BACKGROUND
The Colorado Cross-Disability Coalition (CCDC), a statewide organization operated by and for people with disabilities, works to ensure full participation of all people with all types of disabilities in society. The CCDC offers numerous programs and services including legal aid, advocacy, training, resources, and regional groups to achieve its mission of independence, self-reliance, and full participation of people with disabilities. In addition, the CCDC is very involved in policy development and the legislative process in Colorado to protect and support the rights of people with disabilities. Historically, the CCDC focuses significant effort on the implementation of the Americans with Disabilities Act and health care issues.
STATE WHY A POLICY NEEDS TO BE DEVELOPED OR MODIFIED
The proposed Senate Bill 05-102 would change a Medicaid program and adversely affect the quality of health care experienced by people with disabilities.
STUDY THE ISSUE A POLICY CHANGE WOULD AFFECT
Numerous people with disabilities depend on Medicaid funding to meet their health care needs. There should be a policy that guarantees that all people with disabilities receive quality health care. As many as one-fifth of all people with disabilities are enrolled in Medicaid and may have no other source of health insurance. Often a reduction in Medicaid funding or change in Medicaid programs greatly affects the health care of people with disabilities. While program change can be positive, the proposed Senate bill would negatively affect health care quality, according to the CCDC. The CCDC is working to ensure that the legislation blocks this bill or the governor vetoes it.
The ideal solution is health care coverage for people with disabilities that is not dependent on the program ideas or budget decisions of politicians.
BASED ON THE KNOWLEDGE ABOUT THE ISSUE AND WHO IT AFFECTS, INDICATE THE TYPE AND CONTEXT OF POLICIES TO BE DEVELOPED
Because this issue is a part of the legislative process, it is a regulatory policy.
STATE WHAT YOUR GROUP WILL DO TO INFLUENCE EACH OF THE STAGES OF POLICY DEVELOPMENT
The Colorado Cross-Disability Coalition’s active membership works together to bring important issues to the attention of decision makers. The CCDC uses its website to alert members when an issue needs attention and posts information about the issue on the website. Members then call and write their elected officials about the issue. At the same time, the CCDC director and other staff meet with key legislators, other organization leaders, and political leaders such as the governor to discuss the issue.
One of the most important goals of the CCDC is to serve on the committees that shape policy. Some committees require an appointment by the governor or some other formal body and some do not, but all are public meetings. The CCDC has seats on four statewide boards that relate to Medicaid such as the Medicaid Re-Design Committee and the Medicaid Advisory Committee for People with Disabilities. The local CCDC groups also coordinate members to ensure adequate representation at the local level on various boards and committees.
IDENTIFY RESOURCES TO BE USED
CCDC has 11 paid and unpaid staff and volunteers and numerous members who are available and committed to working on the problem. Most of the staff and volunteers have extensive background and experience with advocacy and disability rights issues. The organization is a non-profit with a limited budget, so little money is used on policy development. Most of the effort is the time and energy of volunteers.
IDENTIFY POTENCIAL ALLIES AND OPPONENTS OF POLICY DEVELOPMENT EFFORTS
CCDC’s allies for this issue are Colorado’s chapter of the National Alliance for the Mentally Ill and the Colorado Gerontological Society. Both organizations oppose the Senate bill because their constituents also rely on Medicaid for health care. Because of the Medicaid changes proposed in this bill that involve prescription drugs, groups representing minorities are also potential allies in this issue.
Opponents to the issue support the Senate bill and want the Medicaid change that involves the use of prescription drug list for Medicaid patients as a cost saving measure. Potential opponents to the issue include legislators who want to save Medicaid dollars and address prescription drug issues. These opponents can be countered by helping them understand the issues at stake for people with disabilities and how this change to Medicaid would risk the quality of this population’s health care. The best way to deal with the opposition is to tell “your story” and help them understand from the point of view of the person with the disability.
IDENTIFY TARGETS AND AGENTS OF POLICY CHANGE EFFORTS AND THEIR ASSETS AND INTERESTS
Targets of change are the elected officials who will vote on this Senate bill and propose future legislation that affects Medicaid funding and programs. Agents of change are the advocates and special interest groups such as CCDC and other allies who can influence the elected officials and sway their vote.
They should support the position of the CCDC on this Senate bill because they recognize how it can harm the quality of health care received by people with disabilities who rely on Medicaid. They benefit by receiving the support of the CCDC and other allies, which could represent a strong voter base. The issue may not affect legislators directly, but it is likely that they know someone with a disability who depends on Medicaid.
DEPENDING ON THE BROAD GOAL OF YOUR POLICY DEVELOPMENT EFFORTS, CHOOSE THE STRATEGIES AND ACTION PLAN TO BE USED
During the legislative session, the CCDC takes the following steps to mark its role in the policymaking process and to ensure that the interests of people with disabilities are represented at the State Capitol.
- Read every proposed bill.
- Those bills that contain issues relevant to people with disabilities are analyzed for the CCDC membership and relevant information posted on the website.
- CCDC lobbyists attend regular legislative committees to build relationships with legislators and educate them about issues important to people with disabilities.
- If a specific bill needs to be addressed or policy changed, then the membership is alerted and asked to contact elected officials through a letter writing campaign.
- If necessary, a formal complaint may be filed or legal action taken depending on the policy that is being addressed. However, this is rarely the case with legislative action.
REVIEW WHETHER PLANNED POLICY GOALS FIT THE SITUATION
The usual steps taken to address policy issues are appropriate for this situation. The only step that will not be necessary is a formal complaint or legal action.
CREATE AN ACTION PLAN TO CARRY OUT YOUR POLICY EFFORTS
The action plan involves the following steps:
- Read and analyze the proposed Senate bill(s).
- Post an alert on the website and request that membership write elected officials about the bill and how it affects individuals with disabilities.
- CCDC director and volunteer lobbyist attend committee meetings related to the Senate bill.
- CCDC director and other members meet with legislators and testify before Senate regarding the bill to educate them about how it will adversely affect people with disabilities who rely on Medicaid.
- Gather support of allies.
- Continue to follow the Senate bill until a decision is made within the legislature.
All these steps involve a mix of CCDC staff and volunteers. The timeframe depends on the legislative process. Staff and volunteer time are the majority of the resources required for the effort.
ASSESING THE EVALUATION OF THE POLICY DEVELOPMENT EFFORT
A successful effort is indicated by a proposed Senate bill that does not pass the through the legislature or is vetoed by the governor (if the bill would be harmful to the well-being of individuals with disabilities). Follow-up measures may be required pending the outcome of the legislative process, especially if the vote is postponed to the next session. A debriefing following the legislative session helps determine if different tactics should have been used and what can be done differently in the future.