Tell DOL to postpone rules which would promote institutionalization
Posted by: Bruce Darling
Date Mailed: Tuesday, February 21st 2012 06:12 PM
Date Mailed: Tuesday, February 21st 2012 06:12 PM
--_000_7008B0115C2A554B935AB37DF28AF17105746B66EXCHANGEROCHEST_ Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: quoted-printable BACKGROUND The Department of Labor (DOL) has proposed changes in federal labor rules t= hat, although well-intentioned, will have a negative impact on people with = disabilities and most seriously impact people who have the most significant= disabilities who rely on Medicaid home and community based services to be = independent. Labor advocates have urged people to support these rules which are intended= to assure that attendants get paid minimum wage and are paid time-and-a-ha= lf for overtime work. The disability community recognizes the invaluable ro= le that attendants play in supporting the independence of people with disab= ilities and has advocated for increased funding for attendant services to i= mprove wages, however the way DOL is implementing this rule change will hav= e a serious negative impact on people with disabilities and promote unwante= d institutionalization. Please TAKE ACTION before the comment deadline of February 27, 2012. TAKE ACTION There are several ways to TAKE ACTION on this important issue. 1. Submit comments on the web. ADAPT has worked with the Center for Disabi= lity Rights to set up a system online to make this process easy for you. Go to: http://ly.adapt.org/dol When you submit your comments, be sure to edit and personalize the body of = the message. Your comments to the Department of Labor will first be sent t= o the Center for Disability Rights who will forward them by the deadline to= DOL. 2. Mail written comments directly to the US Department of Labor. Send writ= ten comments to: Mary Ziegler, Director Division of Regulations, Legislation, and Interpretation Wage and Hour Division U.S. Department of Labor Room S-3502/ RIN 1235-AA05 200 Constitution Avenue NW. Washington, DC 20210 Please TAKE ACTION before the comment deadline of February 27, 2012. DETAILED POLICY IMPLICATIONS Most notably, people with disabilities could face unwanted institutionaliza= tion as a result of implementing these proposed rules. * Increasing the cost of home and community based services by requiring= overtime pay, without increasing the Medicaid rates or raising the Medicai= d caps for available funding, will result in a reduction in hours of person= al assistance, forcing some people with disabilities into unwanted institut= ionalization. * Requiring minimum wage payments for overnight assistance may raise th= e cost of serving individuals above established Medicaid caps, resulting in= people with significant disabilities either going without needed assistanc= e or being forced into unwanted institutionalization. * The proposed DOL change will limit the availability of family and fri= ends as paid attendants in consumer directed personal assistance programs. = Reducing the availability of this vital component of the attendant workfor= ce threatens the independence of Americans with disabilities. The DOL also significantly mischaracterizes consumer directed services. DO= L describes consumer directed services "as a 'grey market;' that contains a= n element of 'over-the-back-fence network of women [who are] usually untrai= ned, unscreened, and unsupervised, but more affordable without an agency's = fee, less constrained by regulations and hired through personal recommendat= ion.' The term 'grey market' is sometimes used to suggest that at least so= me of these private arrangements are designed to avoid applicable labor law= s..." DOL notes that "There is no consolidated source of data on state consumer-d= irected programs" even though there are several resources within the disabi= lity community, and DOL fails to assess the impact that the proposed change= s will have on that system for providing services and supports to people wi= th disabilities. It is also likely that the proposed changes will not significantly improve = the lives of attendants. Because Medicaid and Medicare rates are not being= increased to cover the additional cost associated with these changes, home= care agencies will limit the hours attendants can work, forcing attendants= who currently to work for multiple agencies in order to match their curren= t standard of living. The necessity to balance efforts to enhance workers' wages and benefits wit= h the needs of people with disabilities was identified and addressed in Gui= ding Principles which were developed between SEIU and disability advocates.= According to those Guiding Principles, signed on November 16, 2011, "As a= general principle, enhancements to workers' wages and benefits shall be pa= id for through increased funding." The DOL proposal does not do this. KEY POINTS FOR MAILED COMMENTS Although I want attendants to have good wages, I am deeply concerned that e= stablishing a requirement that attendants be paid overtime in this manner w= ill negatively impact people with significant disabilities and their abilit= y to live in the Most Integrated Setting. * Increasing the cost of home and community based services by requiring= overtime and overtime pay without increasing the Medicaid rates or raising= the Medicaid caps for available funding will result in a reduction in hour= s of personal assistance, forcing some people into unwanted institutionaliz= ation. * Requiring minimum wage payments for overnight assistance may make rai= se the cost of those services above established Medicaid caps, resulting in= people going without needed assistance or being forced into unwanted insti= tutionalization, and the proposed DOL change will limit the availability of= family and friends as paid attendants in consumer directed personal assist= ance programs. Reducing the availability of this vital component of the at= tendant workforce threatens the independence of Americans with disabilities= . * According to DOL's own analysis, the proposed rules have the potentia= l to increase the rate of institutionalization of people with disabilities. Finally, I am concerned that the proposed changes will not significantly im= prove the lives of attendants. Because Medicaid and Medicare rates are not= being increased to cover the additional cost associated with these changes= , home care agencies simply will limit the hours attendants can work, forci= ng attendants to work for multiple agencies in order to match their current= standard of living. I urge the Department of Labor to postpone implementation of these proposed= changes until it has worked with disability and labor advocates to develop= an approach that can enhance workers' wages and benefits without eroding t= he availability of long term services and supports. --_000_7008B0115C2A554B935AB37DF28AF17105746B66EXCHANGEROCHEST_ Content-Type: text/html; charset="us-ascii" Content-Transfer-Encoding: quoted-printable <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <html> <head> <meta http-equiv=3D"Content-Type" content=3D"text/html; charset=3Dus-ascii"= > <meta name=3D"GENERATOR" content=3D"MSHTML 8.00.6001.18876"> </head> <body> <div><font size=3D"2" face=3D"Arial"> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><b style=3D"mso-bidi-f= ont-weight: normal"><span style=3D"FONT-FAMILY: Arial; COLOR: black"><font = size=3D"3">BACKGROUND <?xml:namespace=20 prefix =3D o ns =3D "urn:schemas-microsoft-com:office:office"=20 /> <o:p></o:p></font></span></b></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">The Department of Labor (DOL) h= as proposed changes in federal labor rules that, although well-intentioned,= will have a negative impact on people with disabilities and most seriously impact people who have the most significan= t disabilities who rely on Medicaid home and community based services to be= independent.<span style=3D"mso-spacerun: yes"> </span><o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">Labor advocates have urged peop= le to support these rules which are intended to assure that attendants get = paid minimum wage and are paid time-and-a-half for overtime work. The disability community recognizes the invaluable role= that attendants play in supporting the independence of people with disabil= ities and has advocated for increased funding for attendant services to imp= rove wages, however <u>the way DOL is implementing this rule change will have a serious negativ= e impact on people with disabilities and promote unwanted institutionalizat= ion</u>.</font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"></font></span> </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><span style=3D"FONT-FAMILY: Arial; COLOR: black"= ><font size=3D"3">Please <u>TAKE ACTION</u> before the comment deadline of February 27, 2012.</font>= </span><span style=3D"FONT-FAMILY: Arial; COLOR: black"><o:p></o:p></span><= /span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"></font></span> </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><b style=3D"mso-bidi-f= ont-weight: normal"><span style=3D"FONT-FAMILY: Arial; COLOR: black"><font = size=3D"3">TAKE ACTION<o:p></o:p></font></span></b></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">There are several ways to TAKE = ACTION<span class=3D"518062917-21022012"> on this important issue</span>.<o= :p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><font size=3D"3"><b st= yle=3D"mso-bidi-font-weight: normal"><span style=3D"FONT-FAMILY: Arial; COL= OR: black">1. Submit comments on the web.</span></b><span style=3D"FONT-FAM= ILY: Arial; COLOR: black"><span style=3D"mso-spacerun: yes"> </span>ADAPT has <span class=3D"518062917-21022012">worked with the Ce= nter for Disability Rights to </span>set up a system online to make this process easy for you<span class= =3D"518062917-21022012">.</span></span></font></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><span class=3D"518062917-21022012"></span><font = size=3D"3"><span class=3D"518062917-21022012">Go to</span>: </font><a href=3D"http://ly.adapt.org/dol"><font size=3D"3">http://ly.adapt= .org/dol</font></a><font size=3D"3"> <o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">When you submit your comments, = be sure to edit and personalize the body of the message.<span style=3D"mso-= spacerun: yes"> </span>Your comments to the Department of Labor will first be sent to the C= enter for Disability Rights who will forward them by the deadline to DOL. &= nbsp;<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><font size=3D"3"><b st= yle=3D"mso-bidi-font-weight: normal"><span style=3D"FONT-FAMILY: Arial; COL= OR: black">2. Mail written comments directly to the <?xml:namespace prefix =3D st1 ns =3D=20 "urn:schemas-microsoft-com:office:smarttags" /> <st1:country-region w:st=3D"on"><st1:place w:st=3D"on">US</st1:place></st1= :country-region> Department of Labor.</span></b><span style=3D"FONT-FAMILY:= Arial; COLOR: black"><span style=3D"mso-spacerun: yes"> </span>Send written comments to:<o:p></o:p></span></font></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><span style=3D"mso-spacerun: ye= s"> </span>Mary Ziegler, Director<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><span style=3D"mso-spacerun: ye= s"> </span>Division of Regulations, Legislation, and Interpretation<o:p></o:p><= /font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><span style=3D"mso-spacerun: ye= s"> </span>Wage and Hour Division<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><span style=3D"mso-spacerun: ye= s"> </span><st1:country-region w:st=3D"on"><st1:place w:st=3D"on">U.S.</st1:pla= ce></st1:country-region> Department of Labor<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><span style=3D"mso-spacerun: ye= s"> </span>Room S–3502/ RIN 1235–AA05<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><span style=3D"mso-spacerun: ye= s"> </span><st1:Street w:st=3D"on"><st1:address w:st=3D"on">200 Constitution Av= enue NW</st1:address></st1:Street>.<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><span style=3D"mso-spacerun: ye= s"> </span><st1:place w:st=3D"on"><st1:City w:st=3D"on">Washington</st1:City>, = <st1:State w:st=3D"on"> DC</st1:State> <span style=3D"mso-spacerun: yes"> </span><st1:PostalCo= de w:st=3D"on">20210</st1:PostalCode></st1:place><o:p></o:p></font></span><= /p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><font size=3D"3"><b st= yle=3D"mso-bidi-font-weight: normal"><span style=3D"FONT-FAMILY: Arial; COL= OR: black">Please <u>TAKE ACTION</u> before the comment deadline of February 27, 2012.</span>= </b><span style=3D"FONT-FAMILY: Arial; COLOR: black"><o:p></o:p></span></fo= nt></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><b style=3D"mso-bidi-f= ont-weight: normal"><span style=3D"FONT-FAMILY: Arial; COLOR: black"><font = size=3D"3">DETAILED POLICY IMPLICATIONS<o:p></o:p></font></span></b></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">Most notably, people with disab= ilities could face unwanted institutionalization as a result of implementin= g these proposed rules.<span style=3D"mso-spacerun: yes"> </span><o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <ul style=3D"MARGIN-TOP: 0in" type=3D"disc"> <li style=3D"MARGIN: 0in 0in 0pt; COLOR: black; mso-list: l2 level1 lfo1; t= ab-stops: list .5in" class=3D"MsoNormal"> <span style=3D"FONT-FAMILY: Arial"><font size=3D"3">Increasing the cost of = home and community based services by requiring overtime pay, <u>without increasing the Medicaid rates or raising the Medicaid caps for a= vailable funding</u>, will result in a reduction in hours of personal assis= tance, forcing some people<span class=3D"518062917-21022012"> with disabili= ties</span> into unwanted institutionalization. <o:p></o:p></font></span></li></ul> <p style=3D"MARGIN: 0in 0in 0pt 0.25in" class=3D"MsoNormal"><span style=3D"= FONT-FAMILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p>= </span></p> <ul style=3D"MARGIN-TOP: 0in" type=3D"disc"> <li style=3D"MARGIN: 0in 0in 0pt; COLOR: black; mso-list: l0 level1 lfo2; t= ab-stops: list .5in" class=3D"MsoNormal"> <span style=3D"FONT-FAMILY: Arial"><font size=3D"3">Requiring minimum wage = payments for overnight assistance may <u>raise the cost of serving individuals above established Medicaid caps</u= >, resulting in people with significant disabilities either going without n= eeded assistance or being forced into unwanted institutionalization.<o:p></= o:p></font></span></li></ul> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <ul style=3D"MARGIN-TOP: 0in" type=3D"disc"> <li style=3D"MARGIN: 0in 0in 0pt; COLOR: black; mso-list: l3 level1 lfo3; t= ab-stops: list .5in" class=3D"MsoNormal"> <span style=3D"FONT-FAMILY: Arial"><font size=3D"3">The proposed DOL change= will <u>limit the availability of family and friends as paid attendants in= consumer directed personal assistance programs</u>.<span style=3D"mso-spac= erun: yes"> </span>Reducing the availability of this vital component of the attendant w= orkforce threatens the independence of Americans with disabilities.<o:p></o= :p></font></span></li></ul> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">The DOL also significantly misc= haracterizes consumer directed services.<span style=3D"mso-spacerun: yes">&= nbsp; </span>DOL describes consumer directed services “as a ‘grey mar= ket;’ that contains an element of ‘over-the-back-fence network = of women [who are] usually untrained, unscreened, and unsupervised, but mor= e affordable without an agency’s fee, less constrained by regulations and hired through personal recommendation.’ <span style= =3D"mso-spacerun: yes"> </span>The term ‘grey market’ is sometimes used to sugges= t that at least some of these private arrangements are designed to avoid ap= plicable labor laws…”<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">DOL notes that “There is = no consolidated source of data on state consumer-directed programs” e= ven though there are several resources within the disability community, and DOL fails to assess the impact that the proposed changes wi= ll have on that system for providing services and supports to people with d= isabilities.<span style=3D"mso-spacerun: yes"> </span><o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">It is also likely that the prop= osed changes will not significantly improve the lives of attendants.<span s= tyle=3D"mso-spacerun: yes"> </span>Because Medicaid and Medicare rates are not being increased to cover= the additional cost associated with these changes, home care agencies will= limit the hours attendants can work, forcing attendants who currently to w= ork for multiple agencies in order to match their current standard of living.<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt 0.25in" class=3D"MsoNormal"><span style=3D"= FONT-FAMILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p>= </span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><span class=3D"518062917-210220= 12">T</span>he necessity to balance efforts to enhance workers’ wages= and benefits with the needs of people with disabilities was identified and addressed in Guiding Principles which were developed be= tween SEIU and disability advocates.<span style=3D"mso-spacerun: yes"> = ; </span>According to those Guiding Principles, signed on November 16, 2011, = “As a general principle, enhancements to workers’ wages and ben= efits shall be paid for through increased funding.”<span style=3D"mso= -spacerun: yes"> </span>The DOL proposal does not do this.<span style=3D"mso-spacerun: yes">= </span> <o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><b style=3D"mso-bidi-f= ont-weight: normal"><span style=3D"FONT-FAMILY: Arial; COLOR: black"><font = size=3D"3">KEY POINTS FOR MAILED COMMENTS<o:p></o:p></font></span></b></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">Although I want attendants to h= ave good wages, I am deeply concerned that establishing a requirement that = attendants be paid overtime in this manner will negatively impact people with significant disabilities and their abil= ity to live in the Most Integrated Setting.<span style=3D"mso-spacerun: yes= "> </span><o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <ul style=3D"MARGIN-TOP: 0in" type=3D"disc"> <li style=3D"MARGIN: 0in 0in 0pt; COLOR: black; mso-list: l1 level1 lfo4; t= ab-stops: list .5in" class=3D"MsoNormal"> <span style=3D"FONT-FAMILY: Arial"><font size=3D"3">Increasing the cost of = home and community based services by requiring overtime and overtime pay wi= thout increasing the Medicaid rates or raising the Medicaid caps for availa= ble funding will result in a reduction in hours of personal assistance, forcing some people into unwanted institu= tionalization. <o:p></o:p></font></span></li></ul> <p style=3D"MARGIN: 0in 0in 0pt 0.25in" class=3D"MsoNormal"><span style=3D"= FONT-FAMILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p>= </span></p> <ul style=3D"MARGIN-TOP: 0in" type=3D"disc"> <li style=3D"MARGIN: 0in 0in 0pt; COLOR: black; mso-list: l1 level1 lfo4; t= ab-stops: list .5in" class=3D"MsoNormal"> <span style=3D"FONT-FAMILY: Arial"><font size=3D"3">Requiring minimum wage = payments for overnight assistance may make raise the cost of those services= above established Medicaid caps, resulting in people going without needed = assistance or being forced into unwanted institutionalization, and the proposed DOL change will limit the availabil= ity of family and friends as paid attendants in consumer directed personal = assistance programs.<span style=3D"mso-spacerun: yes"> </span>Reducing the availability of this vital component of the attendant w= orkforce threatens the independence of Americans with disabilities.<o:p></o= :p></font></span></li></ul> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <ul style=3D"MARGIN-TOP: 0in" type=3D"disc"> <li style=3D"MARGIN: 0in 0in 0pt; COLOR: black; mso-list: l1 level1 lfo4; t= ab-stops: list .5in" class=3D"MsoNormal"> <span style=3D"FONT-FAMILY: Arial"><font size=3D"3"><span class=3D"51806291= 7-21022012">A</span>ccording to DOL’s own analysis, the proposed rule= s have the potential to increase the rate of institutionalization of people= with disabilities.<span style=3D"mso-spacerun: yes"> </span><o:p></o:p></font></span></li></ul> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3">Finally, I am concerned that th= e proposed changes will not significantly improve the lives of attendants.<= span style=3D"mso-spacerun: yes"> </span>Because Medicaid and Medicare rates are not being increased to cover= the additional cost associated with these changes, home care agencies simp= ly will limit the hours attendants can work, forcing attendants to work for= multiple agencies in order to match their current standard of living.<o:p></o:p></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><font size=3D"3"><u>I urge the Department of Lab= or to postpone implementation of these proposed changes until it has worked= with disability and labor advocates to develop an approach that can enhance workers’ wages and benefits wit= hout eroding the availability of long term services and supports.<o:p></o:p= ></u></font></span></p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><span style=3D"FONT-FA= MILY: Arial; COLOR: black"><o:p><font size=3D"3"> </font></o:p></span>= </p> <p style=3D"MARGIN: 0in 0in 0pt" class=3D"MsoNormal"><o:p><font size=3D"3" = face=3D"Times New Roman"> </font></o:p></p> </font></div> </body> </html> --_000_7008B0115C2A554B935AB37DF28AF17105746B66EXCHANGEROCHEST_--
