HD14 - Annual Report of the Disability Commission (2003)

Executive Summary:
The Virginia Disability Commission was formed thirteen years ago under House Joint Resolution 45 to identify legislative priorities for the General Assembly in order to provide ongoing support in developing and reviewing services and funding related to Virginians with disabilities. The Commission is the primary forum within the legislature where the needs and issues of people with physical, sensory, and other disabilities can be addressed through the cooperation of the legislature, the Lieutenant Governor, the Governor's appointees, and the agencies of the Executive branch. With the Lieutenant Governor as the Chair, the Commission has been carefully composed to plan and facilitate development of a coordinated, community-based, and consumer–driven system of services for individuals with disabilities across the State. Initially focused on physical and sensory disabilities, over the last five years, the Commission has become instrumental in the growth and oversight of services to other disability populations and has initiated a strong focus on those groups that traditionally have been underserved in Virginia by state agencies, including persons with brain injury and those with autism.

Five meetings of the Virginia Disability Commission were held in the interim prior to the 2004 Virginia General Assembly session. The Commission continued its focus in four priority areas: the review and maintenance of the Commission’s community services initiatives, employment, transportation, and housing concerns. Commission efforts were carefully interwoven this year with the work of the Commonwealth’s Olmstead Task Force, which focused on ensuring appropriate community living options, choices, and supports for persons with disabilities who are institutionalized or at risk of institutionalization.

The Commission also analyzed the need and appropriateness of continuing the Commission itself, which was due to sunset in 2004 according to the House Joint Resolution 34, passed in 2000. Throughout the interim, the Commission received public testimony as well as considerable follow up input validating the need for the Commission as the primary forum where the issues of people with disabilities can be addressed and brought to attention of the legislature, the Lieutenant Governor, the Governor's appointees and the agencies of the Executive branch. There was unanimous agreement by members to submit legislation to the General Assembly this year to continue the Disability Commission (SB 381 and HB 817).

The Disability Commission’s three work groups were again active this year working on issues of great concern for Virginians with disabilities. Activities of the work groups were as follows:

• The Medicaid Infrastructure Grant, Stakeholder Advisory Committee was involved in developing a Section 1115 Research Waiver proposal to Centers for Medicare and Medicaid Services (CMS) pursuant to the 2003 legislation (HB 1822), originally initiated by the Disability Commission. This was legislation that, Require(d) the Board of Medical Assistance Services to prepare and seek a Section 1115 waiver to implement one of the options for a Medicaid Buy-In program for up to 200 working families with disabilities. A Medicaid Buy-In will allow people to finally earn higher incomes and reserve some savings while ensuring continuation of needed health care coverage, thus providing opportunities and incentives for all Virginians to seek gainful employment.

• The new Interagency Specialized Transportation Work Group, which includes a Disability Commission member, James McDonald, was formed. Mr. McDonald volunteered to serve on this work group with the key agency representatives in order to ensure that the business community was involved in the expansion and furthering of public and alternative transportation options for all Virginians with disabilities throughout the Commonwealth. Mr. McDonald worked successfully with the work group this year to encourage Henrico County to extend a City of Richmond bus route to the Department for the Blind and Vision Impaired and the State Rehabilitation Center, which lies within Henrico County jurisdictional lines.

• The Disability Housing Work Group, formed by the Commission with direct support of the Lieutenant Governor’s office, has continued work to enhance intergovernmental and interagency coordination, as well as to gain stakeholder input on critical disability housing issues and decisions. This year, outstanding demonstrations in collaboration and coordinated strategic planning have been accomplished and are included in this report.

Leadership Role

The foundation of the Disability Commission is its critical role in advocacy on behalf of Virginians with disabilities. The Commission’s leadership role this year was evidenced in the following key activities:

• Support of an amicus curiae brief in a critical case in the United States Supreme Court regarding the Americans with Disability Act (ADA). The Commission reviewed the State of Tennessee v. Lane, et. al., in which Tennessee asserted that Title II of the Americans with Disabilities Act (ADA), requiring fair treatment of disabled citizens in the provision of governmental services, was unconstitutional. In the case that gave rise to this appeal, the parties challenged their own state for the failure to provide courthouses and courtrooms that were accessible to everyone. The district court and the 6th Circuit Court of Appeals both ruled in favor of the citizens with disabilities of Tennessee. The Chairman’s letter to the Governor and the Attorney General is included as an Appendix to this report.

• The Commission sought to proactively informing budget planning by providing the Governor with bipartisan recommendations early in the budget planning process. The Disability Commission provided the Governor with the following recommendations for his budget planning, most of which were included in the Governor’s final budget.

• Focus on immediate progress toward core Olmstead compliance issues, rather than the broader goals of Olmstead Task force;

• Preserve existing community programs; and

• Fund two smaller community initiatives, which when fully implemented will save dollars by allowing Virginians with disabilities greater self-sufficiency and community inclusion (i.e., the Medicaid Buy-In Waiver ($200,000), and Brain Injury Home and Community Based Services Waiver). Note: the latter was not recommended in the Governor’s budget.

Commission’s 2004 Legislative Agenda included the following items:

Legislation for Reauthorization of the Disability Commission

The most recent reauthorization of the Disability Commission expires on June 30, 2004. In order to continue the important work of the Commission, commissioners recommended another reauthorization, this time through June 30, 2007. Senator Toddy Puller introduced the Commission recommendation as Senate Bill 381. Delegate Marian Van Landingham introduced the Commission recommendation as House Bill 817.

Legislation to Raise Revenues to Support Continuation of Brain Injury Programs

The Commission received extensive public comment regarding the need to continue some of the programs funded by the Commonwealth Neurotrauma Initiative (CNI) Trust Fund. This initiative was passed in 1998 legislation to establish a special nonreverting fund in the state treasury and a $30 reinstatement fee to restore driver’s license revoked or suspended for specified offenses (e.g., DUI, hit-and-run, reckless driving, habitual offenses). The Department of Motor Vehicles (DMV) collects the $30 fee to reinstate operator's license and directs $25 to the CNI Trust Fund, with $5 to DMV (if DUI-related, then $5 to VASAP). The total revenue collected between SFY 1998 – SFY 2003 is $5,966,733.

This year, based upon analyses completed by the DRS, the Commission determined that key programs (with the best outcomes) could be continued if the fees were doubled to $60. Commissioners agreed that raising the driver’s license reinstatement fees for these Virginians, who often cause the traumatic brain injuries through reckless driving, may be the only option to continue Brain Injury Programs. Senator Puller introduced the Commission recommendation as Senate Bill 380.

Accessible Housing Legislation

Local comprehensive plans are currently required to plan for “affordable” housing in all communities. Consideration of “accessible” housing is not required. The national consultants, the National Disability Institute, NCB Development Corporation, Washington, DC and Technical Assistance Collaborative, Inc., recommended that a requirement to plan for accessible housing should be added to the requirements for comprehensive planning at the community level. Delegate Van Landingham introduced the Commission recommendation as House Bill 1433.

Resolutions Commending Commissioners Bloxom and Broman

Two resolutions were submitted this year commending the Commissioners who were retiring: the Vice Chairman, the Honorable Robert Bloxom; and a newer member, the Honorable George Broman. The Commission submitted the resolutions in conjunction with the Virginia Board of People with Disabilities.

2004 Other Administrative Actions Suggested

Review of Olmstead “no cost” recommendations - The Commission will review the recent report from the VA Centers for Independent Living (VACIL’s) that recommended that the Commonwealth adopt the “no-cost” Olmstead Recommendations first, especially the recommended changes to the Nurse Practices Act. These latter changes would allow more flexibility for Personal Assistants to be able to perform some health maintenance tasks, now prohibited. Legislative changes like this in Kansas and other states have promoted more consumer-direction and consumer control of services and more cost effective services. The Commission agreed to explore this approach with thoughtful deliberation, and will involve all parties affected, including the State Board of Nursing, DMAS, DRS and consumer advocates. The Chairman prepared a letter to the Secretary of Health and Human Resources asking her to carefully study possible changes to the Nurse Practices Act.

Housing Work Group Administration Action Recommendations - In addition to the legislative housing action recommended above, the Disability Commission’s Housing Work Group provided a rich list of potential administrative actions to help guide the Commission after the 2004 General Assembly. The Commission agreed to explore these changes at its next meeting in the Spring/Summer 2004.