ACA Launches Ambitious Legislative Agenda for 2009

By: Morgan Sheets, National Advocacy Director

 

The Amputee Coalition of America advocates for equal access to, and delivery of, information, quality care, appropriate devices, insurance coverage, and the services required to lead empowered lives. The ACA provides the public, the limb loss community and health care providers a comprehensive source of information regarding amputation and rehabilitation through its National Limb Loss Information Center. We also conduct the model for peer visitation in the limb loss community. Our national peer visitor program has been used within US military medical centers and, in 2009, will be conducting training for the Veterans Administration.

We are dedicated to advancing causes and promoting prevention of limb loss and enhancing the quality of life for all individuals with limb loss and their families by encouraging effective prevention and intervention, fostering research, and protecting amputee rights under the law.

The ACA is working to capitalize on our past achievements with the launch of a diverse range of legislative initiatives designed to not only provide concrete benefits to our members, but also enhance our reach into the political arena.

2009 Legislative Agenda

Advancing Parity Legislation
To address this goal, ACA supports:

• Requiring private health insurers to provide parity in coverage for prosthetic care
• Availability of prosthetic devices for all amputees, so parents are not forced into financial hardship in order to obtain appropriate prosthetic care
• Continued grassroots efforts at the state and federal levels calling for lawmakers to support legislation that creates a consistent standard of coverage with adequate benefits to allow amputees to lead active lives.

Protect Funding of Critical ACA Programs
To address this goal, ACA:

• Supports the continuation of the Centers for Disease Control and Prevention (CDC) appropriation for the ACA's National Limb Loss Information Center, which also supports the ACA's peer visitor program and National Conference (Note: No funding from the CDC is used to support ACA advocacy efforts.)
• Calls on lawmakers to maintain funding of programs aimed at providing support and educational resources to amputees.
  

Increasing and Enhancing Access to Care in Public Health Programs
To address this goal, ACA:

• Calls on lawmakers to promote policies and regulations that ensure access to care in government health programs.
• Works with coalitions to address these issues through administrative and legislative channels.
  • Medicare
    • Two-Year Waiting Period: Unlike older Americans, who typically enroll and become eligible for Medicare coverage within months of turning age 65, disabled beneficiaries must wait two years before their coverage takes effect.
    • “In Home” Restriction: Medicare only provides coverage for mobility devices that are necessary for use inside a beneficiary's home. They will not provide an assistive device if they need it to return to work or participate in activities such as church or school. The ACA will help to support efforts like the Medicare Independent Living Act of 2007 (HR 1809), which eliminates the "in the home" restriction on mobility devices.
    • DME Competitive Bidding: The ACA was part of a grassroots initiative around the 2008 Medicare law, competitive bidding and the possible implications on orthotic and prosthetic benefits. There was a temporary resolution that allows the Centers for Medicare and Medicaid Services 18 months to reevaluate the various proposals. Utilizing our coalition membership and relationships with key partners, we will continue to monitor this process in order to ensure that orthotic and prosthetic benefits are not compromised.
  • Medicaid
    • State Prosthetic Benefit Levels: We worked with the North Carolina campaign committee to update the state Medicaid regulations. Their state program was paying for most prosthetic items once a year for ages 0-20 and once every 3 years for ages 21 and older. The new proposed policy changes will pay for prosthetic items once every 6 months regardless of age.

We will work to conduct research into the benefit levels and restrictions on coverage in state Medicaid programs with an eye towards developing campaigns in targeted states to push for increased coverage.

Protecting Access to Transportation
To address this goal ACA:

• Calls on state and federal agencies to work to ensure that amputees have equal access to transportation.
  • Transportation Security Administration (TSA): While the ACA appreciates the opportunities we have had in the past to participate in discussions around best practices for TSA regulations concerning people with disabilities, we feel that there is still much work to be done in terms of developing strategies that balance the security needs of the general population with the privacy rights and transportation access of amputees. In addition to overall policy development, the ACA will also look to engage in conversations around the training of personnel and consistent enforcement of regulations. We will look to meet these goals through administrative and regulatory means.
  • Public Transportation: The Americans with Disabilities Act (ADA) was enacted to prevent discrimination against people with disabilities in areas of employment, public services and public transportation, public accommodations, and telecommunications. A series of Supreme Court decisions narrowed who is covered by the ADA. The ADA Amendments Act (S. 3406) was passed in 2008 in order to restore and expand the definition of disability and make it easier for workers to prove discrimination.

The ACA will work with partners to monitor the rulemaking and enforcement of the expanded protections offered under the new law with a particular emphasis on access to public transportation.

• Disabled Parking Permits: The regulations around the application and renewal process and the distribution of disabled parking permits are very inconsistent. There are cases in which amputees are being put through a very grueling renewal process on a regular basis despite a proven, ongoing need for the permit. There are also states that only allow one permit per person. This poses a significant obstacle to travel given that individuals may need to utilize their permit to access disabled parking areas, but will also need to utilize the permit once they have reached their destination. The ACA is looking to utilize administrative contacts within state governments to try to respond to the need to improve and standardize the permit procedures.

We will begin this effort by targeting the states that have a limit of one permit per individual in order to meet the immediate needs of our members who utilize permits in those states. After the first six months, we will evaluate the first phase of this effort in order to re-evaluate our strategies and success.

Influence the National Debate on Healthcare
To address this goal, ACA:

• Works to include access to specialized care such as the provision of prosthetic devices in the national dialogue on the need for comprehensive access to quality, affordable health care
• Coordinates with our coalition partners and key allies to ensure that the specific treatment and rehabilitation needs of amputees are included in the policy discussions around health care reform.

This ambitious legislative agenda will enable us to continue to meet the needs of people with limb loss as they seek to reach their full potentials. With the help of our dedicated activists, volunteers and donors, we are confident that we will continue to make progress.

To learn more about our Congressional efforts, contact the ACA at federal@amputee-coalition.org or 202/742-1886. For more information about our work to shape policies at the state level, we can be reached at state@amputee-coalition.org or 202/742-1885.