Wednesday, June 28, 2017

What Happens When You Cut Medicaid? - Texas

New from AP today on the time Texas cut 350 million from Medicaid:
Some Texas children with special needs like Addison have lost critical services since the state implemented $350 million in Medicaid cuts to speech, occupational and physical therapy in December. In Texas, reimbursement offered to providers fell up to 50 percent for certain therapy procedures, said Rachel Hammon, president of Texas Association of Homecare and Hospice. Clinics closed and therapists quit.

The Texas cuts are separate from Republican proposals now before Congress, which academics say could cut federal Medicaid spending as part of a law to replace the Affordable Care Act. But the fallout could eventually be similar if some form of what’s been approved in the U.S. House, and is under consideration in the Senate, becomes law, said Elizabeth Burak, the senior program director of Georgetown University’s McCourt School of Public Policy’s Center for Children and Families

The Texas Legislature voted in 2015 to cut the state’s Medicaid reimbursement for pediatric acute therapy services, which effectively capped how much providers can be paid. Proponents of the cuts argued that Texas’ previous reimbursement rates were too high, sometimes even encouraging fraud.
In related news, my piece on the history of Republican attacks on Medicaid was picked up by the Dallas Morning News. My inbox has been lived.

Monday, June 26, 2017

Block Grants: A History

I have a piece today at The Washington Post about the history of Republicans trying to gut Medicaid, why they failed, and why they might win this time. 
As detailed in a 2013 report by the National Council on Disability (a nonpartisan, federally funded advisory council) on Medicaid block grants and their effect on Americans with disabilities, the first attempt to turn Medicaid into a block grant came in 1981, in Reagan’s first year in office. It made it into a big omnibus budget bill, but was stripped out in a congressional committee. House Speaker Newt Gingrich (R-Ga.) actually got block grants passed in 1995 as part of his “Medigrant” proposal, but President Bill Clinton vetoed it (with strong backing from health policy experts), and it was dropped from the subsequent compromise bill. President George W. Bush and the Republican congresses of 2003 and 2005 could have passed block grants at any time, but sustained resistance from advocacy groups, Democratic leaders such as Rep. Henry A. Waxman (Calif.) and Edward M. Kennedy (Mass.) and the legislative distractions of forming Medicare’s prescription drug benefit kept the bill from advancing.
 Moreover, at the time, many Republicans wanted to find bipartisan solutions whenever possible. Henry Claypool, who has been working on Medicaid policy in and out of government since the 1990s, told me that the Deficit Reduction Act of 2005 did include some Republican changes to eligibility, but also expanded support for home- and community-based services in ways that have helped many disabled Americans.
Today, everything has changed. House Speaker Paul D. Ryan (R-Wis.) has been proposing block grants since 2010, but he had no chance to get them enacted under President Barack Obama. Now, he and McConnell have co-opted the legislation intended to fulfill GOP promises to “repeal Obamacare” (which would be bad enough) as a way to sneak through decades-long assaults on the basic American promise of Medicaid.

This time, the phrasing is “per capita caps.”

Thursday, June 22, 2017

Juice and Stereotypes

Zuma Juice made the worst piece of disability stereotyping commercial I've ever seen. The disability community let them know what was going on, and I wrote it up for Pacific Standard.
This ad trades on two of the most pervasive stereotypes facing disabled folks. First, that their disability is attributable to poor lifestyle choices—i.e. drinking soda and eating junk food. Second, that lots of them are faking and are just lazy. The choices in this ad reflect deeply held stigmas about bodies, health, and disability. As we've reported at Pacific Standard, people working to cut disability benefits tend to blame disabled people for their disabilities, while simultaneously accusing many people receiving those benefits of having perpetrated fraud. Moreover, the belief that lots of people are just pretending to be disabled leads to public accusations and humiliation, even violence.
See more on the ad here.

Police Violence, Race, and Stigma in Chicago

I was recently on a boat with a friend who said - I never read Twitter or Facebook any more, but I do check your blog for new stuff. So when I publish new pieces, I'm posting little excerpts here. Hi Melissa! :)

How do you find my stories? What's the role of the blog for you today? Let me know ... maybe on Twitter.

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My first feature for The Guardian is on the intersections of racism, poverty, and trauma in Chicago, and the black disabled leaders working to make a better city. They are fighting police violence, working to educate their communities on disability, and it was an honor to talk to them and write this:
Chris lives in Ogden Park in Englewood, a neighborhood on the South Side of Chicago, where I drove to meet him. As the hot afternoon waned, we spent an hour in the shade of the sycamore trees, sitting on a slanted wooden bench, talking.
He was restless. He sat. He stood up. He paced and smoked. Piece by piece, Chris revealed his theories about disability, race, poverty, policing and the vicious cycle in which Chicago’s disabled black residents have found themselves.
Chris Huff is a member of Advance Youth Leadership Power(AYLP), an advocacy group organized through Access Living, one of Chicago’s leading disability rights organizations. They have taken on a complicated twofold mission.
First, they are trying to teach those concerned about police conduct, including the US justice department (DoJ) taskforce, to see the disability component in the broader narrative of an abusive Chicago police department – especially as a third to half of people killed by police have a disability. Second, and perhaps even more critically, these activists are hoping to help their own communities perceive the links between disability and racial and economic justice.
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Monday, June 19, 2017

Privacy Laws: Substitutes and IEPs

In my recent piece on criminalization of autistic children, I wrote: 
The prosecutor's office told me they could not discuss the case because Ashton was a minor. The school district told me they could not discuss any individuals because of federal privacy law (namely the Family Educational Rights and Privacy Act, or FERPA), and did not respond to a follow-up email asking to discuss the conditions in the district for children with IEPs and 504 plans more generally. The Student Press Law Center notes that privacy laws are often used to protect institutions from having to comment to the press, rather than protecting individuals, and that seems to be the case here.
I'm going to be following up on this. One issue that emerged in the interviews and the comments related to whether substitutes can see IEPs/504s. Schools frequently defend their poor responses to behaviors by saying subs didn't know ... but they must know.
Your school administrators may incorrectly believe the IEP is confidential.
If so, the administrator thinks he cannot release it to teachers and other staff members. This is not true.Schools can release confidential information about your child to anyone at school who has a genuine need for that information.
From the Federal Special Education Regulations –
34 CFR 300.323 (d) Accessibility of child’s IEP to teachers and others.  Each public agency must ensure that-
(1) The child’s IEP is accessible to each regular education teacher, special education teacher, related services providers, and any other service provider who is responsible for its implementation; and
(2) Each teacher and provider described in paragraph (d)(1) of this section is informed of-
(i) His or her specific responsibilities related to implementing the child’s IEP; and
(ii) The specific accommodations, modifications, and supports that must be provided for the child in accordance with the IEP.
We need to reclaim privacy laws and use them to protect individuals, not institutions.


Friday, June 16, 2017

Disability Myths in Higher Ed

Too many college professors treat requests for reasonable accommodations as either students trying to get away with something (extra time, for example, on assignments) or signs of poor moral character (toughen up!). I would like such statements treated with the same care as casual racism, classism, sexism, and other forms of bigotry. Which isn't to say we always handle those well.

Three professors have written a terrific essay for The Chronicle on attacking these "disability myths."
We live in a time where the discourse of diversity is practically a bumper sticker found in faculty orientation packets. Yet the presence of disabled students in our classrooms is too often presented as an anomalous burden, a challenge to be met. Its overarching goal? To normalize disabilities by setting them up as simple problems to be easily overcome.
We saw a good example of that in a recent advice essay in The Chronicle — "Why I Dread the Accommodations Talk," by Gail A Hornstein. While her efforts as an ally of disability rights are certainly appreciated, her rhetoric — labeling disability conversations with students as something to dread — is dangerous, not just for the students it minimizes, but for the "advice" it offers to faculty members.
Disability activists and theorists such as Simi Linton and Margaret Price have been working for years to combat and dispel calcified and problematic tropes about disability. Unfortunately, Hornstein’s essay served to perpetuate them: the myth of overcoming disability (or what Hornstein labels "resiliency"), the trope of the able-savior, and the notion that disability itself is inherently deficient and, thus, runs contrary to academic life. We’d like to explore each of those in turn and then share some of our own suggestions for handling "the accommodations talk."
As always, READ THE WHOLE THING.

Thursday, June 15, 2017

Seanan McGuire - INTERVIEW

I have a new interview up with Seanan McGuire, the awesome speculative fiction author. We talked about her new portal fantasy, Down Among the Sticks and Bones, her genre-queering approach to writing, and, of course, My Little Pony.

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When you were a kid, what did you read, and what did you feel was missing in the fantasy that you consumed?
I grew up on welfare, which I bring up a lot because it's really relevant to what I used to read. Growing up super poor, you read what your mom brings home because you can't get anything else. My mother would come home from flea markets and yard sales with these gigantic boxes of whatever people were getting rid of. She was bringing books with unicorns and space ships on them for her nine-year-old, so I was getting science fiction that was 20 years out of date and I grew up on that.
There were virtually no women [in those books]. What I noticed was that only boys got to have adventures and go out and fight dragons or befriend dragons. Then a woman would show up and she would, 90 percent of the time, be a sexual reward for the guys for going out and having these adventures that were never offered to her in the first place. I didn't want to sit at home and then have sex with the hero when he came back from going on this grand quest.

Tuesday, June 13, 2017

Segregated Proms are Segregated

A segregated DC school throws a segregated prom and applauds itself for its segregation. Everyone in this story has nothing but good intent. They are working hard for their students. But this is the wrong attitude.
“If we had these students in a conventional school, they’d probably sit in a corner and not engage, or they’d be made fun of,” says AimeĆ© Cepeda, principal at River Terrace. “Here, they get to celebrate with their peers.”
That's a justification for intensifying segregation, as David Rosenblatt said:
Disability segregation does sometimes happen in our educational system (and housing, workforce, etc.). We should always be working to turn it back towards inclusiveness, not celebrating our segregation.

Monday, June 12, 2017

Pacific Standard: Why American Keeps Criminalizing Disabled Children of Color

I have a longform piece for Pacific Standard today. I've been working on it for about 6 weeks. Please read and share throughout your networks, if you are so inclined. TWs for abuse of children by authorities.
"Why would a school cop in Florida throw a slender, autistic fourth-grade student to the ground? You might assume that the child must have presented some kind of serious threat to himself or others, that other skilled experts had already tried de-escalating interventions, and that there was no other choice. Such was not the case for 10-year-old Seraph Jones. This spring, a school cop threw him down and held him against the ground with sufficient force to cause rug burn.

It turns out that Seraph's worst day at school—so far—happened because he was clicking a key too loudly, then ended up trapped in a situation where he had no good way to safely calm down."

Friday, June 9, 2017

Saint Wars and Russian Cinema

My scholarly work centers around a simple premise: When you make a saint, you gotta tell a story. The same holds true for when you move a saint, create relics, place relics in new locations, develop new festivals. These sacred acts can have enormous cultural and political consequences, but only if you tell the right story.

In Russia, pro-authoritarians have been resurrecting (pun intended) the notion that Tsar Nicholas II was a saint and martyr due to his execution by the Communists. That's one story. Now a major Russian motion picture shows him in love with a ballet dancer (which is true), and one not appropriately beautiful or Russian-looking enough for the authoritarians. Controversy follows.

New York Times reporter Neil MacFarquhar has a fabulous feature on the controversy. Here's an excerpt.
That has done little to douse the hostility from the Russian Orthodox Church and its adherents. Some want the movie banned, while the most extreme have threatened to torch movie theaters that show it.
The main objection from the church is that because Czar Nicholas II and his wife were canonized in 2000, the movie is an insult to the faithful, which is a crime in Russia.
“This film represents, in my opinion, the apotheosis of vulgarity,” Bishop Hilarion, the head of the church’s external relations department, said on television, noting that the director had invited him to view a rough cut. The bishop conceded that there had been some manner of love affair, although he dismissed it as a youthful infatuation.
And
Even as Mr. Uchitel acknowledged that the movie contained elements of fantasy, he questioned the historical interpretation used by his religious critics. Nicholas II became a sainted martyr because of the way he and his family died — in a hail of bullets fired by a Bolshevik firing squad — not because of the way he lived.
“Their main concern is that since he was shot with his whole family, and thus became a saint, he could not have had any affairs,” Mr. Uchitel said. “On the contrary, it is totally correct to show him in this human way.”
Making saints requires stories. As always, READ THE WHOLE THING.