Legislative Agenda of Blind Americans

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Legislative Agenda of Blind Americans: Priorities for the 107th Congress, Second 
Session

Public policies and laws affecting blind people have a profound impact 
throughout our entire society. Most people know someone who is blind, and 
seventy-five thousand Americans become blind or visually impaired every year. 

The blind population in the United States is estimated to exceed 1.1 million 
with several million more classified as visually impaired. In addition, the 
social and economic consequences of blindness directly touch the lives of each 
blind person's family members, co-workers, and friends.  Public policies and 
laws that result from misconceptions or lack of information 
about blindness are often more limiting than the loss of eyesight itself. This 
is why we have formed the National Federation of the Blind. The Federation's 
leaders and the vast majority of its members are blind, but anyone is welcome to 
join in the effort we are making to win understanding and equality in society.

Our priorities for the second session of the 107th Congress reflect an urgent 
need for action in three key areas of vital importance to the blind. (For an 
explanation of these issues, please see the attached fact sheets.)

  Congress should enact mandated increases in the earnings limit for blind 
  people, under Title II of the Social Security Act, similar to those enacted 
for seniors in 1996. This proposal would help reduce the harsh work 
  disincentive of the Social Security earnings limit as it now affects blind 
beneficiaries. 

  Congress should amend Title XVIII of the Social Security Act to include 
Medicare coverage for rehabilitation services provided to older blind 
individuals. This proposal would ensure that older blind Medicare 
  beneficiaries have access to the critical rehabilitation services they need to 
remain independent and in their homes, rather than being forced into costly 
long-term care facilities. 

  Congress should pass legislation requiring publishers of elementary and 
  secondary textbooks to provide electronic copies which are capable of 
  producing texts in specialized formats, including Braille. This proposal would 
  provide textbooks simultaneously in print and Braille editions, assuring that 
  no student, blind or sighted, is left behind. 

People who are blind are asking for your help to address these priorities in the 
present session of Congress. By acting in partnership with the National 
Federation of the Blind, each member of Congress can help build better lives for 
the blind, both today and in the years ahead. The legislative actions 
recommended in this memorandum will benefit the blind, but they will also help 
create a better future for all Americans. 
For Further Information Contact: 
James McCarthy, Assistant Director of Governmental Affairs
National Federation of the Blind
1800 Johnson Street
Baltimore, Maryland 21230
E-mail: jmccarthy@nfb.org
Phone: (410) 659-9314 ext. 240
Updated: January 29, 2002



Promoting Work and Fairness for the Blind 

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Promoting Work and Fairness for the Blind Common-Sense Work Incentives for Blind 
Social Security Beneficiaries


Pending Bills
H.R. 498, "Blind Empowerment Act," by Congressman Robert Ehrlich
S. 682, "Blind Persons Earnings Equity Act," by Senator John McCain 
 
Purpose
To amend title II of the Social Security Act to increase the level of earnings 
under which no blind individual is determined to have demonstrated an ability to 
engage in substantial gainful activity for purposes of determining disability.
 
Background
By increasing the Social Security earnings limit in 1996, Congress provided a 
powerful incentive for seniors age sixty-five and older to work. Advocates for 
this change made the case that seniors would continue to work, earn, and pay 
taxes since they could do so without fearing loss of income from Social 
Security. Now the need for a higher earnings limit for the blind is even more 
compelling because of an "all or nothing" penalty for working above it. However, 
Congress has disregarded this fact in the case of the blind while encouraging 
seniors to work by removing the earnings limit altogether. 
As a result, earnings exceeding $15,600 for a blind person who is age sixty-four 
or younger cause the complete loss of Social Security benefits until that 
individual attains age sixty-five. At that point there is no limit on the amount 
that same individual can earn. This is the inequity that now exists.
 
Existing Law
Like "retirement age," "blindness" is specifically defined in the Social 
Security Act and can be readily determined. By contrast, "disability" is not 
precisely defined and is determined on the basis of an "inability to engage in 
substantial gainful activity," a highly complex and rather subjective 
determination. 
Although blindness is precisely defined, monthly benefits are not paid to all 
persons who are blind but only to those whose earnings (from work) are below the 
annually adjusted earnings limit. Personal wealth arising from all sources, 
except present work, is not counted as earnings and does not affect eligibility. 
Only work is penalized, and recognition of this fact led to the increased 
earnings limit for seniors and its eventual elimination. The situation for 
seniors prior to 1996 is precisely the same for blind people today.
 
Need to Remove Work Disincentives
An increase in the earnings limit would be cost-beneficial. With a 
seventy-four-percent unemployment rate, the vast majority of working-age 
individuals who are blind are already beneficiaries. Providing them with a 
meaningful work incentive would allow them to become taxpayers as well. Members 
of Congress supported raising the exempt earnings threshold for seniors, and it 
is only appropriate that they do the same for blind people of working age. The 
chance to work, earn, and pay taxes is a constructive and valid goal for senior 
citizens and blind Americans alike. 
Increasing the earnings limit will allow blind people to work without being 
penalized financially for doing so, providing more than 100,000 blind 
beneficiaries with a powerful work incentive. At present a blind individual's 
earnings must not exceed a strict monthly limit of $1,300. When earnings exceed 
this threshold, the entire sum paid to a primary beneficiary and dependents is 
abruptly withdrawn after a trial work period. The economic risk resulting for a 
blind head of household is far greater than any economic benefit derived. 
When a blind person finds work, there is absolutely no assurance that earnings 
will replace the amount of lost disability benefits after taxes and work 
expenses are paid. Usually they do not. Therefore, few beneficiaries can 
actually afford to attempt substantial work. Those who do often sacrifice income 
and the security of a monthly check.
 
Action Needed
Congress should enact mandated increases in the earnings limit for blind people 
similar to those enacted for seniors in 1996. This proposal would be a step 
towards equity for blind people and reduce the harsh work disincentive policy 
now in effect. Under this proposal blind individuals would eventually be able to 
work and earn up to $30,000 without fearing the loss of benefits. 
Legislation for this purpose has been introduced as H.R. 498 by Congressman 
Robert Ehrlich and S. 682 by Senator John McCain. These bills enjoy broad 
bipartisan support with 251 members of the House and 30 Senators as cosponsors. 
Please support Blind Americans by cosponsoring H.R. 498 or S. 682 and request 
action on this legislation before this session is adjourned.
 
Contact Information
James McCarthy
Assistant Director of Governmental Affairs
National Federation of the Blind
1800 Johnson Street
Baltimore, Maryland 21230
Phone: (410) 659-9314, extension 240
E-mail: jmccarthy@nfb.org
Updated: January 29, 2002


Medicare Coverage Equity for Older Blind Persons 

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Medicare Coverage Equity for Older Blind Persons 


Pending Bills
H.R. 2674, "The Medicare Coverage Equity Act for the Blind," by Congressman 
Martin Frost


Purpose 
To amend Title XVIII of the Social Security Act to permit state rehabilitation 
agencies serving blind persons age fifty-five and older to be reimbursed by 
Medicare. 


Existing Law
The Medicare programTitle XVIII of the Social Security Actprovides health 
insurance coverage for people age sixty-five and older and for persons who have 
received Social Security Disability Insurance cash benefits for at least two 
years. This program pays for reasonable and necessary services to prevent 
illness, maintain health, and restore functioning after injury or disease. Part 
A of MedicareHospital Insurancecovers hospital services. Part BSupplementary 
Medical Insurancecovers a wide range of outpatient services such as physician's 
services; physical, occupational, and speech therapy; mental health services; a 
variety of rehabilitation services; the purchase of durable medical equipment 
(including wheel chairs); and home health care services. Despite Medicare's 
coverage of these and many more services, coverage of rehabilitation services 
for older blind individuals is not included.
Chapter II of Title VII of the Rehabilitation Act of 1973, as amended, 
authorizes grants to designated state vocational rehabilitation agencies to 
provide independent living rehabilitation services to older persons who are 
blind and visually impaired. These services include visual screening; 
independent living skills training, such as orientation and mobility and daily 
living skills; and other appropriate rehabilitative services needed for older 
individuals to live independently. This program is currently funded at $25 
million for fiscal year 2002. While funding has grown significantly in recent 
years, the program will only serve approximately five percent of those in need.
 
Need for Legislation
Costs associated with age-related vision loss are substantial. For example, the 
Alliance on Aging Research reports that visual impairment is one of the top four 
reasons why seniors lose their independence, contributing to medical and 
long-term care costs of $26 billion annually. In addition, the Framingham Eye 
Study (ongoing) reports that eighteen percent of all hip fractures among seniors 
can be attributed to age-related vision loss. At $35,000 for treatment and care 
in each case, the total annual cost attributable to hip fractures due to visual 
impairment exceeds $2 billion.
Rehabilitation services for older blind persons teach safe travel, daily living 
skills, and use of adaptive aids and devices. Individuals who receive these 
services are able to continue living independently in their own homes and 
communities. This is consistent with the goals of Medicare. By receiving these 
services covered by Medicare, seniors who become blind can regain self-reliance 
and self-worth. This will allow them to remain active and valued members of 
their communities for as long as possible. Without these services, older blind 
individuals often become dependent and isolated.
Recent growth in the appropriation made for the Title VII Chapter II program 
shows that Congress recognizes a significant need to be met. At $25 million 
annually, these funds are helping to lay the foundation for a state-administered 
service delivery system. However, current and future appropriations are not 
likely to be large enough to pay the entire cost of services for the growing 
population of seniors who become blind. The solution is to permit state agencies 
which already serve older blind persons to be eligible for reimbursement of 
direct service costs from Medicare. 
 
Proposed Legislation
Congress should amend Title XVIII of the Social Security Act to include Medicare 
coverage for rehabilitation services provided to older individuals who are 
blind. This proposal is designed to ensure that older blind Medicare 
beneficiaries have access to critical rehabilitation services. H.R. 2674, 
introduced by Congressman Martin Frost would do this. Efforts are underway for 
similar legislation to be introduced in the Senate. The proposed amendments 
define rehabilitation services as those services furnished or supervised by a 
designated state vocational rehabilitation agency to an older blind individual 
under Chapter II of Title VII of The Rehabilitation Act and approved pursuant to 
regulations issued by the Department of Health and Human Services. 
The state vocational rehabilitation agency or other provider chosen by the 
beneficiary and supervised by the state would provide services. The term, "older 
individual who is blind" means "an individual age fifty-five or older whose 
severe visual impairment makes competitive employment difficult to attain but 
for whom independent living goals are feasible." This is identical to the 
definition currently in Chapter II of Title VII of the Rehabilitation Act. 
As with Chapter II of Title VII, only state vocational rehabilitation agencies 
could receive payment for services provided in this program. This approach 
utilizes a well-established and accountable system for the delivery of 
rehabilitation services to older blind Medicare beneficiaries while also 
allowing beneficiaries to exercise choice when selecting among service 
providers. Title XVIII allows hospitals, community rehabilitation centers, home 
healthcare centers, and other entities enrolled as Medicare service providers to 
receive payment for services. Under this proposal, state vocational 
rehabilitation agencies could also enroll as Medicare service providers. Once 
approved by a state Medicare carrier, these agencies could submit claims and 
receive payment for the rehabilitation services they provide.
Please support Blind Americans by cosponsoring H.R. 2674 or its Senate 
companion, when introduced, and request action on this legislation before this 
session is adjourned. 
 
Contact Information
James McCarthy
Assistant Director of Governmental Affairs
National Federation of the Blind
1800 Johnson Street
Baltimore, Maryland 21230
Phone: (410) 659-9314, extension 240
E-mail: jmccarthy@nfb.org
Updated: January 29, 2002


Instructional Materials

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Access to Instructional Materials: Leaving No Blind Child Behind


Background
In the mid-nineteenth century, states established centralized schools for the 
blind to educate blind and visually impaired students. To support this, Congress 
authorized the American Printing House for the Blind (APH) in Louisville, 
Kentucky, to produce educational materials in alternative formats, including 
Braille. Today, APH continues to fulfill this function, receiving annual 
appropriations for this purpose. 
In the 1960's blind children first began to attend schools in their home 
communities in significant numbers, and today the vast majority do so. As a 
result, Braille, audio, and large print books must be obtained or created by any 
local school district having one or more blind children. Converting printed 
instructional materials into "specialized formats" such as Braille is often 
time-consuming, labor-intensive, and costly, taking six or more months and 
several thousand dollars to complete. Relying on APH alone cannot fulfill the 
need. Therefore, it is the exceptionnot the rulefor blind students to have 
access to required textbooks at the same time as their sighted classmates.

Existing Law
The Americans with Disabilities Act, the Individuals with Disabilities Education 
Act, and other federal laws clearly establish the policy that individuals with 
disabilities are entitled to equal treatment in all areas of society. However, 
the successful implementation of these laws does not occur without clear, 
specific, and practical standards and systems in place to anticipate 
accessibility needs. Currently, there are no federal laws that create standards 
to facilitate the production of textbooks in Braille. 
Twenty-six states have responded to this need by requiring publishers to provide 
electronic copies of print editions of textbooks. However, there is no 
consistent file format used among the states, and the electronic copies provided 
by publishers are frequently not usable for Braille reproduction at all. 
Therefore, inconsistent and often conflicting state requirements place 
burdensome obligations on publishers without efficiently facilitating more 
timely production of books in accessible formats. An agreed-upon, uniform 
electronic file format would reduce the burden to publishers and significantly 
reduce the cost of creation, while helping to provide materials to blind 
students at the same time they are provided to others.

 
Proposed Legislation
Congress should enact the "Instructional Materials Accessibility Act," which has 
been negotiated by textbook publishers, the National Federation of the Blind, 
and other affected groups. This legislation will ensure that blind and visually 
impaired students will not be left behind in having the textbooks they need in a 
form they can use. 
Prepared for introduction in Congress, the draft legislation would: 
  require state plans to ensure that students who are blind or visually impaired 
  have access to instructional materials in formats they can use at the same 
  time the materials are provided to students who can see;
  develop a uniform electronic file format for instructional materials prepared 
  by publishers;
  require publishers to produce a copy of each textbook in the uniform 
  electronic file format and furnish it to a National Instructional Materials 
  Access Center for distribution to schools; and 
  fund capacity-building initiatives to assist state and local educators in 
  using electronic files supplied by publishers. 

 
Benefits and Costs
The principal benefit of this legislation will be a uniform electronic file 
format. This will allow rapid creation of textbooks in the desired format for 
each student, sighted or blind. For students who read Braille, their books can 
be presented through the use of synthetic speech or stored and read with small 
computers, which display Braille dots. 
Without this legislation, local school districts will continue to bear the 
burden and cost of converting printed books into Braille. However, modern 
technology can now support shifting much of this responsibility to publishers 
without placing an undue burden on them. This legislation does not remove the 
school's responsibility to provide materials but will institute a shared burden 
between the schools that teach the children and the publishers that create the 
books. This will be the effect of having a uniform electronic file format and 
national distribution center. 
This shared obligation between school and publisher has been carefully crafted 
with publishers fully engaged in the effort to create it. The cost anticipated 
and authorized to operate the National Distribution Center will be $1 million 
annually, with $5 million needed to fund training and technical assistance 
programs for local schools. Although publishers have agreed to provide 
electronic books, nothing can happen without federal legislation to establish 
procedures and create the Center. 
Introduction of the "Instructional Material Accessibility Act" is expected to 
occur early in the second session of the 107th Congress. Anticipating this, 
members are being asked to become original cosponsors and to request prompt 
enactment of this bill. 
Please support Blind Americans by cosponsoring the "Instructional Materials 
Accessibility Act" and request action on this legislation before this session is 
adjourned.

 
Contact Information
James McCarthy
Assistant Director of Governmental Affairs
National Federation of the Blind
1800 Johnson Street
Baltimore, Maryland 21230
Phone: (410) 659-9314, extension 240
E-mail: jmccarthy@nfb.org
Updated: January 29, 2002


