State Success: Revising NH State Building Codes to Promote Equal Access

In recent decades many "doors" previously closed to people with disabilities have been opened, allowing fuller participation in all aspects of community life.

The 20th anniversary of the Americans with Disabilities Act this year, however, serves as a reminder that barriers remain, such as public doors that are challenging if not impossible to open independently.

The ADA stops short in requiring push button doors at accessible public entrances. This is not equal access. This short fall does not preclude states or municipalities from imposing such a requirement. All public buildings are subject to federal, state or local building codes. Most states choose to adopt the latest International Building Code (IBC) as their own state building code with added amendments. The latest IBC version (IBC 2009) does not require push button door openers at accessible entrances. Improved access for customers with disabilities is good business and federal tax credits and deductions enable businesses to offset the cost of making such adaptations.

The New Hampshire Government Relations Committee sought to amend the NH building code during the review of the IBC 2009 code by requiring push button door openers at accessible public building entrances 1) in new construction 2) during renovations which trigger the state building code. Amendment 82 was drafted and approved for consideration in September 2009 with technical assistance from a member of the NH Code Review Board.

Opening New Doors: A Push to Victory!
In November 2009 the NH Code Review Board officially adopted Amendment 82 into the state building code by a vote 14 to 2!

• Amendment 82 language in bold: Chapter 11 1105.1 in the IBC 2009 1105.1 Public entrances. In addition to accessible entrances required by Sections 1105.1.1 through 1105.1.6, at least 60 percent of all public entrances shall be accessible. At least one door at accessible public entrances in Use Groups* A, B, E, I, M and R shall be full powered automatic doors in compliance with ANSI A117.1.

• Exceptions:
1. An accessible entrance is not required to areas not required to be accessible.
2. Loading and service entrances that are not the only entrance to a tenant space.

* Use Groups refer to categories of public buildings. Type A (recreational) Type B (Business) Type E (Educational) Type I (Institutional) Type M (Mercantile) Type R (residential)

The IBC 2009 with adopted state amendments takes effect in New Hampshire April 1, 2010. The final code requires approval of the legislature with an up or down approval or rejection. Because this new building requirement is not in the IBC code it will be considered again in three years when the NH Code Review Board reviews IBC 2012. The GRC and its community allies will be prepared to defend or repeat this amendment process if necessary, confident this victory sets a precedent. The Society’s Federal Activist Council has voted to pursue adding the door opener requirement to the IBC as a top priority in the next few years. If successful, this requirement will reduce the need for states to replicate this effort, while providing greater uniformity for all citizens.

Key strategies that resulted in success were as follows:
• Recognizing one MS activist’s determination and success can spur policy change
• Identifying the accessibility barrier as requiring a regulatory change
• Engaging the GRC to prioritize and advance the issue
• Getting up to code: understanding federal and state building codes, how they are created and intersect
• Timing is everything! Understanding the state process, time frame and key players
• Determining the most effective strategy: regulatory vs. legislative, state code vs. municipal ordinance
• Seeking expertise and champions of the cause: a state representative with MS and a NH Code Review Board member with a MS connection!
• Building alliances: disability activists, military veterans, the business community
• Countering opposition is key! Research, compelling testimony, photographic evidence, cost analysis and making the dual case as a policy and civil rights issue

MS 101 Briefing Raises Awareness and Educates Capitol Hill

On Monday, June 14th, the National MS Society's Public Policy Office hosted a briefing on Capitol Hill entitled "MS 101." The briefing is part of an ongoing effort to educate federal lawmakers and Congressional staff about multiple sclerosis, its impact on the more than 400,000 Americans living with MS, and key policy initiatives that could improve the lives of people living with MS.

Sponsored by Co-Chairs of the Congressional MS Caucus in the House Congressmen Russ Carnahan (MO-3) and Michael Burgess, M.D. (TX-26), the briefing was kicked off by Congressman Burgess who shared with the audience his personal experiences as a physician, his interactions with patients living with MS and the importance of meeting their unmet needs. Dr. Tim Coetzee, Executive Director of Fast Forward, provided an overview of MS including symptoms, prevalence, potential causes, effective treatments, and drug innovation.

Rob Engel, an engaged volunteer with the National Capital Chapter, then offered a vital perspective as a person living with MS. Mr. Engel concluded by detailing important steps Congress can take including providing $15 million for MS research in the Congressionally Directed Medical Research Programs (CDMRP), providing full funding for the Lifepan Respite Care program, and cosponsoring the National MS and Parkinson's Disease Registries Act (H.R. 1362/S. 1273).

The briefing was attended by over 30 Congressional offices and served as an important awareness-building and educational forum.

State Success: Securing Preventive Physical Therapy Coverage in Illinois

Currently, no treatment exists to reverse the damage multiple sclerosis causes upon the central nervous system. Medications may slow disease progression, but nothing exists to eradicate it. Physical therapy has been clinically proven to help individuals with MS maintain current mobility and muscular strength.

Many insurers generally only pay for physical therapy for restorative purposes, recovery from surgery, fractures, etc. Once a patient reaches a plateau, i.e. improvement ceases, those insurers decline coverage for the physical therapy.


Status
Two Illinois Public Acts - 94-1076 created in 2006 and 96-0139 created on August 7, 2009 - mandate insurance coverage for preventative physical therapy for Illinois citizens with multiple sclerosis, for specific health plans that include:

• Fully-insured health plans, and
• State, county, and municipally sponsored self-insured health plans.

Excluded from this state regulation are other self-insured health plans, regulated by the Employee Retirement Income Security Act (ERISA).

Public Act 94-1076 legislates that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued or renewed after the effective date of this amendatory Act of the 94th General Assembly must provide coverage for medically necessary preventative physical therapy for insureds diagnosed with multiple sclerosis.

For purposes of this Section, “preventative physical therapy” means physical therapy that is prescribed by a physician licensed to practice medicine in all of its branches for the purpose of treating parts of the body affected by multiple sclerosis, but only where the physical therapy includes reasonably defined goals, including, but not limited to, sustaining the level of function the person has achieved, with periodic evaluation of the efficacy of the physical therapy against those goals.

Public Act 96-0139 amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to require coverage for medically necessary preventative physical therapy for insureds diagnosed with multiple sclerosis.


Background
Key strategies and tactics pursued included:

• Soliciting the House Speaker’s participation and support to assure accuracy, momentum and bipartisan support for both pieces of legislation.
• Seeking a sponsor within the State Senate, diagnosed with MS, and a co-sponsor in the State Assembly for each piece of legislation.
• Identifying a bill sponsor in the Senate from the majority party to enhance the movement of the bills and to ensure bi-partisan support.
• Recruiting grassroots activists to attend the Illinois Public Policy Network MS Action Day and seek additional authors.
• Leveraging the MS Activist Network to reach Illinois State Legislators and engaging grassroots activists.

MS Activist Featured on CDMRP Website

MS activist Fiona Hoey is featured on the Congressionally Directed Medical Research Programs (CDMRP) website for her notable advocacy and active participation as a consumer reviewer for both the Peer Reviewed Medical Research Program and the Multiple Sclerosis Research Program (MSRP). As a result of a bold grassroots campaign led by MS activists just a couple of years ago, Congress has provided nearly $10 million for research funding to study the potential link between combat service and developing MS. Fiona plays a vital role in the process, sitting on panels with prominent researchers and offering a strong consumer voice in the selection high-risk, high-reward proposals for the MSRP. A volunteer with the New York City-Southern New York Chapter, Fiona is certainly helping us move toward a world free of MS.

In FY 2011, MS activists are urging Congress to provide $15 million for MS research in the CDMRP. Click here to take action today and urge your Senators' and Representative's support.

Contact Your Senators to Restore State Medicaid Relief

Medicaid provides health and long-term care coverage to more than 59 million Americans, including many people living with disabilities. With the rise in unemployment during troubled economic times, more Americans rely on Medicaid to help cover their health care costs. At the same time of enrollment growth, state budget pressures swell as revenues decline.

To help avoid drastic cuts to health services, the Recovery Act provided significant assistance to state-run Medicaid programs. This fiscal relief prevented harmful budget cuts, saved jobs and protected the healthcare coverage of those in need. The economic situation remains dire, however, and since states are currently planning their FY 2011 budgets, Congress must take immediate action to extend federal Medicaid assistance.

There is great support for extending federal Medicaid assistance. In March, the Senate passed a six-month extension of the Recovery Act's enhanced federal Medicaid match. The House just passed a similar bill, but the Medicaid provision was removed. It is up to the Senate to quickly correct this omission.

Call your Senators today using this toll-free phone number: 1-888-340-6521. Click here to learn more and receive talking points.

State Success: Delaware Income Tax Check-Off for Multiple Sclerosis

With the fragile state of the American economy, times are tight for everyone. The Delaware Chapter has seen a significant reduction in donations over the past 24 months. Less money means fewer programs and less financial assistance available for people living with multiple sclerosis in Delaware.

Benefits of an MS Tax Check-Off
After a proactive and exciting advocacy effort, the Delaware Chapter successfully passed legislation to establish a MS donation check-off on the state income tax form. Every person who files a Delaware State Income Tax form this year will see an option to make a donation to the Delaware Chapter of the MS Society.

Every dollar donated will stay in Delaware to be used for programs and services for Delawareans living with multiple sclerosis. This means that approximately 500,000 working adults will have the opportunity to make a donation. In addition to raising money, this will be a great way to raise awareness of multiple sclerosis and the MS Society simply by getting our name out there.

Section 1. Amend Title 30 of the Delaware Code by adding thereto a new section to read as follows: § 1192. The Delaware Chapter of the National Multiple Sclerosis Society Fund. An individual who claims an overpayment of taxes on an income tax return may designate that $1 or more be deducted from the refund that would otherwise be payable to the individual and, instead, be paid to the Fund.

The Division of Revenue shall forward the amounts designated for the Fund to the Delaware Chapter of the National Multiple Sclerosis Society to be used exclusively by the Delaware Chapter for the benefit of Delawareans who have been diagnosed with multiple sclerosis, and of those Delawareans who may be diagnosed in the future. A contribution to the Fund must be forwarded by the Division of Revenue to the Delaware Chapter of the National Multiple Sclerosis Society within 20 days after the receipt of the contribution.

Strategy
The Delaware Chapterʼs GRC members scheduled meetings with elected officials to take place in their offices at the state capitol. On April 1, 2009 a team of eight advocates traveled south to Dover with orange-iced cupcakes and fullcolor leave-behind postcards in hand. During the meetings with DE representatives and senators, the advocates discussed five talking points, one of which was an ask for a tax check-off bill.

The MS advocates spoke in teams of two or three at the scheduled meetings, as well as spoke to people as they ran into them in the hallways. On several other occasions, teams of advocates traveled to Legislative Hall to speak to the elected officials whom they were unable to speak with on April 1. Follow up phone calls were made and e-mails were sent to reiterate the talking points and thank them for meeting with us.

State Representative Deborah Hudson responded to an e-mail asking if we had procured a sponsor for a tax checkoff bill. We had not, and she graciously offered to be the main sponsor of the bill. Rep. Hudson had the bill drafted, and then forwarded it to the GRC for review. The GRC approved the bill as written, and thanked Rep. Hudson for taking the lead. The advocates made calls to key senators and state representatives asking them to sign on as cosponsors.

The bill had a total of three senators and an amazing 19 representatives sign on as sponsors. Small teams of three or four advocates made two additional trips down to Legislative Hall near the end of the legislative session to garner support for the bill.



Pictured above: DE Governor Jack Markell with MS activists who helped advance the tax check-off legislation. Pictured at left: Governor Markell receiving the Society's 2009 Governor of the Year award.