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<title>Views From the Hill - Senator Tom Harkin and Congressman James Langevin</title>
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      <p>&nbsp;</p>
      <h4><img src="images/Senator_Harkin_Langevin.jpg" width="360" height="245" align="left" alt="Harkin and Langevin Images">Views 
        From the Hill - Senator Tom Harkin and Congressman James Langevin</h4>
      <p align="left"> <br>
        Senator Tom Harkin is no stranger to Capitol Hill. First elected to Congress 
        in 1974, he served 10 years before his election to the Senate, where he 
        is now serving his third term. An author of the 1990 Americans with Disabilities 
        Act (ADA), Harkin has a long-standing history of commitment to people 
        with disabilities. This last session found Harkin lending his time, energy 
        and advocacy to issues ranging from the Medicaid Community Attendant Services 
        Act (MiCASSA) and Money Follows the Person Act to legislation affecting 
        accessibility on an international level.<br>
        <br>
        A central figure in the creation of the ADA, Harkin is understandably 
        protective of its preservation, and he supports a future ADA restoration 
        act. &#8220;There are a number of Supreme Court decisions that have really 
        chipped away the fundamental ADA Law,&#8221; notes Harkin. &#8220;The 
        Supreme Court has declared that if you have epilepsy that is controlled 
        by medication, for example, the law will not protect you from discrimination 
        based on your disability. On the other hand, you may be dismissed from 
        your job because your epilepsy is considered a disability. It really is 
        a Catch-22.&#8221; Harkin is not alone in his concerns; Democrats and 
        Republicans alike recognize the need for an act to restore the rights 
        originally invoked by Congress under the ADA. <br>
        <br>
        While an ADA restoration act is still in the conceptualization phase, 
        two bills Harkin is currently passionate about passing are MiCASSA and 
        the Money Follows the Person Act. MiCASSA would require states to provide 
        Medicaid coverage not only for nursing home care, but also for personal 
        attendant services in home-based or community-based environments. &#8220;The 
        opposition we&#8217;re getting to MiCASSA is simply the cost of implementation. 
        If you look at it in a 10-year budget cycle, the cost will not be much 
        more than what it would be to keep people institutionalized,&#8221; Harkin 
        says. Understandably, he is frustrated by a lack of support from both 
        the Bush administration and the Office of Management and Budget. &#8220;I&#8217;m 
        going to keep on it and I&#8217;m going to keep pushing until we get MiCASSA 
        passed,&#8221; Harkin adds, although he acknowledges that in the current 
        budgetary climate, chances are not realistic until next year. <br>
        <br>
        Initially, to implement MiCASSA, states will have to train personnel and 
        make changes in their administrative and service systems.. The Money Follows 
        the Person Act sets up time-limited federal funding to help states with 
        the transition, helping states get a jump-start on the accommodations 
        needed to implement MiCASSA by providing up-front money ($350 million 
        for the first five years, totaling $1.75 billion). <br>
        MiCASSA and the Money Follows the Person Act have received opposition 
        from nursing homes concerned about their potential loss of clients and 
        revenue. &#8220;I understand their concern, but times change, conditions 
        change, our society changes, we are changing, and we are not going to 
        warehouse people anymore. We&#8217;re just not,&#8221; says Harkin. He 
        adds, &#8220;There is nothing in MiCASSA that dictates a person can&#8217;t 
        choose to go to a nursing home. Sometimes people feel that institutional 
        care is their best situation.&#8221; <br>
        <br>
        Proponents of MiCASSA point to the desperate need for a less wasteful 
        and more humane avenue for obtaining personal attendant services as an 
        alternative to nursing home care. Many people with health problems who 
        have relied on the assistance of caretakers are faced with a dilemma when 
        their caretakers become elderly or ill, or acquire disabilities of their 
        own. When this happens, they are often forced to move into nursing homes, 
        even though they do not need 24-hour care, but rather simple assistance 
        getting out of bed, managing medications or grocery shopping. For this 
        group, it is more cost-effective to provide personal care assistance in 
        community settings, for only the hours needed. The states of Oregon and 
        Kansas have implemented community care similar to what is proposed for 
        MiCASSA and have good data about its feasibility. At first there is some 
        increase in the number of people using services, but this rise is offset 
        down the road by savings on less-costly community-based services and a 
        decrease in the number of people entering institutions. Furthermore, the 
        financial benefits can&#8217;t compare with the improved quality of life 
        people have when they are given a choice in the location and manner in 
        which they may live. &#8220;We give subsidies to all kinds of people. 
        Farmers get subsidies and we don&#8217;t tell them what to do with the 
        money; we give food stamps to millions of people and we don&#8217;t tell 
        them what they have to buy, with a few exceptions. People with disabilities 
        ought to be able to decide what they want to do with their money and their 
        housing rather than having the government tell them what they have to 
        do,&#8221; says Harkin. <br>
        <br>
        Harkin&#8217;s strong views don&#8217;t come only from years of talking 
        to his constituents or his ability to delineate between what is just and 
        what is unjust. Rather, his personal experiences with disability in his 
        family have made him conscious of the various accommodations that benefit 
        people with disabilities. &#8220;First of all, if my brother had been 
        able to be mainstreamed in school rather than going to a school for the 
        deaf he would have had more choices,&#8221; Harkin explains. &#8220;The 
        school gave three choices to my brother: he could be a baker, a shoe cobbler, 
        or a printer&#8217;s apprentice, and that was it. If interpretive services 
        or job training programs had been in place he would have had a much different 
        life. On the other hand, my nephew, Kelly, [acquired a disability] while 
        serving in the United States military. He had a terrible accident that 
        left him with quadriplegia. Because he was in the military, he received 
        good care and rehabilitation, after which he got the GI Bill and went 
        to school. [The military] provided him with a good wheelchair and an accessible 
        van. He now lives by himself and has for some time. He has a nurse who 
        comes in the morning and gets him up and ready for the day. That&#8217;s 
        a pretty good deal. But again, it is still cheaper than putting him in 
        an institution or nursing home. He goes to work and he actually pays taxes. 
        I&#8217;m just saying that what happens in the military ought to happen 
        for the rest of society.&#8221;<br>
        <br>
        Harkin is also addressing disability issues on an international level. 
        As a member of the Appropriations Committee, the committee that funds 
        international operations, Harkin was confronted a few years ago by a representative 
        from Disability Rights Education and Defense Fund, a California-based 
        organization. During a visit to Bosnia, the woman had discovered that 
        a significant portion of the money the United States was allocating to 
        re-build facilities, such as schools, was going to structures that were 
        not accessible. &#8220;We had the strange case that in the United States 
        they wouldn&#8217;t be allowed to [construct inaccessible buildings], 
        but over there they were doing it with our taxpayers&#8217; dollars,&#8221; 
        he explains. Harkin raised the issue with Secretary of State Colin Powell, 
        who agreed to address the problem. A year later, Harkin was still not 
        seeing the results he expected, and he confronted Powell with the transcripts 
        of his initial promises. The next time Powell came to testify, the Secretary 
        was prepared to present the State&#8217;s plan. Harkin explains, &#8220;I 
        was able to get language in the Foreign Assistance Bill that requires 
        USAID [the agency providing U.S. economic, development, and humanitarian 
        assistance around the world] to develop access standards governing all 
        U.S.-funded construction anywhere in the world. This is not just in Bosnia, 
        but in Afghanistan, in Iraq or anywhere else that we are.&#8221; <br>
        <br>
        In the recent Supreme Court case Tennessee vs. Lane, five plaintiffs won 
        a 5-4 victory against the state of Tennessee for its violation of Title 
        II of the Americans with Disabilities Act (ADA) in not providing adequate 
        access to court buildings. Congressman James Langevin finds it outrageous 
        that such a case had to go to the Supreme Court to be resolved, and finds 
        the narrow margin of victory troubling. &#8220;In my mind, there should 
        not have been any question that the courthouse had to be accessible. An 
        individual was required to go to court and was [penalized for failing 
        to show] because it wasn&#8217;t accessible. Public buildings must be 
        accessible to people with disabilities,&#8221; Langevin says emphatically. 
        &#8220;I find it disappointing that it was a split decision. I&#8217;m 
        certainly glad the individuals suing prevailed, but I also find it very 
        concerning and disappointing that it was so close.&#8221; Legislators, 
        advocates and people with disabilities are also concerned that the close 
        margin will send a mixed message to the rest of the world about other 
        accessibility rights addressed by the ADA. &#8220;If it is not a requirement 
        that public buildings have to be accessible, then there may be a strong 
        belief that businesses don&#8217;t have to be accessible with respect 
        to public accommodations to people with disabilities,&#8221; says Langevin. 
        <br>
        <br>
        Although Langevin believes &#8220;the spirit of the law&#8221; has been 
        significantly narrowed in focus, the ADA has brought great progress in 
        leveling the playing field and opening doors for people with disabilities. 
        &#8220;I saw the importance of the ADA as more than just a law that brought 
        down physical barriers. The ADA also changed perceptions. No longer were 
        accessible accommodations a courtesy; they were now viewed as a right. 
        People had a right to public accommodations and equal access to public 
        buildings,&#8221; says Langevin.<br>
        <br>
        A life in politics and government was not the planned career for Congressman 
        Langevin. While he enjoyed public service, his sights were originally 
        set on law enforcement, and he started exploring the field in his early 
        teens as a cadet working with police officers. When Langevin was 16, an 
        accidental discharge of an officer&#8217;s weapon left him with a spinal 
        cord injury, and he recognized that his original career path was no longer 
        a possibility. &#8220;I had been around politics and I understood a little 
        about elections,&#8221; says Langevin, &#8220;but more so, I felt touched 
        by the community as it rallied behind me at a time when I needed it most. 
        It showed me what good people could do by coming together and making a 
        difference, and I wanted to give something back if that was ever possible.&#8221; 
        <br>
        <br>
        When Langevin arrived in Congress, there was not a caucus specifically 
        examining the issues surrounding disabilities. It didn&#8217;t take long 
        to recognize the need, and shortly thereafter Langevin&#8212;together 
        with Major Owens as the Democratic co-chair and Jim Ramstad and former 
        Congresswoman Connie Morella as the Republican chairs&#8212;created a 
        Bipartisan Disabilities Caucus, which has now grown to 42 members. Congresswoman 
        Nancy Johnson has joined as the new Republican co-chair. The representation 
        of both parties reflects the universal importance of disability issues 
        for all Americans, regardless of party affiliation. The caucus tackles 
        projects such as the Work Incentives Act, the Assistive Technology Act, 
        the Vocational Rehabilitation Programs, the Developmental Disabilities 
        Act and reauthorization of the Individuals with Disabilities Education 
        Act (IDEA). In addition to addressing important legislation, the caucus 
        also helps raise awareness and educate people about issues that affect 
        people with disabilities. For example, it recently hosted a Web Accessibility 
        Day, where members of Congressional staffs could learn the elements needed 
        for an accessible website. <br>
        <br>
        In the same way the Disabilities Caucus is educating congressional staffs, 
        Langevin feels the government should be educating the rest of the country. 
        &#8220;While there are a lot of people in the business community who truly 
        want to comply with the ADA, I think there is a lot of confusion about 
        the ADA. Businesses often fear what it means and what they are specifically 
        required to do. I want to see government do a better job educating people 
        about what the ADA is and what it is not, to take away the fear. [Compliance 
        with the ADA] doesn&#8217;t necessarily require expending a lot of money. 
        A number of [small changes] can be reasonable accommodations, and in some 
        cases there are tax credits to help pay for complying with the ADA. There 
        certainly needs to be more money for a public education program about 
        the ADA,&#8221; says Langevin.<br>
        <br>
        Langevin feels one flaw of the ADA is that it does not give any particular 
        entity the authority to verify whether a company has met specific accessibility 
        criteria and is in compliance with the ADA. He says one proposed solution 
        has been to have local building inspectors serve as the sign-off entities. 
        When a company is building or trying to retrofit, the inspectors would 
        have the authority to come in and sign-off that the business has complied 
        with the letter and spirit of the ADA. &#8220;I understand from a businesses 
        point of view that it&#8217;s a frustration if they have made a good-faith 
        attempt and think that they have done everything right, and then a lawsuit 
        is filed because something is an inch off or not exactly perfect. We need 
        to find a happy medium, because I think the overwhelming majority of businesses 
        do want to be good neighbors, want to comply and want to be responsible,&#8221; 
        says Langevin.<br>
        <br>
        Accessibility has also been a contentious issue for voting, especially 
        since the controversial 2000 presidential elections. In his former position 
        as Secretary of State of Rhode Island, Langevin implemented an overhaul 
        of the State&#8217;s entire election system. The outdated lever voting 
        machines were discarded in favor of new Optical Scan equipment that is 
        generally accessible to people with all types of disabilities. A few years 
        later, he found himself in Congress dealing with voter technology at a 
        national level. &#8220;I was able to be instrumental in helping guide 
        Congress through this process of acquiring new voting equipment,&#8221; 
        Langevin says.<br>
        <br>
        In addition to the Optical Scan system, another option for accessible 
        voting is the Direct Recording Electronic (DRE) equipment. Both technologies 
        can be used by people with all types of disabilities, but each has unique 
        merits. &#8220;One of the advantages of Optical Scan over the DRE equipment 
        is that you have the ballot itself as the ultimate audit trail. DRE is 
        the new stuff, sexier, more modern, but the lack of an automatic paper 
        trail or verification system (such as what the Optical Scan system could 
        offer) is considered a drawback. However, it is still better than the 
        older systems that are out there,&#8221; explains Langevin. One purported 
        advantage of the DRE equipment is that if a polling place can&#8217;t 
        be made accessible, the DRE equipment can be transported to another location, 
        still allowing the person the opportunity to cast a private ballot. Langevin 
        is wary of this &#8220;advantage,&#8221; however. &#8220;I would prefer 
        that every place be made accessible. That has to be the primary goal,&#8221;he 
        cautions. [For a more detailed discussion of accessible voting, see the 
        Laura Bush issue of ABILITY Magazine.]<br>
        <br>
        Another passionate issue for Langevin is the growing crisis in funding 
        health care in the U.S. There are more than 40 million Americans who lack 
        health insurance. In my opinion this is the number one public policy issue 
        that we need to address, and yet the legislative process doesn&#8217;t 
        seem to be moving fast enough to solve the crisis,&#8221; he warns.<br>
        <br>
        Since there has been no clear consensus how to solve the national health 
        care problem, Langevin is preparing to introduce his own health care bill, 
        featuring a time-tested approach. The Federal Employees Health Benefits 
        Program already provides health insurance for more than 8 million federal 
        employees, their dependents and retirees. In essence, the federal government 
        negotiates on a national level with several different health plans on 
        behalf of federal employees. Employees then have a wide range of options&#8212;everything 
        from the basic plan with small co-payments through the classic Cadillac 
        version, with larger co-payments but increased choices and coverage. Langevin&#8217;s 
        plan calls for expanding the risk pool of the Federal Employees Health 
        Benefits Program to include all Americans, either through the income tax 
        or payroll tax systems. &#8220;I think the citizens of this country who 
        support and pay for the government through their tax dollars deserve the 
        same kind of health care coverage as federal employees and members of 
        Congress,&#8221; Langevin says. He expects opposition primarily from the 
        insurance industry. &#8220;They would probably make less of a profit, 
        but it would control costs and bring more stability to the market in terms 
        of insuring reimbursements.&#8221; <br>
        <br>
        When asked to reflect on his experience in politics thus far, Langevin 
        responds, &#8220;It&#8217;s a wonderful way to make a difference.&#8221; 
        However, despite his accomplishments, he&#8217;s not immune to frustration. 
        &#8220;It gets frustrating when the process moves so slowly in addressing 
        important issues.&#8221;<br>
        <br>
        Senator Harkin <br>
        <a href="http://www.harkin.senate.gov" target="_blank">www.harkin.senate.gov</a> 
        <br>
        <br>
        Congressman Langevin<br>
        <a href="http://www.house.gov/langevin" target="_blank">www.house.gov/langevin</a></p>
      <p align="left"><i>Other articles in the Roma Downey issue include&#8212; 
        Operation Smile, Destination Athens, Stand-Up Comedy Scholarship, Reflections 
        on the ADA, Ticket to Work, UN Update, Events/Conferences, Humor Therapy...</i><a href="/subscribe.html">subscribe</a>!</p>
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            <p><a href="Mental_Health_parity.html">Mental Health Parity</a></p>
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