[Missouri-l] Fwd: Vision Loss Community's Health Care Agenda Remains in Critical Condition

[Chip Hailey]

>Delivered-To: chiphailey at cableone.net
>From: "AFB DirectConnect" <blemoine at afb.net>
>To: "AFB Subscriber" <afbweb at afb.net>
>Subject: Vision Loss Community's Health Care Agenda Remains in 
>Critical Condition
>Date: Tue, 4 Aug 2009 10:22:45 -0400
>
>
>
>As Congress Takes August Respite, Vision Loss Community's Health 
>Care Agenda Remains in Critical Condition
>
>For further information, contact:
>
>Mark Richert
>Director, Public Policy, AFB
>202-822-0833
><mailto:mrichert at afb.net>mrichert at afb.net
>
>Reviewing the Chart
>
>The beginning of Congress's August recess is a good time to review 
>where we are with respect to health care reform and our field's 
>policy priorities and to map a clear path of travel moving forward.
>
>Progress in Congress to negotiate complex health care reform has 
>come in fits and starts over the last couple of months. While 
>prominent members and their staff continue to struggle to keep talks 
>moving forward behind the scenes dealing with the decisive macro 
>matters that will determine whether health reform can in fact make 
>it to the President's desk, several key congressional committees 
>have nevertheless kept the momentom moving forward by passing an 
>array of widely varying approaches to health care reform. However, 
>with one small exception, none of these proposals addresses the 
>health care inequities experienced by people with vision loss. 
>Therefore, much more work needes to be done.
>
>Signs of Life: Some Hope for Device Coverage
>
>Our ommunity has united around three health reform priorities: drug 
>label accessibility, wider availability of low vision and other 
>devices, and coverage for vision rehabilitation services provided by 
>appropriately trained vision rehabilitation professionals. To date, 
>only one of these issues has received attention in health care 
>legislation, and even that modest effort falls short.
>
>The version of health reform legislation passed by the Senate Health 
>Education Labor and Pensions (HELP) Committee would require that 
>rehabilitative and habilitative devices be recognized as a mandatory 
>coverage category in a newly-restructured health care delivery 
>system. A House Education and Labor Committee bill was also adopted 
>with a direct reference to mandatory coverage for durable medical 
>equipment, prosthetics, orthotics and supplies, but that bill fails 
>to define those terms of art in a way that ensures inclusion of low 
>vision devices within such coverage categories. As a result, the 
>Senate HELP Committee's approach, while strictly speaking less 
>precise in its terminology, is nevertheless preferable to the House 
>Education and Labor Committee's approach which would essentially 
>perpetuate the status quo categorical exclusion of low vision aids.
>
>Inclusion of the language in the HELP bill was the result of 
>cross-disability collaboration among many organizations including 
>AFB. This broadly worded Senate HELP Committee move to include 
>devices, a coverage category that had not been part of any health 
>reform legislation initially proposed in either chamber, is a small 
>but important victory and may lay the groundwork for further 
>advocacy in the months ahead.
>
>Troubling Complications: Recognition of Vision Rehab Services in a Muddle
>
>None of the proposals currently in play either address Medicare 
>coverage for vision rehabilitation services or Medicare recognition 
>of vision rehabilitation professionals. Some advocates in our field 
>are calling on Congress to support the vision rehab professions by 
>including direct reference to them in provisions of health care 
>legislation currently on the table intended to enhance the health 
>care practitioner workforce. If successful, this alternative effort 
>would establish grant programs, loan forgiveness, interdisciplinary 
>professional development initiatives, and other financial incentives 
>to possibly create additional future funding streams for training of 
>vision rehabilitation professionals. While clearly valuable, such an 
>approach is unrelated to Medicare coverage of the services provided 
>by orientation and mobility specialists, vision rehabilitation 
>therapists, and low vision therapists.
>
>Chronic Conditions: Drug Label Access Adrift
>
>The effort to ensure medication information and label accessibility 
>has been meeting with considerable sympathy on the Hill, but like 
>many other proposals, key Congressional health staff have yet to 
>acknowledge this issue as a legitimate aspect of health care reform. 
>This is so in spite of the fact that many provisions in the various 
>health reform bills run far afield of the central health care reform 
>debate. For example, the Senate HELP Committee bill includes 
>requirements to clearly list caloric and other nutritional 
>information on chain restaurant menus and vending machines.
>
>It has also been argued that drug label access is an Americans with 
>Disabilities Act (ADA) issue and, as such, is already dealt with 
>elsewhere and inappropriate to consider in health reform. This 
>perspective is in error. The ADA does place a general requirement on 
>public accommodations like retail pharmacies to effectively 
>communicate information. However, the ADA does not guarantee that 
>customers will receive medication information access in their 
>preferred medium (e.g., large print, audio, Braille, etc.) and does 
>not prescribe specific standards for retail pharmacies to follow to 
>ensure safety, reliability, and privacy.
>
>The Prognosis and the Prescription: The Message Congress Needs to Hear Now
>
>Each of the three policy priorities our field has endorsed are 
>critical to meet the health care needs of people with vision loss. 
>Even though considerable work has already taken place to move health 
>reform legislation toward enactment, much more work will be 
>undertaken in the months ahead. In particular, Washington insiders 
>predict that the real hard core action will begin once both the 
>House and Senate have passed all of their respective health reform 
>packages because then negotiators from both chambers will need to 
>resolve the inevitable myriad dissimilarities. All of that is simply 
>to say that there is still plenty of opportunity to influence the 
>policy process.
>
>It is, however, imperative that our field's message be clear and 
>consistent. Each of the issues we care about needs to be 
>communicated with commitment. If we elevate one issue over others, 
>we are inviting outright dismissal of those issues we deemphasize.
>
>The August Congressional recess, when members come back home to hear 
>from you, is a great time for advocates to communicate the following 
>message to Congress--
>
>To meet the needs of Americans living with vision loss, health 
>reform legislation must:
>
>
>
>    * ensure that individuals with vision loss and other 
> disabilities can properly identify and take medications by 
> mandating appropriate labeling standards and methods for providing 
> nonvisual and enhanced visual access to drug container labeling and 
> related information;
>    * establish clear Medicare (or other national minimum benefit 
> plan) coverage for, and foster broader private plan availability 
> of, low vision devices and other medically necessary assistive 
> technologies; and
>    * allow orientation and mobility specialists, vision 
> rehabilitation therapists, and low vision therapists to be full 
> participants in the professional team providing specialized 
> services to people with vision loss by establishing unambiguous 
> Medicare (or other national minimum benefit plan) reimbursement for 
> the services such professionals offer.
>
>
>
>Tell Congress that the vision loss community will not endorse health 
>care reform legislation that fails to address any of these critical 
>needs. We must withhold our formal support for health reform 
>legislation unless and until it passes the test our field has set 
>for it, namely full treatment of each of the three policy priorities 
>to which our field is committed. Half measures and vague language 
>must not be allowed to substitute for the very real changes in 
>health care access and quality needed by people living with vision loss.