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OFFICE OF HANDICAPPED CONCERNS
WILL'S CORNER, OKLAHOMA
(Serving the Disability Community of Oklahoma)
Volume 7, Issue 1
January, 2006
Help for Families of Children with Disabilities
TEFRA is a new Medicaid program rolled out October 1, 2005. In
today’s political climate, expansion of Medicaid is the
exception rather than the rule, but Tobacco Tax monies have
permitted this new program to be born.
At the Office of Handicapped Concerns I receive the phone calls
of desperate parents who have young children with severe
disabilities, but the families do not qualify for Medicaid
because the family income is too high. These parents have felt
that our state did not fully consider the cost of medical care,
expensive adaptive equipment, and special therapies involved in
raising a child with severe disabilities.
Sometimes these children are covered by their parent’s
insurance, but even where this is the case there are high
deductibles and co-pays and an unrelenting fight with adjustors
who want to shift the costs back to the family. Families with
respectable incomes can be reduced to poverty with high medical
costs—all because they chose to raise their children at home.
This has been the lot of all too many families who have children
with severe disabilities. The TEFRA program makes it possible
for these children to qualify for Oklahoma Medicaid even though
family income is higher than would normally qualify. Oklahoma
Medicaid becomes a support to the child’s primary insurance if
the child is covered through private insurance, and it becomes
primary in those cases where the child has no other coverage.
Families who qualify for TEFRA can breathe a sigh of relief.
In 1982 Congress in Washington, D.C. authorized states to offer
an optional Medicaid program for children with disabilities who
could be served in an institutional setting. However with the
approval of the Tobacco Tax the state now has the opportunity to
offer this program. A collaboration of the Oklahoma Health Care
Authority and the Department of Human Services met regularly for
ten months to develop this program for our state.
Let’s look at how a child may qualify for TEFRA. The child must:
•be under the age of 19
•have a Social Security number
•be a U.S. citizen or qualified alien
•be a resident of Oklahoma
•meet the Social Security definition of disability
•have been medically determined to need an institutional level
of care
•have a gross monthly income (2005) at or below $1737 and $2000
or less resources
•be safely and appropriately cared for in the home
•be cared for in the home at an estimated cost not more than an
institution.
So what steps do you take to apply for TEFRA? Call or visit your
local office of the Department of Human Services. You will be
given a PS-1 for you to complete and a TEFRA-1 for your child’s
doctor to complete. If your child is not already receiving
Supplemental Security Income (SSI), you will need to get a
letter which says your child does not qualify for SSI because of
family income. Call the Social Security Administration
(800-772-1213) for this information. You should present a copy
of this letter to the Department of Human Services.
You may also need a psychological evaluation from a Licensed
Clinical Psychologist documenting the level of functioning of
your child. You will receive a home visit from a healthcare
professional to determine the appropriateness of receiving
services in the home. The OKDHS worker must then certify the
case, and you will receive a letter telling you when benefits
begin. You will also receive a white plastic medical ID card to
use when your child needs services.
Medicaid coverage under TEFRA lasts up to twelve months. You
must reapply every year. If you need assistance in this process,
by all means ask for help from your local OKDHS representative.
I always suggest to people who are applying for any social
service program to get a manila folder and name that folder
whatever program you are applying for—in this case TEFRA. In
that folder place copies of every paper you submit to OKDHS.
Have copies ready in case some of the papers you turn in get
lost. Also keep a phone log of all your efforts with Social
Security, the doctor, the psychologist, and the OKDHS worker in
case you need that information. Who did you speak to, when did
you speak to them, and briefly what was said.
Now let’s talk about some of the benefits your child may be
eligible for if the child qualifies for TEFRA. Some of the
services paid for through TEFRA include doctor visits, hospital
care, pharmacy, medical equipment, dental care, physical
therapy, and speech therapy. This list is not exhaustive. Call
the SoonerCare Helpline toll free 800-987-7767 for more
information. Ask that written information be sent to your home
about the program so that you may better understand how this
program may benefit your family.
As a note of caution to families who may get too high
expectations, this program is paid for through the Tobacco Tax.
If Oklahoma voters decided to repeal this tax or remove that
part of the tax which funds TEFRA, the continuance of the
program would be threatened. Families who already have medical
coverage for their children with disabilities should carefully
weigh the family situation before they drop coverage of their
child. TEFRA can act as a safety net paying expenses not covered
through private insurance.
TEFRA is not a simple program to access. There are several steps
in the process for approval and a lot of information must be
gathered from multiple sources to qualify the individual child.
With that said, the benefits which a family might receive are
great. As we said earlier, call the SoonerCare Helpline for more
information (800-987-7767). Get on the Health Care Authority
website at www.okhca.org/client/programs/tefra/tefra.asp. Your
research into this new Medicaid program may be well worth the
effort.
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OHC web site:
www.ohc.state.ok.us
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Civitan Homes and Apartments
Civitan is a civic organization across the United States with
five chapters in Oklahoma: Enid, Tulsa, Broken Arrow, Sand
Springs, and Bartlesville. The Enid chapter of Civitan was
looking for a project to help the elderly and disabled of their
city back in March of 1998. They had heard inspiring stories
about another Civitan chapter which got into the field of
subsidized housing, and they decided they wanted to bring more
subsidized housing to Enid as well. Loretta Drennan who is on
the board of Civitan Homes, Inc. says that the City of Enid had
already done a study that indicated a need for 700 affordable
housing units in Garfield County (where Enid is located).
The Enid Civitan applied to the U.S. Housing and Urban
Development agency (HUD) in Washington, D.C. for a grant of $2.6
million to build and offer subsidized housing to the elderly and
disabled in Enid for forty years. That was a pretty ambitious
project for an organization with only 30 members, but they did
it anyway. They heard back from the application in November of
1998 that they needed to have land available to build their
project. This began a three-year battle with potential neighbors
in Enid who basically said NIMBY (not in my backyard).
Loretta Drennan recalls a tumultuous city hall meeting in which
angry people complained against having a subsidized housing
project in their neighborhood. Loretta courageously stood up and
reminded her detractors that if they had a birthday this year
they were also a year older. Someday they would be elderly and
disabled themselves and might appreciate having affordable
housing in the community. Civitan Homes, Inc. broke ground in
March 2002 for 46 units on four acres of land on the northwest
edge of Enid.
In 2003 Civitan Homes and Apartments was opened, and it was full
within three months. The rest is history. Cadres of little old
men planted flowers in common areas among the apartments.
Another group of seamstresses sewed curtains for the community
building where residents meet every Monday evening for a musical
jam session. Others play cards and work jigsaw puzzles together.
A small lending library is available of books and movies where
residents check out materials on the honor system.
Loretta Drennan says all 46 units have some accessible features
for people with disabilities, but six units are fully
accessible. These six units are equipped with a roll-in shower,
lower countertops in the kitchen, lever door handles, and wide
doorways to accommodate a wheelchair. All units are one bedroom
with a total of 540 square feet of floor space. All units have a
security system which is connected to the office on premises.
All apartments are also equipped with smoke alarms connected to
the local fire station less than a block away.
The rent for each unit is $311 per month which is subsidized
through HUD where no resident pays over 30% of their income in
rent. Each resident is given a $67 per month utility allowance
to help pay their gas and electric bill. Residents are
responsible for telephone and cable bills. A common laundry room
with four washers and dryers available allows residents to
socialize while doing their laundry.
Each apartment has its own outside entrance. There are no steps
in any apartment, and all are located on ground level. It is no
wonder that Civitan Homes gets ten to twelve calls a day from
locals who are wanting to rent. Word has gotten out in Enid and
surrounding Garfield County that the good life is available for
senior citizens 62 with or without disabilities.
Civitan Homes is a 501 C3, private non-profit agency. HUD audits
the agency’s records every year and insures a high standard.
Civitan the civic organization had to come up with $10,000 seed
money to show HUD they were serious about wanting to build a
housing project for senior citizens. They also had to sign a
contract that the housing project they built would be maintained
for senior citizens for forty years. Civitan Homes is not part
of the public housing authority. They are witness to what can be
done when public money is matched with private know-how to
benefit the general public. For more information, call Civitan
Homes (580-237-8200). HUD grant money is available every year to
build housing for the elderly and disabled.
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State of Oklahoma
www.ok.gov
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International Solidarity
Recently, an organization called the International Visitor
Leadership Program contacted our office and asked me to speak to
one of their groups. The group, Minorities and Public Policy, a
Project for Croatia was made up of Dr. Azim Durmic, Imam with
the Islamic Community in Maljevac, Mr. Hrvoje Klasic, a Lecturer
in the History Department and School of Philosophy, University
of Zagreb, Ms. Vesna Skulic who is a member of the Croatian
Parliament in Zagreb, Ms. Iva Coza, an undergraduate student at
the University of Zagreb, Dr. Sasa Lalic, a medical doctor and
Project Coordinator for NGO in Knin and Ms. Sanja Omicikus, a
psychologist and Head of Social Programs, Serbian Democratic
Forum NGO, Dalmatia Regional Office in Knin. The group also had
two interpreters but most of the members of the group were
fluent in English.
Steve Stokes and I met with them on November 15, 2005, when they
were about half way through their tour of the United States. The
group started out in Washington, D.C. where they focused on a
Federal government overview, agency visits and advocacy. While
they were there they met with the Department of Justice and
discussed the Americans with Disabilities Act. They had also
been to New York City to discuss civil rights and affirmative
action. One of the groups they met with there was the Asian
American Legal Defense and Education Fund, a group who advocates
for social and economic justice for Asian Americans and all
Americans. The group was in Oklahoma City to study state
agencies, minority services and non-governmental organizations.
They were also meeting with the Office of the Governor’s Latin
American Council on Government and Hispanic Affairs, the
Oklahoma State Department of Commerce, the Oklahoma Public
Defenders Office, Urban League and Catholic Charities. After
their visit in Oklahoma City, they were going on to Minneapolis
to learn about multiculturalism, tolerance among diverse
populations and non-governmental organizations. There they were
to meet with the Center for Victims of Torture, Senator Mee Moua
a State Representative (Hmong Community) regarding refugee
experiences. Then they were ending their tour in Philadelphia to
study state and local government, women, children and families
issues. There they were scheduled to meet representatives from
the Welcoming Center for New Philadelphians, a referral resource
for immigrants, the Philadelphia Commission on Human Relations,
the Philadelphia Police Department regarding its hiring
practices for minorities and community relations in minority
neighborhoods, and they were also going to enjoy the
Thanksgiving Day Parade.
The visit was very interesting and enlightening. We discussed
with them the services our office provides. We explained to them
that we were unique as we did not focus on one issue of
disability but all issues of disability. We showed them how a
person could contact our agency and receive information
regarding job discrimination, how or where to find another
position, what services were available not from just one agency
or resource but multiple resources and agencies. A person might
also want to know how to advocate for their child within the
school system and receive information on the rights of their
child if the school were not providing equal access to
education. If a person is a Vocational Rehabilitation client who
needs advocacy through that program the Client Assistance
Program is also located here in our office. We were pleased to
tell them that no other agency now provides or has ever provided
the range of services, advocacy and information regarding
disability that our agency provides. We also told them about the
success of our Disability Awareness Training classes, an
educational service we provide to other agencies or private
businesses. They were very interested and impressed with the
range of services that we provide and when we told them the
amount of our budget and that last year we served 93,000
consumers on that budget, they were amazed.
I was impressed by the youth, education and intelligence of this
group. They were very interested in making changes in their
country that would improve the quality of life of its residents.
Ms. Skulic who was a person with a disability told us that in
Croatia, people are very willing to help her if she needs
something. She told us that if she needed something from a store
there was always someone willing to go and get it for her which
was really nice but her point, was that it should be accessible
for her to get it for herself.
Ms. Skulic also informed us that Croatia has made great strides
in making the buildings accessible and that all government and
state buildings were to be accessible by 2007. Croatia is an
ancient part of the world and I asked Ms. Skulic what they would
do about the historical buildings, some of which are two
thousand years old. She indicated that if they were government
buildings they would preserve the historical integrity of the
buildings but they would do whatever could be done to make them
accessible.
I asked the group about the willingness of the community to make
these types of changes. They indicated that the Croatian people
are compassionate and that it has not been a big problem for the
physical access changes thus far. Dr. Lalic also told us that
just like here in the United States, even though there is a lot
of compassion the underlying attitudinal barriers were a
universal problem. His impression was that much of this is a
lack of education mixed with fear. I told him that even in this
country it has not been that long since people with disabilities
were put in nursing homes rather than living in their community
like everyone else. He agreed and told us that as a medical
doctor, he has seen this type of attitude first hand. He also
indicated though that a shift in consciousness had been
occurring for a long time and that the new laws regarding civil
rights and accessibility were spurring these great changes.
I think I speak for myself and Steve when I say that this was a
very enjoyable experience and an excellent opportunity to,
literally, let the world know about our office. Ms. Skulic made
a point of asking that we stay in touch via email and we have
already made contact with her. It was truly rewarding experience
for me personally and reinforced my belief that educating people
about diversity and differences is the best way to promote
change and also how the attitudes we experience in this country
and this state are universal. Hopefully, this visit has begun a
valuable exchange of ideas and information for the members of
the group and for this agency. I think we could learn a lot from
one another.
Kara Morrow
Disability Program Specialist
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You cannot help men permanently by doing for them what they
could and should do for themselves.
Abraham Lincoln
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Interpreter Services for the Deaf
Most of us are aware of interpreter services for the deaf and
hard of hearing. We may see someone interpreting at our local
church, for a public meeting, or even on television. Beyond
knowing that the services exist, we know very little. It’s nice.
Seeing the service in operation gives us a warm feeling inside
that something good is happening for a group of people in our
midst. But, unless we ourselves have experienced a significant
hearing loss or someone in our family, the meaning usually
extends little further than that initial warm feeling. However,
for people who are deaf and hard of hearing, interpreter
services are of major importance. They make the difference
between inclusion in the community and exclusion. Without the
ability to communicate with other people, the deaf community is
effectively excluded from the day-to-day affairs of life which
you and I take for granted. Oklahoma has many interpreter
services, two of which have absorbed the lion’s share of
business. Tulsa Speech and Hearing offers interpreting services
in northeastern Oklahoma and Sign Language Resource Services,
Inc. dominates the market in other parts of the state.
Sign Language Resource Services (SLRS) recently moved into a new
office in northwest Oklahoma City. They contract with 75
individual interpreters throughout the state. They can send an
interpreter to a public meeting, a doctor’s office, or anywhere
that a person who is deaf or hard of hearing needs access to
what is being said.
Stephanie Nichols, executive director, smiles as she surveys her
new space which includes a director’s office with a stunning
view of nearby woods. She smiles with good reason after building
her company from the ground up since 1997. She started the
business doing about 200 hours of interpreting services per
month. SLRS now does 1300 hours of interpreting services per
month, and the number keeps growing as more and more businesses
and agencies that have deaf customers become aware of the need
to attract people who cannot hear and whose primary language is
American sign language.
Stephanie points out that she and her staff do a lot of
education in the public about federal laws which require public
access to people who are deaf and hard of hearing. She cites
Section 504 of the Rehabilitation Act of 1973 and the Americans
with Disabilities Act of 1990 which require access to the spoken
word be provided for people who cannot hear. Contrary to what
many people continue to think, the cost of interpretation is to
be absorbed by the business or agency—not by the person with the
disability.
Sign language interpretation is done at seven levels of
expertise. We have a new law in Oklahoma which designates that
only a level 7 interpreter (the highest level) can interpret in
a court of law. There are two national certifications for
interpreters (Certificate of Interpretation and Certificate of
Transliteration) both of which are necessary to qualify as a
level 7 interpreter.
We have four interpreter training programs in Oklahoma. Oklahoma
State University, Oklahoma City campus and Tulsa Community
College offer associate degrees in interpretation. East Central
University in Ada offers a minor in interpretation. Oklahoma
State University in Stillwater offers a bachelor’s degree in the
subject. Stephanie says she could use five more interpreters
right now during their busiest time. She is willing to provide
$250 toward the cost of national certification to interpreters
who will come to work for SLRS.
Stephanie Nichols has a vision for her company. She would like
SLRS to be a resource to the deaf community. She would even like
to have mental health counselors on staff who could counsel
people who are deaf in the language which they can understand.
She talks about the latest technology which is video relay where
the sign language interpreter acts as a medium between the deaf
person and the person they are calling on the telephone.
Stephanie would like SLRS to provide video relay which would
provide instant communication on the phone in contrast to the
more cumbersome, time-consuming method we currently have of
typing into a machine and having a relay operator read the typed
words to the party being called.
More and more businesses and agencies are becoming aware of
their obligation to serve all the public—yes even those people
who are deaf and hard of hearing. Conferences are required to
have an interpreter present if an attendee who is deaf requests
the service. Schools and public agencies are also required to
provide access to the spoken word for people who cannot hear.
Employers are expected to have an interpreter present at in-
services if they have an employee who cannot hear. To create a
better world it is important to include everyone in what is
happening. Imagine yourself or a member of your family not able
to communicate with anyone else. Deafness isolates and cuts us
off from other people. Sign language interpreters restore that
vital communication with others which is fundamental in the
development of the human soul.
Sign Language Resource Services, Inc. can be reached toll free
at 888-842-9953 or 405-721-0800 voice, 405-721-0847 TTY in the
Oklahoma City area. Tulsa Speech and Hearing can be reached at
888-311-3523 statewide or 918-832-8742 (voice and TTY) in the
Tulsa area. If you are a deaf person with a TTY and want to call
a person who is not deaf, you may contact a Relay Oklahoma
operator at 800-522-8506.
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A lot of people have a good aim on life, they just don’t seem to
know when to pull the trigger.
Roy Rogers
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Health care is vital to all of us some of the time, but public
health is vital to all of us all of the time.
C. Everett Koop
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CALENDAR OF EVENTS
January 1, 2006 The Centers for Medicaid and Medicare (CMS) has
announced its long-promised internet tool to help beneficiaries
compare prescription drug plans available under the new Medicare
drug benefit. You can find all prescription drug plans available
in Oklahoma with monthly costs at www.medicare.gov/MPDPF.
January 28, 2006 The first annual Couple’s Conference will take
place on Saturday, January 28 at the Downtown Sheraton Hotel in
Oklahoma City. Speakers will explore the family challenges in a
family with a child with disabilities. For more information,
contact Juanita Killingsworth at 405-348-6770 or jbk3360@sbcglobal.net.
March 24, 2006 The first ever Disability Boot Camp for
organizations interested in networking with other
disability-related organizations at the South Penn campus of the
Moore-Norman Vo-Tech. Contact Beverly Graham for more
information at 405-951-3506.
April 1, 2006 There will be a fundraiser walk for the mind of
America at Stars and Stripes Park in Oklahoma City sponsored by
NAMI Oklahoma. For more information, contact Andrea Volk at
405-230-1900.
If you have an event coming up relating to disability, let us
know at 800-522-8224 and we’ll help you publicize.
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