[nabs-l] Fw: [Fwd: [acb-l] FW: ALERT! Sign-On to Letter to Congressional Leadership Concerning Health Reform and Vision Loss]

[Jedi]

Listers:

This petition was generated from a conference call holsted by the 
American Foundation for the blind earlier this month. The conference 
topic was including blindness rehab services and assistive technology 
in the overall U.S. health care reform plans being made by Congress. 
Here are the basics of the consensus reached at this conference.

1. We're about to experience a significant growth in the blindness 
community, particularly from the baby boom generation.

2. The baby boomers are savvy consumers and want services which will 
enhance their quality of life in the event of vision loss.

3. since many of these consumers are familiar with MediCare and will 
already consume MediCare services, blindness rehabilitation should be 
included as far as what Medicare can cover.

4. MediCare reimbursements should cover rehabilitation specialists such 
as cane travel instructors and low vision rehabilitators by providing 
economic perody comparable to occupational therapists who are already 
reimbursable. This would allow blind people to access services and pay 
for them using their medical coverage.

5. Assistive technology is expensive. One possibility for lowering 
costs is to use medical insurance to cover the cost of assistive 
technologies such as magnifiers, computers, software, canes, etc.

6. All medical technologies should be blind accessible.

7. Blindness services and technologies should be paid for through 
MediCare and other related health services because blindness without 
technology and training could be a health risk: untrained blind persons 
could be at risk for falls, in-home accidents, and a general loss of 
independence which could mean institutionalization and higher health 
care costs in the long-run.

8. More emphasis should be placed on blindness prevention and 
treatments than we currently have.

Here were my thoughts as I participated in the conference.

First, I think that using health care money might be a viable way to 
insure that people get the training they need. Right now, too many 
people, especially newly blinded adults not covered through vocational 
rehabilitation, have difficulty paying for training. In some cases, a 
newly blinded senior can get $200 worth of A.T. and minimal training, 
but that's really it. Using medical money might help solve this 
problem. Also, using medical money would insure that rehabilitation 
specialists get paid appropriately for their services which can only 
stimulate the economy in this sector.

I have some real concerns, however.

First, blindness is not necessarily a health problem. If anything, 
blindness is a social issue of an economic and educational nature 
rather than a health care problem. Those running this conference (the 
AFB and Vision-Serve Alliance) seem to disagree. I'm also concerned 
that some types of professional certifications for rehabilitators would 
be favored over others. I'm concerned that our NOMC's might find it 
difficult to achieve economic perody to those certified through the 
Academy (AER). While there's nothing wrong with AER certification, 
history has shown us that our NFB philosophy permiates the NOMC 
certification, and more blind people need access to good 
training/philosophy that's definitely available through an NOMC/NFB 
trained professional. There was also heavy emphasis on a vision-first 
philosophy. I believe that we may be in danger of making blindness seem 
more troubling than it is by saying that it's a health care issue (see 
above). Finally, I personally think that the cost of A.T. won't go down 
simply because MediCare can pay for it. If anything, the ability of the 
government to pay for high-priced technology has kept the price the 
same simply because the government has more money than the consumer. 
Instead, I think we need to lower technology costs by supporting 
companies such as KNFB Reading Technologies and SEROTEK. both of these 
companies are doing whatever possible to provide low-cost technology to 
the consumer. Supporting these companies and their practices as 
consumers will probably do more to lower technology costs since we'll 
be telling conventional companies that it's not okay to nickel and dime 
us to death simply because we're a captive audience.

In short, I think this health reform petition is one possible way to 
resolve the issue of rehab services and technology for older consumers 
and those not otherwise covered by Rehab. However, I think this 
petition needs a whole lot of tweeking, and I think the NFB needs to 
make it known that we don't want to turn blindness into a health care 
issue when it isn't exactly. Just my thoughts.

Oh, one more thing.

This petition also recommends the creation and/or renewal of more 
university programs to train staff. the problem is, who will be the 
teachers and what will these new students learn about blindness?

In other words, consume this petition carefully before signing it. 
While this is a good start, we still have some bugs that definitely 
need adjustment. That is my opinion for what it's worth.

Respectfully,
Jedi
Original message:


> Homer Simpson's brain: "Use reverse psychology."
>  Homer: "Oh, that sounds too complicated."
>  Homer's brain: "Okay, don't use reverse psychology."
>  Homer: "Okay, I will!"

> --- On Wed, 5/27/09, Gerald Hutch <modrepro at mt.net> wrote:

> From: Gerald Hutch <modrepro at mt.net>
> Subject: [Fwd: [acb-l] FW: ALERT! Sign-On to Letter to Congressional 
> Leadership  Concerning Health Reform and Vision Loss]
> To: "Dan Burke" <burke.dall at gmail.com>
> Date: Wednesday, May 27, 2009, 9:21 PM






> FYI  !



> Comments?



> Jerry Hutch





> -------- Original Message --------



>       Subject:
>       [acb-l] FW: ALERT! Sign-On to Letter to Congressional
> Leadership Concerning Health Reform and Vision Loss


>       Date:
>       Wed, 27 May 2009 19:37:12 -0700


>       From:
>       Andy Baracco <wq6r at socal.rr.com>


>       To:
>       acb-l at acb.org


>       CC:
>       acb-hsp at acb.org,ccb-l at googlegroups.com,blind-counselors at topica.com







> From: AFB DirectConnect [mailto:blemoine at afb.net]
> Sent: Wednesday, May 27, 2009 10:33 AM
> To: AFB Subscriber
> Subject: ALERT! Sign-On to Letter to Congressional Leadership
> Concerning Health Reform and Vision Loss




> Sign-On to Letter to Congressional Leadership Concerning Health
> Reform and Vision Loss

> For further information, contact--

> Mark Richert
> Director, Public Policy
> American Foundation for the Blind
> 202-822-0833
> mrichert at afb.net

> Leadership in Congress needs to hear from the vision loss community
> immediately to ensure that policy addressing the unique health care
> needs of people who are blind or visually impaired is part of
> comprehensive health care reform legislation. You are invited to join
> in a sign-on letter to be delivered by AFB next week to the chairs
> and ranking members of the committees of the U.S. Senate and House of
> Representatives with particular responsibility for health care
> legislation. Copies of the letter will also be delivered to senior
> House and Senate leadership of both parties.

> If your organization can sign on to the letter below, please forward
> the complete name of your organization (no abbreviations please) to
> Barbara LeMoine (a href="mailtoblemoine at afb.net" blemoine at afb.net) by
> noon on Wednesday, June 3.

> Organizational names will be listed alphabetically at the end of the
> letter; no actual signatures are necessary. We strongly encourage all
> organizations of and for people who are blind or visually impaired to
> join in this effort, and please share this sign-on request widely
> inviting any groups beyond our field to join us as well.

> The letter's text follows--

> We, the undersigned organizations representing, serving, and
> advocating for the more than 20 million Americans of all ages
> experiencing significant vision loss, urge you to exercise your
> leadership to ensure that any comprehensive health reform legislation
> enacted by the 111th Congress adequately addresses the needs and
> rights of individuals living with vision loss. Specifically, we call
> upon Congress to send to President Obama legislation that, at a minimum

> • ensures that individuals with vision loss and other disabilities
> can properly identify and take medications by mandating appropriate
> labeling standards and methods for providing nonvisual and enhanced
> visual access to drug container labeling and related information;

> • establishes clear Medicare (or other national minimum benefit plan)
> coverage for, and fosters broader private plan availability of, low
> vision devices and other medically necessary assistive technologies; and

> • allows orientation and mobility specialists, vision rehabilitation
> therapists, and low vision therapists to be full participants in the
> professional team providing specialized services to people with
> vision loss by establishing unambiguous Medicare (or other national
> minimum benefit plan) reimbursement for the services such professionals offer.

> Congress is currently weighing a variety of health care policy
> options that have the potential to fundamentally transform the scope
> and delivery of health care to all Americans. While many of these
> policy options could be of significant benefit to Americans with
> vision loss, we are concerned that proper attention is not being
> given in the policy debate to several basic health care needs
> experienced by people who are blind or visually impaired. We
> therefore ask for your help to craft and enact policy solutions as
> part of health care reform to address these unmet needs.

> Drug Label Information

> Current Law: No state in the union clearly requires labeling of
> prescription or other medications to be accessible to individuals
> with vision loss through minimum large print font size, audible
> labeling technologies, tactile markings or braille, or other methods
> calculated to provide alternatives to visual use of medication
> labeling and related information. Moreover, current federal law
> places no meaningful requirements on such labeling to ensure
> nonvisual and enhanced visual access. Additionally, while retail
> pharmacies can be held accountable for providing some degree of
> access to label information under the Americans with Disabilities
> Act, the ADA neither provides standards for pharmacies to follow nor
> establishes a consistent national policy ensuring that customers
> will, upon request, be provided the nonvisual or enhanced visual
> means of their choice to use drug labeling safely and independently.
> The failure to make medication labeling accessible to people with
> vision loss has been shown to lead to significant health risks (see
> e.g., consumer survey conducted by the American Foundation for the
> Blind at www.afb.org/labels).

> Proposed Policy: Congress should enact legislation requiring retail
> pharmacies to offer, upon the request of a customer, nonvisual or
> enhanced visual means for using medication labeling and related print
> information safely and independently. The means to accomplish label
> accessibility must be the means of the customer's choice and conform
> to national minimum standards to ensure customer privacy, consistency
> and reliability.

> Low Vision Devices and Other Medically Necessary Assistive Technology

> Current Law: Very few private health plans offer customers access to
> low vision devices or other assistive technologies that maximize
> remaining usable vision or otherwise provide nonvisual access to
> information and the environment. Moreover, the Centers for Medicare
> and Medicaid Services (CMS) refuse Medicare coverage of any device
> that employs one or more lenses regardless of a device's other
> technological features simply on the grounds that devices using
> lenses fall within the long-standing statutory bar on coverage for
> eye glasses. Other categories of assistive technology are routinely
> denied coverage on the grounds that they are convenience items, are
> not primarily for use in the home, or on other erroneous bases.
> People with vision loss can use low vision devices and other
> assistive technologies to manage their health care needs, properly
> identify medications, maintain proper diet, and ensure safe mobility
> at home and in community. Along with appropriate rehabilitation
> services, low vision devices and other assistive technologies prevent
> injury and the acquiring of additional disabling conditions.

> Proposed Policy: Congress must overturn the CMS regulation barring
> coverage for low vision devices and establish clear criteria for
> their provision. Such criteria should acknowledge other distinctive
> features employed by the most valuable low vision devices, other than
> their mere use of a lens, such as a device's integration of a light
> source, use of electrical power, or other distinctive features. In
> addition, Congress must establish clear parameters for CMS to follow
> to provide Medicare beneficiaries with vision loss access to
> assistive technologies meeting their unique needs.

> Vision Rehabilitation

> Current Law: Medicare currently pays for some forms of vision
> rehabilitation services provided under the direct supervision of a
> physician and offered by an array of state licensed personnel.
> However, orientation and mobility specialists, vision rehabilitation
> therapists, and low vision therapists, professionals who are
> explicitly trained to provide such vision rehabilitation services,
> are not among the professional disciplines recognized for purposes of
> Medicare reimbursement. This means that, while the services offered
> by other professionals--such as occupational and physical
> therapists--are services provided by personnel who are regularly part
> of the team of providers offering some limited form of vision
> rehabilitation addressing, for example, a beneficiary's needs for
> daily living skills training or other related services, the
> professional team is incomplete. As a result, beneficiaries are not
> ensured access to the full range of quality services, such as
> orientation and mobility, provided by the best qualified professional
> disciplines. Moreover, since the limited vision rehabilitation-like
> services that CMS will pay for must be provided under strict
> physician supervision, these services, which are most relevant when
> offered in a beneficiary's home or in community, are diminished in
> effectiveness. Finally, a Medicare demonstration project currently
> being undertaken to assess vision rehabilitation reimbursement has
> such significant design and administrative flaws that Congress should
> not wait for its conclusions or have confidence in their validity.

> Proposed Policy: Congress must establish unambiguous coverage for the
> services offered to Medicare beneficiaries by orientation and
> mobility specialists, vision rehabilitation therapists, and low
> vision therapists to allow the most qualified and complete team of
> professional service providers to meet the unique needs of
> individuals with vision loss. Such services should be allowed to be
> provided in a beneficiary's home and community to maximize their effectiveness.

> Thank you for your thoughtful consideration and for your advocacy on
> behalf of Americans living with vision loss. We look forward to
> working closely with you as health reform moves forward.

> Respectfully,

> [organizations listed alphabetically]







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