[Nfbmt] Call For Action

[d m gina]

Good morning,
I sent an email with my comments on this matter.
Thanks again.

Original message:
> Greetings Members,

> We had a full meeting on Saturday in passing an at-large chapter
> constitution.  But we didn't get to talk about the status of the Medicaid
> issue proposed by the Department of Public Health and Human Services to pay
> for O & M for blind kids in K through 12.


> There is a proposed rule.  There was a public hearing in Helena today,
> though none of us were able to attend for various reasons.  However, the
> comment period is still open until May 23. That gives us a week to act.

> We need to act  because those that support using Medicaid for K-12 O & M are
> putting the word out to ask for support.  We need to ensure that the voices
> of those that oppose medicalizing blindness and blindness-related services
> are heard.

> Here is the proposed Medicaid rule:

> NEW RULE I  EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT SERVICES
> (EPSDT), ORIENTATION AND MOBILITY SPECIALIST SERVICES (1)  Orientation and
> Mobility Specialist Services are those services provided by an individual
> with:

> (a)  a certification from the Academy for Certification of Vision
> Rehabilitation and Education Professionals (ACVREP); or

> (b)  a National Orientation and Mobility Certification (NOMC) offered by the
> National Blindness Professional Certification Board (NBPCB) to Medicaid
> clients
> with a diagnosis of a visual impairment.

> (2)  Orientation and Mobility Specialist Services are medically necessary
> services provided to Medicaid clients whose health conditions cause them to
> need
> vision-assisted services.

> AUTH:  53-2-201, 53-6-101, 53-6-113, MCA

> What to do -

> We need to say that we oppose this rule.  Start by saying that you are blind
> and a member of the NFB of Montana.  Then cover the following:

> 1.      Blindness is not a health condition, and should not be musicalized
> 2.      O & M services are already required educational services and as such
> are funded, Frank Podobnik of OPI has indicated that to be the case.
> 3.      We are concerned that this rule will cause costs to go up and will
> make O & M services less accessible to all Montana children, rather than
> more accessible.

> "Nothing about us without us" is the motto of many disability rights
> activists, and it applies here.

> *****

> Send comments to:


> 7.  Concerned persons may submit their data, views, or arguments either
> orally or in writing at the hearing.  Written data, views, or arguments may
> also
> be submitted to: Kenneth Mordan, Department of Public Health and Human
> Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana,
> 59604-4210; fax
> (406) 444-9744; or e-mail
> dphhslegal at mt.gov,
> and must be received no later than 5:00 p.m., May 23, 2013.


> Prior to leaving in April, Dan Burke submitted the following on behalf of
> the NFB of Montana.  But we need to have more comments.
> ***

> This is obviously the core of the new rule and related changes, and of
> course the core of our disagreement, though there are other points as
> well.  Blindness and low vision (visual impairment) may be associated
> with health conditions that require or may benefit from medical
> intervention I(diabetes, glaucoma, cataracts, etc.), but blindness and
> visual impairment themselves are not health conditions as such, and
> those services which are necessary are educational services, not
> medical services.  This applies to Orientation and Mobility
> instruction, and absolutely critical service to the development of a
> successful, self-determining independent adult, as are services such
> as Braille and the use of other alternative techniques and strategies
> for learning, working and day-to-day activities.  It is decidedly
> developmental, but no more medical for a blind child than for any
> child to learn to read or do fractions.  It is the very custodialism
> of this thinking that is so objectionable to us in the National
> Federation of the Blind, revealing as it does such disabling attitudes
> of the education system and society in general toward blind and
> visually impaired students and ultimately blind adults.

> Having said that, I will focus on the language of (2) of the new rule.

> *  replace "health conditions" with blindness or visual impairment.
> You can check with Frank Podobnik or Steve Gettel about this, but I
> believe that is the language required for the IEP, and it seems to me
> it should be parallel here
> * What is "vision assisted services?"  My guess is it is not a term
> defined in law or regs for education or Medicaid, but I may be wrong.
> In any case the term is so inoffensive as to be  of no use. In fact, O
> & M is not a "vision assisted service," but one of the alternative
> strategies of blindness and visual impairment.  It is much like the
> practice of referring to teachers of the blind as "vision teachers,"
> when vision is the thing least involved in a blind child's learning.
> The term does betray, however, the prejudice that blind people are
> broken sighted people. It has no place in our state government or
> rules.  And again, it makes sense to keep the language parallel with
> the IEP.

> Here are my suggested revisions:

> (2)     Orientation and Mobility services are educationally necessary
> services provided to Medicaid clients whose blindness or visual
> impairments cause them to need services in alternative techniques of
> blindness and visual impairment.

> Duane, I very much appreciate your openness and forthrightness in
> sharing the process under way and the draft of the rule.  That is
> top-notch public service in the best tradition of Montana government
> and our state Constitution.  At the same time, the process at hand and
> the language and the attitudes underlying them are absolutely
> abhorrent to me.  Good intentions are no guarantee of good works, and
> misguided compassion too often is as deleterious as the old radical
> saw--  "the booted heel on the throat of the oppressed."  This is
> especially true when there is at best scant evidence that blind and
> visually impaired children in Montana will benefit from this rule
> change.

> Further, this entire discussion was initiated without any kind of
> consensus in the "blindness community," though you may have been led
> to believe otherwise.  It breaks down almost on the lines of
> professionals versus the NFB, with only a few informed exceptions.
> Thus, it is not a good foundation for public policy.

> This has taken me all morning to write and I have been compelled to
> revise regularly and delete often as I danced none too steadily along
> the line between reasoned argument and rant.  Our passion - my passion
> - about this stems from our view that blind kids are our spiritual
> children and we are bound to do our best to do right by them, just as
> I know that you feel the same in your role.  But this rule is
> custodial and does harm.  We will of course submit our arguments in
> opposition to it

> Thanks again. Very respectfully,
> Dan

> ***

> ... Our opponents have history and outmoded concepts on their side. We
> have democracy and the future on ours. For the sake of those who are
> now blind and those who hereafter will be blind-and for the sake of
> society at large-we cannot fail.

> ***

> In the Sixteenth Century, John Bradford made a famous remark which has
> ever since been held up to us as a model of Christian humility and
> correct charity and which you saw reflected in the agency quotations I
> presented. Seeing a beggar in his rags creeping along a wall through a
> flash of lightning in a stormy night Bradford said: "But for the Grace
> of God, there go I." Compassion was shown; pity was shown; charity was
> shown; humility was shown; there was even an acknowledgement that the
> relative positions of the two could and might have been switched. Yet
> despite the compassion, despite the pity, despite the charity, despite
> the humility, how insufferably arrogant! There was still an
> unbridgeable gulf between Bradford and the beggar. They were not one
> but two. Whatever might have been, Bradford thought himself Bradford
> and the beggar a beggar-one high, the other low; one wise, the other
> misguided; one strong, the other weak; one virtuous, the other
> depraved.

> We do not and cannot take the Bradford approach. It is not just that
> beggary is the badge of our past and is still all too often the
> present symbol of social attitudes towards us; although that is at
> least part of it. But in the broader sense, we are that beggar and he
> is each of us. We are made in the same image and out of the same
> ingredients. We have the same weaknesses and strengths, the same
> feelings, emotions, and drives; and we are the product of the same
> social, economic, and other environmental forces. How much more
> consonant with the facts of individual and social life, how much more
> a part of a true humanity, to say instead: "There, within the Grace of
> God, do go I."

> -- Jacobus TenBroek, 1956
> https://nfb.org/Images/nfb/Publications/convent/tb1956.htm


> Travis S. Moses, President
> National Federation of the Blind of Montana
> chiefblindtech at gmail.com
> Phone: 406-369-5605
> www.nfbmt.org


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--Dar
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every saint has a past
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