Wednesday, September 12, 2012

Upward Bound and Forward

New resources help older Americans and people with disabilities maintain their independence

Seniors, people with disabilities and their families get assistance from local resource centers
Health and Human Services (HHS) Secretary Kathleen Sebelius announced $12.5 million in awards to Aging and Disability Resource Centers (ADRCs) to support older Americans and people with disabilities stay independent and receive long-term services and supports. In recognition of  National HIV and Aging Awareness Day, September 18, 2012, COP 24/7 will be highlighting a series of items that address this significant population and the result impact of the HIV/AIDS health delimma has played within it. This is most notable due to the fact that many long term survivors are now reaching ages that most likely will usher them into the medicare
realm as some now have crossed the threshold of Sixty years of age.
This forum will continue to explore the challenges and barriers that present themselves as well as
possible solutions that should be considered for those dealing with "aging issues."

These grants, funded by the Affordable Care Act and the Older Americans Act, support counselors who help individuals and their caregivers identify and access long-term services and supports, regardless of income or financial assets.
“Whether someone is in the hospital and ready to be discharged, or living at home but needing additional care, an options counselor can help them evaluate their needs and sift through the options available in their community to create a plan that meets their needs,” Secretary Sebelius said.
ADRCs are “one-stop shops” for older adults, people with disabilities, their caregivers and families to get the information and services they need as their health and long-term care needs change.

ADRCs offer a single, coordinated system of information and access for people seeking long-term services and supports and help consumers and their families identify options that best suit their needs.
ADRCs also make it easier for state and local governments to manage resources and monitor program quality through coordinated data collection and evaluation efforts.

The ADRCs are made possible through a collaborative effort led by the Administration on Community Living and the Centers for Medicare & Medicaid Services (CMS), both agencies of the Department of Health and Human Services. The Veterans Health Administration, an agency of the Department of Veterans Affairs, is a key partner.
Currently, all 50 states and four territories are operating or are in the process of implementing an ADRC.

Two different types of grants are being announced. Part A is for states or territories receiving an initial ADRC grant for an Enhanced ADRC Options Counseling Program. Part B is for states and territories receiving continuation funding.
For more information about the grants, recipients and the ADRC initiative, see

 Institutional Discrimination and the Case of Dr. Franke

“What if there are many other older people, and this is the first wave of them, who are not used to speaking out about anything, and they’ll just quietly pack up their blankets and leave? And I thought, damn, that’s not right.” —Dr. Robert Franke, Little Rock, AR

When the Reverend Dr. Robert Franke decided he was no longer able to care for himself, he relocated to Little Rock, AR, to be closer to his family. After a thorough search for just the right place, he applied to – and was accepted by – a tony assisted living facility in North Little Rock where he thought he could be happy. Less than a day after he moved in, Dr. Franke was forced to move out of his new home because of his HIV-status. With the help of Lambda Legal, the family sued; the case settled in 2010. Even though his case was groundbreaking including a visit to the White House,  the Rev. Dr. Robert Franke on December 27, 2011, died at the age of 78. His commitment to raising awareness and fighting injustice will surely have a positive impact on the lives of many. His fight will be honored in his memory; the commitment of his family and their legal champion, Lambda Legal; and the hard work of all those who fight against HIV-related discrimination every day.

Lambda Legal has created a variety of tool kits that can inform members of the LGBT and HIV/AIDS communities about their rights in different contexts, including “When Health Care Isn’t Caring,” the first survey to examine barriers to health care (including refusal of care) among these communities on a national scale. They have also produced helpful Fact Sheets on a variety of topics, including “HIV Stigma and Discrimination in the US.”
An assisted living facility is both a form of housing and a health care provider. Legal mandates regarding housing discrimination can vary from state to state, but federal fair housing laws explicitly forbid housing discrimination “based on race, color, national origin, religion, sex, familial status…and handicap (disability).” According to the Americans with Disabilities Act (ADA), “An individual is considered to have a ‘disability’ if he or she has a physical or mental impairment that substantially limits one or more major life activities, has a record of such impairment, or is regarded as having such impairment. Persons with HIV disease, either symptomatic or asymptomatic, have physical impairments that substantially limit one or more major life activities and thus are protected by the ADA.”

If you or someone you care about is experiencing HIV-related institutional discrimination, there are a number of resources out there that may help:
The Well Project’s website can answer many basic questions about your rights; care providers might find many of their questions answered by the “Discrimination and HIV/AIDS: A Factsheet for Practitioners” page on The National Association of Social Workers site. The website for the US Department of Housing and Urban Development (HUD) has an entire subsection that focuses on fair housing laws that includes, among other things, a library of relevant publications and links that allow victims of discrimination to file a complaint in eight different languages. The US Department of Justice is also committed to protecting your rights under the Americans with Disabilities Act (ADA).
But sorting through all of the information out there can be overwhelming, and it is often wise to consult with an attorney to clarify how your rights are — and are not — currently protected under the law. Lambda Legal can take on only a small number of cases, but through their legal help desk (in English and in Spanish) they can refer you to other organizations that can help; can answer some of your questions (if you fill out their on-line form); and can suggest some important questions to ask when you looking for an attorney who can help you with your situation. The National Senior Citizens Law Center offers a number of links to other organizations that might also be able to help, including the National Academy of Elder Law Attorneys.
Not surprisingly, institutional discrimination against people living with HIV/AIDS in health care settings is a worldwide problem. The HRH Global Resource Center offers a variety of articles, training materials, and other resources that speak to how these issues are being addressed in other countries. The World Medical Association very clearly outlines the rights of patients to receive quality care without being subjected to provider discrimination. A number of researchers, organizations, and independent projects (like The Graying of AIDS) are looking at how we might best tackle issues related to HIV-related discrimination on the part of care providers; this article from the Journal of the International AIDS Society offers an excellent introduction to some of the issues involved when fighting discrimination in health care settings.
Around the world, provider ignorance and fear are getting in the way of quality patient care; we must work together to better educate those providing care today and the care providers of tomorrow.
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