support, CCDC made a deliberate decision to NOT run our own proactive bills this year but to focus on our coalition work, and building relationships with the many new Senators and Representatives.   We laid groundwork for policies we want to promote over the next few years while focusing on the many coalition bills and responding to bills that affected our community.    We followed 139 bills.  This report shares the highlights-not every bill that we worked on during the session.

Housing:

This is being dubbed the year of the renter.    There were many bills that helped renters, along with some that will fund affordable housing.

  • HB 19-1085 Increases the property tax/heat/rent rebate program both the amount of the grant and the income limits for people eligible for this grant through July 2021.
  • HB 19-1106 Limits rental application fees to actual costs
  • HB 19-1118: Requires landlords to expand the notice before eviction from three to 10 days, hopefully giving people a way to either find a new place to live or cure the problem that led to the eviction
  • HB 19-1135 Clarifies that income tax credits for retrofitting a home for accessibility are available when one retrofits a home for a dependent.
  • HB 19-1170 Improves warranty of habitability in housing to make it work for tenants.
  • HB 19-1285 and HB 1332 Affordable housing funding
  • HB 19-1309 Creates mobile home park dispute resolution and enforcement program, also increasing time to move if there is sale or eviction.
  • HB 19-1328 Responsibilities of landlords & tenants to address bed bug infestations.
  • SB 19-180 Creates an eviction defense fund to help low-income people

Health Care:

  • HB 19-1044 Allows for an advanced directives for behavioral/mental health.
  • HB 19-1120 Multiple approaches to address and prevent youth suicide
  • HB 19-1151 Revisions to the Traumatic Brain Injury Program funded by the Brain Injury Trust Fund.
  • HB 19-1176 Enables a study of various methods of health care reform including an option for universal health care.
  • HB 19-1189 Reforms wage garnishment laws to take into account medical expenses and medical debt.
  • HB 19-1211 Reforms what health insurance companies can and cannot do regarding prior authorization. This is to stop insurance companies using prior authorization to harass doctors and deny patients.
  • HB 19-1216 Measures to reduce the cost of insulin.
  • HB 19-1233 Health care payment reform to promote increasing utilization of primary care.
  • HB 19-1269 Mental Health Parity-variety of measures to require both private insurance companies and Medicaid to pay for mental health care appropriately.
  • HB 19-1287 Increases treatment funding for substance use disorders
  • SB 19-001 Expands the Medication Assisted Treatment pilot program
  • SB 19-005 Gives state permission to request permission from the federal government to import drugs from Canada to give Colorado residents price relief
  • SB 19-010 Funds professional mental health services in schools
  • SB 19-073 Creates statewide system to allow electronic uploading of advance directive documents so in the case of emergency any hospital can ascertain the wishes of the individual. This is voluntary.
  • SB 19-079 Requires some doctors to submit prescriptions of controlled drugs electronically
  • SB 19-195 Creates a system to better coordinate children’s mental health policy
  • SB 19-222 Increases mental health services for people at risk of institutionalization
  • SB 19-238 Requires the 8.1% increase for personal care and homemaker be passed directly to workers, and sets up stakeholder group to address issues with personal care workforce.

THERE WERE A NUMBER OF BILLS RELATED TO THE COST OF PRIVATE INSURANCE AND HOSPITALS.  PLEASE CHECK OUT THE COLORADO CONSUMER INITIATIVE OR THE COLORADO CENTER ON LAW AND POLICY FOR REPORTS ON THOSE BILLS.

Good Government:

  • HB 1062 Allowing sale of property at the Grand Junction regional center
  • HB 19-1063 Allows information sharing between adult and child protective services and allowed people who are subject to adult protective services to see their own records.
  • HB 19-1084 Requires that staff of legislative council prepare demographic notes on certain bills. For a handful of bills each future session the citizens and elected officials of Colorado will be able to have research on how a bill affects specific (often underrepresented) populations.
  • HB 19-1239 Creates a grant program to do outreach for the 2020 census.
  • HB 19-1278 A variety of changes to election law making it easier for voters
  • SB 19-135 Requires a study of state procurement disparities to see if state contracting is being fair and inclusive to businesses owned by people of color, women and people with disabilities.

Education:

  • HB 19-1066 Requires schools to count special education students in graduation rates.
  • HB 19-1134 Research for better methods to identify dyslexia in young children
  • HB 19-1194 Limits schools ability to expel and suspend children in and below the 2nd grade
  • HB 19-066 Creates grant program to help defray costs of high cost special education students

Employment:

  • HB 19-1025 Limits employers’ ability to ask about criminal backgrounds (with appropriate exemptions) before employee goes through the application process.
  • HB 19-1107 Creates job retention and employment support as part of the Department of Labor and Employment
  • SB 19-085 Increases enforcement for those facing pay-based discrimination
  • SB 19-188 Creates a study of Family Medical Leave

Transportation:

  • HB 19-1257 and HB 19-1258 Brings to the voters a request for state to keep and spend excess revenue for transportation and schools
  • SB 19-239 Creates a stakeholder process to address the changes in transportation

Justice Systems:

  • SB 19-036 Creates pilot program to remind people of court dates
  • HB 19-1045 Provides funding for an office of Public Guardianship
  • HB 19-1104 Creates a right to counsel for parents who are facing custody loss to be represented through the office of respondent parent counsel.
  • HB 19-1777 “Red Flag” bill that sets out when a judge can temporarily take away someone’s gun if they are at imminent risk of harming themselves or someone else. CCDC was initially concerned that this might be based on diagnosis, but it was not.  It is based only on behavior, has many protections and excellent due process.
  • HB 19-1225: Prohibits money bail for some low-level offenses to avoid people being jailed for not having small amounts of money for non-violent crimes.
  • SB 19-172 Makes it easier to prosecute people that abuse at risk adults and makes it clear that inappropriate confinement is abuse and illegal.
  • SB 19-191 Creates defendants’ rights to pretrial bonds to reduce the number of people with low-level crimes sitting in jail just because they are poor.
  • SB 19-223 Reforms regarding the competency process in the criminal court system

State Budget (aka the long bill SB 19-207)

  • Increases personal care and homemaker rates for CDASS and IHSS by 8.1%
  • Funds housing inspections for host homes in the I/DD system for basic life-safety issues
  • Creates an Office of Employment First at JFK Partners
  • State funded SLS and Family Support Services waiver slots
  • Creates a Supported Employment pilot at HCPF for I/DD waivers
  • Provides funding for HCPF customer service
  • Provides funding for food and travel for HCPF Member Experience Advisory Council
  • Provides state mental hospital funding for Disability Law Colorado settlement

Disability Specific:

  • HB 19-1069 Allows Colorado to create our own certification system through the Colorado Commission on the Deaf, Hard of Hearing and Deaf/Blind CCDHHDB to adopt or develop a certification system for American Sign Language interpreters. This is address the shortage of interpreters, especially in the rural areas.  THANKS TO THE INDEPENDENCE CENTER OF COLORADO SPRINGS FOR LEADING THIS BILL.
  • HB 19-1151 Revisions to the Traumatic Brain Injury Program funded by the Brain Injury Trust Fund. THANKS TO THE BRAIN INJURY ALLIANCE OF COLORADO FOR LEADING THIS BILL.
  • HB 19-1223 Provides application assistance to people on the Aid to Needy Disabled program to help them obtain approval for Supplemental Security Income (SSI). THANKS TO THE COLORADO CENTER ON LAW AND POLICY FOR LEADING THIS BILL
  • HB 19-1332 Funds the talking book library
  • SB 19-202 Creates a path for accessible ballots for people who are print disabled to allow such individuals to vote in private in our all mail ballot system. THANKS TO THE NATIONAL FEDERATION OF THE BLIND OF COLORADO FOR LEADING THIS BILL.

Overall it was a good year.  There were some disappointments, but there always are—now we have to make sure the bills we like get implemented and make sure people know about these new laws and programs.

 

 

Alert: RA for Access-a-Ride Users with Hearing Issues

If you are an RTD Access-a-Ride user or plan to be, RTD may provide a reasonable accommodation for persons with hearing loss.  The accommodation would allow user to use an email to make or change Access-a-Ride reservations.

For more information please visit RTD website at http://www.rtd-denver.com/accessARide.shtml

Click “Accessibility Services”

Scroll down to “Request Reasonable Modification


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Information received from CCDC’s employees or volunteers, or from this site, should NOT be considered a substitute for the advice of a lawyer. www.ccdconline.org DOES NOT provide any legal advice, and you should consult with your own lawyer for legal advice. This website is a general service that provides information over the internet. The information contained on this site is general information and should not be construed as legal advice to be applied to any specific factual situation.

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