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Share Your Story and Help Protect Healthcare

Congress and the Trump Administration are moving toward repealing the Affordable Care Act (ACA) and changing the fundamental structure of the Medicaid program. Below, we have provided additional information about these proposals and some suggested ways to get more involved. Your story can help illustrate the importance of access to healthcare and gives a voice to many other Americans facing the same issues.

A few ways that the ACA repeal and changes to Medicaid financing would affect the Medicaid program:

  1. Under the ACA, Maryland joined 30 other states in allowing childless adults up to 138% poverty – an estimated 115,000 Marylanders – to access Medicaid coverage, which includes treatment for mental illness and substance abuse disorders that many had previously lacked. Repealing the ACA would likely end coverage for these people.
  2. The ACA allowed states to implement the Community First Choice program (CFC) that covers Medicaid services (including personal care aides) which allows over 9,500 seniors and people with disabilities in Maryland to live at home in the community rather than in institutions.
  3. Other Congressional proposals include changing how Medicaid is paid for in a way that will limit people’s access to healthcare. Currently, Federal and State governments share the cost and changes would limit federal funding by either:
    1. providing a fixed amount of money to each state for its entire Medicaid population (“block grants”)
    2. providing a fixed amount of money per person (“per capita caps”)

With less federal money coming in, either proposal would put great pressure on State funding and likely lead to cuts in services and/or eligibility.

The ACA repeal would affect everyone in Maryland, particularly people with disabilities:

  1. Certain reforms apply to nearly any health insurance plan. Insurance companies are now prohibited from denying coverage based on pre-existing conditions and from limiting how much they will pay for someone each year and over her lifetime. Also, women may not be charged more for insurance than men; there are limits to how much more seniors may be required to pay than young people; and dependents can stay on their parents’ insurance plans until age 26.
  2. The ACA made private insurance affordable through plans available on the exchanges, which are subsidized for people below certain income limits. It also required a more comprehensive benefit package in private plans, including mental health and substance abuse disorder services, and required that many preventative health services be covered for free.

 

Ways you can get involved today:

  1.  Share your story – why you need access to healthcare through the ACA or Medicaid – with the National Health Law Program (NHeLP) Share your story with NHeLP
  2. Call your U.S. Senators and Representative, even if you believe they already agree with you, it is helpful for them to hear what their constituents think is important. Look up contact information here.
  3. Send a letter to your member of Congress – National Disability Rights Network (NDRN)

Learn More:

How the ACA repeal would impact Marylanders.
How people with disabilities benefit from the ACA.
How changes in funding would impact Marylanders

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Project Homeless Connect

Disability Rights Maryland had another successful year participating in United Way’s 5th annual Project Homeless Connect.  Project Homeless Connect provides free, on-site, direct services such as medical, dental, employment, and legal services, all held at the Baltimore Convention Center. Over 2,000 people experiencing, or at risk for homelessness attended the event on Friday, September 30th, 2016.

It was amazing to see and hear how many people lined up hours before the event kicked off. In fact, the Mission of Mercy Dental Clinic, which offered services over two days, had reached capacity by 9:30 am. I had the opportunity to volunteer at My Sister’s Place, which provides meals and access to various services to women, the day before and many of the women were busy chatting about what types of haircuts they wanted to get or how receiving a new ID would help them in their daily lives. Most of the services, like getting a haircut or visiting the dentist, are often things we take for granted, however, for many of the participants these services will help alleviate some of their hardships and hopefully help them access stable housing.

This was my first time volunteering at the event, but it was incredible to see how well organized this event was. Participants were quickly checked in and paired with a volunteer guide. The event space was huge and perhaps a bit overwhelming, but the volunteer guides became familiar with their participant’s specific needs as the day progressed and helped them navigate.  There were some participants who visited our table and were perhaps a bit shy or not quite sure what questions to ask, but the volunteer guides were able to advocate on their behalf.

Disability Rights Maryland was one of over 130 organizations present, and helped answer their legal questions about public housing, such as how to apply, waitlist status, and more. DRM not only provided information and assistance to those experiencing homelessness, but also to providers who were excited to share our resources with their clients. There were instances where DRM did not offer the types of assistance or resources that the participant needed, however, we were almost always able to refer the participant to another service provider, just a few tables away.

It was both humbling and inspiring to see how many people rely on the vital services offered through Project Homeless Connect and the vast amount of volunteers and service providers who worked tirelessly to ensure the event ran smoothly. Even though my DRM internship will be ending this year, I hope I can volunteer in some capacity at next year’s Project Homeless Connect.

Post authored by Jessica Ramdat, Intern for DRM. (pictured above)

Learn more about Project Homeless Connect

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The Civil Rights Crisis in Our Schools

The termschool to prison pipelinerefers to the link between school failure, zero-tolerance discipline policies, exclusionary discipline, school-based arrest and the likelihood that youth who have these experiences in school will become involved in the juvenile, and later, adult criminal justice systems. Children of color and children with disabilities are over represented at all stops on the school to prison pipeline, beginning with exclusionary discipline and academic failure in early childhood.

The fact that Black children and children with disabilities are suspended and expelled more often than other children for the same offenses reflects the same inequalities that exist in the adult world. We live in a society where the rate at which Black men are subject to imprisonment is unparalleled, and where people with disabilities are at disproportionate risk of lethal encounters with law enforcement.[i] The deaths of Freddie Gray and Ethan Saylor indicate that Maryland is no exception.

Although the overall number of suspensions and expulsions are down across Maryland, the disproportionate impact of school exclusion and push-out of children with disabilities and children of color continues. According to Maryland State Department of Education (MSDE) data, in 2014-2015, there were 70,404 total suspensions and expulsions. Students with disabilities represented 12% of the population, but 27% of suspensions and expulsions were of students with disabilities. In the same year, Black students made up 35% of the population but 62% of the suspensions and expulsions were of Black students.[ii] Nationally, the data is even more troubling, with Black students 3.8 times as likely to be suspended as white students, and children with disabilities more than 2 times as likely to be suspended as students without disabilities, according to the Department of Education’s Office for Civil Rights.

Unfortunately the requirement that districts track, reduce and eliminate disproportionate suspensions of students with disabilities and students of color has not been implemented. MSDE is now considering methods of measuring disproportionality, but after two years, has not yet begun measuring it.

Don’t some students need to be removed?

Violent or dangerous behavior in school is never acceptable, and there are times when a student must be removed from a learning environment to ensure the student’s safety and that of other students. However, according to MSDE data, most suspensions are not for violent actions. Rather, the majority of suspensions statewide fall into the categories of disrespect, insubordination, and disruption.  Restorative practices can address these categories of behavior effectively. “Restorative practices” are a way of effecting behavior and school “climate” that focuses on relationships and having individuals repair wrongs they have committed. If our goal is to change inappropriate behavior, suspension has not been proven to make schools safer.[v] What suspension has been proven to do however, is increase the likelihood of substance abuse, school failure, dropout, and involvement in the juvenile justice system. [vi]

Students with Disabilities

We know that students with disabilities are more frequently suspended and/or expelled from school, but why? When schools fail to identify students with disabilities, when disability is misunderstood or underestimated, or when students with disabilities do not have effective, appropriate academic instruction, challenging behavior can result.

Schools have specific legal obligations regarding students with disabilities under the Individuals with Disabilities in Education Act (IDEA), Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act. These include identifying students who have disabilities, providing a free and appropriate public education to all children, even those who are suspended; questioning whether problematic behavior is a “manifestation” of the child’s disability before suspending them; and providing positive behavior supports.[vii] Too often, school systems fail to meet these obligations and respond to the resulting behavior issues in a manner that discriminates against that student due to their disability. Without access to legal representation, many low-income families of children with disabilities are unsuccessful in getting help for their children in situations where disability is misunderstood, underestimated, or not properly addressed.

Alternatives to Suspension

For students with disabilities, there are already systems in place that are underutilized for addressing problem behavior, including correctly identifying students with disabilities through the existing special education process and planning for appropriate accommodations and services for those students. Functional behavior assessments (FBA) and behavior intervention plans (BIP), which are in use to varying degrees throughout the state for both students with disabilities and students without them, aim to identify the main problematic behaviors and the “function” of those behaviors, and direct adults how to respond in a consistent, specific way to teach and reward appropriate “replacement” behaviors. Other programs aim to teach children the skills they are lacking in order to resolve conflicts.

There are also research-based methods of improving school climate and reducing the need to suspend so many children. These alternatives have costs associated with them, but those costs are less than the economic and social costs of school drop-out and incarceration. It is up to the community to demand that education budgets include funding for these restorative justice programs. Two examples of many are Community Conferencing and Holistic Life Foundation. Community Conferencing reports that 98% of Community Conferences resulted in a written agreement between the parties, with 95% compliance to those agreements. Holistic Life Foundation reports an overall reduction in the stress levels of students, many of whom have experienced high levels of trauma. Importantly, these programs teach students critical life skills that will ensure their success, rather than their failure, beyond school. Finally, teachers report that their training should include more information about behavior and classroom management.[viii]

Given the alternatives and the damaging impact of suspension, other school systems including New York and Minneapolis have determined that children in pre-kindergarten to 2nd grade—or four-six year olds–should not be suspended. Maryland should follow suit, especially given that in 2014-2015, almost 3000 four, five, and six year olds were suspended in Maryland, mostly for minor misbehavior.

While Disability Rights Maryland and other organizations represent some children whose civil rights have been violated in the school discipline process, a vast gap exists between the number of students who are removed from school inappropriately and the number of students we can serve. We rely on pro bono attorneys to help bridge the gap. Disability Rights Maryland’s pro bono program provides training and technical assistance to attorneys willing to assist a student and their family. Please consider volunteering your time to represent these students.

Nicole Joseph is an attorney with Disability Rights Maryland and co-chair of the Maryland Coalition to Reform School Discipline. Fazia Hasan contributed to this post.

 

[i] NAACP, Criminal Justice Fact Sheet. http://www.naacp.org/pages/criminal-justice-fact-sheet; Perry, David and Carter-Long Lawrence, How Misunderstanding Disability Leads to Police Violence. The Atlantic, May 2014.

[ii] Maryland State Department of Education, Suspension, Expulsion, and Health Related Exclusions in Maryland Public Schools 2014-2015, available at http://marylandpublicschools.org/MSDE/divisions/planningresultstest/doc/20142015Student/2014-2015_Suspensions.pdf

[iii] Maryland State Board of Education, School Discipline and Academic Success: Related Parts of Maryland’s Education reform. (July 2012) Available at http://marylandpublicschools.org/NR/rdonlyres/42ED8EDA-AF34-4058-B275-03189163882D/32853/SchoolDisciplineandAcademicSuccessReportFinalJuly2.pdf.

[iv] COMAR 13A.08.01.-04.

[v] Steinberg, M.P., Allensworth, E., & Johnson, D.W. (2015). What conditions support safety in urban schools? The influence of school organizational practices on student and teacher reports of safety in Chicago. In Losen, D.J. (Ed.) Closing the School Discipline Gap: Equitable Remedies for Excessive Exclusion. New York: Teachers College Press.

[vi] Tracy J. Evans-Whipp, et al., Longitudinal Effects of School Drug Policies on Student Marijuana Use in Washington State and Victoria, Australia. American Journal of Public Health: Vol. 105, No. 5 (2015); Krezmien, M. and Leone, P. Suspension, Race, and Disability: Analysis of Statewide Practices and Reporting, Journal of Emotional and Behavioral Disorders (2006); Leone, P. et al., School failure, race and disability: Promoting positive outcomes, decreasing vulnerability for involvement with the juvenile delinquency system, The National Center on Education, Disability and Juvenile Justice (2003).

[vii] 20 U.S.C. 1412(a)(3); providing a free and appropriate public education to all children, even those who are suspended, 20 U.S.C. § 1400, et seq., 34 CFR 300, 34 CFR 300.101(a); and questioning whether problematic behavior is a “manifestation” of the child’s disability before suspending them, 34 CFR 300.530 (e); and providing positive behavior supports.

[viii] American Federation of Teachers, Reclaiming the Promise: A new path forward on school discipline practices. Available at http://www.aft.org/position/school-discipline#sthash.DJf7GIID.dpuf

 

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Prima Pro Bono!

Disability Rights Maryland (DRM) celebrates Caitlin McAndrews and the McAndrews Law Offices, P.C. for their compassionate representation of DRM’s clients at no cost to the families in the area of special education.  This past year alone, Ms. McAndrews and McAndrews Law represented six children from DRM and furthered their special education claims.

Caitlin McAndrewsBased originally in Pennsylvania, McAndrews Law has grown from its modest beginnings in 1983 to include 4 offices in Pennsylvania, 2 offices in Delaware, and an office in Alexandria, Virginia that serves Maryland and Washington, DC clients. McAndrews Law provides services not only in special education law, but in estate planning, administration and probate for individuals with and without disabilities, elder law, long-term medical care planning, guardianship, and personal injury.

Caitlin McAndrews began working at McAndrews Law Offices, P.C. when she was still in high school. From that experience, she developed a keen interest in serving people with disabilities and became a special educator in Pennsylvania. She went on to pursue her J.D. at George Mason University School of Law, and now practices in the area of special education law and estate planning, including special needs trusts and powers of attorney.

McAndrews Law Offices, P.C. requires its attorneys to engage in community outreach by providing free presentations to groups, participating in legal walk-in clinics, and attending presentations for educators. Although none of this time is billable, it helps to advance Caitlin and her fellow attorneys as advocates.

Caitlin looks for the mutual benefits in her pro bono service – the win-wins. She has found that pro bono work helps to expand her skill-set and practical knowledge in special education law. Without the constraints of a typical, hourly fee arrangement, Caitlin finds clients are willing to consider creative solutions to problems and Caitlin feels more freedom to plan her advocacy accordingly. Her clients appreciate her time and efforts, and this, in turn, fulfills Caitlin’s desire to serve others. DRM is thrilled and grateful that Caitlin McAndrews participates in DRM’s Pro Bono Program to serve families in need and improve lives.

A Recent Success Story!  Caitlin stepped in to represent Spencer, an 18 year old student with Autism Spectrum Disorder. The school had scheduled Spencer for graduation even though he could not perform many simple life skills such as tying his shoes. In addition, the school had failed to develop a transition plan for Spencer to pursue a career or pursue post-secondary education. Caitlin and her team were able to obtain evaluations (some independently derived and some through the School District) and $8,000 in compensatory services, extend Spencer’s eligibility to remain in school through the age of 21, and secure Spencer’s enrollment in a much-desired technical training program.

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Defending the Housing Rights of Tenants with Disabilities

The Maryland Court of Special Appeals issued an opinion in Hosford v. Chateau Foghorn, LP holding that Maryland landlord-tenant law is not preempted by federal law and policy that requires federally subsidized landlords to include lease provisions that permit landlord to evict tenants for the use or possession of marijuana.

Under Maryland law, to evict a tenant, a landlord must prove that i) there was a breach; ii) the breach was material; and iii) the breach was so substantial that it warrants eviction. In Hosford v. Chateau Foghorn, LP a federally subsidized landlord argued that they need not produce evidence that the breach was substantial and warrants eviction because of federal law requiring certain lease terms that permit landlords to evict tenants for the use or possession of controlled substances on the premises.[1]

The Court of Special Appeals rejected the landlord’s argument and held, in part:  “To require a state court, as a matter of law, to evict a disabled member of that class [low-income persons] out of the home had had resided in for 24-25 years for having one marijuana plant in his bathtub, for his own medical use, with no evidence of distribution or attempted distribution, further no Congressional intent that we have been able to identify.”

This decision builds on an earlier success by Disability Rights Maryland in the Circuit Court of Baltimore City.  Similar to Hosford, the landlord in DRM’s case argued that a jury could not consider whether a breach was substantial and warranted eviction when a poor disabled tenant admitted to drug use, even though there was evidence of rehabilitation and treatment on the part of the tenant. DRM defeated the landlord’s legal argument in that case and later settled the matter.

Regardless, these decisions together are a very strong bulwark against the third-party policing policies that deprive and shut too many persons with disabilities from much needed assistance. As the Maryland courts and legislature have made evident, there is room for compassion in the context of federally subsidized landlords and the critical need for housing.

Protecting the Maryland landlord tenant law requiring a review of an individual’s circumstances to determine whether an eviction is substantial and warrants eviction is all the more critical as medical practitioners become more aware of the connection between disability, pain control, and substance abuse. While the decision in no way sanctions the use and abuse of controlled substances, it makes clear that a Court’s duty is not to rubber-stamp a landlord’s complaint for possession.

Perhaps a happier solution to complex problems for individuals is not reactionary, indiscriminate evictions in all cases, but a more nuanced approach that permit individuals who struggle with drug abuse to seek the help they need and continue to be successful in the community.

[1] IN October 2015, Maryland decriminalized the possession of Marijuana in small amounts.

Author: David Prater, Attorney 
September 12, 2016

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