Bridges to Better Advocacy”
Hilton Garden Inn, Austin, Texas
October 22-23, 2009
Conference Handouts
Program Objective: To provide attorneys, paralegals, and legal advocates the legal advocacy tools and strategies needed to successfully advocate for assistive technology devices and services for individuals with severe disabilities.
Preparation for a Medicaid Assistive Technology Hearing - Handouts from the Pre-Conference
Day 1 - Thursday, October 22, 2009
Session 1 - Medicaid Waivers and AT: Expanding Available Services without Giving Up Any Procedural Rights
Sarah Somers, Esq., National Health Law Program, Chapel Hill, NC
States continue to use Home and Community Based Services (HCBS) waivers to provide expanded services to special populations. Presenter will discuss the legal authority for HCBS and other waivers, provide examples of expanded services through waivers, and discuss some of the key legal issues that arise when waivers are implemented outside the usual framework for overseeing state Medicaid programs.
- Handout – Medicaid Waivers (power point)
- Handout – Q&A: Home and Community Based Waivers: Federal Guidance
- Handout - Q&A: Medicaid Coverage of Habilitation vs. Rehabilitation Services
Olmstead and the ADA Integration Mandates to mannge Medicaid Service Cuts and DenialsSteve Elliot, Esq., Senior Attorney & Garth Corbett, Esq., Senior Attorney, Advocacy, Inc., Austin, Texas, and Karen Ward, Esq. Senior Counsel, Equip for Equality, Chicago, Illinois
The 1999 U.S. Supreme Court decision in Olmstead v. L.C. held that unjustified institutionalization of individuals with disabilities violated the most integrated setting mandates of the Americans with Disabilities Act (ADA). The presenters will discuss how the Olmstead and ADA mandates have been used to systemically challenge Medicaid service cuts and denials in service categories such as private duty nursing. The presenters will also explain what is needed to obtain temporary and preliminary injunctive relief in this type of litigation.
Session 3 – Anatomy of a Successful Medicare Local Coverage Determination (LCD) Challenge
Marge Gustas, Staff Paralegal, NY PAAT Program & James Sheldon, Esq., National AT Advocacy Project, Neighborhood Legal Services, Buffalo, NY
Medicare’s durable medical equipment (DME) program is overseen by four DME Medical Administrative Contractors (DME-MACs). An LCD is a policy developed by a DME-MAC and governs claims for DME within its region of the country. The presenters will describe the administrative complaint process for challenging the enforceability of an LCD and how it was successfully used to challenge an LCD that had barred funding for ceiling track lifts.
- Handout – Anatomy of Successful Medicare LCD Challenge (power point)
- AT Advocate Newsletter – Procedures for Challenging a Medicare LCD
Diana M. Straube, Esq., Staff Attorney, National AT Advocacy Project & Ronald M. Hager, Esq., Senior Staff Attorney, National Disability Rights Network, Washington, D.C.
Attorneys and advocates at Protection and Advocacy agencies regularly work with clients who have cognitive or communication disabilities that affect their ability to have a traditional attorney-client/advocate-client relationship. What are the attorney’s or advocate’s responsibilities when this is the case? Will discuss the guidance provided by the ethical rules.
Day 2 - Friday, October 23, 2009
Curt Decker, Esq., Executive Director, National Disability Rights Network, Washington, D.C. & Steven Mendelsohn, Esq., Disability Law Policy Consultant, San Leandro, California
Presenters will discuss new and pending federal legislation, regulations, and policy change and how it will impact on the work of advocates and attorneys who work for Protection and Advocacy Programs, with an emphasis on issues related to assistive technology advocacy.
Session 6 – Asset Development Strategies for Funding AT: A Survey of Special Programs and Strategies
Andrew Riggle, Public Policy Advocate, Disability Law Center, Salt Lake ity, Utah, Martha Wunderli, State Director, Utah Individual Development Account Network, Steven Mendelsohn, Esq., San Leandro, California & James R. Sheldon, Jr., Esq., National AT Advocacy Project, Buffalo, NY
Will first introduce concept of asset development, explaining why it is important to individuals with disabilities and why it is important for acquiring AT, providing examples of several federally-based asset development programs or strategies. Presenters will then describe Utah’s four Individual Development Account (IDA) programs, including its new, AT-related IDA program, and how these “matched savings programs” can be used to save toward home ownership, education expenses, establishment of a business, or the purchase of AT. Will also describe how the money in the IDA matched savings account may impact on needs based government benefits and the strategies/special rules in place, for some IDAs, to avoid that impact..
- Handout - ASSET BUILDING AND ASSISTIVE TECHNOLOGY: The Role of Individual Development Accounts
- Handout – The Utah Individual Development Account Network (power point
- Handout – Using the IDA and PASS Together
Session 8 – Preparing the Expert Witness for Testimony
Peter Hoffman, Esq., Law Professor, Director, Blakely Advocacy Institute, University of Houston (long-time NITA trainer)
Attorneys and advocates at Protection and Advocacy agencies must work with expert witnesses who will present testimony in court proceedings and in administrative hearings. The presenter will go through the frameworkfor preparing the expert witness and doing a direct examination of the expert at a trial or administrative hearing.
Session 9 – Accessing AT for Infants and Toddlers: Funding Possibilities under the Individuals with Disabilities Education Act A) and Medicaid’s Early and Period Screening, Diagnosis and Treatment (EPSDT) Program
Ronald Hager, Esq., Senior Staff Attorney, National Disability Rights Network and Diana M. Straube, Esq., National AT Advocacy Project
Children under the age of five have very unique needs for AT. In some cases, they may need traditional durable medical equipment that is ned for very young children (such as a power wheelchair). In other cases, they may need items that we do not typically think of as medical in e (such as a therapeutic trycle). The presenters will describe the special requirements of IDEA (including IDEA Part C) and Medicaid (including the EPSDT program) and how they can be used to meet these unique AT-related needs.
Handout – Services to Pre-School Children
Handout – Medicaid, AT and Kids (power point)