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The 2002 Washington Seminar
Those at the Sunday-afternoon-briefing head table were (left to right) James McCarthy, NFB Assistant Director of Governmental Affairs; Diane McGeorge, President of the NFB of Colorado and coordinator of seminar arrangements; Joanne Wilson, Commissioner of the Rehabilitation Services Administration; NFB President Marc Maurer; and James Gashel, NFB Director of Governmental Affairs.
From the Editor: Nearly 500 Federationists gathered in Washington, D.C., beginning Friday, February 1, for the 2002 Washington Seminar of the National Federation of the Blind. The first event of the week was the mid-winter conference sponsored by the National Association of Blind Students. Joanne Wilson, Commissioner of the Rehabilitation Services Administration, keynoted the day-long conference on Saturday, and Ever Lee Hairston, First Vice President of the NFB of New Jersey, spoke at the banquet that evening. As always the conference was inspiring to the students who came from across the country to take part and to get to know other members of NABS.
Sunday saw tours of the National Center for the Blind and several workshops and committee and division meetings. The newest of these was a workshop for those interested in writing their own Individualized Plan for Employment. It was conducted by the National Association of Blind Rehabilitation Professionals.
Late that afternoon the first briefing of the Washington Seminar took place. President Maurer discussed a number of current issues of interest to the gathering. Then Jim Gashel and Jim McCarthy of the NFB's Governmental Affairs Department described and briefly discussed the three legislative issues about which we would be talking to Members of Congress during the week. The fact sheets and legislative memorandum were available in print and on cassette, so participants had been talking about the issues all weekend. Here are the documents that we took to Capitol Hill:
Legislative Agenda of Blind Americans
Priorities for the 107th Congress, Second Session
Public policies and laws affecting blind people have a profound impact throughout our entire society. Most people know someone who is blind, and seventy-five thousand Americans become blind or visually impaired every year. The blind population in the United States is estimated to exceed 1.1 million with several million more classified as visually impaired. In addition, the social and economic consequences of blindness directly touch the lives of each blind person's family members, co-workers, and friends.
Public policies and laws that result from misconceptions or lack of information about blindness are often more limiting than the loss of eyesight itself. This is why we have formed the National Federation of the Blind. The Federation's leaders and the vast majority of its members are blind, but anyone is welcome to join in the effort we are making to win understanding and equality in society.
Our priorities for the second session of the 107th Congress reflect an urgent need for action in three key areas of vital importance to the blind. (For an explanation of these issues, please see the attached fact sheets.)
1. Congress should enact mandated increases in the earnings limit for blind people, under Title II of the Social Security Act, similar to those enacted for seniors in 1996. This proposal would help reduce the harsh work disincentive of the Social Security earnings limit as it now affects blind beneficiaries.
2. Congress should amend Title XVIII of the Social Security Act to include Medicare coverage for rehabilitation services provided to older blind individuals. This proposal would ensure that older blind Medicare beneficiaries have access to the critical rehabilitation services they need to remain independent and in their homes, rather than being forced into costly long-term care facilities.
3. Congress should pass legislation requiring publishers of elementary and secondary textbooks to provide electronic copies which are capable of producing texts in specialized formats, including Braille. This proposal would provide textbooks simultaneously in print and Braille editions, assuring that no student, blind or sighted, is left behind.
As usual it was standing room only at the kick-off briefing for the 2002 Washington Seminar.
People who are blind are asking for your help to address these priorities in the present session of Congress. By acting in partnership with the National Federation of the Blind, each member of Congress can help build better lives for the blind, both today and in the years ahead. The legislative actions recommended in this memorandum will benefit the blind, but they will also help create a better future for all Americans.
PROMOTING WORK AND FAIRNESS FOR THE BLIND
COMMON-SENSE WORK INCENTIVES FOR BLIND
SOCIAL SECURITY BENEFICIARIES
H.R. 498, "Blind Empowerment Act," by Congressman Robert Ehrlich, S. 682, "Blind Persons Earnings Equity Act," by Senator John McCain
To amend title II of the Social Security Act to increase the level of earnings under which no blind individual is determined to have demonstrated an ability to engage in substantial gainful activity for purposes of determining disability.
By increasing the Social Security earnings limit in 1996, Congress provided a powerful incentive for seniors age sixty-five and older to work. Advocates for this change made the case that seniors would continue to work, earn, and pay taxes since they could do so without fearing loss of income from Social Security. Now the need for a higher earnings limit for the blind is even more compelling because of an all-or-nothing penalty for working above it. However, Congress has disregarded this fact in the case of the blind while encouraging seniors to work by removing the earnings limit altogether.
As a result, earnings exceeding $15,600 for a blind person who is age sixty-four or younger cause the complete loss of Social Security benefits until that individual attains age sixty-five. At that point there is no limit on the amount that same individual can earn. This is the inequity that now exists.
Like "retirement age," "blindness" is specifically defined in the Social Security Act and can be readily determined. By contrast "disability" is not precisely defined and is determined on the basis of an "inability to engage in substantial gainful activity," a highly complex and rather subjective determination.
Although blindness is precisely defined, monthly benefits are not paid to all persons who are blind but only to those whose earnings (from work) are below the annually adjusted earnings limit. Personal wealth arising from all sources, except present work, is not counted as earnings and does not affect eligibility. Only work is penalized, and recognition of this fact led to the increased earnings limit for seniors and its eventual elimination. The situation for seniors prior to 1996 is precisely the same for blind people today.
Need to Remove Work Disincentives
An increase in the earnings limit would be cost-beneficial. With a seventy-four-percent unemployment rate, the vast majority of working-age individuals who are blind are already beneficiaries. Providing them with a meaningful work incentive would allow them to become taxpayers as well. Members of Congress supported raising the exempt earnings threshold for seniors, and it is only appropriate that they do the same for blind people of working age. The chance to work, earn, and pay taxes is a constructive and valid goal for senior citizens and blind Americans alike.
Increasing the earnings limit will allow blind people to work without being penalized financially for doing so, providing more than 100,000 blind beneficiaries with a powerful work incentive. At present a blind individual's earnings must not exceed a strict monthly limit of $1,300. When earnings exceed this threshold, the entire sum paid to a primary beneficiary and dependents is abruptly withdrawn after a trial work period. The economic risk resulting for a blind head of household is far greater than any economic benefit derived.
When a blind person finds work, there is absolutely no assurance that earnings will replace the amount of lost disability benefits after taxes and work expenses are paid. Usually they do not. Therefore few beneficiaries can actually afford to attempt substantial work. Those who do often sacrifice income and the security of a monthly check.
Congress should enact mandated increases in the earnings limit for blind people similar to those enacted for seniors in 1996. This proposal would be a step towards equity for blind people and reduce the harsh work disincentive policy now in effect. Under this proposal blind individuals would eventually be able to work and earn up to $30,000 without fearing the loss of benefits.
Legislation for this purpose has been introduced as H.R. 498 by Congressman Robert Ehrlich and S. 682 by Senator John McCain. These bills enjoy broad bipartisan support with 251 members of the House and 30 Senators as cosponsors.
Please support blind Americans by cosponsoring H.R. 498 or S. 682 and request action on this legislation before this session is adjourned.
MEDICARE EQUITY FOR OLDER BLIND PERSONS
H.R. 2674, "The Medicare Coverage Equity Act for the Blind," by Congressman Martin Frost
To amend Title XVIII of the Social Security Act to permit state rehabilitation agencies serving blind persons age fifty-five and older to be reimbursed by Medicare.
The Medicare program--Title XVIII of the Social Security Act--provides health insurance coverage for people age sixty-five and older and for persons who have received Social Security Disability Insurance cash benefits for at least two years. This program pays for reasonable and necessary services to prevent illness, maintain health, and restore functioning after injury or disease. Part A of Medicare--Hospital Insurance--covers hospital services. Part B--Supplementary Medical Insurance--covers a wide range of outpatient services such as physician's services; physical, occupational, and speech therapy; mental health services; a variety of rehabilitation services; the purchase of durable medical equipment (including wheel chairs); and home health care services. Despite Medicare's coverage of these and many more services, coverage of rehabilitation services for older blind individuals is not included.
Chapter II of Title VII of the Rehabilitation Act of 1973, as amended, authorizes grants to designated state vocational rehabilitation agencies to provide independent living rehabilitation services to older persons who are blind and visually impaired. These services include visual screening; independent living skills training, such as orientation and mobility and daily living skills; and other appropriate rehabilitative services needed for older individuals to live independently. This program is currently funded at $25 million for fiscal year 2002. While funding has grown significantly in recent years, the program will only serve approximately five percent of those in need.
Need for Legislation
Costs associated with age-related vision loss are substantial. For example, the Alliance on Aging Research reports that visual impairment is one of the top four reasons why seniors lose their independence, contributing to medical and long-term care costs of $26 billion annually. In addition, the Framingham Eye Study (ongoing) reports that eighteen percent of all hip fractures among seniors can be attributed to age-related vision loss. At $35,000 for treatment and care in each case, the total annual cost attributable to hip fractures due to visual impairment exceeds $2 billion.
Rehabilitation services for older blind persons teach safe travel, daily living skills, and use of adaptive aids and devices. Individuals who receive these services are able to continue living independently in their own homes and communities. This is consistent with the goals of Medicare. By receiving these services covered by Medicare, seniors who become blind can regain self-reliance and self-worth. This will allow them to remain active and valued members of their communities for as long as possible. Without these services older blind individuals often become dependent and isolated.
Recent growth in the appropriation made for the Title VII Chapter II program shows that Congress recognizes a significant need to be met. At $25 million annually, these funds are helping to lay the foundation for a state-administered service delivery system. However, current and future appropriations are not likely to be large enough to pay the entire cost of services for the growing population of seniors who become blind. The solution is to permit state agencies which already serve older blind people to be eligible for reimbursement of direct service costs from Medicare.
Congress should amend Title XVIII of the Social Security Act to include Medicare coverage for rehabilitation services provided to older individuals who are blind. This proposal is designed to ensure that older blind Medicare beneficiaries have access to critical rehabilitation services. H.R. 2674, introduced by Congressman Martin Frost, would do this. Efforts are underway for similar legislation to be introduced in the Senate. The proposed amendments define rehabilitation services as those services furnished or supervised by a designated state vocational rehabilitation agency to an older blind individual under Chapter II of Title VII of the Rehabilitation Act and approved pursuant to regulations issued by the Department of Health and Human Services.
Representatives of the Connecticut affiliate visited with Senator Dodd in his office. This picture appears on Senator Dodd's Web site. Left to right are Jim Gashel, NFB of Connecticut President Betty Woodward, Senator Dodd, Junerose Killian, and Gary Allen.
The state vocational rehabilitation agency or other provider chosen by the beneficiary and supervised by the state would provide services. The term, "older individual who is blind" means "an individual age fifty-five or older whose severe visual impairment makes competitive employment difficult to attain but for whom independent living goals are feasible." This is identical to the definition currently in Chapter II of Title VII of the Rehabilitation Act.
As with Chapter II of Title VII, only state vocational rehabilitation agencies could receive payment for services provided in this program. This approach uses a well-established and accountable system for the delivery of rehabilitation services to older blind Medicare beneficiaries while also allowing beneficiaries to exercise choice when selecting among service providers. Title XVIII allows hospitals, community rehabilitation centers, home healthcare centers, and other entities enrolled as Medicare service providers to receive payment for services. Under this proposal state vocational rehabilitation agencies could also enroll as Medicare service providers. Once approved by a state Medicare carrier, these agencies could submit claims and receive payment for the rehabilitation services they provide.
Please support blind Americans by cosponsoring H.R. 2674 or its Senate companion, when introduced, and request action on this legislation before this session is adjourned.
ACCESS TO INSTRUCTIONAL MATERIALS
LEAVING NO BLIND CHILD BEHIND
In the mid-nineteenth century states established centralized schools for the blind to educate blind and visually impaired students. To support this, Congress authorized the American Printing House for the Blind (APH) in Louisville, Kentucky, to produce educational materials in alternative formats, including Braille. Today APH continues to fulfill this function, receiving annual appropriations for this purpose.
In the 1960's blind children first began to attend schools in their home communities in significant numbers, and today the vast majority do so. As a result Braille, audio, and large-print books must be obtained or created by any local school district having one or more blind children. Converting printed instructional materials into "specialized formats" such as Braille is often time-consuming, labor-intensive, and costly, taking six or more months and several thousand dollars to complete. Relying on APH alone cannot fulfill the need. Therefore it is the exception--not the rule--for blind students to have access to required textbooks at the same time as their sighted classmates.
The Americans with Disabilities Act, the Individuals with Disabilities Education Act, and other federal laws clearly establish the policy that individuals with disabilities are entitled to equal treatment in all areas of society. However, the successful implementation of these laws does not occur without clear, specific, and practical standards and systems in place to anticipate accessibility needs. Currently there are no federal laws that create standards to facilitate the production of textbooks in Braille.
Twenty-six states have responded to this need by requiring publishers to provide electronic copies of print editions of textbooks. However, no consistent file format is used among the states, and the electronic copies provided by publishers are frequently not usable for Braille reproduction at all. Therefore inconsistent and often conflicting state requirements place burdensome obligations on publishers without efficiently facilitating more timely production of books in accessible formats. An agreed-upon, uniform electronic file format would reduce the burden to publishers and significantly reduce the cost of creation, while helping to provide materials to blind students at the same time they are provided to others.
Congress should enact the "Instructional Materials Accessibility Act," which has been negotiated by textbook publishers, the National Federation of the Blind, and other affected groups. This legislation will ensure that blind and visually impaired students will not be left behind in having the textbooks they need in a form they can use.
Prepared for introduction in Congress, the draft legislation would:
* require state plans to ensure that students who are blind or visually impaired have access to instructional materials in formats they can use at the same time the materials are provided to students who can see;
* develop a uniform electronic file format for instructional materials prepared by publishers;
* require publishers to produce a copy of each textbook in the uniform electronic file format and furnish it to a National Instructional Materials Access Center for distribution to schools; and
* fund capacity-building initiatives to assist state and local educators in using electronic files supplied by publishers.
Benefits and Cost
The principal benefit of this legislation will be a uniform electronic file format. This will allow rapid creation of textbooks in the desired format for each student, sighted or blind. For students who read Braille, their books can be presented through the use of synthetic speech or stored and read with small computers, which display Braille dots.
Without this legislation local school districts will continue to bear the burden and cost of converting printed books into Braille. However, modern technology can now support shifting much of this responsibility to publishers without placing an undue burden on them. This legislation does not remove the school's responsibility to provide materials but will institute a shared burden between the schools that teach the children and the publishers that create the books. This will be the effect of having a uniform electronic file format and national distribution center.
This shared obligation between school and publisher has been carefully crafted with publishers fully engaged in the effort to create it. The cost anticipated and authorized to operate the National Distribution Center will be $1 million annually, with $5 million needed to fund training and technical assistance programs for local schools. Although publishers have agreed to provide electronic books, nothing can happen without federal legislation to establish procedures and create the Center.
Introduction of the "Instructional Material Accessibility Act" is expected to occur early in the second session of the 107th Congress. Anticipating this, members are being asked to become original cosponsors and to request prompt enactment of this bill.
Please support blind Americans by cosponsoring the "Instructional Materials Accessibility Act" and request action on this legislation before this session is adjourned.
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