Young Adults Will Soon Be Able To Remain on Parents’ Health Plans

Last Updated: 8/20/2010

Help is available for families of children with special needs whose private health insurance will no longer cover children once they reach a certain age. The new federal health insurance law requires many private insurers to allow children to remain on their parents’ health insurance plans until they are 26 years old.

Families of children with special needs who have private health insurance, typically through work, face a dilemma when their child gets older. Under many private health insurance plans, coverage for children ends once the child reaches a certain age — typically 21, depending on state law. Although some private insurance plans allow parents of a child with disabilities to continue coverage well into the child’s adult years, many plans terminate coverage regardless of the child’s disability status. At that point, parents must obtain alternate health insurance for their child, often through Medicaid or some other state or federal program.

There is some good news for families who find themselves in this position. As part of this year’s healthcare reform law, many private insurers must allow children to remain on their parents’ health insurance plans as dependent family members until they are 26 years old. While some states may require insurance plans to extend coverage even further than this, the new law makes sure that all children will have access to their parents’ insurance until at least age 26.

Unlike many provisions of the new law that do not go into effect until 2014, the age limit requirement begins to take effect in October 2010 and must be completely in effect as of the new year. Although the law applies to many types of employer-provided group health insurance, it does not apply to state-sponsored plans or ERISA plans. However, for a majority of families who receive health insurance through their employers, the new law adds several years of certainly to what was previously an unclear future for their children with special needs.

Attention Deficit Hyperactivity Disorder (ADHD) Information

ADHD is a persistent pattern of inattention or hyperactivity/impulsivity manifested in academic, employment, or social situations. There are three distinct subtypes of ADHD. The Inattentive Subtype primarily involves difficulty consistently directing and sustaining one’s attention. The Hyperactive Subtype primarily involves severe restlessness or difficulty remaining still, and in some cases difficulty controlling one’s impulses. The Combined Subtype describes people who demonstrate a significant portion of both Inattentive and Hyperactive symptoms.

Onset & Characterizations

ADHD arises during childhood and is not attributed to gross neurological, sensory, language or motor impairment, mental retardation, or severe emotional disturbance. It is marked in school settings by careless mistakes and disorganized work. Students often have difficulty concentrating on and completing tasks, frequently shifting from one uncompleted activity to another. In social situations, inattention may be apparent by frequent shifts in conversation, poor listening comprehension, and not following the details or rules of games and other activities. Symptoms of hyperactivity may take the form of restlessness and difficulty with quiet activities. Students with ADHD often have significant problems with time-management, task-completion, organization and memory.

Some Considerations

• ADHD is not a form of mental retardation or emotional disorder
• ADHD is not a disorder that a student “grows out of”. Diagnostic criteria for ADHD in adults include current, persistent attention difficulties.
• Errors in the written work of students with ADHD may appear to be “careless” but actually are the result of the disability.
• Common accommodations for students with ADHD are notetaking assistance, taped lectures, a quiet test environment, extended time on tests, priority registration, early syllabus and study skills/strategies training.

Instructional Strategies

The following strategies are suggested to enhance the accessibility of courses instruction, materials, and activities. They are general strategies designed to support individualized reasonable accommodations.

• Include a Disability Access Statement on the syllabus, inviting students with disabilities to request accommodations.

• Students with ADHD generally perform better if given a syllabus with clear explanations of tasks and specific due-dates.

• As the semester progresses, verbal reminders in class of impending deadlines (e.g.” Remember, the problem sets are due Friday”) are very helpful to students with ADHD.

• Assist the student with finding an effective notetaker, if the student is eligible for this service.

• Allow the student to tape-record lectures.

• Whenever possible, start each lecture with a summary of material to be covered or provide a written outline. Broad margins and triple-spacing on handouts enables students to take notes directly onto the outline, an aid to organization. Provide a review of the major points at the conclusion of each lecture.

• Avoid making assignments in oral form only, since students with ADHD may miss them. In addition to oral announcements, write assignments on the board or pass them out in written form.

• Students with ADHD may tend to “drift” mentally during class, especially during long lectures. They are better able to stay focused when the class format is varied, as when lecture alternates with presentation and class discussion.

• For large projects or long papers, students with ADHD benefit from assistance with breaking the task down into its component parts and setting deadlines for each part.

• Since they are often distractible, students with ADHD benefit from preferential seating near the front of the class or away from possible sources of distraction like windows, doors or noisy heaters.

• When in doubt about how to assist the student, ask him or her.

• Allow the student the same anonymity as other students (i.e., avoid pointing out the student or the alternative arrangements to the rest of the class).

The Disability Pride Parade will take place in 2010 on July 24th.
Not only will there be the parade but there will also be exhibits in Daley Center of organizations which serve individuals with disabilities.

The overall mission of the Disability Pride Parade is:

To change the way people think about and define “disability”;
To break down and end the internalized shame among people with Disabilities; and
To promote the belief in society that Disability is a natural and beautiful part of human diversity in which people living with Disabilities can take pride.

The specific objectives for the parade are:

To organize a fully inclusive, annual event that will celebrate and strengthen the pride, power, and unity of people with disabilities, our families, and allies;
To generate national visibility of the Disability community

At the request of Sage Publications, Sarah Triano wrote the following definition of “Disability Pride” for the Encyclopedia of Disability:

” ‘Disability Pride represents a rejection of the notion that our physical, sensory, mental, and cognitive differences from the non-disabled standard are wrong or bad in any way, and is a statement of our self-acceptance, dignity and pride. It is a public expression of our belief that our disabilities are a natural part of human diversity, a celebration of our heritage and culture, and a validation of our experience. Disability Pride is an integral part of movement building, and a direct challenge to systemic ableism and stigmatizing definitions of disability. It is a militant act of self-definition, a purposive valuing of that which is socially devalued, and an attempt to untangle ourselves from the complex matrix of negative beliefs, attitudes, and feelings that grow from the dominant group’s assumption that there is something inherently wrong with our disabilities and identity.’

By Guest Blogger Laura Ibanez, Office of Disability Employment Policy (ODEP), U.S. Department of Labor

Transitioning to adulthood is not easy for many young people. There are a number of circumstances that can create challenges during this time. These can include the typical anxiety experienced by most youth, or more serious issues such as substance use, mental health issues, poverty, separation of parents, death of family members and friends, early parenthood, etc.

Imagine dealing with circumstances such as these and trying to navigate the system to get your mental health care needs met, while simultaneously trying to figure out your place in the world and what you want to be when you grow-up. Overwhelming? Yes, it can be – which is why having mental health needs can affect how young people transition to adulthood.

In some cases, young people receive good mental health interventions and services. Having access to a supportive environment (e.g., engaged family, adult mentors, wraparound services, etc.) helps youth with mental health needs stay or get back “on track.” Yet, this isn’t the case for everyone. There are many young people with mental health needs who have limited access to mental health care services and other supportive structures. In fact, many times a person’s mental health needs are not identified until after he or she ends up institutionalized.

In addition, statistics show that youth with mental health needs are overrepresented in the Juvenile Justice and Foster Care systems:

• Youth with emotional disorders comprise over 47.4 percent of students with disabilities in secure care (juvenile justice facilities), while within public schools they account for only about eight percent of students with disabilities (Source: “Making the Right Turn: A Guide About Improving Transition Outcomes for Youth Involved in the Juvenile Corrections System”).

• A majority (just under four-fifths) of adults formerly in foster care have significant mental health disabilities (e.g., depression, social phobia, panic syndrome, anxiety, etc.), with one in four (25.2 percent) experiencing post-traumatic stress disorder (PTSD) within the previous 12 months (Source: “Negotiating the Curves Toward Employment: A Guide About Youth Involved in the Foster Care System”). 

As a family member of a young person with mental health needs and as a former youth service professional, I can’t stress enough the value of having engaged families and other caring individuals; access to effective, inclusive programs; and systems that work together to align their programs and policies that support youth with mental health needs (including both youth who are institutionalized and not institutionalized) to develop their full potential.

For More Information

If you would like information on how to help youth with mental health needs better prepare for post-secondary, education, employment and independent living, visit: http://www.ncwd-youth.info/topic/mental-health.

You can also check out the following resources from the National Collaborative on Workforce and Disability/Youth:

• Helping Youth with Mental Health Needs Avoid Transition Cliffs: Lessons from Pioneering Transition Programs (http://www.ncwd-youth.info/information-brief-24)
• Navigating Tunnels and Cliffs: Empowering Families and Caregivers to Assist Youth with Mental Health Needs in Preparing for Work (http://www.ncwd-youth.info/short-cut/navigating-tunnels-and-cliffs)
• Successful Transition Models for Youth with Mental Health Needs: A Guide for Workforce Professionals (http://www.ncwd-youth.info/information-brief-23)
• Transitioning Youth with Mental Health Needs to Meaningful Employment and Independent Living (http://www.ncwd-youth.info/white-paper/transitioning-youth-with-mental-health-needs)

A Model to End Unnecessary Institutionalization.http://www.stevegoldada.com with a searchable Archive at this site divided into different subjects. http://www.stevegoldada.com

Information Bulletin # 312 (5/2010)

It’s been 11 years since the Supreme Court ruled in the Olmstead case that unnecessary institutionalization of people with disabilities violated the ADA. On May 6, 2010, the United States Department of Justice filed a lawsuit against the State of Arkansas and its Governor, Mike Beebe. I believe this is the first legal complaint that really begins to spell out what an Olmstead violation looks like. While some of you may have become cynical or discouraged, take heart with this lawsuit. The principles are applicable to all institutions that segregate people with disabilities.

When reading over what the DOJ lawsuit alleges as a violation of the ADA, think about your State. Are the conditions in your State similar to Arkansas? Could a similar lawsuit be brought in your State? If the situation in your State is similar to Arkansas, we are confident that there are disability rights, public interest, legal aid, law school, and/or private attorneys in your state who will know how to apply the Arkansas DOJ model. Talk to them.

Because of this lawsuit’s importance, we are providing many of its highlights, albeit with some edits.

BACKGROUND:

“The State segregates hundreds of individuals with … disabilities in institutions that are not the most integrated setting appropriate to their needs, and fails to provide adequate community supports and services to individuals who are discharged from the institutions or who are at risk of institutionalization.” [Note: This applies to people who are either in institutions, or discharged from institutions, or at risk of going into an institution.]

“The State gives individuals with … disabilities the draconian choice of receiving services in segregated institutions or receiving no services at all.”

“Congregate institutions … segregate individuals with … disabilities from the community.” These institutional “settings discourage its residents from engaging independently in activities of daily living, fosters dependence on institutional supports, and erodes the skills necessary for community living.”

PERSONS CONFINED TO INSTITUTIONS:

“Most, if not all, of the residents confined to the institution can handle or benefit from community settings, and therefore can be served successfully in a more integrated setting in the community.”

“State’s treatment professionals agree that many of the residents currently confined could be served in the community with appropriate supports and services.”

“The State has not given many residents, and/or their family/guardian, the opportunity to make an informed objection to receiving services in a setting less-restrictive than the institution.”

STATE FAILS TO TRANSITION PERSONS TO THE MOST INTEGRATED SETTING APPROPRIATE TO THEIR NEEDS:

“Typically, the State does not meaningfully consider a resident for a more integrated setting unless the resident or their family/guardian proactively requests a more integrated setting.

“Most residents do not proactively request a more integrated setting because the State does not properly educate residents on what community resources are available, or the possible benefits of community placements.

“The States does not adequately assess whether residents could be served in a more integrated setting appropriate to their needs.”

“The States does not properly educate staff at the institution on how to appropriately assess a resident for community placement.

“Institution staff typically tailor an assessment of a resident’s appropriateness for community placement based upon their limited understanding of what community resources are available (or not available), rather than specifically what supports and services a resident needs in order to be adequately supported in the community.”

“While confined in the institution, residents do not receive appropriate treatment to support their eventual discharge to a less restrictive setting in the community.”

“Residents who have been confined for many years are not actively reassessed for opportunities to move to a less restrictive setting appropriate to their needs.”

“The State fails to properly evaluate individuals with disabilities for a more integrated setting before these individuals become residents of the institution. Institutionalizing these individuals fosters their dependence on institutional supports, and erodes the skills necessary for community living.”

THE STATE’S INADEQUATE COMMUNITY SERVICES:

“The State fails to provide services in the community in sufficient quality, quantity, and geographic diversity to enable individuals with disabilities to be served in the most integrated setting appropriate to their needs.”

“The State has not conducted an adequate assessment of the needs of its disability services system, including, particularly, those services necessary in order to provide services to all residents in the most integrated setting appropriate to their needs.”

“Numerous residents are confined to institutions because the services necessary to address their needs in the community are not offered by the State in sufficient quality, quantity, and geographic diversity to serve residents’ needs.”

“Many individuals with disabilities are segregated in institutions for no reason other than they are waiting for funding to become available to support their placement in a Home and Community-based waiver slot under the federal Medicaid Waiver Program.”

“The current wait list for a Home and Community-based waiver slot total approximately 1,400 people waiting for community services. This wait list moves at an extremely slow pace, with most people waiting several years for funding for community services. Individuals currently at the bottom of the wait list will likely wait more than a decade to receive community services.”

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You know your State. Does the Arkansas

complaint sound familiar? Please, get to the legal advocates in your State and tell them about what DOJ has written. This Arkansas complaint should be the first step in a cascade of other lawsuits, but only if disability advocates on a local and state level take the lead.

Steve Gold, The Disability Odyssey continues

Back issues of other Information Bulletins are available online at

To contact Steve Gold directly, write to stevegoldada@cs.com or call 215-627-7100.

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Steve Gold, The Disability Odyssey continues

Back issues of other Information Bulletins are available online at