2020 Presidential Primary Candidate Survey on Disability
Joe Sestak’s Responses
Employment: What are your views on paying a subminimum wage based on disability?
The issue of paying a subminimum wage to people with disabilities is a difficult one. While the lawmakers who originally made it legal had the best intentions — enabling more people with disabilities to find roles in the workplace — it is also ripe for abuse and exploitation. It traps people with disabilities into menial jobs, instead of getting the chance to try more complicated tasks with greater responsibilities. I therefore believe we must phase out the legal subminimum wage, which is codified in Section 14(c) of the Fair Labor Standards Act. I would support a plan along the lines of the Transformation of Competitive Employment Act, raising subminimum wages for people with disabilities gradually over 6 years, ultimately meeting the federal minimum wage. The same bill also includes additional funding to pay for grants and creating a technical assistance center for businesses that currently employ people with disabilities at a subminimum wage, to help them transition to employing people with disabilities following a more integrated, competitive model.
Assistive Technology: What do you plan to do to increase access to assistive technology for people with disabilities who need it to effectively and independently engage in their communities?
Firstly, I will issue a directive to all federal agencies upon entering the Presidency to ensure that websites and all other information technology run by the government is accessible to all. Leadership at agencies that fail to make necessary upgrades within a reasonable amount of time will be held accountable for their inaction. I will also ensure that the government plays a stronger role in regulating the tech industry, including by forcing the industry to ensure that the “Internet of Things” does not exclude people with disabilities. Technological advancements offer potential to help improve the lives of people with disabilities, but we sometimes need the government to ensure access. Finally, I will push hard for the passage of the Disability Integration Act (currently S.117/HR.555), which will increase funding for long term services and supports, including access to assistive technology, with the overall goal of preventing people from being forced into institutions against their will. Home and community-based services are nearly always preferable, and increased access to assistive technology will allow more people to stay in their homes and communities.
Special Education: How would you propose to strengthen the IDEA when it is reauthorized so that it truly fulfills its stated purpose of preparing children with disabilities for post-secondary education, employment, and independent living, including children with the most significant disabilities?
Most crucially, we simply need to fully fund IDEA. It is an important law, but it is a major unfunded mandate as well. The federal government is supposed to fund 40% of the differential cost of teaching students with disabilities. Yet we have never even met 20% of the differential cost (we reached 19% in 2010). Increasing funding to meet the 40% mandate will support students with disabilities from kindergarten to the workforce. We must also increase funds for educational outreach, in particular to parents of students with disabilities and to schools, so that all students eligible for an Individualized Education Program (IEP) know that they are eligible. Parents also must know that they are entitled to due process hearings if a student is not getting the individualized services they need and deserve. And funding must be added to hire social workers who can advocate on behalf of students with disabilities who have no parents, or whose parents are unable to effectively advocate on their behalf, with schools, government authorities, and medical professionals.
Mental Health Services: What is your vision for a system of services to support people with mental illness?
Too often mental health is considered an issue apart from our broader healthcare system. But we know that mental health is critical to overall health and well being. We also know that our mental health system is failing. While some 43 million Americans suffer from a mental health condition, only 43% of them have received some form of treatment, according to a report from Mental Health America (MHA). The same report found that over 76% of youth with severe depression — some 1.7 million kids — do not get the treatment they need. It’s no wonder that both suicidal ideation and major depressive episodes among our youth are increasing.
Shockingly, nearly half of all psychiatrists refuse to accept Medicare or Medicaid patients, or even patients with private health insurance, instead preferring to see only cash-paying patients. While this is their right, it is incumbent on policymakers at the state and federal level to provide incentives to mental health professionals to do the right thing and take on the patients who need their help the most. We must also increase the number of hospital beds available for inpatient psychiatric treatment, currently at the same level as it was in the 1850s — though our population is roughly 10 times larger today.
The federal government is already required to play a role in assuring that mental health and addiction are covered by health insurers under the Mental Health Parity and Addiction Equity Act (MHPAE) — which requires that restrictions and insurer’s requirements for coverage of mental health and substance use disorders are no more restrictive or onerous than those set for other medical and surgical benefits — but the Act is largely unenforced. Unfortunately it was written without a mechanism to monitor and evaluate its effective implementation, so it must be amended and updated as soon as possible — and then we must enforce it, with the federal government having a significant role in overseeing the enforcement by the states of equity between mental and physical healthcare. The ACA did improve coverage for behavioral health patients, we still have a long way to go but the parity protections of the MHPAE do not extend to Medicare, traditional Medicaid, or certain bare-bones catastrophic coverage plans currently offered. We must extend parity protections so that people in such plans are also able to access mental health and substance abuse treatment.
Workforce Shortage: Please explain how you would address this immediate and growing workforce shortage?
For one, we must increase the federal minimum wage so that it is a living wage. Many at-home health professionals are paid at or near the minimum wage, so they are often forced to look for and accept higher paying work — even if this means changing fields. Increasing the minimum wage will make the workforce more stable. We also need to expand guest worker visa programs to expand the number of immigrants coming to this country to work as home health workers. Passing the Disability Integration Act will help ameliorate the situation as well by increasing funding.