by Melanie Brunson
I am writing this article two days after the conclusion of another very successful legislative seminar. Again this year, attendees at this year's seminar spent their final day in Washington visiting the offices of members of Congress. They took information with them about two issues which we are focusing on this year, namely Medicare coverage of low-vision devices, and the education of children who are blind or visually impaired. The text of the paper we distributed to Congressional offices is below.
Legislative Imperative: Low Vision Aid Exclusion
The Issue: In November of 2008, the Centers for Medicare and Medicaid Services (CMS) promulgated a regulation that has had a detrimental impact on the lives of countless individuals who are blind or visually impaired.
To the dismay of the blind community, the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Acquisition Rule contains a provision entitled "Low Vision Aid Exclusion" which states that all devices, "irrespective of their size, form, or technological features that use one or more lens to aid vision or provide magnification of images for impaired vision" are excluded from Medicare coverage based on the statutory "eyeglass" exclusion. ACB is well aware that this extremely restrictive reading of the "eyeglass" exclusion has resulted in the denial of vital assistive devices for seniors and other Medicare beneficiaries who may have disabilities, particularly those with vision loss, who need to use such devices to live healthy, safe and independent lives.
This proposal has had a significant impact on beneficiaries with vision impairments who depend on assistive technology that incorporates "one or more lens" to aid in their vision. The expansion of the eyeglass exclusion has prevented access to devices such as hand-held magnifiers, video monitors, and other technologies that utilize lenses to enhance vision.
ACB urges Congress to introduce and promptly pass the Medicare Demonstration of Coverage for Low Vision Devices Act of 2013.
This legislation would evaluate, through a five-year national demonstration project administered by the Department of Health and Human Services, the fiscal impact of a permanent change to the Social Security Act. This legislation would allow reimbursement for certain low-vision devices that cost $500 or more as durable medical equipment.
Individuals will be eligible to participate in the demonstration project only after completing a low-vision exam performed by a physician who would then deem a low-vision device as medically necessary.
The national demonstration project is designed to provide a rich, well-structured and defined data set that can yield Medicare-program-wide evidence-based conclusions using appropriate statistical methods.
Legislative Imperative: The Anne Sullivan Macy Act
The Issue: Since 1975, Public Law 94-142, now the Individuals with Disabilities Education Act (IDEA), has revolutionized educational opportunity for all children and youth with disabilities. However, without key improvements, our national special-education system cannot fully keep IDEA's promise of a truly appropriate education for students who are blind or visually impaired. The Anne Sullivan Macy Act is intended to do just that, to improve the delivery of appropriate special education and related services to all students who are blind or visually impaired, including students who may have additional disabilities. Once enacted, the legislation will ensure that properly designed and individually tailored services are in fact provided, meeting the unique learning needs of students who are blind or visually impaired and that the educators who serve them are prepared and supported to do their jobs well, based on evidence-driven best practice.
ACB urges Congress to introduce and promptly pass the Anne Sullivan Macy Act. This legislation will:
- Ensure that every student with vision loss is properly identified regardless of formal disability category or classification so that all students who are blind or visually impaired, including those with additional disabilities, are counted and properly served;
- Expand knowledge about the scope and quality of special education and related services provided to students who are blind or visually impaired through refined data collection that tracks all students with vision loss, regardless of formal disability category or classification;
- Expect states to conduct strategic planning, and commit such planning to writing, to guarantee that all students who are blind or visually impaired within each state receive all specialized instruction and services needed by students with vision loss provided by properly trained personnel;
- Clarify that proper evaluation of students who are blind or visually impaired includes evaluation for students' needs for instruction in communication and productivity (including braille instruction, and assistive technology proficiency inclusive of low-vision devices where appropriate); self-sufficiency and interaction (including orientation and mobility, self-determination, sensory efficiency, socialization, recreation and fitness, and independent living skills); and age-appropriate career education. Such instruction and services constitute the Expanded Core Curriculum, the body of services which teachers of students with visual impairments and related professions are expertly trained to provide;
- Ramp up U.S. Department of Education responsibilities to monitor and report on states' compliance with their obligations with respect to instruction and services specifically provided to students who are blind or visually impaired;
- Assist parents and educators of students who are blind or visually impaired through regular and up-to-date written policy guidance from the U.S. Department of Education; and
- Establish a national collaborative organizational resource, the Anne Sullivan Macy Center on Vision Loss and Educational Excellence, to proliferate evidence-based practices in the education of students who are blind or visually impaired, to keep special educators current with the latest instructional methods, and to supplement state and local educational agency provision of the instruction and services constituting the Expanded Core Curriculum.
For more information, contact Eric Bridges, ACB's director of advocacy and governmental affairs. He can be reached by phone at (202) 467-5081, or 1-800-424-8666. His e-mail address is [email protected].