Need for Fair Overtime Hourly Wages for Consumer Directed Personal Care Assistants

The success of Consumer Directed Personal Assistance (CDPA) is largely dependent  on consumers’ ability to hire and retain workers.  Because of a growing wage gap, this ability is clearly being threatened and would compromise the integrity of the entire self-sustaining independent paradigm of
Consumer Directed Personal Assistance Program which my agency Concepts of Independence follows.

Changes at the Federal level by the Department of Labor will require full overtime to workers after 40 hours.  While we support this in theory, it is an unfunded mandate that current reimbursement does not allow for.  Because workers schedule their own workers, Fiscal Intermediaries will have no ability to restrict hours to limit the cost.  If they try, consumers will lose workers who will not be able to afford to work at the lower hours.

The future of CDPA relies on workers’ ability to hire and retain quality workers.

We are seeking two policies that would help make sure consumers can recruit and retain high quality workers:
1. Fund a pass-through from the State to fiscal intermediaries such as Concepts  of $1.35/hr., $1.94/hr. in New York City.  The difference in the amounts accounts for costs not factored into the Medicaid rate for fiscal intermediaries in New York City.

2. Require the Commissioner of Health and the Commissioner of Labor to establish a regional rate for personal assistants, based on the cost of living and other factors, and require managed care companies to reimburse at a level that allows fiscal intermediaries to reimburse consumer’s workers
at that rate.

Community First Choice proposed legislation provides New York State an extra 6% in Federal Matching funds for Medicaid.  This can be used to pay for the proposal, which we estimate would cost $33 million.  Revenues from CFC could be as high as $350 million, if fully implemented. Community First Choice actually mandates in line with Olmstead that supportive services for
consumers and patients with disabilities be provided within the home and community setting.

When the Department of Health issued their regulations for CDPA in 2011, they stated that CDPA was $2.16/hr. less expensive than traditional personal care, and that the savings grow with increasingly higher skilled levels of care.  This means that even at the higher level of reimbursement, the program is still the most cost-effective means of providing community-based long term care.

People performing traditional personal care tasks are now receiving substantially more than those
 doing personal care to nursing tasks, making it harder for consumers using the CDPA model to find and keep essential workers.

Salaries at the current level are threatened:
1. New Federal will dramatically change consumers’ ability to hire workers and increase the costs      associated by requiring full time and a half.  This unfunded mandate from the Federal government will cost hundreds of millions of dollars to implement.
2.Worker’s Compensation costs are going up 40%.
3.Unemployment costs are going up 20%.
4. Fiscal Intermediaries work on approximately 10-12% administrative overhead.  The only place they have room to trim is worker wages.

Economic and Social Parity Equals Power - Workers with Disabilities

On Wednesday March 12,  2014, President Obama signed an Executive Order raising the minimum hourly wage for all workers at the rate of $10.10 per hour, thus raising them from the poverty level. The order becomes effective on January 1, 2015. What is significant about the legislation is that the measure includes people with disabilities for the first time. Traditionally, the Department of Labor since the New Deal of FDR has allowed employers to work for subminimum wages below the accepted hourly wage standard, often around $5.00 an hour out of the belief that workers with disabilities, physical as well as intellectual, simply did not possess the stamina or basic knowledge to work competitively, a situation that is generally not true in the present time. For the federal government to tolerate the subminimum rate for over 40 decades, spoke volumes of how despite the rhetoric of inclusion and diversity, the disability community has traditionally been devalued by society that places a premium on fitness and an almost obsessive drive to reach reach the pinnacle of a chosen profession - in other words, the rat race! The Executive Order for the first time creates a baseline economic parity between a worker with a disability and his able-bodied counterpart. This gesture has been long overdue and should be applauded. I hope it is a harbinger of the trend towards full equality throughout all segments of the population. There may be a few kinks that will need to be ironed out during the implementation of the Order but if all stakeholders, employers in both government and private sectors collaborate harmoniously together, these bumps in the road will be minimized.

Irony in Society - Hate and the 50th Anniversary of the Dream

As I watched the media coverage of the 50th anniversary of the March to Washington where Martin Luther King Jr. made his iconic oration called "I Have A Dream" which effectively was the springboard of the civil rights movement, the progenitor of the ongoing disability rights movement. It was and still resonates as the symbolic battle cry against injustice, bigotry and discrimination in all its diverse forms. The speech heralded the promise of eguality of opportunity and the elimination of abject impoverishment as well as the narrowing of the racial divide and the economic chasm between the have and the have-nots. That promise is still unfulfilled as the speeches by President Barack  Obama and more pointedly by former President Bill Clinton attest. There is still a great deal of work to be done before the  stirring rhetoric matches the reality. To underscore this point as for as the disability community is concerned is the recent surfacing in the Internet of a hate flyer disseminated in Portland Oregn  by a group calling itself the Artemis Underground against people with disabilities who are recipients of various types of government benefits. They claim that such essential services "wrecks" the economy and therefore they should be institutionalized. Such thinking is indicative of the eugenic belief  popular during the 19th and early 20th century, at it zenith during the Nazi era that "inferior" races and those with less than "perfect" or Aryan physiques should be eradicated. Here is the link to the post that highlighted the hate flyer:

http://www.portlandoregon.gov/oehr/article/458971

This is just one example among many instances of backlash against the disability community.

Devaluing People with Disabilities

Hi, welcome back!

In my last post, I mentioned that I was going to discuss the means by which people with disabilities have historically been devalued by the very society they live in in spite of political rhetoric embodied in the Americans with Disabilities Act, the Individuals with Disabilities Edufcation Act, the Fair Housing Act and related enabling legislation with a national scope, and the United Nations Convention on the Dignity and Rights of People with Disabilitie on the international arena, all mandating equal access to participation in every sector of society and the right to lead a fully complete life comparable to able-bodied peers. These are all ideals to aspire towards but unfortunately they are honored in the breach or more often, simply not acknowledged by those charged to enforce them. The reality does not match the political rhetoric. Let me give you an idea of what I'm talking about.

1) The unemployment rate nationally for people with disabilities this month is 16%. Contrast that with a 7% for those without disabilities. I'm not absolutely certain about the exact figure but you get the idea that the gap is a significant one.

2) Access to transportation options in NYC is abysmal. Only 10% of the entire taxi fleet is wheelchair accessible at thuds point. This means interminably long waits on the streets before a single accessible cab is available . The Mayor and City Council President refuse toacknowlegde the problem as a civil rights issue requiring access to the mainstream. Disability advocates are fighting hard to redress this huge imbalance, working towards the goal of 100% accessibility comparable to the checker cab fleet in London. Accessible prototypes and a few innovative minivans were presented to the NYC Taxi and Limoisine Commission which ultimately decided to purchase inaccessible minivans for it's fleet, completely disregarding the needs of the disability community! Therefore, a person in wheelchair or scooter forced to use either paratransit vans(often unreliable and highly inflexible, requiring a day's reservation in advance) or public transportation utilizing fixed routes unilaterally cut by the Metropolitan Transit Authority as part of austerity measures a few months ago.

3)

Letter of Hate - Example of Devaluation of People with Disabilities

An absolutely shocking and hateful letter from an anonymous neighbor in Ontario Canada was posted as a handbill, targeting an innocent child who just happened to have autism, a developmental disability, went viral on the Internet last week. It was full of invective and strongly urged the family to put away the child "forever " claiming that his loud vocalizations, idiosyncratic behaviors and even his very presence "disturbed" the author of the missive and by extension the very community that family resides in. Upon investigation, the local police deemed that the letter although malicious in intent and deed "did not legally rise to the level of a hate crime" because a class group was not targeted. Such sentiment is indicative of society's systemic and often subtle devaluation of people with disabilities within which the child(nameless) is a member of by virtue of his cognitive dysfunction. This is a clear instance where although accessibility and equality regulations are on the books and often are mandated in various codes, one cannot legislate attitudes and bias against an often disenfranchised minority group. The incident should be taken seriously by Canadian society because if other similar occurrences surface unacknowledged, a eugenic frame of mind could easily resurface even within a democratic society. I truly hope that it is an isolated incident but make no mistake: vigilance by both the community and by human rights authorities must not lag.

Twin Atttacks on Disability Rights - National & International

It seems that during the last week or so, the hard-won dignity and enabling laws, both national and international, are under attack by Industry and conservative-backed lobbying interests seeking to unravel the political gains achieved by the disability community. The battle is being fought in The storied chambers and the weapons used are legislative statutes and proposed amendments that weaken or nullify existing laws through exceptions. For example, the American Hotel Association, an industry organization, stridently opposed the public accommodation requirement of the Americans with Disabilities Act, enforced by the US Department of Justice mandating that permanent modifications to existing pools or pools under construction be modified to facilitate easy access for patrons with disabilities, claiming a myriad of excused including that the presence of swimmers with disabilities are "unsanitary", among other flimsy excuses for noncompliance. This at at time when hotel visitors are climbing to record numbers! The problem is if such an exemption is codified, it might create a domino effect in which other provisions in the ADA would be nullified or compromised. The Disability community CAN NOT afford that risk.

A second issue being considered by the Senate Foreign Relations Committee is whether to ratify the United Nations Convention on the Rights of People with Disabilities, an Obama-backed measure. The CRPD, which embodies the basic rights and dignity of persons with disabilities worldwide, has been embraced by almost every member of the United Nations General Assembly with the US as one of the few that has not ratified it. The action is being opposed by right-wing lobbying groups such as the Home School Legal Defense Association which is against mandated intrusion into the family unit, a libertarian perspective. The irony is that the CRDP was developed on the ADA framework and actually expands on it with additional mandates.

OWS, Disability & Power Dynamics,

Here are my personal reflections on the exponential growth of the Occupy Wall Street movement and the role the disability rights movement can and should play in it. OWS has developed into a global phenomenon very quickly that provides a platform for the 99% of the wealth distribution. The members of the middle class and poor members of society are given a platform to express their rage, discontent and frustration over numerous injustices perpetuated by governing forces and the elite(1%) of their societies. Many of the inequities such as exorbitant bank fees, arrogant concentrations of power and income among the few echelons in power, are valid concerns and rightfully should be rectified through the political process of creating a coherent political agenda.

A number of disability activists, many of whom are personal friends of mine, are actively participating in the protests in an around Zuccotti Park and the financial epicenter, Wall Street itself on a weekly basis manning the barricades with protest signs highlighting systemic policy inequities fostered by society at large and especially by entities that subscribe to the medical, stigmatizing model of disability. What I find interesting and disconcerting is that every disenfranchised and minority group is represented and recognized by the governing body of the New York City OWS, the NYC General Assembly with one glaring exception: disability group is not mentioned in the NYCGA mega site (wwww.NYCGA.org) at all! It means that this group, 40 million strong nationwide is not acknowledged as a viable force to contend with. Such neglect is in line with historical trends where disability had traditionally been devalued by society at large, a residue of the eugenics era of the 19th and first half of the 20th century. Issues of great concern to the disability community are: access to employment opportunities (& adequate preparation for them through education)' health care coverage for well being and personal assistant services, affordable and accessible housing built according to universal design (disability-friendly) codes, utilizing public transportation modded such as subways and taxis, to cite a few of many issues. Key landmark legislation since the 1970s were passed creating unprecedented opportunities for many people with disabilities but relatively few were were able to take maximum advantage of them while the majority of them were either placed in custodial institutions or restricted within the confined of their home environments. Many battles were and continue to be fought by the grass roots disability rights movement. There have been successes and reversals with each succeeding generation.i believe that the experiences of the disability community is highly relevant to the Occupy Wall Street democratic force. Strategies a can be shared and the nascent anger can be shaped into a specific political agenda such as taxing the 1% to fund essential social services, will benefit all. Including a disability group in the NYCGA system is an excellent start in acknowledging our potential contributions to the cause long overdue. The late disability historian Paul K. Longmore and activist Frieda Zames would have agreed with this.