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ADAPT Vigil Days 11 and
Spending the night on the
sidewalk with ADAPT
sleep on the sidewalk
By Tim Wheat
On the 11th day of the ADAPT vigil I spent the night with the advocates on the sidewalk in front of the Colorado Human Services Building.
Late in the evening when the downtown area is fairly quiet and few cars drive past, the ADAPT members talked of the events of the day and strategy for tomorrow. Mostly, advocates repeated what was said with HCPF officials and discussed the validity and ramifications of the statements. What stood out most however was a change in the general feel of the action.
“We got pissed today, we got tired and we took control,” said Tisha Cunningham about the change in the vigil’s temperament. “All of us worked together and kicked ass.”
At a meeting earlier in the day, ADAPT showed their frustration by collectively walking out.
“The meeting began with Gary Schneider, the HCPF long-term care director, saying that they had made mistakes in the freeze on HCBS and the scoring for eligibility,” said Dawn Russell. “Basically, it was their way of saying they have met two of our three demands.”
The walkout occurred after Gary Schneider admitted he was powerless to meet the final demand, no home health budget cut, and Julie Reiskin presented a new agenda. ADAPT left together and rejoined those holding vigil on the street.
This evening I decided to stay up with Dawn Russell who had volunteered for a watch from 1:30 to 3:00 am. Everyone in the group, in pairs, does a shift of remaining awake as a general “lookout,” and helping others sleep.
Dawn has the reputation of getting the exciting shift – the shift with the humorous stories to tell in the morning. My shift with Dawn was pretty mild; however, we did have a discussion with a passer-by named Nick. He wanted to know what was going on and why people were sleeping on the sidewalk. Nick and his friend were the only ones to come by the camp on our shift.
Dawn and I never finished talking about the events of the day, but as it got later our conversation was mixed more with personal feelings and speculation of what would happen. Much of the frustration among advocates was how Rienertson is patronizing the advocates; asking questions of seemingly false concern for ADAPT’s safety and comfort and not treating them as professionals. Another frustration was with the
negotiations seemingly being directed to the agencies rather than with the people on the street.
When the shift was over I was ready to get some sleep. The night was cool and clear with a mild breeze above the quiet downtown streets. Rick and Ruth took over the next shift as I crawled into a sleeping bag under the ADAPT banner that reads, FREE OUR PEOPLE.
Sometime after 5 am I was wakened by a clop-clop sound behind my head. My semi-lucid thought was that there was a horse behind me. The sound actually were wheels of a state employees bag as it hit the joints in the sidewalk. I got some sleep after that, but I did notice people walking past just inches from my head.
The morning felt great. Cool and clear with the sun reflected off of the Colorado State Capitol dome. Everyone but the final shift and me were asleep at around 6 am. One group of about seven slept under the ADAPT banner, another group of four or five were under the ADAPT flag with four or five spread around the entrance area of the building.
After I stretched and put my shoes on, I walked around the block to get the two morning local newspapers. I watched as ADAPT slowly woke up and state employees one at a time came to the office building. From sleeping bags ADAPT members said good morning to the various state workers that have shown support for the vigil.
The morning of the 12th day of the vigil an impromptu meeting began at the foot of Babs Johnson’s sleeping bag. David Bolin, the Executive Director of the Center for People with Disabilities showed up around 7:45 am and Karen Reinertson came by at 8:15. By 8:30 at least two other agency directors had joined the gathering as well as Gary Schneider.
The Agencies are asking that if they are able to find other ways to cut the 5% from their budgets, not from attendant services, that HCPF will allow it. Early indications are that HCPF will allow the agency proposal, but Karen Reinertson has not put anything in writing yet.
The discussion is basically to change the Occupational and Physical Therapy (OT and PT) in-home treatments, many of which may be billed alternatively to Medicare. The proposal is to save money be putting a limit on these payments, for example, 20 visits one year after an injury. This idea would stop agencies from billing for infinite in-home therapy. Cutting the OT and PT expenditures in half would save $3.5 million. That would be enough to cover current personal attendant services amounting to no cuts.
A letter yesterday to Karen Reinertson however, made apparent the dynamic of what and who will be making a decision over the proper resolution of the standoff at the Human Services Building. ADAPT advocates reminded the Executive Director of HCPF in the letter that it was necessary to meet the demands of the ADAPT rather than the specific dealings with the various agencies involved.
By Tim Wheat
The Rienertson Letter:
Dear Ms. Rienertson:
As we approach the second week of the Medicaid Cuts Stand-Off, Colorado ADAPT would like to clarify some issues. ADAPT is made up of advocates and activists from all walks of life. Our mutual interests include the civil rights of people with disabilities and the public perception and treatment of people with disabilities, or simply stated, discrimination. Although we are looking for similar outcomes as the Home Health Agency Directors and other bureaucrats with whom you are meeting, we feel that you have overlooked valuable input from the people your decisions affect most. During the past week, you have met with a number of vested parties, but have only patronized ADAPT members with inquires about our safety and comfort. That is discrimination of the ugliest kind.
We have a dual mission in camping on your doorstep. We insist on having our demands considered, and we want you and other people who make decisions that affect our lives to look at us every morning and every evening, so that you can remember that you are dealing with the lives of human beings.
ADAPT members outside your building are not the dregs of society or the inconsequential rabble you may assume us to be. Most of us are taxpayers who hold professional positions. Some of us are here because our jobs are in jeopardy, some of us are jeopardizing our jobs by being here. But most importantly, all of us know that our lives and the lives of our friends will be in jeopardy if attendant services are cut.
ADAPT is asking that you read the enclosed demands, respond to us in writing as to your understanding of our demands, and meet with ADAPT today. You may arrange this meeting by walking outside and asking. Among those of us waiting for your decision, and those of us who have been here all or part of the last ten days, are: Attendants, Local Business People, Executive Directors and Co-directors of several Colorado Centers for Independent Living, Administrator, Benefits Specialist, Client Financial Services Coordinator, Life Skills Instructor, Attendant Team Leaders, Shift Supervisors, Home Modification Specialist, Learning Center Director, Section 8 Housing Coordinator, Peer Coordinator, Client Advocate, Receptionist, LPN . . . .
We ask you to meet with the professionals you have been ignoring. We are also the people whose lives you may be destroying.
Text of the demands:
July 17, 2002
To: Karen Reinertson, Executive Director, HCPF
Re: Home Health
Department has implemented or is considering several changes to home health in efforts to address necessary budget reductions for fiscal year 2002-2003. Among these suggestions are:
1. Rate reductions long term home health aides (CNA) ; RN/LPN and therapy services are reduced 5%.
Any proposed changes to a discrete reduction (CAN), requires an offsetting reduction in another service in order to preserve the required budget reduction. Members of ADAPT and ten home health agencies, have suggested that placing limits on the therapy benefits may present savings that could be used to restore all of the home health aide rate reductions.
Data is being analyzed to estimate the amount of potential savings. The savings to the state from the home health aide rate reduction is $1.5 million. ADAPT is proposing savings in the areas of physical, occupational, and speech therapy. If these savings can be realized, HCPF has assured ADAPT that there will be no cuts in home health aide rates.
2. HCBS/EBD Waiver Cap and raising the ULCP100 minimum score to 25.
The Department is concerned that persons not in need of long term care are being admitted to the EBD Waiver. The Department is redefining the definition of long term care. Long term care is defined as anyone needing attendant services to live independently within the community. Attendant services include, but are not limited to: getting people in and out of bed, dressing, bathing, toileting, transferring to and from a wheelchair, eating, reading, writing, and housekeeping. Prioritization of persons will give preference to those seeking de-institutionalization or at immediate risk of nursing home placement.
The department raised the waiver admission score from 20 to 25. The intent is to reduce inappropriate admissions to the waiver program. Review of the complete approval process has revealed that while the functional assessment score contributes to the decision process, there are additional screening criteria that also contribute to the overall decision to admit or deny a person’s access to the program. Care should be taken, however, when increasing the scoring, as there are clients who are appropriate for the program who will be
eliminated due to low scores. ADAOT suggests that the scoring tool be reviewed, as it doesn’t take certain aspects of disability into account, which may have a negative impact on eligibility. For example, the scoring tool should allow an opportunity for more individualized assessment. The Department and stakeholders are now reviewing the admission process in its entirety to make the eventual assessment more appropriate. Those findings may have an impact on the waiver admission score.
The Department is also considering:
1. Medicaid only agency certification
2. Better use of nurse delegation
3. Quick implementation of Senate Bill 27
4. Nurses and CNAs as direct providers