Steve Gold's Treasured Bits of Information

, Comparing States on Access to Community-Based Services. Information

Date Mailed: Thursday, March 29th 2012 12:54 PM

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Comparing States on Access to Community-Based Services.  Information
Bulletin #354  (3/2012).

There are various criteria one can use to evaluate a State=92s commitment t=
o
provide services to persons with disabilities in the community instead of
in an institution. The Kaiser Commission used four criteria together and
ranked states.  See =93State Options That Expand Access to Medicaid Home an=
d
Community-Based Services,=94 [HCBS] [10/11],
http://www.kff.org/medicaid/8241.cfm

The four criteria used are:

1.   #1 Participants receiving HCBS Per 1,000 Population in the State.  Usi=
ng
this criterion eliminates differences among States with regards to size,
wealth, and per capita.  It says for every 1,000 persons (with and without
a disability) in a State, how many people with disabilities receive HCBS.

 2.    Expenditures Per Capita.  This criterion divides the total number of
people in a State (with and without a disability) by the total HCBS
expenditures for people with disabilities. The =93per capita=94 is what eac=
h
person in a State pays for HCBS.  This eliminates State differences
regarding wealthy states, big/small, etc.

3.#3    % of HCBS to Total Medicaid Long-Term Care Participants. This looks
at the total Medicaid number of people with disabilities in both the
community and institutions, and shows the percentage of the total number of
people with disabilities (in both the community and institutions) who
receive Medicaid services in the community.

 4.    % of HCBS to Total Medicaid Long-Term Care Expenditures.  Whereas #3
compares % of people with disabilities who receive services in the
community,  this criterion looks at the total Medicaid expenditures =96 the
money =96 for people with disabilities in both the community and
institutions, and shows the % of the total expenditures (again in both the
community and institutions) spent in the community.

Here are the worst States using each criterion.


#1 Criterion - National average per 1,000 is 9.34. Best in country is 15.36=
.
Worst:

HI     5.15

DE    5.03

NV   4.62

AL   4.61

MD  4.48

IN    3.86

UT   3.56

TN   3.42

VA  3.30

GA  3.22



#2  Criterion -  National average per capita expenditure is $166.  Best in
country is $487.  Worst:



AL  $93

MI  $84

FL  $81

GA $76

IL   $71

UT  $64

MS  $61

NV  $59



# 3 Criterion - % of HCBS to total participants.  National average is
62%.  Best
in country is 86%.  Worst:



FL  46%

OH 45%

LA  45%

AL  45%

MS  44%

RI   44%

GA 43%

TN  37%

IN  34%



#4 Criterion - % of HCBS Expenditures to total expenditures.  National
average is 45%.  Best is 83%.  Worst:



AR  34%

KY  33%

IN  33%

AL 31%

NJ 31%

ND 30%

IL 30%

MS 30%



Caveats =96 A. this data includes both people with intellectual disabilitie=
s
and people with physical and all other disabilities. Using these four
criteria but focused on only ID or only A/PD would show different results;
B. this data is a few years old.



Nevertheless, the data shows which States were far below the national
average and overwhelmingly below the best States, and which States were not
committed to implementing the ADA or complying with the Olmstead decision.



Disability Advocates - the ball is on your side of the court.  Only you can
change your States.  Don=92t expect CMS to do it.  Don=92t assume DOJ (or a=
ny
other agency) will ride in to fix up your problem. Don=92t think your
Governor will see the light.  If your State is among the worst, the
responsibility is yours.



Power Concedes Nothing Without A Struggle.  F.  Douglas



Steve Gold, The Disability Odyssey continues



Back issues of other Information Bulletins are available online at
http://www.stevegoldada.com

with a searchable Archive at this site divided into different subjects.

As of August, 2010, Information Bulletins will also be posted on my blog
located at http://stevegoldada.blogspot.com/

To contact Steve Gold directly, write to
stevegoldada1@gmail.com<stevegoldada@cs.com>or call 215-627-7100. Ext
227.

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<p class=3D"MsoNormal" style=3D"margin-right:1.5in"><span style=3D"font-siz=
e:14.0pt;line-height:115%">Comparing States on Access to Community-Based Se=
rvices.<span style>=A0 </span>Information Bulletin #354<span style>=A0 </sp=
an>(3/2012).</span></p>


<p class=3D"MsoNormal" style=3D"margin-right:1.75in;text-align:justify"><sp=
an style=3D"font-size:14.0pt;line-height:115%">There are various criteria o=
ne can
use to evaluate a State=92s commitment to provide services to persons with
disabilities in the community instead of in an institution. The Kaiser
Commission used four criteria together and ranked states.<span style>=A0 </=
span>See =93State Options That Expand Access to
Medicaid Home and Community-Based Services,=94 [HCBS] [10/11],</span> <span=
 style=3D"font-size:14.0pt;line-height:115%"><a href=3D"http://www.kff.org/=
medicaid/8241.cfm">http://www.kff.org/medicaid/8241.cfm</a></span></p>

<p class=3D"MsoNormal"><span style=3D"font-size:14.0pt;line-height:115%">Th=
e four
criteria used are:</span></p>

<p class=3D"MsoListParagraphCxSpFirst" style=3D"margin-right:103.5pt;text-a=
lign:justify"><span style=3D"font-size:14.0pt;line-height:115%"><span style=
>1.<span style=3D"font:7.0pt &quot;Times New Roman&quot;">=A0=A0 <font size=
=3D"4">#1 </font></span></span></span><span style=3D"font-size:14.0pt;line-=
height:115%">Participants
receiving HCBS Per 1,000 Population in the State.<span style>=A0 </span>Usi=
ng this criterion eliminates differences
among States with regards to size, wealth, and per capita.<span style>=A0 <=
/span>It says for every 1,000 persons (with and
without a disability) in a State, how many people with disabilities receive
HCBS.</span></p>

<p class=3D"MsoListParagraphCxSpMiddle" style=3D"margin-right:1.5in;text-al=
ign:justify"><span style=3D"font-size:14.0pt;line-height:115%">=A0<span sty=
le>2.<span style=3D"font:7.0pt &quot;Times New Roman&quot;">=A0=A0=A0
</span></span></span><span style=3D"font-size:14.0pt;line-height:115%">Expe=
nditures
Per Capita.<span style>=A0 </span>This criterion divides the
total number of people in a State (with and without a disability) by the to=
tal
HCBS expenditures for people with disabilities. The =93per capita=94 is wha=
t each person
in a State pays for HCBS.<span style>=A0 </span>This
eliminates State differences regarding wealthy states, big/small, etc.</spa=
n></p>

<p class=3D"MsoListParagraphCxSpMiddle" style=3D"margin-right:1.5in;text-al=
ign:justify"><span style=3D"font-size:14.0pt;line-height:115%"></span></p>

<p class=3D"MsoListParagraphCxSpMiddle" style=3D"margin-right:103.5pt;text-=
align:justify"><span style=3D"font-size:14.0pt;line-height:115%"><span styl=
e>3.<span style=3D"font:7.0pt &quot;Times New Roman&quot;"><font size=3D"4"=
>#3</font> =A0=A0
</span></span></span><span style=3D"font-size:14.0pt;line-height:115%">%
of HCBS to Total Medicaid Long-Term Care Participants. This looks at the to=
tal
Medicaid number of people with disabilities in both the community and insti=
tutions,
and shows the percentage of the total number of people with disabilities (i=
n
both the community and institutions) who receive Medicaid services in the
community.</span></p>

<p class=3D"MsoListParagraphCxSpLast" style=3D"margin-right:103.5pt;text-al=
ign:justify"><span style=3D"font-size:14.0pt;line-height:115%">=A0<span sty=
le>4.<span style=3D"font:7.0pt &quot;Times New Roman&quot;">=A0=A0=A0 </spa=
n></span></span><span style=3D"font-size:14.0pt;line-height:115%">% of HCBS=
 to Total Medicaid Long-Term
Care Expenditures.<span style>=A0 </span>Whereas #3 compares %
of people with disabilities who receive services in the community,<span sty=
le>=A0 </span>this criterion looks at the total Medicaid
expenditures =96 the money =96 for people with disabilities in both the com=
munity
and institutions, and shows the % of the total expenditures (again in both =
the
community and institutions) spent in the community.</span></p>

<p class=3D"MsoNormal" style=3D"margin-right:103.5pt;text-align:justify"><s=
pan style=3D"font-size:14pt;line-height:115%">Here are the worst States
using each criterion.</span></p><p class=3D"MsoNormal" style=3D"margin-righ=
t:103.5pt;text-align:justify"><span style=3D"font-size:14.0pt;line-height:1=
15%"><br></span></p>

<p class=3D"MsoNormal" style=3D"margin-right:103.5pt;text-align:justify"><s=
pan style=3D"font-size:14.0pt;line-height:115%">#1 Criterion - National
average per 1,000 is 9.34. Best in country is 15.36.<span style>=A0 </span>=
Worst:</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">HI<span style>=A0=A0 </span><=
span style>=A0=A0</span>5.15</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">DE <span style>=A0</span><spa=
n style>=A0=A0</span>5.03</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">NV <span style>=A0=A0</span>4=
.62</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">AL <span style>=A0</span><spa=
n style>=A0</span>4.61</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">MD <span style>=A0</span>4.48=
</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">IN <span style>=A0=A0=A0</spa=
n>3.86</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">UT <span style>=A0</span><spa=
n style>=A0</span>3.56</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">TN<span style>=A0 </span><spa=
n style>=A0</span>3.42</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">VA <span style>=A0</span>3.30=
</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">GA <span style>=A0</span>3.22=
</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">#2 <span style>=A0</span>Crit=
erion -<span style>=A0
</span>National average per capita expenditure is $166.<span style>=A0 </sp=
an>Best in country is $487.<span style>=A0 </span>Worst:</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">AL<span style>=A0 </span>$93<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">MI <span style>=A0</span>$84<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">FL <span style>=A0</span>$81<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">GA $76</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">IL<span style>=A0 </span><spa=
n style>=A0</span>$71</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">UT <span style>=A0</span>$64<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">MS <span style>=A0</span>$61<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">NV <span style>=A0</span>$59<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt"># 3 Criterion - % of HCBS to
total participants.<span style>=A0 </span>National average is 62%.<span sty=
le>=A0 </span>Best in country is 86%.<span style>=A0 </span>Worst:</span></=
p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">FL <span style>=A0</span>46%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">OH 45%</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">LA <span style>=A0</span>45%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">AL <span style>=A0</span>45%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">MS <span style>=A0</span>44%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">RI<span style>=A0 </span><spa=
n style>=A0</span>44%</span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">GA 43%</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">TN <span style>=A0</span>37%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">IN <span style>=A0</span>34%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">#4 Criterion - % of HCBS
Expenditures to total expenditures.<span style>=A0
</span>National average is 45%.<span style>=A0 </span>Best is 83%.<span sty=
le>=A0 </span>Worst:</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">AR<span style>=A0 </span>34%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">KY<span style>=A0 </span>33%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">IN<span style>=A0 </span>33%<=
/span></p>


<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">AL 31%</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">NJ 31%</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">ND 30%</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">IL 30%</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">MS 30%</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">Caveats =96 A. this data incl=
udes
both people with intellectual disabilities and people with physical and all
other disabilities. Using these four criteria but focused on only ID or onl=
y
A/PD would show different results; B. this data is a few years old.<span st=
yle>=A0 </span></span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">Nevertheless, the data shows
which States were far below the national average and overwhelmingly below t=
he
best States, and which States were not committed to implementing the ADA or
complying with the Olmstead decision.</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">Disability Advocates - the ba=
ll
is on your side of the court.<span style>=A0 </span>Only you
can change your States.<span style>=A0 </span>Don=92t expect CMS
to do it.<span style>=A0 </span>Don=92t assume DOJ (or any other
agency) will ride in to fix up your problem. Don=92t think your Governor wi=
ll see
the light.<span style>=A0 </span>If your State is among the
worst, the responsibility is yours. </span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">Power Concedes Nothing Withou=
t
A Struggle.<span style>=A0 </span>F.<span style>=A0 </span>Douglas</span></=
p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.7pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;text-align:justify;line-he=
ight:normal"><span style=3D"font-size:14.0pt">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.5pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal"><span =
style=3D"font-size:14.0pt;color:windowtext">Steve Gold,
The Disability Odyssey continues<span style>=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=
=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0 </span></span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.5pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal"><span =
style=3D"font-size:14.0pt;color:windowtext">=A0</span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.5pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal"><span =
style=3D"font-size:14.0pt;color:windowtext">Back issues of other Informatio=
n Bulletins
are available online at <a href=3D"http://www.stevegoldada.com">http://www.=
stevegoldada.com</a> <span style>=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=
=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0 </span></span></p=
>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.5pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal"><span =
style=3D"font-size:14.0pt;color:windowtext">with
a searchable Archive at this site divided into different subjects.<span sty=
le>=A0 </span></span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.5pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal"><span =
style=3D"font-size:14.0pt;color:windowtext">As
of August, 2010, Information Bulletins will also be posted on my blog locat=
ed
at <a href=3D"http://stevegoldada.blogspot.com/">http://stevegoldada.blogsp=
ot.com/</a></span></p>

<p class=3D"MsoNormal" style=3D"margin-top:0in;margin-right:103.5pt;margin-=
bottom:0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal"><span =
style=3D"font-size:14.0pt;color:windowtext">To
contact Steve Gold directly, write to <a href=3D"mailto:stevegoldada@cs.com=
"><span style=3D"color:blue">stevegoldada1@gmail.com</span></a> or call 215=
-627-7100. Ext
227.<span style>=A0 </span></span></p>


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