Budget and Policy Priorities
The Vermont Coalition for Disability Rights presents our legislative platform for 2014. This document highlights some of the legislative, policy and state budget issues affecting Vermonters with disabilities and their families.
Rights and the essential services needed by Vermonters with disabilities and their families must be preserved. Disability affects individuals and families from every Vermont community and from all social, cultural and economic backgrounds. It is a human experience that can come to any of us at any time; and it is a fact of life for many children, working age adults and elders in Vermont. These Vermonters and their families look to government for the protection of rights and services that make equality, self-determination, independence, community participation and work possible. This is the expectation that drives VCDR’s advocacy and public education activities and that will direct our work in the 2014 legislative session.
The interests and concerns of Vermonters with disabilities must influence health care reform, economic and community development, and the preservation and renewal of Vermont’s health, education and human services strategies. VCDR will continue to advocate for the Medicaid benefits and long term care services that individuals with disabilities of all ages depend on to maintain health and independence. We will continue to advocate for successful peer directed services and other mental health, children and family services, transportation and economic development initiatives, legal resources, educational services, and other state and community programs that promote self determination, community participation, health and employment.
We look forward to working with both the Administration and the legislature to ensure that the work of this legislative session addresses the hopes and needs of Vermonters with disabilities and results in policies and programs that are beneficial to all.
Respectful Language Legislation Follow Up: VCDR urges the legislature to take the next step in the process and pass S.27 in order to amend Vermont statutes to refer to people with disabilities using respectful language. And we urge the legislative council and state agencies to insure that all policy drafting proceed in the spirit of the 2010 bill.
Safeguarding Mental Health Rights and Protections: VCDR will monitor and oppose legislative proposals that may diminish the civil rights of people with mental health issues, particularly those that might relate to forced treatment. Due process should not be compromised as new inpatient and community services are developed.
Values and Quality Assurance in Developmental Services: People with intellectual disabilities served by the Vermont’s developmental service system should be protected from abuse and neglect, have choices, and be able to be full participants in community life. The values of self determination and community integration in Vermont’s Developmental Disabilities Act be should be adhered to in related laws, regulations, policies and in the provision of services and supports. Twenty years after closing Brandon, we need to rebuild our quality assurance infrastructure for developmental services.
Individual and Family Engagement in Health Care Reform: VCDR will monitor health care reform activities, especially the Vermont Blueprint for Health’s implementation in communities, to ensure that patients and family members are integral participants in their design, implementation, and evaluation. VCDR will continue to monitor state and federal health care reform with the goal of ensuring that Vermont’s financing, service delivery and administrative practices benefit individuals with disabilities and their families and that related policies and practices ensure equal access and necessary rights protection for these Vermonters.
Open Meetings: VCDR Supports efforts in H.440 that would extend the requirements of the Open Meeting Law to meetings of the Governing Boards and subcommittees of hospitals and Accountable Care Organizations. New ACOs will no doubt impact services for people with disabilities and there should be transparency within hospitals and ACOs when decisions are being made that affect our community.
Palliative Care & Pain Management Task Force: VCDR will monitor and follow the progress of H.237 to insure that the bill treats people with disabilities equitably when mechanisms are set up to identify and empower surrogate decision makers. Access to protected health care information, consent issues around DNR/COLST orders, and admission to palliative and hospice care are among the potentially controversial issues.
Integrated Family Services: VCDR will monitor the actual budget and policy actions being implemented under the Integrated Family Services initiative to ensure that IFS realizes its potential for family directed services that effectively and responsively meet children and families’ needs. Families and youth engagement is needed in the design, implementation, and evaluation of the changes.
Seclusion & Restraint in Vermont Schools: Efforts should be continued to ensure enforcement of Agency of Education Rule 4500 regulating the use of restraint and seclusion in Vermont schools. Ongoing monitoring of school data by the AOE, the legislature, families and other stakeholders is crucial to ensure that all students, particularly those with disabilities are being protected and that positive behavioral supports are being implemented.
State Education Agency (SEA): The legislature should monitor Vermont’s State Education Agency (SEA) as it transitions from a department with a Commissioner reporting to a statewide board to an agency with a Secretary that reports to the Governor. Monitoring should ensure that the departments within the new agency structure that are responsible for the enforcement and implementation of the mandates of the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973are appropriately staffed and supported through this transition and afforded a significant role within the agency, enabling them to ensure that students with disabilities are fully included in Vermont schools and given appropriate services and supports to achieve their maximum potential. We ask that the Legislature monitor the SEA to ensure that the voices of families and youth with disabilities are included throughout the transition and on an ongoing basis as decisions are made that will ultimately impact them directly.
Common Core Standards: VCDR recommends that the Legislature monitor the State Education Agency (SEA) and Local Education Agencies (LEA’s) during Vermont’s transition to the Common Core Standards. The purpose of this monitoring is to ensure that there is appropriate planning and preparation to implement the Common Core with all students, including students with disabilities. Students with disabilities should be included in this new general education curriculum and given appropriate support to ensure that they are able to achieve their maximum potential.
MEDICAID & BUDGET
“People First” Budget: VCDR agrees with the “People’s Budget Campaign” that people have a right to healthcare, education, housing, and dignified work. Yet our state is cutting necessary public services and public jobs, instead of raising new revenue. We join with them to demand a say in how our state raises and spends our tax dollars. Our leaders should understand and manage to the NEED, rather than simply manage to current revenue.
EPSDT Medicaid: The state should review funding levels for mandated EPSDT services (including case management , rehabilitative therapies, and transportation including family van modifications) for Vermont’s Medicaid eligible children.
Family Funding & CSHN Respite: VCDR requests level or increased funding of respite opportunities for families provided via Developmental Services Flexible Family Funding, the Department of Health/Children with Special Health Needs Respite Program, the Children’s Mental Health Respite Program, the Children’s Personal Care Services Programs, and/or any other programs in order to restore past funding levels, and to bring the programs to parity.
Children’s Integrated Services – Early Intervention: In order to assure that all children with a legal entitlement to services that are guaranteed by federal and state law, including Part C and B or the Individuals with Disabilities Education Act (IDEA) and the Early, Periodic, Screening, Diagnosis and Treatment (EPSDT) Services under Medicaid, receive these services at the level and for the duration medically and developmentally necessary, we propose that Vermont:
1. Appropriate $1,500,000 to the Department for Children and Families (DCF), Child Development Division (CDD) to increase funding for Part C services under Children’s Integrated Services (CIS).
2. Appropriate additional money TBD to the Agency of Human Services (AHS) to increase access to EPSDT services.
3. Assure CIS services and EPSDT services are included in the planning and implementation of Vermont’s single payer insurance system.
4. Require CIS representation on all Community Health Teams.
5. Direct Building Bright Futures (BBF) to work with the Agency of Education (AOE) and DCF to explore the implementation of the Birth to Five option for early intervention and early childhood special education services under IDEA.
6. Direct BBF, in conjunction with AOE and DCF, to do an analysis of the staffing needs to assure an adequate and appropriately trained workforce to provide early childhood prevention and early intervention services in accordance with established state and national standards.
7. Ensure that an appropriate portion of funding moves from AOE to AHS CDD to compensate for the transfer of evaluation responsibility from Early Essential Education (EEE) to Early Intervention (EI).
8. Ensure input from the field on the Interagency Agreement for Part C as rule changes on eligibility and evaluation responsibility move forward.
Long Term Care & Supports: A realistic level of long term supports must be available to those with serious needs. This includes developmental services, especially those oriented towards transition to adulthood. Most people don’t realize that only about 25% of the people who have developmental disabilities get services. Each year about 100 new people come into the system because of some crisis in their life, like homelessness, the death of a parent, or abuse. And once they come into the system they likely will need services for the rest of their lives. Services for people with serious mental health issues need to be robust so that, with other people with disabilities, they can have equal access to the opportunity to participate in all aspects of society.
Work Incentives: The administration and the legislature should expand Vermont’s work incentive benefits, including expanding eligibility and asset protections in Vermont’s Medicaid for Working People with Disabilities Program, to encourage more people with disabilities to participate in the workforce. Employment initiatives should be part of the State Innovation Model, the Dual Eligibles Project and the Community Rehabilitation & Treatment Program since it has been shown that people who are employed and productive are healthier and lower the overall cost of health care.
SERVICES & NEW INITIATIVES
Support for Peer Initiatives: The state should continue and expand support for Peer initiatives and organizations like Vermont Psychiatric Survivors, Green Mountain Self-Advocates, Another Way Drop-in Center, and Alyssum. These, and projects like the “Soteria House” currently being developed, build on the life experience and wisdom of people with disabilities.
Peer Navigation for Families with Complex Needs: Vermont should reinstate this program in which people with the lived experience of complex needs in their OWN families assisted other families to find their way through the complex system of social, economic and health programs. Formerly federally funded for 6 years (Family Support 360 Project), peer navigation has a documented record of success in supporting more informed choices and positive outcomes for families with children and/or parents with disabilities.
Support Service Providers (SSP) for DeafBlind Individuals: VCDR is requesting that $60,000 for SSP services be included in the DAIL budget. We believe that SSPs, individuals who are trained to act as links between persons who are deaf-blind and their environment, are essential to support the independence and community participation of individuals who are DeafBlind and other Vermonters with dual sensory loss. The Vermont Center for the Deaf and Hard of Hearing (VCDHH) has received funding for initial administrative costs and the Vermont Association for the Blind and Visually Impaired (VABVI) has helped to train people to provide this service, but cannot provide direct services funding to the many Vermonters who would benefit.
The Sue Williams Freedom Fund: VCDR supports this longstanding VCIL initiative to provide grant assistance, unavailable through medical insurance, for people with disabilities in need of services, adaptive equipment and equipment necessary to live independently in their own homes. VCDR asks the state to augment VCIL’s program with $67,500 to serve the 45 people currently on their waiting list.
Emergency Housing Needs for People With Disabilities: Last year DCF’s EA/GA Temporary Housing Program was dramatically cut. This eliminated DCF funding for emergency motel housing for many people with disabilities, families with children, and young people aging out of DCF foster care. Individuals with disabilities who are not current Social Security recipients are no longer eligible. VCDR asks that the legislature increase the funding to ensure that the most minimal emergency housing needs are met and that rules be changed so that assistance is not categorically denied to individuals with disabilities NOT receiving Supplemental Security Income or SSDI.
Insurance Coverage for Hearing Aids: Private insurance should be required to provide some reasonable level of coverage for hearing aids.
Affordable and Accessible Housing: VCDR will support efforts to expand Vermont’s available stock of affordable and accessible housing. This requires legislative support for increasing the number of appropriate rental and purchase units, and for regulation that prohibits credit scoring bias. These services require an infrastructure expansion for developers, housing authorities, and private landlords.
Transportation: VCDR will support efforts to expand Vermont’s public transportation options, including a unified (state-wide) approach to sub-contracting and support for both medical and non-medical needs. This requires legislative support to unify the varied regional contracts and to regulate the criteria for use and public support. These services require an infrastructure and regulatory revision expansion for regional and local transportation providers.
Van Modification: Funding of approximately $424,000 should be provided to assist families with expenses related to modifying a van or other vehicle to make the vehicle accessible to children whose medical condition requires adaptive equipment and/or a wheelchair.
Parking Placard Statute Update: VCDR supports updating Vermont’s parking placard statute to clarify that individuals transporting a person with a valid placard have the same rights as the individual would have if she or he were driving the vehicle.
VCDR thanks the Vermont Developmental Disabilities Council, VCDR members and friends for their contributions and support of our work. For more information about particular bills and other VCDR advocacy activities, or to share your recommendations and concerns, contact us: VCDR, 11 East State St., Suite 2, Montpelier, VT 05602; firstname.lastname@example.org; on the web: www.VCDR.org