January 6th, 2021

In case you missed it the first time - House Impeachment Managers' Video Compilation of January 6 Attack on the U.S. Capitol

 

Michigan vaccination priorities include people with IDD living with their families or in their own homes

Michigan has expanded eligibility for vaccination to all people over 65 years old, as it continues to vaccinate people in the highest risk categories. This includes people with intellectual and developmental disabilities (IDD) living at home with their families or in their own homes, as well as residents of long-term care facilities and their caregivers.

My two sons live in a licensed group home that is a long-term care facility under the vaccination guidelines. All six residents of the group home received their second shots more than a week ago. None have experienced significant side effects. They are all fine.

When people with IDD live at home with their families or in their own home, they usually receive services through the Community Mental Health (CMH) system, funded through Medicaid waivers. Medicaid waivers allow CMH to provide for their care at home as an alternative to an institutional setting such as an Intermediate Care Facility for people with IDD or a skilled nursing facility. People with IDD, regardless of where they live, are more vulnerable than the general population to bad outcomes from the virus and are among those given priority for vaccination by the state and county health departments.

In Washtenaw County, many families were notified to sign up for vaccinations for their disabled family members, unpaid family caregivers, and paid CMH caregivers. They were asked to complete a survey for the county department of health and then to wait for more information about when and where to be vaccinated. Rather than being given the option of in-home vaccination, some were informed of large vaccination centers, where they would have to bring their family member, increasing the risk of exposure to the virus and having to deal with problems such as their family member being unable to wear a mask or to comply with social distancing rules. Part of the problem was that the survey did not ask for or take into account the special accommodations needed by people with IDD in setting up vaccinations.

Just Us Club, an activity program for adults with IDD in Ann Arbor that my sons attended in non-COVID days, maintains contact with families and sent out emails to help them overcome delays and barriers to vaccination.

I suggested that families use “magic words” when contacting the county health department to help them flag their request involving people already prioritized for receiving the vaccines:

“It sounds like Just Us Club families are having difficulty getting the county to respond and schedule a time to give vaccinations. I looked at the survey and, as usual, it is mostly about organizations and healthcare without any special consideration of the minority population of people with DD. They may just be overwhelmed, but it might be useful for people to use 'magic words' where they can fit them into an answer on the survey or in correspondence with the county. Among those magic words are 'Developmental Disabilities' or 'intellectual and developmental disabilities' or better yet, 'severe Developmental Disabilities' or 'severe IDD', 'Medicaid funded Home and Community Based Services', 'Home healthcare for a person with DD', 'Caregiver of person with severe DD, '…and related severe medical conditions'…anything to get their attention that we are talking about severe disabilities with related medical fragility and health conditions putting even younger people with DD at increased risk from COVID.”

Another parent suggested, “… I'll add to it that if your loved one has any physical ailments that might put them at greater risk (asthma, COPD, diabetes, etc.), it might help to spell it out in the email. If you include your phone number in your email, you may get a call from the County nurse to ask additional questions and potentially schedule your home visit. They really are swamped and using the 'magic words' can help get your loved one appropriately prioritized.”

Another parent came up with a sample email to send:

Hello,
My adult child, ______, receives Medicaid funded Home and Community Based Services through Community Mental Health. He /she has significant developmental disabilities and other underlying medical issues. He/she cannot tolerate wearing a mask for any length of time. I/we provide full time care for _______ in our home. My child has been sheltering at home all these months because he/she is medically fragile and thus more vulnerable to the Covid 19 virus. I am wondering what the procedure would be to schedule vaccination for my child in the home or at a drive through location, rather than at a large vaccination site.
Thanks so much,_______________

Another parent added that her son’s lack of expressed language and his seizure disorder qualified him as high risk and that because he couldn’t effectively communicate how he was feeling or whether he was feeling pain, was also helpful in identifying him as high risk.

JUC heard back from a number of families who were delighted to have a visiting nurse scheduled to come to their home to administer the vaccines, once their need for special accommodations was heard. 

I hope this helps with the frustrations of trying to get vaccinations for people with complex disabilities and needs.

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Information from the AARP on "The COVID-19 Vaccine Distribution Plan in Michigan" by Catherine Maddux , February 03, 2021

 

Proposals to raise the minimum wage for all workers may leave some workers with disabilities struggling with unintended consequences

The federal Raise the Wage Act was introduced in the last Congress in an effort to eventually raise the minimum wage to $15 per hour for all workers, including those with even the most severe disabilities. This has apparently been reintroduced as H.R. 603 and S. 53 and included in The American Rescue Plan. Besides raising the minimum wage for all workers, It would eliminate special wage certificates for people with severe disabilities. These 14(c) special wage certificates are authorized by the Fair Labor Standards Act and allow work centers (formerly called “sheltered workshops”) to pay workers less than minimum wage when their level of productivity prevents them from being competitive in the general workforce. These specialized work centers provide opportunities and special accommodations for people who would otherwise be unable to compete for jobs.

Elimination of the 14(c) wage certificates would ultimately lead to the closure of work centers that thousands of workers with intellectual and developmental disabilities (IDD) and their families rely on for meaningful employment and other benefits of a specialized work environment that accommodates the needs of people with the most severe disabilities. Although this has often been framed as a civil rights issue, no one is compelled to accept employment at a work center and the law provides protections for workers and requirements for employees designed to prevent exploitation. [See Fact Sheet on The Employment of Workers with Disabilities at Subminimum Wages]

In a recent news update, ACCSES, an organization representing providers of disability services, provides details of the Raise the Wage Act  and follows these with comments on the parts of the legislation affecting workers with disabilities:

“Before moving on to other news, we want to pause for a moment and talk about 14(c). At ACCSES, we see 14(c) as part of a continuum of paid work opportunities that increase options for people with the most significant disabilities. Neither this bill, nor others introduced in the past, will lead directly to more employment for individuals working under a certificate. It is not a binary choice. Rather, for many, it will eliminate an option that is highly valued and regularly coupled with other services, including competitive employment, which often provides for only a few hours of work per week.

“A great deal of energy is devoted to trying to eliminate 14(c). Imagine if all of that collective attention were repurposed to reducing the need for 14(c) by focusing instead on closing the vast competitive employment gap for individuals with disabilities, expanding options, educating commercial and nonprofit employers generally of the tremendous workforce available to them, finding legislative solutions that encourage more employers to hire people with the most significant disabilities, increasing funding for supported employment and customized employment, increasing funding for social enterprise models and apprenticeship programs, recognizing disability service providers as the foundation of the disability service system (including employment) rather than trying to exclude them or dismiss their incredible depth of knowledge and experience, and most importantly, honoring the legitimate choice of individuals to have the job they want. This could lead to more positive results than simply eliminating 14(c) and forcing people into unpaid work, day support programs (which is a perfectly fine choice for individuals and already available as an option) or leaving individuals with few options at all other than being at home. This pandemic has shown many of us how difficult it is to be isolated at home away from our communities for long periods of time. Moreover, it has underscored the trauma of job loss, which should not be overlooked.

“At no time has the federal government conducted an actual study as to what has happened to individuals in states where 14(c) has been eliminated as a work payment choice. A true, unbiased study should be undertaken as a first step before any movement to eliminate 14(c) or limit its use, as it will highlight where attention for positive change should be focused. There are numerous ancillary concerns that must be taken into consideration – social security asset limits, transportation, the unemployment rate generally as well as specifically in the most rural parts of our country, the movement toward robotic solutions for businesses, jobs leaving the U.S., and the economic impact on families of eliminating an option that is providing a source of consistency and community, etc. Taking a paid work opportunity from people who take pride in their work will not by itself lead to more paid employment options or opportunities. This is a complex issue, and it will take getting everyone around the table to sit down with open minds to come up with good ideas to increase opportunities, not to just take away an option. A solution that will deny some individuals the dignity of work or that denigrates their jobs is the ultimate demoralizer. This is what keeps us up at night."

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More on specialized work centers, sub minimum wages, and supported employment from The DD News Blog.