Thursday, May 4, 2017

The Senate and Health Care Reform

Today, the Republicans in the House of Representatives had a win. They passed the American Health Care Act (AHCA). Now the Senate needs to act. 

First, thoughtful, reasonable people, regardless of political persuasion, need to read the AHCA, or at least objective summaries written in plain English. Then, they need to decide how the legislation affects them or people they know. And, finally they need to write that up and send it to their Senators. Only by sending thousands of stories about impact will we be able to affect the Senate's approach to health care reform.

Second, people who know how health care is or is not working in specific states need to prepare state profiles and share them widely, but especially with Senators.

Third, state profiles need to drive solutions. One solution will never fix everything.

Fourth, Senators need to set priorities. What needs to be guaranteed? What needs to be optional? How do we attract people, from different demographic groups, to secure health care? Fundamentals like this need to be discussed, addressed, and agreed to across party lines first.

Fifth, the Senate needs to attend to and respect stakeholder input, be transparent and clear about points of disagreement and points on which there is consensus, and especially listen to governors AND state Medicaid directors.

There is no doubt that Obamacare needs to be fixed. Democrats may think that the House passage of AHCA gives them a political sledge hammer to go after Republicans in swing districts in 2018. Who is to say? But I for one, want our Senators to act like statesmen and engage, and solve the mess we are in now. Health care represents one fifth of our economy. It needs predictability and certainty. It does not know how to interpret political brinksmanship.

If we consider and take the steps outlined here maybe we can get to something that makes sense. I certainly hope so. So many lives are hanging in the balance, as well as a significant part of our economy.

Thank you.

Common Grounder




Sunday, April 2, 2017

Faith McCormick

Today my friend, Faith McCormick, of 42 years passed away from cancer. She was the healthiest, most disciplined person I have known. She ate right; exercised daily; kept her mind active; and was a champion in a behind-the-scenes way for self-advocates.

It was quick. Her world and that of those around her changed in six short weeks. She and her husband returned from a short vacation to Barcelona one day. The next day she began her first of two rounds of chemotherapy.

I have a theory. God takes the good people early and quick to force the rest of us, less than perfect mortals, to take stock and reshape our priorities,

Faith spent her days helping others. She would do anything that needed doing. She provided delivery of meals to the less fortunate. She worked with self-advocates to develop expertise on emergency preparedness. She did research on international companies and their approaches to hiring people with disabilities for the U.S. International Council on Disabilities, where she was a member of the board of directors. She traveled to Istanbul with me twice in 2015 to train CEOs from disabled persons organizations from Iran on the Convention on the Rights of Persons with Disabilities. She traveled with me to China and presented on the important role of persons with disabilities in emergency preparedness. She served as a senior, nonpolical, administrator in the Administration on Intellectual and Developmental Disabilities in the U.S. Department of Health and Human Services for over eight years. She was sous chef to her husband, a five-star chef. She helped me pack my suitcase and put on my socks and shoes when we traveled together. Once in Istanbul she pushed me up and down a 60 degree incline in my wheelchair, and we both lived to tell about it.

Faith was organized and purpose-driven. She had a passion for politics, the right kind, and reading James Patterson. Her heart was open to all. Her spirit was infectious. I spoke to her via FaceTime last Sunday. She was strong, optimistic, and gave me and Donald Trump an ear full on what to do and how to do it. She loved LaMarca prosecco and our many trips to Hawaii.

I am sure many of us have friends like Faith. We are the lucky ones. Cherish those friends. Let them know how much you value them.

Thank you.
Common Grounder

Monday, March 6, 2017

Medicaid Is on the Chopping Block

I have heard that the House of Representatives will take action to repeal Obamacare, the Affordable Care Act, on March 8, 2017 through reconciliation legislation. Reconciliation is a process by which the House can put a lot of stuff in one bill without hearings and act speedily in the name of saving money.

I have read summary documents from the House and from disability organizations. The bottom line is that money that has been available for people newly covered under Medicaid expansion in some states and money for community-based services and supports will shrink and then disappear. If states want to continue these services, they will need to find money elsewhere. A lot of people with disabilities will either need to rely on their families for support or enter institutions. People that could have benefitted from Medicaid expansion may need to find their health coverage elsewhere. People that already have coverage may see it change in a bad way.

One of the things I read suggested to me that if a state has a robust lottery program, that could affect their Medicaid allotments, that is could result in a reduction in their Medicaid allotment.

There are plenty of places to go to get more details on the pending House reconciliation bill (http://www.c-c-d.org/fichiers/CCD-MedicaidLeaveBehind_Final03012017.pdf; http://www.c-c-d.org/fichiers/CCD_ProtectACA_03012017.pdf).

At a minimum contact your governor, Democrat or Republican, and let them know they will be left holding the bag if this reconciliation bill becomes law. They won’t like it.

Also, let your elected representative in the House know that this proposed legislation has a ton of unknown consequences on the economy –

·      Family members leaving jobs to stay home to take care of a love one with a disability
·      Emergency room costs going up exponentially
·      New or increased costs for maintaining institutions

There are smart governors and members of the House of Representatives. Urge everyone to slow down, hold hearings, and give thoughtful, measured attention to how to amend the Affordable Care Act.

Thank you.

Common Grounder

Saturday, February 18, 2017

Health Care, a Process That Might Work to Get to a Bi-Partisan Solution

Republicans have the votes to pass a uni-party solution. Democrats see the Republican repeal and replace strategy as a way to bring their supporters to a disruptive frenzy in town halls. Both sides have a lot to lose if they can't reach a consensus-driven solution. The health care market is a major factor in the economy. Having access to affordable health care is a major factor for each family and many single people. The current strategies used by both sides do not guarantee a particular outcome, a sure winner.

Twenty years ago this month an unorthodox strategy was tried to reach consensus on the reauthorization of the Individuals with Disabilities Education Act. Republicans and Democrat members of the House and Senate and the Clinton Administration agreed to have the appropriate staff meet and draft a bill to be considered by both the House Education and Workforce Committee and the full House, and the Senate Health, Education, Labor and Pension Committee and the full Senate. In late May 1997 that happened. The House and Senate passed the same bill. Two weeks later President Clinton signed it.

The process used to achieve this miraculous conclusion was the following:

1. Staff meetings on Monday through Wednesday for 4-6 hours a day through mid-April.
2. Notes from negotiations shared with staff in a chart every Thursday by noon every week.
3. An edited version (reflecting clarifications from staff who read the Wednesday chart) was shared with stakeholders around the country by email every Thursday night.
4. On every Friday an open mike meeting was held by staff with stakeholders from throughout the country. This input was considered the following Monday.
5. The staff started negotiations with text that was easier on which to agree. Then the staff took on the tougher issues. By then, they respected each other and saw that the process was working. Everyone -- staff, their bosses, and stakeholders were operating in good faith.

Perhaps a process like this could work to develop consensus on health care policy. I was the note taker in 1997.  David Hoppe, who was then Chief of Staff for Trent Lott, was the convenor in chief for and the architect of the process I just described. Until recently he was Speaker Paul Ryan's Chief of Staff. Perhaps he would elect to help once again.

Something to think about.

Thank you.
Common Grounder

Friday, February 17, 2017

Health Care, Where Do You Stand?

There are two things that I have chosen to avoid in my professional life — trying to figure you how to make sure people with mental health challenges are fairly and adequately treated by society, especially with regard to making choices about what happens to them; and trying to develop smart health care policies. Why? Because, doing either is very complicated and there are tons of better equipped people to tackle these challenges.

That said, I must weigh in on the health care debate. I have read the 19-page paper the House Republicans have put out ( https://gallery.mailchimp.com/301a28247b80ab82279e92afb/files/5c7c3226-a149-4842-ab43-707b7b4720fc/Healthcare_Policy_Brief.pdf), two articles from the New York Times (https://www.nytimes.com/2017/02/16/us/politics/affordable-care-act-congress.html?action=click&contentCollection=The%20Upshot&module=RelatedCoverage&region=Marginalia&pgtype=articlehttps://www.nytimes.com/2017/02/16/upshot/republican-health-proposal-would-redirect-money-from-poor-to-rich.html?smid=tw-nytimes&smtyp=cur&_r=1), and talking points put together by the Association of University Centers on Disabilities (http://www.aucd.org/docs/talking%20points%20and%20things%20to%20consider%20regarding%20Medicaid.pdf).

Here’s what I have deciphered: Republicans know how to make the case for change without giving you all the facts. The New York Times points out what is missing in the Republican plans and what the adverse effects will be if their plan were enacted. AUCD points out that Medicaid is the vital resource that allows many people with significant disabilities to live and work in the community.

From other sources I learned that: Republicans are waiting for the Congressional Budget Office to say how much their plan would cost (outside sources estimate the Republican plan will cut Medicaid $1 billion a year for 10 years); putting people with catastrophic conditions in risk pools will cost 10 times what Republican project; and if Medicaid is given to states as block grants or with limits on per-person coverage, states are screwed.

So, the smart thing to do is to contact our governors (https://www.usa.gov/state-governor) and tell them not to accept a lemon.

Do we need to repair Obama care (the Affordable Care Act)? Absolutely. Some of the facts the House Republicans share are down right depressing. But, we have to consider carefully how we go about it, because everything is connected.

What do I suggest?

  1. Survey young people about how much and for what they would be willing to buy health care if they were required to.
  2. Let people design their own packages of services.
  3. Ask health insurance companies to share their data with Congress on services and costs.
  4. Put a freeze on everything and anything in health care for 18 months.
  5. Create a bicameral bipartisan commission to develop amendments to the existing approach to health care, considering both public and private health insurance plans.
  6. Give the package of amendments to Congress before the federal elections in 2018.

If we don’t do something like I just described to calm things down and move Congress on to topics on which there may be a reason for bipartisan consensus (e.g., tax reform, and rebuilding our infrastructure), this country may unravel and have massive unrest. Who the heck wants that?

Thank you,
Common Grounder

Saturday, February 11, 2017

Open Letter to Betsy DeVos

Dear Madam Secretary,

You are a brave soul. You certainly don't need a secretary's paycheck. You had a powerful sphere of influence in Michigan.

When you testified before the Senate HELP Committee, where I worked for five years, and you were asked about the federal special education law, those of us who care about and know federal policy affecting the education of children with disabilities, were at least surprised, but most likely shocked by your answer. And then today, I learned a key IDEA website, maintained and sponsored by the U.S. Department of Education since the time of George W. Bush, has disappeared!

There was some time between when you were notified of your selection to be Secretary of Education and when you testified. Why did you not seek to learn more about the Individuals with Disabilities Education Act, a civil rights law that has been on the federal law books since 1975, 42 years? Providing each child with a disability a free appropriate public education is not a matter of state discretion.

Well, now whether we agree with each other or not, we are partners in shaping what children and their parents may expect from our schools in the next four, possibly eight, years. We must find a way to work together. You indicated as much in your remarks to employees in the U.S. Department of Education. The challenge is how do we do that?

Here are my suggestions:

1. Recognize that charter schools and school choice are part of a much bigger equation.  They are mere strategies that must be joined with substance, reflect respect for law, do not foster a logistical nightmare, and include meaningful accountability.
2. Acknowledge that parents want the best education for their children, so we must invest in teachers, wherever they work, and recruit the brightest to become the teachers of tomorrow.
3. Realize that making America great again in education requires that we address issues on the ground, in every neighborhood. From this input, of great expectations, work with states and local community leaders, educators, and families to develop local benchmarks and goals. Supply the necessary resources for goals to be achieved.
4. Accept that national organization representatives care about children as you do, and this fact can be the common ground that provides the bridge to your working together.
5. Consider the diversity of our communities, their cultural and ethnic richness, and respect it as you design or promote accountability measures.
6. Embrace your role as a protector of civil and human rights, ensuring that each child has the right to an education that is empowering and allows the child to achieve his or her full potential.
7. Acknowledge that there is value, but also limits in states rights and flexibility in education, and as you continue as the national leader in education, you identify  circumstances that require a national solution in order for children to thrive.
8. Respect and protect longstanding websites, do not silence them. They are the fertile ground through which we learn essential information and develop a basis to work together.

We come to this point with differences in perspectives and experiences, but I hope common goals. I wish you well.

Thank you,

Patricia Morrissey
Aka: Common Grounder

Saturday, February 4, 2017

24 Hours

We each have 24 hours a day. What differentiates us is what we do with our personal 24 hours. President Trump and his political advisor, Steve Bannon, are focused on how they think terrorists can be kept outside our borders, and in President Trump's case, tweeting about it. Now, because for every action there is a reaction, they will need to devote part of their precious 24 hours countering judicial actions with which they don't agree. We may be in the middle of a Constitutional crisis, one that could have been avoided, if President Trump and Steve Bannon had focused on something else -- something like rebuilding our transportation infrastructure. Just think, there would have been good faith bi-partisan brainstorming. People who oppose President Trump would have been relieved or at least distracted, or perhaps, disarmed.

No such luck. President Trump and Steve Bannon have given those who oppose Trump, daily, cumulative, growing reasons to get organized, to keep the judicial branch busy, and vigorously oppose a solid appointment for the Supreme Court.

From my perspective, President Trump and Steve Bannon, have triggered an inevitable process -- aggressive use of the courts -- unnecessarily early in the Trump administration. It will eat up their time, it will take over their tweeting, and will delay or stop steps they could have taken to really strengthen the American economy and workforce.

Well, they could take a deep breathe and recalibrate, shift gears. They are only in week three after all.

Why not invite people who repair bridges to lunch?
Why not visit some inner city schools and talk to teachers, kids, and parents?
Why not nominate an educator to be Secretary of Education? One who gets unanimous bi-partisan support. If President Trump can nominate a powerful candidate for the Supreme Court, he can surely nominate a solid Secretary of Education, rather than Betsy DeVos.
Why not have a Skype call with some entrepreneurs who just happen to have disabilities?
Why not learn more about the farm-to-table movement?
Oh yes, how about letting Ivanka share her ideas about child care with more of us?
Why not talk to immigrants in Silicon Valley on H1B visas about what they are doing?

Make America great again, buy American, and hire American are slogans that scare allies and trading partners, which may be neither soon, and leave many of us scratching our heads and praying, in equal measure.

No one doubts President Trump's power or energy level. It is time to change how he uses his 24 hours. If he doesn't the history books will treat his time in office as a temporary deviation from true American values. I hope he makes the right correction now, and see the potential in consensus building and puts aside coercion, threats, and promotion of isolationism as his preferred tactics. The latter may keep his 40 percent base. But, as he has said, he will bring us together, he is the president of us all. So he needs to start acting like it.

Thank you.
Common Grounder


Friday, February 3, 2017

Whoa!

I was sent a link to a blog post by the Arc (https://blog.thearc.org) titled: The Arc On Leaked Draft Executive Order That Would Impact People with Disabilities Legally Residing in the US and Seeking to Legally Immigrate. The Washington Post was the first to share this draft executive order (apps.washingtonpost.com/documents/national/draft-executive-orders-on-immigration/2315/).

It covers three things.
1. No potential immigrant comes into the U.S. if the person cannot support himself or herself (not be a public charge).
2. Remove any immigrant who is in the U.S. and is a public charge
3. Get reimbursement from anyone who sponsors an immigrant who receives/received public benefits

The purpose of this policy is make sure the taxpayers aren't left holding the bag for these people and that everyone let in or is is here already, who happens to be an immigrant, is self-sufficient. There are no exceptions.

What about families? Children? Grandparents? Individuals with developmental disabilities? Perhaps, if the family is Christian the whole family gets in, but then again perhaps not.

I have learned that at Ellis Island, at the turn of the 20th century, potential immigrants were made to climb stairs. If you couldn't climb stairs you couldn't enter the U.S. I guess the Department of Homeland Security could shut down the elevators connected to international arrival areas at airports.

The drafter of the memo accompanying this draft executive order, Andrew Bremberg, recommends to President Trump that he sign it, although Bromberg gives him three options -- approve, disapprove, or needs more discussion.

Here's hoping Ivanka tells her Dad to trash it.

Thank you.
Common Grounder


Saturday, January 21, 2017

What We Need to Do Now!



As the gridlock in Congress got worse, as gerrymandering made congressional district elections more partisan and predictable, I started to think a viable third party of solution-driven members would force Republicans and Democrats to work together toward the common good. Then, along came Donald Trump, a party unto himself.

His progression to his inauguration has galvanized people. His inaugural speech and his references to the power of the people has awaken us. The sister marches for equality has confirmed our strength and passion. All this now must be channeled into demands for specific actions.

As I see it there are now four power bases.

Donald Trump
The Democrats in Congress
The Republicans in Congress
The people, not just those who agree with Trump, but everybody

Today I think Trump and the people have the upper hand. Republicans and Democrats are confused and scared.

Business in Washington is going to change.  People who use to watch the news and complain to their friends are now going to let the President and Congress know what they need and want, not once in awhile, but daily. People are going to stop things they don't want by flooding the offices of Congress people, the President, and cabinet secretaries.

What we the people will initially focus on, I suspect, is what happens to Obamacare, Planned Parenthood, the National Endowment for the Arts, the National Endowment for the Humanities, and PBS because they have had the most visibility in the media lately. Fine. Flood those Presidential and Congressional social media accounts this coming week, and the week after that until Congress does the right thing! In some cases this may mean just not undo something.  These items may be our test cases, a chance for us to test our strength, to demonstrate the power of solidarity.

But then we must move on to other risks, such as having a cabinet secretary who does not understand that the Individuals with Disabilities Education Act (IDEA) is a federal civil rights law, that each child with a disability has the right to a free appropriate public education. Such an education is not an elective option for states. If Ms. DeVos is confirmed we need to work with her fast! We need to explain to her the role and value of not only IDEA, but also discretionary funding in personnel preparation, research, and demonstration grants that bring about innovation in American classrooms.

We need to ensure that President Trump picks a Commissioner for the Administration on Developmental and Intellectual Disabilities in the Department of Health and Human Services that knows how the grant programs under the Developmental Disabilities and Bill of Rights Act help state service systems for individuals with developmental and intellectual disabilities work in a more consumer-friendly way.

We need to ensure that accessible housing options are embraced by Dr. Carson, and expanded. For example, let people with disabilities pool their Section 8 vouchers, and live together in bigger, better rentals, and eliminate the policy that a voucher can only be used by one person for a one bedroom rental.

Ask the President to preserve executive orders related to employing veterans with disabilities and others with disabilities. Ask the Secretary of Labor to retain regulations outlining quota for federal contractors related to hiring people with disabilities.

These are the thing I will be working for in the next months. I hope you will join your friends and colleagues to mount campaigns to address things that are important to you -- things you want to preserve, protect, expand, and strengthen. We cannot let the next four years be a time of undoing, unwinding, weakening, or ignoring the right to freedom, respect, equality, and opportunity. We have a lot to do and not a minute to waste.

Thank you.
Common Grounder