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<DIV style="FONT: 10pt arial">----- Original Message -----
<DIV style="BACKGROUND: #e4e4e4; font-color: black"><B>From:</B> <A
title=blemoine@afb.net href="mailto:blemoine@afb.net">AFB DirectConnect</A>
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<DIV><B>To:</B> <A title=afbweb@afb.net href="mailto:afbweb@afb.net">AFB
Subscriber</A> </DIV>
<DIV><B>Sent:</B> Monday, June 01, 2009 3:32 PM</DIV>
<DIV><B>Subject:</B> Reminder: Sign-On to Health Reform and Vision Loss Letter
by noon on June 3rd</DIV></DIV>
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<P><STRONG>Reminder: Sign-On to Health Reform and Vision Loss Letter by noon on
June 3rd</STRONG><BR><BR>For further information, contact--<BR><BR>Mark
Richert<BR>Director, Public Policy<BR>American Foundation for the
Blind<BR>202-822-0833<BR><A
href="mailto:mrichert@afb.net">mrichert@afb.net</A><BR><BR>Leadership in
Congress needs to hear from the vision loss community immediately to ensure that
policy addressing the unique health care needs of people who are blind or
visually impaired is part of comprehensive health care reform legislation. You
are invited to join in a sign-on letter to be delivered by AFB next week to the
chairs and ranking members of the committees of the U.S. Senate and House of
Representatives with particular responsibility for health care legislation.
Copies of the letter will also be delivered to senior House and Senate
leadership of both parties.<BR><BR>If your organization can sign on to the
letter below, please forward the complete name of your organization (no
abbreviations please) to <A href="mailto:blemoine@afb.net">blemoine@afb.net</A>
by noon on Wednesday, June 3. <BR><BR>Organizational names will be listed
alphabetically at the end of the letter; no actual signatures are necessary. We
strongly encourage all organizations of and for people who are blind or visually
impaired to join in this effort, and please share this sign-on request widely
inviting any groups beyond our field to join us as well.<BR><BR><STRONG>The
letter's text follows--</STRONG><BR><BR>We, the undersigned organizations
representing, serving, and advocating for the more than 20 million Americans of
all ages experiencing significant vision loss, urge you to exercise your
leadership to ensure that any comprehensive health reform legislation enacted by
the 111th Congress adequately addresses the needs and rights of individuals
living with vision loss. Specifically, we call upon Congress to send to
President Obama legislation that, at a minimum<BR><BR>• ensures that individuals
with vision loss and other disabilities can properly identify and take
medications by mandating appropriate labeling standards and methods for
providing nonvisual and enhanced visual access to drug container labeling and
related information;<BR><BR>• establishes clear Medicare (or other national
minimum benefit plan) coverage for, and fosters broader private plan
availability of, low vision devices and other medically necessary assistive
technologies; and<BR><BR>• allows orientation and mobility specialists, vision
rehabilitation therapists, and low vision therapists to be full participants in
the professional team providing specialized services to people with vision loss
by establishing unambiguous Medicare (or other national minimum benefit plan)
reimbursement for the services such professionals offer.<BR><BR>Congress is
currently weighing a variety of health care policy options that have the
potential to fundamentally transform the scope and delivery of health care to
all Americans. While many of these policy options could be of significant
benefit to Americans with vision loss, we are concerned that proper attention is
not being given in the policy debate to several basic health care needs
experienced by people who are blind or visually impaired. We therefore ask for
your help to craft and enact policy solutions as part of health care reform to
address these unmet needs.<BR><BR><STRONG>Drug Label
Information</STRONG><BR><BR><STRONG>Current Law:</STRONG> No state in the union
clearly requires labeling of prescription or other medications to be accessible
to individuals with vision loss through minimum large print font size, audible
labeling technologies, tactile markings or braille, or other methods calculated
to provide alternatives to visual use of medication labeling and related
information. Moreover, current federal law places no meaningful requirements on
such labeling to ensure nonvisual and enhanced visual access. Additionally,
while retail pharmacies can be held accountable for providing some degree of
access to label information under the Americans with Disabilities Act, the ADA
neither provides standards for pharmacies to follow nor establishes a consistent
national policy ensuring that customers will, upon request, be provided the
nonvisual or enhanced visual means of their choice to use drug labeling safely
and independently. The failure to make medication labeling accessible to people
with vision loss has been shown to lead to significant health risks (see e.g.,
consumer survey conducted by the American Foundation for the Blind at <A
href="http://www.afb.org/labels">www.afb.org/labels</A>).<BR><BR><STRONG>Proposed
Policy:</STRONG> Congress should enact legislation requiring retail pharmacies
to offer, upon the request of a customer, nonvisual or enhanced visual means for
using medication labeling and related print information safely and
independently. The means to accomplish label accessibility must be the means of
the customer's choice and conform to national minimum standards to ensure
customer privacy, consistency and reliability.<BR><BR><STRONG>Low Vision Devices
and Other Medically Necessary Assistive
Technology</STRONG><BR><BR><STRONG>Current Law:</STRONG> Very few private health
plans offer customers access to low vision devices or other assistive
technologies that maximize remaining usable vision or otherwise provide
nonvisual access to information and the environment. Moreover, the Centers for
Medicare and Medicaid Services (CMS) refuse Medicare coverage of any device that
employs one or more lenses regardless of a device's other technological features
simply on the grounds that devices using lenses fall within the long-standing
statutory bar on coverage for eye glasses. Other categories of assistive
technology are routinely denied coverage on the grounds that they are
convenience items, are not primarily for use in the home, or on other erroneous
bases. People with vision loss can use low vision devices and other assistive
technologies to manage their health care needs, properly identify medications,
maintain proper diet, and ensure safe mobility at home and in community. Along
with appropriate rehabilitation services, low vision devices and other assistive
technologies prevent injury and the acquiring of additional disabling
conditions.<BR><BR><STRONG>Proposed Policy:</STRONG> Congress must overturn the
CMS regulation barring coverage for low vision devices and establish clear
criteria for their provision. Such criteria should acknowledge other distinctive
features employed by the most valuable low vision devices, other than their mere
use of a lens, such as a device's integration of a light source, use of
electrical power, or other distinctive features. In addition, Congress must
establish clear parameters for CMS to follow to provide Medicare beneficiaries
with vision loss access to assistive technologies meeting their unique
needs.<BR><BR><STRONG>Vision Rehabilitation</STRONG><BR><BR><STRONG>Current
Law:</STRONG> Medicare currently pays for some forms of vision rehabilitation
services provided under the direct supervision of a physician and offered by an
array of state licensed personnel. However, orientation and mobility
specialists, vision rehabilitation therapists, and low vision therapists,
professionals who are explicitly trained to provide such vision rehabilitation
services, are not among the professional disciplines recognized for purposes of
Medicare reimbursement. This means that, while the services offered by other
professionals--such as occupational and physical therapists--are services
provided by personnel who are regularly part of the team of providers offering
some limited form of vision rehabilitation addressing, for example, a
beneficiary's needs for daily living skills training or other related services,
the professional team is incomplete. As a result, beneficiaries are not ensured
access to the full range of quality services, such as orientation and mobility,
provided by the best qualified professional disciplines. Moreover, since the
limited vision rehabilitation-like services that CMS will pay for must be
provided under strict physician supervision, these services, which are most
relevant when offered in a beneficiary's home or in community, are diminished in
effectiveness. Finally, a Medicare demonstration project currently being
undertaken to assess vision rehabilitation reimbursement has such significant
design and administrative flaws that Congress should not wait for its
conclusions or have confidence in their validity.<BR><BR><STRONG>Proposed
Policy:</STRONG> Congress must establish unambiguous coverage for the services
offered to Medicare beneficiaries by orientation and mobility specialists,
vision rehabilitation therapists, and low vision therapists to allow the most
qualified and complete team of professional service providers to meet the unique
needs of individuals with vision loss. Such services should be allowed to be
provided in a beneficiary's home and community to maximize their
effectiveness.<BR><BR>Thank you for your thoughtful consideration and for your
advocacy on behalf of Americans living with vision loss. We look forward to
working closely with you as health reform moves
forward.<BR><BR>Respectfully,<BR><BR>[organizations listed
alphabetically]<BR><BR></P>
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