Thursday, January 28, 2010

Promoting Employment of Adults with AD/HD to the SSA

I am pleased to share a message from public policy specialist Cindy Smith on CHADD’s efforts to promote employment for adults with AD/HD. My 19-year-old son is in a post-high school program. He is struggling with getting to class and obligations on time, bringing all the materials necessary to learn and participate, and effectively organizing his time. Many young adults have these challenges. But if the daily and weekly challenges continue—even with supports—there is a disability factor involved. My son has had these substantial challenges his entire life.

Three CHADD volunteers—a young woman with AD/HD, an educator teaching adults in a community college setting, and a physician specializing in the diagnosis and treatment of AD/HD—recently testified to the Social Security Administration on accommodations needed by some adults with AD/HD in order to become and remain meaningfully employed. Chronic and substantial inattention and executive functioning challenges can be disabling and should be so recognized by the SSA. I am proud to share Cindy’s summary of CHADD’s advocacy efforts with the SSA.


CHADD Provides Comments to Social Security Administration Advisory Panel
On January 20 and 21, 2010, three members of CHADD’s public policy committee provided public comment to supplement CHADD’s written recommendations at the quarterly meeting of the Occupational Information Development Advisory Panel (OIDAP). In addition to discussing their personal and family experiences with AD/HD, they explained how executive functioning skills, including the ability to sustain attention, can impact the ability to be gainfully employed. This is the first time CHADD has provided comment to an advisory panel convened by the Social Security Administration.

A subset of adults with AD/HD is unable to be gainfully employed because of the chronic, substantial inattention and executive functioning challenges caused by the disorder. CHADD is working to have the SSA recognize AD/HD as a disability that can inhibit the ability to work, and to ensure that reasonable job accommodations and supports are available for individuals who cannot engage in substantial and meaningful employment without them.

The OIDAP was formed on December 9, 2008, and charged with providing “independent advice and recommendations on plans and activities to replace the Dictionary of Occupational Titles currently used in the Social Security Administration’s (SSA) disability determination process.” The OIDAP has been working on meeting its charge, and recently published a summary of its work and recommendations in a report titled Content Model and Classification Recommendations for the Social Security Administration Occupational Information System (PDF).

Visit CHADD’s public policy webpage to see what CHADD is doing to advocate for adults with AD/HD and how you can help.

You can read this blog and others like it at the HealthCentral website.

Wednesday, January 13, 2010

Health Exchanges: What Are They?

The healthcare reform legislation now separately approved by the House and Senate contains a new mechanism—health exchanges—for persons not working for large employers and not on Medicaid, Medicare, or other public programs to purchase health insurance. Working adults with AD/HD with modest incomes who not employed by large employers will look to health exchanges to purchase insurance. Enactment of the healthcare reform legislation would result in an estimated 30 million Americans receiving health insurance through exchanges. As a small employer (25 employees), CHADD would likely turn to an exchange for our health insurance.

What are health exchanges and how will they work?

A health exchange is a government-sponsored or authorized organized market for purchasing health insurance. Examples of existing exchanges are the Federal Employee Health Benefits Program (FEHBP), Massachusetts Health Connector, Connecticut Business and Industry Association Health Connections, and the Utah Health Exchange. Exchanges created in California, Florida, and Texas have closed, as they were not financially viable as structured. Governments do not operate these exchanges; rather, governments sponsor or authorize them.

I don’t want to scare people, but exchanges are based on the Clinton administration-proposed managed-competition philosophy, where preregistered and preapproved private insurance companies compete for enrollees based on publicly stated measures of price, benefits, provider networks, consumer satisfaction surveys, and in theory, quality. At a seminar I attended last week in Washington, DC, the CEOs of the Massachusetts and Connecticut exchanges stated that quality is not yet a factor in their exchanges. Only preapproved health plans meeting standards and requirements may compete in an exchange.

Exchanges would prior-approve health plans. Under healthcare reform, plans would have to deliver standardized benefits and would have to ensure practices such as guaranteed coverage and renewal (thus prohibiting pre-existing condition exclusions) and establish publicly known and regulated premiums.

There are major differences between the House and Senate legislation around exchanges: how much national government control and authority versus how much state government; how much public disclosure and transparency by health plans; how much authority to require risk pools and risk adjustments; how much authority to limit-regulate premiums. There are also differences in whether individuals who are not part of small group plans would use the exchange or some other mechanism to purchase health insurance. And, a larger issue of congressional healthcare reform is the affordability and amount of subsidy for people with modest incomes.

The seminar on exchanges was conducted by the Alliance for Health Reform and financed by the Commonwealth Fund and the Kaiser Family Foundation. The Alliance for Health Reform has posted a webcast, podcast, and videos of the seminar for anyone interested in learning more.

I hope this is helpful.


You can read this blog and others like it at the HealthCentral website.