2007-08 common disability agenda-draft version

8/14/2019 2007-08 Common Disability Agenda-draft version

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Introduction: An Executive

Summary

A Call to Action:Toward Our Common Future

Too often persons with disabilities are seen as a niche interest group, separate in itsinterests from the rest of the population. It is long past time to debunk that stereotype as

it disserves both persons with disabilities and their fellow citizens who live - for now -without disabilities. Our interests and our futures are much too inextricably intertwined towaste time or money solving problems just for persons with disabilities.

It is time to make an adequate social investment in the infrastructure needed for aproductive, democratic and caring society for all citizens, with and without disabilities.

Access to basic, comprehensive health care is a common goal.

Michigan needs healthy citizens with access to comprehensive health care andeducation about healthy life styles. Providing preventive and basic health care is costeffective and avoids expensive care later. Our country spends billions of dollars each

year because it fails to provide preventive care, and loses billions more from lostproduction when workers or their family members are ill. Persons with disabilities needhealth care for these reasons and because remaining healthy maintains independence,quality of life, and reduces reliance on outside supports. Yet persons with disabilities areless likely than persons without disabilities to have access to basic health care.

Reforming Michigans long term care system is a common goal.

Michigan needs to reform its long term care system into a system which supports BabyBoomers in their homes as they age. We cannot afford to nor should we continue to relyon nursing homes as the first source of services for people who could continue to live intheir own homes if they had supports. Persons with disabilities likewise need access to

supports to live independently in their own homes.

A strong workforce is a common goal.

Michigan needs workers, all workers. Workers are taxpayers and productivecontributors to the economic welfare of their communities. Persons with disabilities canand should be workers, but face numerous barriers as they seek to access theworkplace.

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Affordable, accessible, visitable housing for all is a common goal.

Michigan needs adequate housing for all its citizens. Major goals related to employmentand independent living cannot be achieved if people cannot find a place to live. Yetthere is no housing market in the entire country in which a person with a disability livingon Supplementary Security Income can afford a safe, accessible modest studio or one

bedroom apartment. Michigan must participate in federal subsidized housing programsto the maximum extent possible, give accessibility requirements some teeth, and passlegislation requiring visitability in all new public housing.

Accessible, affordable and available Public Transportation is a common goal.

Many Michigan citizens with or without disabilities depend on public transportation inorder to pursue their education, to get to work, to receive medical services and toparticipate in community activities such as church, shopping and visiting family andfriends. These transportation services need to be safe, seamless, affordable anduniversally accessible. Nearly half of Michigan's 83 counties have little or no publictransportation services. To achieve the goal of a statewide system of accessible,

affordable and available transportation, Michigan must develop and sustain innovative,diverse and user-friendly options for transit while insuring a stable funding base.

Thoughtful and effective Land Use Policy is a common goal.

The majority of Michigan citizens live in urban and suburban environments which sprawlacross large geographic areas. Citizens with disabilities are increasingly disconnectedand disadvantaged in these environments in large part because they lack the financialresources, the natural supports, and the transportation to readily achieve inclusion inthese sprawling human settlements. Land use policies which plan for an integratednetwork of transportation, services, neighborhoods, leisure activities and technologysupports will greatly increase opportunities for persons with disabilities to be connectedto and included in urban and suburban environments which are livable, diverse, andaccessible.

Inclusive, high quality education is a common goal.

Michigan needs well-educated citizens. They are key to our economic future. Personswith disabilities also need education it leads them to work and to physical andeconomic independence. Yet we continue to maintain two separate education systems one for persons with disabilities, and one for persons without disabilities. A dual systemis untenably expensive, and it doesnt work for children with disabilities who have ahigher drop-out rate than children without disabilities.

Enjoying full rights as citizens is a common goal.

Michigan is stronger with integrated, inclusive communities. Persons with disabilitiesmust be able to make decisions about where and with whom they will live, to live safelywith their rights protected, and to have equal access with their non-disabled neighbors to

jobs and to full enjoyment of their communities.

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A voting, active citizenry is a common goal.

Michigan needs active citizens who vote and participate in their communities. Personswith disabilities should be voters, but face many barriers at the polls.

Access to assistive technology is a common goal.

Michigan must maintain and expand programs and services that promote awarenessand use of assistive technology to accommodate persons with disabilities.

NOTHING ABOUT ME WITHOUT ME

The undersigned organizations are committed to policies that support access, choiceand control by persons with disabilities about where they live, where they get theirservices, and who provides their services. We are also committed to the principle thatpersons with disabilities must be directly involved in the development of policies thataffect their lives if those policies are to be successful.

The Arc MichiganThe Association for Community AdvocacyDeaf, Etc.Developmental Disabilities InstituteDivision on Deaf and Hard of Hearing

MARO Employment and Training AssociationMichigan Association of Centers for Independent LivingMichigan Commission on Disability ConcernsMichigan Council for Maternal and Child HealthMichigan Developmental Disabilities CouncilMichigan Disability Rights CoalitionMichigan Paralyzed Veterans of AmericaMichigan Protection and Advocacy Service, Inc.Michigan Rehabilitation AssociationMichigan Rehabilitation CouncilMichigan Statewide Independent Living CouncilNational Multiple Sclerosis Society, Michigan ChapterUnited Cerebral Palsy of Metropolitan DetroitUnited Cerebral Palsy of Michigan

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What Has Been Done-What

Needs to Be Done____________________________________________________________________-____

The inaugural Common Disability Agenda was first presented to the State Legislature inJanuary 2003. The Agenda continues to serve as a powerful catalyst for advancing therights of Michigan citizens with disabilities and has resulted in progress in the followingareas:

Reshaping Michigans Workforce: In 2003 The Freedom to Work forIndividuals with Disabilities Act was passed. This legislation continues to increaseopportunities for persons who receive Medicaid to obtain employment and

contribute to Michigans economy with continued access to health care,regardless of earnings.

In 2006, The Michigan Department of Labor and Economic Growths Office ofWorkforce Development, Michigan Rehabilitation Services, the MichiganCommission for the Blind and other partners issued the One-Stop Inclusion WorkGroup Report which includes recommendations to promote full inclusion in allOne-Stop Service Centers.

Long Term Care Money Should Follow the Person: As a result of a lawsuit

settlement, Governor Granholm appointed a Medicaid Long Term Care TaskForce to develop recommendations for reform. The Long Term Care Commission

was created from these recommendations. Due to its efforts legislation related toSingle Point of Entry for those seeking long term care services and legislationrequiring criminal background checks for workers in nursing homes and assistedliving facilities was passed.

De-Criminalization of Mental Illness: As a result of the work of the Mental

Health Commission created by Governor Granholm, the Director of RecipientRights for the Department of Community Health now reports directly to theDirector of that Department. In addition, Recipient Rights Advisors who work withCommunity Mental Health Service Programs are now certified and required toreceive ongoing training.

Advanced psychiatric directives legislation has also been passed which allows anindividual to appoint someone to make mental health decisions on their behalfprior to a crisis occurring.

Protection of Citizen Rights: In December 2004 the Governor signed

Michigans version of the Help America Vote Act. This Act put into place a cleardefinition of accessibility for polling places (PA 92 of 2004 Section 622(6)) whichwas implemented beginning with the 2006 election. Collaborative efforts

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between state and local governments, disability organizations and citizens withdisabilities were initiated across the state and resulted in greater access tovoting. Because of this, people with disabilities are now able to voteindependently and privately. Legislation is currently pending that would providefor interpreter standards and licensure to ensure the provision of competentinterpreter services in public schools, places of employment, courts, health

systems and other environments.

Assuring a Responsive Government: Since 2003, State Government has

demonstrated the value of an inclusive and responsive government by appointingpeople with disabilities throughout all levels of the administration and numerousboards and commissions.

State Government has continued to advance the Executive Order issued byGovernor Granholm in 2004 to ensure that the Americans with Disabilities Act(ADA) is fully and effectively implemented in State government. This hasincluded improvements in making meetings and events conducted by StateGovernment fully accessible to people with disabilities.

The Department of Labor and Economic Growth has adopted a policy to ensurethat all videos produced are captioned and narrated for individuals. A policy iscurrently being developed to bring this level of access to all State Departments.

Assistive Technology: The website www.michigan.gov/disability was

implemented in 2006. This is an accessible, one-stop web site providinginformation about a wide array of disability resources, services and programs.Improvements have also been made to State Internet resources and web pagesto be more accessible for individuals using assistive technology.

Building Better Housing Options: The Inclusive Home Design Act was signedin June 2006. This Act mandates that at least fifty percent of family residentialreal estate constructed after December 31, 2006, funded by MSHDA must beconstructed to comply with the accessibility provisions of the Michigan BuildingCode.

These accomplishments have been celebrated by the disability community. However,there is much work yet to be done. The 2007 Common Disability Agenda reflects thesecurrent priorities.

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Section 1

Access To Health Care

Access is an essential component of an effective health care system. The many worthygoals of policy makers and advocates for quality health care cannot be realized ifpersons in need are denied access to services. Issues of access are inextricably linkedto the cost of health care. For example, persons with disabilities are particularly hard hitby the high cost of prescription drugs. Full access depends upon the equitable treatmentof all citizens, regardless of the nature of their disability. Finally, it depends upon thecreation of service delivery systems prepared to accommodate individual needs forphysical access, sensitivity, and effective communication.

Mental Health Insurance Policy

While two-thirds of Michigan residents have private health insurance, most have mentalhealth coverage that is much more limited than that provided for physical care. Mentalillnesses are highly prevalent, very treatable diseases, and the lack of parity amounts toblatant discrimination against persons with brain disorders.

Additionally, when mental illness is not treated, the cost implications for business andsociety are staggering. Under current law there is little or no incentive for private healthplans to offer care to people with mental illness, thus forcing the public system to fill thegaps in coverage.

Need:

One in fourAmericans older than 17 suffers from a diagnosable mentaldisorder in a given year.

A parity law would protect 40-50% of the 6 million people in Michigan whohave private insurance.

The lack of mental health parity has been estimated to cost businesses over$70 billion a year in the form of lost productivity, increased absenteeism andsick leave. (1999, US Surgeon General Report)

Depression alone costs employers $44 billion per year nationally in lostproductive time. (American Medical Association, 2003 study)

Several studies have suggested that children are hardest-hit when it comesto inaccessibility of services due to lack of parity.

Support:

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42 states have enacted mental health parity laws as of January 2007.

Michigan is one of the 8 remaining states which have not ended mentalhealth discrimination.

When polled, 83% of Michigan voters (and 90% of labor households)supported state legislation to establish mental health insurance parity.

Governor Granholms 2004 Mental Health Commission stronglyrecommended parity legislation.

Pending federal legislation has widespread support from major business andinsurance groups.

Cost:

Governmental action requiring parity creates a large enough pool of coveredlives so that the insurance risk is widely spread, keeping costs extremely low.

Direct costs of parity are miniscule typically a 1% premium increase orless.

Recent studies of parityfound that elimination of caps on mental healthcoverage does not lead to increased utilization or spending on theseservices.

The negligible direct cost of parity is offset by increased employeeproductivity; decreased absenteeism; as well as less use of emergency

rooms and medical resources.

Among the 42 states that have enacted parity laws, no state has repealedthem. In fact, several states have broadened the parity coverage due to costsavings.

Governor Granholms 2004 Mental Health Commission strongly recommendedparity legislation for Michigan. In addition, the Commission recognized thatparity law can decrease pressure on the states under-funded and over-burdened public mental health system.

Governor Granholm in her 2006 State of the State address said, it is as

important to cover mental health as it is physical health.

Medicaid Spend-Down

Medicaid spend-down requires individuals on Medicaid whose income is slightly aboveallowable levels to pay each month out-of-pocket a huge monthly deductible for medicalexpenses before gaining Medicaid eligibility for the rest of that month. It is common foran individual to be required to pay $400 for health care out of a total of $800 in income

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before meeting that spend down requirement, leaving only $400 to pay all otherexpenses.

Over 100,000 Michigan residents participate in various types of Medicaid spend-downeach month. Many of them are persons with disabilities. The system also causesconstant breaks in continuity of care, resulting in compromised health care. The

Michigan Legislature has recognized the problems with the spend-down through twoprovisions that require the Department of Community Health to examine ways to simplifyand improve the program. These provisions should be implemented.

Availability of Services

It is very difficult for persons with disabilities to find physicians and dentists who arewilling to treat them, those who are willing to treat them, and even more difficult to findhealth care providers who understand disability. The availability of essential, consumer-responsive services should not depend upon where people live.

Medicaid/Medicare rates must be raised so that providers are willing to treat

Medicaid recipients.

Payments to physicians must be made promptly.

The need for communication accommodations and other specializedresources for persons with disabilities should be recognized and availablestatewide.

Early Prevention, Screening, Diagnosis, and Treatment (EPSDT) Requirements

For many years, the State of Michigan has failed to comply with its obligations under theEPSDT program, a federal program which guarantees comprehensive medical care to

children eligible for Medicaid. As a result, children on Medicaid who are entitled tocomprehensive preventative and treatment services are not getting them.Early Periodic Screening, Diagnosis and Treatment (EPSDT) services are available

under Medicaid to low-income children and adolescents up to age 21. EPSDT providesaccess to comprehensive, periodic evaluations of health, developmental and nutritionalstatus, as well as vision, hearing and dental services, and referral to necessary medicaltreatment to correct medical conditions discovered as a result of these screens.

According to the federal requirements, states are mandated to achieve a 100%screening rate for all EPSDT components. Lead testing is one of the key components. InMichigan, Qualified Health Plans are required to test children 1 and 2 years of age and

once between 3 and 5 years if not previously tested for lead exposure.

Michigan must invest in its young people and provide the required level ofEPSDT services.

All Michigan Children Should Have Access to Screening and Treatment.

Expand MiChild eligibility for pregnant women up to 250% of poverty.

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Assure 100% assessment and access to maternal and infant supportservices for women, both in Medicaid managed care and fee for service.

Include Persons with Disabilities in Current Health and Wellness Programs

The Department of Community Health has numerous initiatives aimed toward the healthand wellness of Michigan citizens. However, these programs do not include persons withdisabilities in the materials or marketing of the initiative. Persons with disabilities have anincreased risk of secondary medical conditions either as a result of their disabilities or asa result of their inability to get appropriate ongoing medical services for their disability.Including persons with disabilities in health and wellness initiatives would be animportant investment in the health of Michigan citizens.

Access to Appropriate and Affordable Pharmaceuticals

In 2002, the state began a prior authorization program for access to pharmaceutical

products under Medicaid. For most Medicaid drug categories, lists of preferred andnon-preferred products were created, with the latter requiring pre-approval from anadministrative agent.

In 2004, the Legislature adopted and the Governor signed Public Acts 248 and 250,permanently exempting from prior authorization several products for mental health, HIV-AIDS, cancer, organ replacement, and epilepsy. The bills also make improvements tothe prior authorization processes utilized in Michigan for example, allowing a specialtyphysician to gain access quickly to a non-preferred product through a declaration ofmedical necessity.

Unfortunately in September of 2004, the Department of Community Health began

violating Public Act 248 (in the opinion of many consumers, advocates, families andproviders) by assigning prior authorization status to certain pharmaceutical productsprotected by the bill.

Access to medication by Michigans citizens is an important issue needing attention bythe Administration and the Legislature. The issue includes compliance with Medicaidrequirements for notification and subsequent appeal of adverse action (in this case, adenial of a particular medication).

Concerned citizens also need to be vigilant about other potential cost-containmentstrategies with negative consumer implications, such as limits on the number ofmedications a person can take, or the establishment of Medicaid recipient co-pays. The

latter may involve amounts that seem small to politicians and the general public, but in avery low-income population even a few dollars can drive many away from having theirprescriptions filled.

Problems with Accessing Dental Services

A Plan of Action for Improving the Oral Health Status of Michigan Residents notes thatspecial needs populations have great difficulty accessing dental services. It also reportsthat there is a shortage of providers willing to serve the low-income population. There is

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an even greater shortage of providers willing to serve people with disabilities.

A Plan of Action also reports that the impacts of Adult Medicaid cuts to dental servicesincludes collapse of the states dental safety net; a rise in carriage rates in poor adultsand children; and increases in dental related hospitalizations.

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Section 2

Long-Term CareMoneyShould Follow the Person

Persons with disabilities and many seniors rely heavily on Medicaid programs to providethem with the services and supports they need to live, work, and participate in theircommunities. Preserving and strengthening these programs ensures quality of life forMichigans most vulnerable citizens and is cost effective to the State. People's rights toreceive long-term supports in the most integrated setting consistent with their needs has

been affirmed by the United States Supreme Court in its Olmsteaddecision.

The Medicaid Long Term Care (LTC) Reform task force will need to develop aconsensus on the top LTC reform priorities identified by aging and disability advocates.These top priorities are:

Expand the single point of entry for LTC options statewide

Many people think nursing home care, which will cost the state billions, is the only optionfor themselves or their loved ones when they need assistance. A statewide single pointof entry could screen and divert those with long-term care needs from nursing homes tocommunity-based care, services, and supports and provide information on options for

those with more extensive needs. After New Jersey implemented a single point of entryprocess, it realized a 10% reduction in nursing home census numbers.

Allow money to follow the person.

Money follows the person allows an individual needing long-term care to take themoney spent on their care and receive needed services in any setting. Michigans long-term care system is unbalanced and lacks choice. Funding for nursing home care morethan doubled between FY 1997 and FY 2002 in Michigan while funding for community-based care remained stagnant. Michigan ranks among the highest in the nation forpercentage of LTC spending on nursing homes (81% in FY 2004) as opposed tocommunity-based care. The long-term care delivery system for those with chronic

conditions is complex and confusing; care is often fragmented, less effective than itmight otherwise be, and more costly. Care coordination is necessary to help consumersnavigate between a variety of LTC services, supports and settings. Individuals who wantto leave restrictive and costly settings should have access to services and supports tomake the transition. Such services are budget neutral, and can be paid for by Medicaid.Using data compiled by the Disability Network/Michigan, the average per personsavings by transitioning people to the community was $26,132 in FY 2003. Otherstates where the shift has been on money following the person into the community haveseen dramatic cost savings.

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Restructure financing of the LTC system.

People with high needs receive higher payments for services, regardless of care settingand those with lower needs receive lower payments. This is commonly referred to as

case mix reimbursement and creates a fairer funding stream. According to a GAO reporton Medicaid nursing home payments, other states have designed their paymentmethods to encourage efficient and economical delivery of care. The same report positsthat adjusting rates for case mix may encourage providers to accept consumers whorequire more expensive care while also providing states with a tool to compare costsmore appropriately. This financing structure should apply to the continuum of Medicaid-funded long-term care services, including home and community-based services.

Create the groundwork for a qualified, reliable long-term care work force.

Persons with disabilities and many seniors rely on committed, competent workers toprovide needed services in their homes and in the community. The State is facing a

growing labor shortage of people willing to provide this care. Some estimate that by2010, Michigan will need an additional 40,000 home health aides, certified nursingassistants, and personal care attendants in order to meet the needs of our agingpopulation. Because of poverty-level wages (an average of $6 per hour in Michigan and

just $5.15 in Wayne County) and a lack of benefits including health insurance, turnoverrates in home health care hover at an astonishing 65%. More money and better benefitscan be found working for McDonalds. Michigan must place a priority on increasing payand benefits for these vital positions. With the establishment of Michigans QualityCommunity Care Council, an organization designed to link home care workers withpeople needing home and community-based care, Michigan may soon begin to addresssome of the critical issues facing the independent provider in the LTC workforce.

The Home Help program is another critical home and community-based supportsprogram for persons with disabilities and many seniors, which has been successful inpreventing many people from going into nursing homes. Funding for Home Help hasbeen targeted for cuts in recent months, putting many peoples health, safety andcommunity living status at risk. DHS caseworker assessments of consumers needs forHome Help services are often unrealistically limited, and create tremendous hardship.This action represents the long standing problem ofeliminating services without seriousanalysis of the impact. The system provides no incentive for overworked caseworkers toprevent unnecessary institutionalization, which has contributed to the steep increases inthe cost of LTC.

Persons with Developmental Disabilities and Mental Illness

People with Developmental Disabilities and Mental Illness should also have access to acomprehensive, statewide array of supports and services, consistent with principles ofself-determination. These consumers have lost significant ground in recent years in theirability to access health care, mental health services, and supports for independent living.

Alternative Services that have been available through community mental health (CMH)service providers include personal care, transportation, job coaching, preparation foremployment, family support, and respite care. These are now threatened by budget

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cuts. Without such services, people are at risk of having to move to far more expensivesegregated settings.

The State should ensure alternative services will continue to be available,and that the CMH system understands how to implement them.

The State must ensure compliance among community mental health serviceproviders with the Mental Health Code's requirement for person-centeredplanning.

The State needs to focus upon preventive services, through such initiativesas the mental health prevention services pilot funded previously in the DCHbudget. The pilot targeted children with emotional illness for an array ofdemonstration programs.

Funding for mental health services for adults and children must be increased. The arrayof services for people with mental illness, dismantled over the last decade, must be re-established, with a focus on self-determination and the provision of care in the mostintegrated setting consistent with the consumer's needs and choices.

Mental Health Insurance Policy

Michigan is one of only eight states without legislation providing mental health insuranceparity, or equality. Mental Health Parity would require employers to provide mental healthinsurance on a par with the health insurance they provide for physical health. Currently,most Michigan private health insurance policies have limited behavioral health benefitsfor mental health and addiction disorders and require higher consumer cost-sharing formental health services than for other medical care.

Recent studies of parity in states and in the Federal Employees Health Benefit Programreported in the New England Journal of Medicine and in Health Affairs that elimination ofcaps on mental health coverage does not lead to increased utilization or spending onthese services--and premium increases attributable to parity would be less than half of1%. There is no reliable evidence that parity legislation causes employees to lose otherbenefits or be dropped from health insurance coverage. Renowned parity actuarialexpert Ronald Bachman has written that the (mental health parity) cost debate is over.Governor Granholm in her 2006 State of the State address said, it is as important tocover mental health as it is physical health.

Among the 42 states that have enacted parity laws, no state has repealed such lawsbecause of cost issues. In fact, several states have broadened the parity coveragebecause of cost savings.

Governor Granholms 2004 Mental Health Commission strongly recommended paritylegislation for Michigan. In addition, the Commission recognized that parity law candecrease pressure on the states under-funded and over-burdened public mental healthsystem.

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Aging with a Disability

People with disabilities are living longer than at any other point in history. Nearly 20% of

the United States population has a disability and is older than 65 years. Even with adisability, men can expect to live to age 70, while women can expect to live an additional5-10 years beyond their male counterparts. However, poverty, health disparities, andlack of supportive and innovative programs and services may well compromise thequality of those senior years. In order to age well, older adults must have access tostimulating and age-friendly environments, cognitive intervention that minimizeintellectual declines, social and financial supports, and meaningful activities. Michiganmust develop and sustain initiatives that promote healthy, self-determined aging forpeople with disabilities.

Self-directed plans and personal budgets

Older people with disabilities should be able to plan their own lives, free fromadministrative and family control and intimidation. With the support of their families,friends, advocates, and support coordinators, they should be able to envision the lifethey wish to experience in their older years and have a support network to help them toachieve that life. Additionally, consistent with emerging federal and state policies, themoney that traditionally has gone to service agencies to fund a program for a personwith disabilities should go directly to the recipient in the form of a personal budget.People with disabilities should be allowed to purchase the life they want.

Active and meaningful participation in the design and management of specializedprograms

Older people with disabilities should be invited to serve on Design Teams and AdvisoryBoards for programs that specialize in services for older people with disabilities. Theseboards should be composed of the service recipients who can assist the staff indeveloping and evaluating the proposed services. This model is consistent with theconcepts of participatory evaluation, self-determination, and nothing about me, withoutme tenets of the disability rights and disability culture movements.

These programs should develop targeted activities that focus on learning, memory, andthinking tasks in order to maximize individuals cognitive abilities.

Stable and stimulating living arrangements

Older people with disabilities should be involved at a very early stage in discussions withtheir support network about living transitions and personal plans before crises generateemergency moves. Most importantly, they need to have real choice and control overwith whom they live. It is one of the most intimate decisions and yet, too often, due tofinancial constraints or lack of awareness on the part of placement agencies, olderpeople with disabilities are placed in residential settings with people with whom theyhave no interests or personal affinity.

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Employment opportunities that maximize the knowledge and interests of olderpeople with disabilities

People with disabilities like to work and feel they are making a positive contribution to

society. Support programs need to encourage and facilitate older citizens withdisabilities to participate in innovative employment schemes, such as microenterprise orself-employment. Such programs can help older people with disabilities to turn theirleisure activities into profit. Additionally, they could develop a residential approach tomicroenterprise in that several housemates could develop a business together. Thistype of employment would give older people with disabilities a profitable way to spendtheir time rather than endless days of busy work without a positive outcome.

Community service that supports older people with disabilities in beingmeaningfully involved in service programs

The concept of being connected with ones community should not disappear as people

with disabilities age. Just as many typical senior citizens provide a valuable asset totheir communities through volunteer activities, older people with disabilities should havethe same opportunity to make their contributions. Supports coordinators should identifythe interests of older people with disabilities and then match that interest with a genericcommunity program that needs help.

Linkage with the generic service system

Few older people with disabilities are involved with community agencies that either serveolder citizens or provide community leisure activities. Intentional retirement planningshould link older people with disabilities with the social opportunities and networks in theaging community. Disability support coordinators should develop partnerships with elder

networks, so that people with disabilities can attend lectures, plays, and activityprograms that are specifically developed to appeal to the interests and needs of oldercitizens.

Intentional program activities that encourage cross-generational stimulation

Support programs should develop cross-generational activities that provide stimulationto older citizens with disabilities. These programs would allow them to serve as mentorsand community elders to younger people with disabilities and to other typical membersof the community.

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Section 3

Reshaping MichigansWorkforce

Thousands of Michigan workers from all fields are finding themselves under-educatedand unskilled to meet the demands of a transitioning economy based more on brainsthan brawn. A plan which actively shifts the Michigan employment culture back to amarketable status on the national level must occur. This depends on government

creating opportunities for cooperation between business, labor and education to matchacademic and vocational training with employer needs. Governor Granholm stated whenintroducing her Jobs Today, Jobs Tomorrow Plan (2007), We are working to make sureall of Michigans citizens have the opportunity for good paying jobs because we knowthat good job is the foundation for a good life. A strong workforce is a common goal.One of the most under utilized resources in our state workforce are persons withdisabilities. This fact is supported by research studies with consistent findings that 65%of persons with disabilities are not working (National Organization on Disability/HarrisSurvey June 2004).

Michigan Department of Labor & Economic Growth (DLEG) has created an Action Plancalled Reshaping Michigans Workforce. It focuses clearly on utilizing all of Michigans

citizens in growing the workforce. We support this plan and encourage DLEG to utilizethe resources within the statewide disability community for additional input as it works tocreate a more inclusive workforce.

Freedom to Work Legislation

The enactment of the Freedom to Work For Individuals with Disabilities removed a majordisincentive for many seeking employment. This legislation provided the opportunity forindividuals to return to work without loosing Medicaid benefits. We strongly encouragethe Department of Human Services (DHS) and the Department of Community Health(DCH) to continue their efforts to market this opportunity as well as to manage anenrollment process which is user friendly. This Medicaid Buy-In opportunity is essential

if individuals are to benefit from the federal Ticket-To-Work Program, which offers workincentives to SSI and SSDI recipients.

An Inclusive Public Workforce Development System

Michigans system of One Stop Employment centers must be programmatic andphysically accessible to all of our citizens.

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The Entrepreneurial Spirit

The entrepreneurial spirit must be championed for persons with disabilities. Smallbusiness development, telecommuting, and self-employment opportunities must berecognized as viable employment options.

Supports for Persons with Disabilities on Public Assistance

Studies demonstrate that many single mothers remain on welfare rolls instead ofengaging in competitive employment because they have disabilities or because theyhave children with disabilities. In both cases, access to education, training, day care, andcommunity supports is restricted. A Jobs Education and Training (JET) program hasbeen implemented in 4 pilot sites in response to this circumstance.

Preparing Youth for Work Youth Transition Services

The State must aggressively enforce the federal mandate for school to work/lifetransition planning for students with disabilities. The effective use of inter-agency

cooperative agreements between school districts, community mental health serviceproviders, and the local VR offices, etc. have enhanced the outcomes for youth.

We strongly encourage the Michigan Commission for the Blind (MCB) and the MichiganRehabilitation Service (MRS) to continue their service priority to the future employmentof youth with disabilities. National statistics indicate that more than two-thirds of theyouth with disabilities who receive VR services successfully enter the workforce, whichsignificantly reduces their need for public assistance programs.

Maximizing Federal Funding for Michigans Employments Supports

Two state agencies are federally mandated to focus on employment counseling, training

and job placement for persons with disabilities. The Michigan Commission for the Blind(MCB) and Michigan Rehabilitation Services (MRS) receive the majority of theiroperational funds through federal grants, as determined by the Workforce InvestmentAct, Rehabilitation Act of 1973, as amended (WIA).The challenge for each of these agencies is that they must be able to fully match thefederal allotment with state (General Funds) and local monies. At the national level, thepublic VR system is viewed as one of the most cost effective and productiveemployment programs in meeting its goals.

The State of Michigan relies very heavily upon third party contributions to generatedollars to earn the maximum federal grant funds available. During the last two decades,

all administrations have decreased the percentage of General Fund support to match thestate's allotment, while substituting increasingly higher requirements to obtain matchingdollars from local community resources. In FY 2004 this amount exceeded $10 million in

just the MRS system.

The net result of this tactic has been to skew resource allocations along two dimensions.First, the two most available sources for local match are Local EducationAgencies/Intermediate School Districts and Community Mental HealthBoards/Authorities. Relying upon these resources skews services to a narrow range of

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disabilities. Since there are few other disability specific statewide organizations withmoney, differential access to services is created as a by product of the funding strategy.

Secondly, communities with available local resources are better positioned to benefitthan poorer ones. The result is that the rich tend to get richer, while poorer communitieswith unmet needs are not as able to tap resources. Thus the accident of residence may

affect an individuals equitable opportunity to access VR services.

Funding policy needs to be crafted and tied to mechanisms that result in creating a levelequitable playing field for all persons with disabilities eligible to receive services from thestates Vocational Rehabilitation agencies. This problem should be faced jointly by theexecutive and legislative branches of government. Elected policy makers must bemindful that when decreasing the General Fund dollars for each of these agencies, thereis a direct impact on the availability of services for persons with disabilities.

Rehabilitation Reauthorization

The Workforce Investment Act, the federal enabling legislation for Michigans two

rehabilitation agencies has been scheduled for reauthorization by Congress since 2004.This Act which contains the title authorizing the Rehabilitation Program will bereconsidered in 2007. The Michigan Congressional delegation must understand and actupon the critical issues associated with this pending reauthorization. The GovernorsWashington D.C. office must play a key role in raising the awareness of theCongressional Delegation.

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Section 4

Building Better Housing

Options

The availability of affordable, accessible housing depends to a great extent but notentirely upon factors beyond the control of state government. The issue is so critical tothe achievement of full community integration for person with disabilities that the Statehas an obligation to take whatever steps it can to address it. Major goals related toemployment and independent living cannot be achieved if people cannot find anaffordable place to live.

Visitability

The State should require visitability for all new public housing and stop the practice ofbuilding homes that are not accessible to persons with disabilities. Governments andprivate industry have testified that visitability does not add cost to a new structure.

Making Needed Supports Available in Integrated Community Housing

It is not uncommon for people to be forced into nursing homes or group homes becauseservices are not provided in the settings of their choice or for want of something assimple as a ramp into their home.

Housing for people with disabilities should be funded separately from services for them.Everyone should be able to live in the setting they choose and get the services they need.They should not need to live in special settings to get their services needs met.

Funding for Community Services

State policymakers should recognize that community-based services can save moneythat the state now spends on unwanted, unneeded residential services and nursing care.They should protect community services from shortsighted budget cuts that risk movingpeople to more costly segregated settings. The Legislature should redirect funding awayfrom restrictive residential settings and use them to pay for home and community-basedservices that enable real choice for those who get them. It should also ban construction

of new large group homes (5 or more beds) and new nursing home capacity

Including The Needs Of People With Disabilities In Community Development

All communities should address the needs of people with disabilities as a discrete part oftheir comprehensive housing plans. Those plans should exclude segregated housing forpeople with disabilities and include means to provide information to people and link themwith resources.

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State and federal agencies should work with each community to assess the housingneeds of its citizens with disabilities, make a plan to meet them, and include it in theirgeneral housing and development plans. Governments at all levels should developpolicy on housing affordability. They should invest resources to assure that all theircitizens can find affordable housing.

Maximum Participation in Federal Subsidized Housing Programs

The Michigan State Housing Development Authority should continue to encouragemaximum use of federal housing subsidies, both by local housing commissions and bythe Authority itself, particularly where subsidies are made available specifically topromote the integration of nursing home residents into the community.

Compliance with Accessibility Requirements in Publicly Financed Housing

Governments at all levels should comply with and strictly enforce federal and stateregulations on accessibility. Violations of these regulations have resulted in many lostopportunities to increase the supply of housing for person with disabilities.

Voluntary Construction Of Accessible Homes

Michigan builders should market a voluntary certification process for private, open markethomes designed in line with the tenets of universal design. Georgias EasyLiving HomeCM

is an example of such a program. (The EasyLiving Home (CM) program is a certificationprogram designed to encourage builders of single-family homes and townhomes toincorporate several features that increase the sellers' market and offer buyers a home easyfor all to live in and visit.

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Section 5

Accessible Public

Transportation

Accessible, Affordable and Available Public Transportation is a Common Goal.

Many Michigan citizens with or without disabilities depend on public transportation inorder to pursue their education, to get to work, to receive medical services and toparticipate in community activities such as church, shopping and visiting family andfriends. These transportation services need to be safe, seamless, affordable anduniversally accessible. Nearly half of Michigan's 83 counties have little or no public

transportation services. To achieve the goal of a statewide system of accessible,affordable and available transportation, Michigan must develop and sustain innovative,diverse and user-friendly options for transit while insuring a stable funding base.

Thoughtful and Effective Land Use Policy is a Common Goal.

The majority of Michigan citizens live in urban and suburban environments which sprawlacross large geographic areas. Citizens with disabilities are increasingly disconnectedand disadvantaged in these environments in large part because they lack the financialresources, the natural supports, and the transportation to readily achieve inclusion inthese sprawling human settlements. Land use policies which plan for an integratednetwork of transportation, services, neighborhoods, leisure activities and technology

supports will greatly increase opportunities for persons with disabilities to be connectedto and included in urban and suburban environments which are livable, diverse, andaccessible.

The Importance of Transportation

For a significant number of Michigan citizens, including those with disabilities, theabsence of affordable, reliable, and accessible transportation is a major deterrent

Many transit-dependent individuals must rely upon public transportation services. Theseservices need to be safe, seamless, affordable and universally accessible, if they are tobe useful for individuals to get to medical care, employment shopping voting and

participation in the life of their communities. Almost half of the states counties (34 out of83) still have little or no public transportation service. A stable public transportationfunding base, supporting a statewide system of accessible transportation, is the key toreaching this goal.

Funding

Transit agencies are facing reduced state funding and increased costs of services; weneed to ensure transit agencies are provided with an adequate and reliable funding

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base. While state funding for public transportation has marginally increased in the lastfew years, funding for public transit systems is still inadequate and unpredictable fromyear to year.

Transit funding should be increased through Public Act 51 so that public transits shareof the transportation budget is the full 10% allowed by the state constitution. It currently

receives only 8.5% of transportation funding.

The State Legislature should implement House Bill 4153 of the 92nd Legislative Sessionwhich would capture the use tax on the lease of automobiles at the same rate the salestax is captured on automobile sales. This would raise $20 million in funding for publictransportation without implementing any new taxes.

Consumer Participation

The State should increase the level of participation in local transit decision-making bythose who use transportation service through increasing the powers and responsibilitiesof transit Local Advisory Councils. The State should explore other ways to ensure

consumers have ready input into local transit decision

Strengthened Local Advisory Councils allowing more citizen input in local publictransportation decisions will create better, more accountable transit systems throughoutthe state.

Statewide Accessible Transportation

Michigan should pursue statewide accessible transportation by implementing the recentlegislative mandate to the Department of Transportation to work with transit agenciesand local units of government to assure statewide demand-response services and toaddress unmet transportation needs. This effort should include consideration of the

need for interface among neighboring public transit systems to ensure regional mobility.Another way to work for statewide public transit is through Transportation Vouchers,which are now being piloted through the Michigan Developmental Disabilities Council.Michigan should use Federal and State funds to fund voucher programs, therebyincreasing transportation service and consumer choice.

Increased Efficiency

The State should continue to pursue improved coordination of transportation servicesthrough the United We Ride effort. Through this effort, all the State Departmentsinvolved in transportation services are taking concrete steps to improve coordination inthe provision of transportation. We support this effort and encourage the Departments

involved to give full support to this process.

Maximizing Federal Funding for Michigan

The federal legislation that determines the mechanisms for federal transportation fundingto the states, the Transportation Equity Act, was scheduled for reauthorization byCongress in 2004. Action is unlikely to be completed this year and will be delayed until2005. Millions of dollars for transportation in Michigan are at stake. Michigan musteffectively educate the Michigan Congressional Delegation about the issues of the

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reauthorization and, in particular, to the potential value of this Act to Michigan and itscitizens. The Governors Washington, D.C. office must be effective in communicatingwith the Michigan Congressional Delegation.

Section 6

Universal Education

Michigan, its lawmakers, educators and citizens, must commit to helping all studentslearn, grow, and go to school together. That certainly includes students with disabilities -they also have a right to a quality education. Students with disabilities must get thesupport they need, in school with other students, to prepare for work and life.

Universal Education

The current educational system directs many students with disabilities to separateschools and classes. This problem is becoming critical, especially for students whohave significant disabilities, and varies widely depending on where a family lives.

All students should have access to inclusive environments that provide human, financial,and natural peer supports for social and academic learning. Students must have accessto a Universal Education system. All instruction should be differentiated and based onprinciples of universal design for learning to assure that students can maximize theiropportunities to learn within the general educational curriculum and classrooms. Allstudents should take assessment tests to record their progress, and all schools shouldbe reviewed for compliance with the No Child Left Behind Law and Education Yes!program.

A Level Playing Field

Financially, some school districts have serious trouble providing high-quality educationand supports for all students, including those with disabilities. The states difficultfinancial situation may threaten the extra supports some students need. GivenMichigans budget problems, its doubly important that the federal government followthrough on its under-funded mandates, such as IDEA and No Child Left Behind.

Federal aid and services for poor students must increase, assuring true equalopportunity to learn and succeed. Underserved parts of the state must receive extrahelp. The state should honor its obligation to educate all students with high needs,

including those who live in foster care, the juvenile justice system, and adult prisons.

Positive Behavior Support

Educators should reinforce creative and positive responses toward seemingly disruptivestudents. Similarly, complaints of abuse and illegal treatment should be investigated.Schools must link their supports to such students to other community resources,including Community Mental Health Services.

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Seclusion and Restraint

The State Board of Educations December 2006 policy, applying to all students, on

seclusion and restraint is an important starting point but is insufficient to protect studentsand staff. The policy should go further to:

Ban seclusion. Seclusion as allowed in the State Board policy is inherentlycoercive and potentially harmful and has no demonstrated educational value.

If allowed at all, limit the use of restraint to unforeseeable emergenciesinvolving significant risk of substantial harm to self or others. Restraintshould never be part of a behavior support plan.

Prohibit practices that are inherently dangerous or used for punishment;

require training to protect safety of students.

Require public reporting.

Integrate the Boards recently approved policy on school-wide positivebehavior support.

Make necessary changes to state law or regulation to make the policyeffective. For example, the restrictions on restraint in the State Board policyare narrower than those in the corporal punishment law. Nor are there anyrequirements that the policy be mandatory.

The school system is the only service system where these practices remain unregulated

and unreported

Following the Law

State-level administrators must have more power to investigate complaints, assureimplementation of IDEA, and resolve problems to the benefit of students. These leadersmust also begin to implement dispute resolution changes mandated by the States owncorrective action plan.

Higher Education

The campuses and lecture halls of Michigans institutions of higher education must

welcome all citizens. According to Cathy Henderson of the American Council onEducation (2001) only 6 percent of our nations first-time, four-year universitiesfreshman population included individuals with disabilities. This statistic demonstrates theserious inaccessibility of advanced education, whether it is due to rising tuition costs,lack of physical accessibility, or the under-preparedness of students with disabilities.Unless our state institutions of higher education aggressively support and welcomecitizens with disabilities, their future economic prosperity is seriously compromised.Attainment of an advanced education is a means to reach economic self-sufficiency andpersonal well-being.

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In addition to increasing the number of high school graduates with disabilities on collegecampuses, Michigan postsecondary institutions should welcome students with cognitivedisabilities on their campuses. Emerging research and innovative practices havedemonstrated that these students can benefit from and be successful in postsecondaryprograms.

Continuing Adult Education

People with disabilities, as is true with general population, are lifelong learners and assuch should have access to the full variety of continuing and adult education programs.These programs should comply with the standards and requirements of the Americanswith Disabilities Act in making their curriculum and instruction accessible to allparticipants.

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Section 7

De-Criminalization of Mental

Illness

Because Michigan has failed to provide adequate mental health services, there is analarming increase in placement of both adults and children with mental illness into jailsand prisons because their psychiatric symptoms are mistaken for delinquent or criminalbehaviors. Reliable data shows that 65% of children in juvenile justice placements sufferfrom an emotional disorder, and that 35% of children in these placements have a seriouspsychiatric disorder. A Department of Community Health study released in 1998 showed50% mental illness prevalence (persons who met the adult commitment criteria in the

Mental Health Code) in the Wayne, Kent and Clinton County jails. Children and adultswith mental illness who are committed to facilities in the justice system are extremelyvulnerable to physical and sexual assault, self-injury, suicide and deterioration in theirmental health status.

In 2005, the Michigan Mental Health Commission released itsrecommendations. To date, the recommendations have not been acted upon.The Governor and the legislature must act to implement recommendationscontained in the Mental Health Commissions report for neededimprovements to the mental health system for persons with mental illnessbeing relegated to the criminal system.

Implementation of Diversion Programs

The State should mandate diversion programs that include best practice screening andassessment tools, and should require that community mental health programs providemental health treatment to individuals who are in the criminal system because ofoffenses related to their illness. Diversion programs should result in provision ofadequate mental health services to individuals in the mental health system in lieu ofcriminal prosecution. The State should develop effective liaison programs for personswith mental illness who are in jail or detention to ensure that upon their release,adequate mental health services are in place, so a revolving door of reincarceration andtreatment in emergency rooms is avoided. Unless adequate mental health services areavailable, children and adults with mental illness often spend more time incarcerated

than others because corrections officials are concerned about releasing theseindividuals without a guarantee of care in the community.

Maximizing the Flow of Federal Funds to Michigan

The State should explore methods of maximizing federal Medicaid dollars for mentalhealth treatment for children who are in the juvenile justice system and who are divertedfrom placement in detention facilities.

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Mandating CMHSP Reporting

The State should mandate reporting by the Community Mental Health Service Providers(CMHSP), of the number of adults and children who have been involved with the adultcriminal system or the juvenile justice system.

Prisons/Jails

Administration segregation, seclusion, and restraint are sometimes used for excessiveperiods of time and as a substitute for positive behavior supports and other bestpractices against individuals with disabilities in the correctional system. Proceduralsafeguards are not always honored.

The legislature should implement better safe guards to improve the delivery of mentalhealth services in correctional settings. The state should develop reporting mechanismsfor incidents of administration segregation.

The legislature should explore allowing an independent external investigation of all

deaths occurring in the correctional setting.

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Section 8

Protection of Citizen Rights

In order for persons with disabilities to become and maintain full citizenship andparticipation in communities, they must be afforded due process, rights, and protectionsto ensure that the services and supports they choose are accessible, affordable, andhigh quality. In addition, individuals rights should not be limited or restricted by othersthrough unnecessary guardianships.

1 Alternatives to Guardianship

Every person can make choices and has a right to make decisions. Persons withintellectual disabilities may express those choices and decisions in non-traditional ways.

To deprive people of their rights to be supported in their decision-making, and to insteadappoint a substitute decision-maker, increases peoples vulnerability, and deprives themof the right to self-determination and other fundamental rights. In a National surveyconducted in 1990, Michigan had more guardians than any other state. Since then, theMichigan legislature has changed state law to limit the use of guardianships. However,guardianship is still widely used for people who need support or accommodations inmaking decisions.

The Michigan legislature should continue work on guardianship reform. Afamily consent statute can help reduce the need for the appointment ofguardians for the purpose of medical decisions. Legislative reforms are

needed regarding Do Not Resuscitate and other end-of-life decisions. Therecent changes in Estates and Protected Individuals Code should beextended to the guardianship provisions of the Mental Health Code.

Court appointed attorneys and guardians ad litem need specific training ondisability issues.

Regulation of professional guardians must be increased.

All other alternatives to guardianship must be exhausted before guardianshipis considered by a court. The Department of Community Health, the Office ofServices on Aging, the Department of Human Services, the Department ofEducation and advocacy organizations should be key in educating individualsabout alternatives to guardianship.

Office of Recipient Rights

The protection of some of the most vulnerable individuals in our society are the mostlikely to be disregarded. We must assure them the strongest protection. The Office of

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Recipient Rights needs a greater autonomy, guaranteed staff and resources and greaterenforcement authority.

The Office of Recipient Rights is the States designated system to protect people whouse the mental health system. Every community mental health service program(CMHSP) is required to have an office of recipient rights. Disability advocates have long

recognized this internal recipient rights system does not adequately protect the rights ofpeople with disabilities for three main reasons: 1) The recipient rights office reportsdirectly to the executive director of the local CMHSP or other service provider, andrecipient rights officers are employees of their local CMHSP or other service provider; 2)The rights system can make disciplinary recommendations to the executive director, butdoes not have the authority to issue disciplinary procedures or other sanctions; and 3)The rights systems are understaffed and under-trained to do their jobs competently andthoroughly.

In spite of the Mental Health Commission recommendations regarding the local rightsoffices, we believe that the local offices should report to the State Office of RecipientRights. Many of the difficulties facing consumers in filing rights violations are the

perceived conflict of issue. The language offered by the Mental Health Commissiondoes not go far enough to address the testimony provided by consumers and advocacygroups during their public comments. The State should review this recommendationvery seriously in providing an efficient recipient rights program that serves everyone withthe perceived conflict of interest.

The recipient rights system for CMHSP's should be external and independentof the CMHSP's. It should be funded with an amount equal to one percent ofthe combined annual budget of all county programs.

The State Office of Recipient Rights must have the authority to imposeappropriate sanctions to assure requirements for rights protection and

advocacy.

Recipient rights services should be made accessible to all persons withdisabilities, and necessary accommodations, including alternative formats,should be available.

The number of recipient rights advisors required should be based on thenumber of people served by the local CMHSP or other service provider.

Strengthening Enforcement of Disability Rights Laws

Michigans disability community is greatly concerned about the impact of recentSupreme Court decisions on the Americans with Disabilities Act (ADA), and the rights itwas intended to protect. Nevertheless, lack of enforcement of disability rights laws is ofequal concern. The State should take steps to toughen enforcement of the ADA, theMichigan Persons with Disabilities Act, and all state civil rights laws. This is particularlycritical in the criminal justice system, where people with mental illness, emotionaldisorders, sensory impairments, and intellectual disabilities are vulnerable tomisunderstanding, ignorance, and the inability to communicate critical information in a

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timely manner. The State must also fully comply with Section 508 requirements,ensuring accessibility of its website and other public communications; programs or publicprocesses using communication technologies, such as automatic voice response, mustbe accessible for all potential users.

Michigans federal delegation must support the ADA Restoration Act introduced by

Congressman Conyers. This piece of legislation clarifies the intent of Congress to havethe ADA be like the Civil Rights Act of 1964 and other Civil Rights Laws that prohibitdiscrimination on the basis of race, color, religion, national origin, and sex. The ADARestoration Act would add new language to the ADA to prohibit discrimination on thebasis of a disability, focusing on the discrimination that people experience rather thanfocusing on their ability to prove they have a disability.

Access to State Identification

For a variety of reasons people with disabilities are among those more likely to have noform of official state identification. Given that proper ID in many instances is required forsuch essential life functions as applying for a job, acquiring a residence, or opening a

bank account, the lack of State ID makes achieving independence and full integrationinto the community significantly more difficult for many individuals. The state shouldrevise current procedures in order to make state identification more easily obtainable forthese individuals.

The state should waive the application fee for individuals for whom it is shownto be a burden.

A wider range of documentation including social security cards, prisoneridentification cards, and state mental health facility records should beaccepted in order to obtain a state ID.

The Secretary of State should make a concerted effort to provide individualsbeing discharged from mental health facilities with an opportunity to obtain astate ID.

Voting Rights

Historically, voters with disabilities have faced barriers in the forms of outright prejudice,inaccessible polling places, antiquated voting methods, and lack of access to registrationopportunities. As a result, people with disabilities are significantly underrepresented inthe electoral process. With the passage of the Americans with Disabilities Act (ADA) in1990, the National Voter Registration Act (NVRA) in 1993, and the Help America VoteAct (HAVA) in 2002, these traditional barriers are coming down, but much remains to bedone in order to ensure full access to the ballot for people with disabilities. Enforcementof federal law, improving state policies and practices, and eliminating barriers wouldempower all of our Michigan citizens to exercise their fundamental right to vote.

Registering people with disabilities to vote should be made a top priority bythe Secretary of State.

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Federal and State laws requiring that every polling place be equipped with atleast one voting device that enables individuals with disabilities to make theirselections privately and independently must be enforced.

All polling places must be accessible in a manner compliant with the ADA.

Election administrators and poll workers must be well trained with regard tothe rights of voters with disabilities, accessibility standards, using theaccessible voting equipment, and how to appropriately assist voters withdisabilities.

Accessible voting devices must be made readily available for use atappropriate locations throughout any time period during which early voting,in-person absentee voting, or any other incarnation thereof may take place.

Federal law allows for a voter who would like assistance in marking a ballot to

select the individual who will accompany her/him into the voting booth. Thisright must be enforced.

Any materials prepared by election officials at any level to educate votersabout candidates, proposals or voting procedures must be made available inalternative formats. This includes accommodation of intellectual disabilities.

The state should recognize and explore the possibility of "no reason"absentee voting.

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Section 9

Assuring a Responsive

Government

The Downsizing of Michigan government coupled with continual budget restraints affectsservices to people with disabilities. The administration must continue to exploreinitiatives and strategies that more effectively address the needs of its citizens.Government organizations can and must change the way they do business, not only tohelp people navigate the system, but also to find ways to make it more user-friendly.

Nothing About Us Without Us

Disability issues are complex, and require everyone's best thinking if they are to beeffectively addressed. Governance at all levels must include users of services andrepresentatives of advocacy organizations in decision-making. There needs to be acommitted effort to appoint persons with disabilities onto councils, committees, andmandated time limited bodies which address issues that directly affect them.

Transparency

Public Policy discussions and budgets to support those policies need to be open tocitizen input and review.

A Person-Centered Approach

Provisions and evaluation of program services must embrace a person-centeredapproach up front not as an after thought. All activities of Government must recognizethat the customer/citizen is the end user.

Consumer Control

A redirection of resources from facility/provider controlled programs to methods likevouchers allows the consumer greater control over innovative ways to address theirgiven needs. The Money Follows the Person initiative is one such example.

Realistic & Fair Cost Containment

There is a recognized need for responsible cost containment. The State must considervalid administrative costs in budgeting for support services that are to be contracted out.Eligible program recipients should not be routinely denied services and be forced to workthrough lengthy grievance and appeals processes.

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Safety Nets

Where a facility or program is discontinued, the state must work with consumers andfamilies to identify the real impact, consider satisfactory alternatives, and define thetransitional phase-in of supports and services.

Ease of Access to Information

Every agency providing services to the public needs to ensure alternative formats areavailable in their public meetings, functions and communications. There should be a tollfree number (with TTY), electronic access, captioning on visual media, voice rely, and onrequest Braille material

Increased Accountability

Findings and recommendations from the Mental Health Commission and the MedicaidLong Term Care Task Force must be widely disseminated and resources identified toensure the recommendations become reality and impactful upon persons lives.

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Section 10

Assistive Technology

People with disabilities are entitled to the same opportunities others enjoy. With thecontinuing developments in technology, being a part of ones community has neverbefore been as possible.

Access to Government

People with disabilities, as citizens of our state, must have equal access to government.

State Internet resources and web pages must be accessible to people who

use AT. Web pages should meet the World Wide Web AccessibilityGuidelines and Section 508 of the Rehabilitation Act.

Michigan should pass a law which requires web pages funded by statemoney to meet the Web Accessibility Guidelines and Section 508.

Employment

Historically, work options for many people with disabilities were limited by their need foraccommodations in the workplace. As a result of advances in technology, the door hasbeen opened, often leveling the playing field for real employment opportunities for thesame people who were ignored in the past.

The State must keep and expand programs and services which promoteawareness and use of AT for people with disabilities in the workplace.

The Michigan Legislature could also support this effort by creating a MichiganLaw which would parallel Section 504 of the Rehabilitation Act, as amended.

The Department of Labor and Economic Growth is strongly urged to add ATinto the goals and outcomes of their Action Plan.

Michigans Workforce Boards should ensure that they are trained on a regularbasis to use the assistive technology and devices so that people with

disabilities are able to use their services.

Funding

While access to technology (hardware or software) is necessary so that people withdisabilities can participate in our communities, finding funding for AT is difficult.Currently, delays and restrictions keep many people from getting the technology andequipment they need.

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The state should support the Michigan Assistive Technology Loan Fund andthe Telework Fund so that these programs can seek match funding from thefederal government.The state could explore the development of a buying cooperative for all statefunded programs which purchase assistive devices for people. In otherstates, this has lowered the cost of AT. People with disabilities, familymembers, and employers could join this cooperative.

Delays in authorization and payment for Medicaid Durable MedicalEquipment must be reduced.

People with brain injuries must be fully included in the group of those eligiblefor AT funding through Medicaid.

The legislature should amend the current law known as the WheelchairLemon Law to include regulating the sale and leasing of AT and to require themanufacturers to provide an express warranty with prescribed remedies.

Long-Term Care

People involved in the Long Term Care (LTC) system need to be knowledgeable aboutAT which allows people to live in any setting. Michigan should make sure training isavailable for people in key positions within the LTC system.

Schools

Students with disabilities must have a direct path to AT devices. This includes devicesand supports such as interpreter services, assessments, textbooks, and modifiedcurricula. Assessment and training to use devices or software is critical in gainingmaximum success.

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Section 11Recreation

As Michigan undergoes a significant change in its economy, our natural resources willcontinue to attract both in-state and out of state visitors for a wide range of recreationalactivities. Travel and tourism will continue to be a significant part of Michiganseconomic health. As we attempt to attract new business, the recreational opportunities

here in Michigan will be a major draw. As the population ages out, an ever greaterpercentage of our citizens will acquire some type of disability. Therefore, it is essentialthat Michigan recreational facilities and programs be designed or modified to provideuniversal access to all our citizens and visitors.

Current medical studies indicate that health and wellness is critical for a viable workforceand for an active population. For persons with disabilities, accessible, useable andaffordable recreational activities will become increasingly important as that segment ofthe population grows in numbers. Our Public policy must reflect a commitment to andinvestment in our parks, our shorelines, our waterways, our trails and our vast acreageof land for sports hunting and other recreational uses. An example of planning andinvestment to respond to a growing need lies within the increasing popularity andutilization of hand cycles and sophisticated tricycles for persons with disabilities and foraging citizens, who experience concerns with balance. Traditional bike paths are notwide enough to accommodate these new technologies which are increasingly found onroadways where their mix into auto traffic is undesirable. The rapidly expanding use ofhorses for both recreational and therapeutic riding will call for expansion of trails andfacilities appropriate for equestrian activities.

All children learn by playing. However, physical, sensory or developmental disabilitiesoften keep children with disabilities from using traditional playgrounds. KelloggFoundation in partnership with community recreation programs, the DNR and theMDOTS Welcome Centers have funded the construction of Boundless Playgrounds thatallow young people both disabled and able bodied to play together. These Playgroundsalso afford the opportunity for parents with disabilities to play with their children. The W.K. Kellogg Foundation partnership with the public sector called Access to Recreation is amodel that should be replicated over and over again throughout Michigan.

The Louis Harris and Associates national survey concerning Americans with Disabilitieshas consistently found that Americans with disabilities are consistently unemployed orunderemployed, report household incomes significantly below average and are muchless likely than non-disabled Americans to participate in regular social activities. Theresult of these findings help explain in part why this segment of the population exhibits a

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lower self-concept, a higher rate of health problems and a lag in soft skills for fullintegration into their communities. Other studies confirm that regular participation inrecreation results in a higher level of health, a more positive self-concept and a greaterrange of team/social skills that are directly transferable to the workplace and toparticipation in other community activities.

Recreation is by its very nature an inclusive mainstream activity. When persons withdisabilities participate in recreational pursuits and programs, they are exercising self-selection of choices. This is important in establishing an independent lifestyle. thatallows one to break the bonds of dependency. People learn competitive skills,planning/training skills and cooperative team skills that are directly transferable to otherareas of life including education, employment and self-sufficiency.

For additional copies of this document, contact the SILC office at 1-800-808-7452or visit www.misilc.org.

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This document was funded in part from state and federal grants.2007

2007-08 common disability agenda-draft version

Documents