Daniel (center) with his sister Melody (left) and his mother Carolyn (right) at Melody’s wedding. [image description: A wedding photo depicting a bride with light skin and long, curly blonde hair wearing a white lace gown and veil stands at the left of a young man seated in his wheelchair. The young man has light skin, short dark hair, and has glasses. He wears a navy blue bow tie and white dress shirt. To the right stands his mother, a woman with light skin and dark brown hair in an up-do, who wears a navy blue, off-the-shoulder gown. She also wears glasses and a wrist corsage of white roses. The party is posed under a trellis arch of white roses and green leaves, with the ocean in the background.]

In the spring of 2010, I headed to the zoo for my son Daniel’s annual school field trip. I loved spending the day with other parents of children with disabilities. The comradery fed my soul. This was the last trip of his elementary school years in our home state of Florida.

Daniel is now a 22-year-old man. He’s a happy guy who loves to drum, swim, and listen to music. He was born in 1998 with a rare genetic disability that affects him physically and intellectually. It wasn’t officially diagnosed until he was 21 years old, thanks to the increased availability of genetic testing. A random deletion on one of Daniel’s calcium channel genes results in a severe seizure disorder and global developmental delay. 

After cruising past the giraffes and elephants, we took a break for lunch. Wheelchairs rolled in, some with IV poles attached for midday g-tube feedings. Pureed lunches were pulled from backpacks for those able to eat by mouth. I could relax knowing there were others who understand my struggles as well as my deep love for my son. Among them was the unfamiliar face of a mother and child new to our school. 

The new mom had recently moved to Florida from Wisconsin. My first suggestion, as it often is, was to contact the Agency for Persons with Disabilities to enroll in the Home and Community-Based Services (HCBS) Medicaid waiver program. Daniel had been on the waitlist for eight years, one of 20,000 Floridians waiting for services that provide respite, personal care assistance, and help with the extra costs of raising a child with disabilities or caring for an elderly relative. Today, there are 72,000 Floridians on HCBS waiting lists. 

“Oh, we’re already on the waiver,” the transplanted Floridian explained. 

“What? Daniel was born here, and we’ve been on the waitlist for years. I have written so many letters to my representatives, helped with state-wide petitions, and made more calls than I can count. HOW did you get on the waiver already?” 

She looked a little embarrassed. I have her to thank for opening my eyes, though.

“Well, my ex-husband has back problems. Not severe, but bad enough that we were able to get crisis services when we documented his chronic pain,” she told me.

I suffer from back pain due to repetitive lifting of Daniel. My back problems were compounded by a car accident. It turns out that a caregiver’s chronic pain moves a child’s status higher on the waiting list in Florida. So, I filed the appropriate paperwork. Several months later, we had some help.

Why do people with disabilities  and their parents have to jump through so many hoops to access the funds that keep them at home and in the community where they thrive? The answer is chronic underfunding, which is why the Better Care Better Jobs Act (BCBJA) is so important. The BCBJA would eliminate state waitlists, increase pay for home care workers, and create good jobs with appropriate training in home health care. In Florida alone, 5,000 new jobs would be created. In addition, 10,100 family caregivers in Florida would be able to return to work themselves. 

Once enrolled in Florida’s HCBS system, we could hire personal care attendants to dress and feed Daniel in the morning and get him on his school bus, so that I could be at my job on time. The downside was significant turnover at the agency I used, and his care was not consistent or high quality. I cringe when I remember travelling out of state to be with my mother as she was dying, and Daniel’s assistant left him unattended, resulting in a fall and the loss of a permanent front tooth. 

Low pay for home care workers meant I couldn’t always rest easily when Daniel was in their care. In Florida, there’s a consumer-directed option (also known as “self-directed” services) that allows me to hire friends, family, or my own hand-picked assistants. After Daniel’s fall and injury, I moved us into that option. 

Florida has a base pay rate of $12 an hour for home health care workers, which is not a living wage. I am able to increase it as our budget allows, but a few dollars more is not enough incentive for the type of caregiver Daniel needs. Plus, increasing hourly pay reduces the number of total hours available to us. As a result, home health care work is not sustainable for those who need employee benefits such as health care and paid time off, a huge barrier to assembling a quality team. I have been lucky to find a few fine people who take good care of my son, but they are the exception, not the rule.  

The HCBS programs, nationwide, are in need of crucial improvement. I am pained that so many in my community are still waiting to be added to this critical waiver, or, like me, are having difficulty finding care providers they can trust. There is an urgent need for the Better Care Better Jobs Act to be passed to create jobs, raise wages for direct care workers, and eliminate HCBS waiting lists. 

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Carolyn Murray is a retired registered nurse currently caring full-time for her son Daniel, who has complex medical needs and disabilities. She is also a writer for professional nursing journals and other publications. Carolyn works closely with her former husband, Tom Murray, to provide a meaningful life for Daniel. Her daughter Melody and son-in-law Andrew live nearby in Jacksonville, Florida.

Dear Senator Sinema,

16-year-old Taryn and her mom and dad embrace.

My daughter, Taryn, is 16. She loves to go camping, she loves her family, and she gives great hugs. She was also born with very complex medical needs, as well as cognitive and physical disabilities. You may remember meeting Taryn and me last March when we had the opportunity to speak during a constituent call over Zoom. In that conversation, I explained how I navigated each day with gratitude for the blessing of my daughter, and with worry about managing all the care she needs to ensure she has a fulfilling life. I shared that my husband and I worked tirelessly together to create a safe and happy home, and provided full-time care for Taryn. While we were able to get some in-home services through Arizona’s Home and Community-Based Services programs (HCBS), there is a shortage of home-care providers. Many families will tell you the same. 

Taryn and her father

A lot has changed for my family since we spoke. My fears have been drastically compounded by the unexpected passing of my husband, Taryn’s father, in late August. I’m suddenly faced with being a single parent. We’ve lost our family’s main financial provider and his job benefits, and now I have to figure out what life will look like for Taryn and myself going forward. Without my partner, I know I will need to rely on Home and Community-Based Services more than ever, yet I also know the care workforce is in a state of crisis, made worse by the COVID-19 pandemic. Without full funding for the Better Care Better Jobs Act in the Build Back Better reconciliation bill, Taryn and I, along with thousands of families like ours, will be left behind to try to endure without access to critical life-saving care. 

When we met with you last March, you assured us that you knew good policy for HCBS was important. You said that we could count on you, and I believed you. But now, without any explanation, you are withholding support for the very policies my family needs. I struggle to understand what part of this policy you have an issue with, because when I look at the financial analysis, it makes good fiscal sense over the next 10 years. The Better Care Better Jobs Act and the Build Back Better agenda will create jobs and allow those with disabilities and the elderly to get the care they need in their own homes and communities (which costs significantly less than institutional care). President Biden’s caregiving infrastructure plan will also allow caregivers to return to work, and it will contribute to the next generation of workforce development.  

Dawn and Taryn in a zoom meeting with Senator Sinema, members of Little Lobbyists, and her staff.

I know there is no such thing as a perfect policy, but your responsibility is to create and pass policies that improve lives in Arizona. As do many Arizonans, I believe the Build Back Better plan does just that. To remind you, roughly 65% of Arizona voters support the 3.5 trillion Build Back Better plan, with over 80% of your constituents supporting investment in Long Term Care. Continuing to stall threatens the lives of Arizonans with disabilities and Arizona’s elderly; that’s cruel and unacceptable. I urge you to consider who you are harming by not supporting this plan and remember that you represent Arizona voters first.  

As I have said before, I am available to talk with you anytime about the effects of policy on my family’s day-to-day life. Finally, I leave you with the words my daughter carefully programmed into her communication device last March to share with you. Taryn told you, “Your work is important.” Please remember that, and vote for the support our families need.

Your constituent,

Dawn Bailey
Registered Voter,
Chandler, AZ

Kim’s sons Elijah (l) and Isaac (r). [image description: Two young boys with light skin stand closely together with their arms around each other. One wears a blue plaid shirt, the other a yellow t-shirt with the words “Wakanda Forever” and an image of Marvel Comics’ Black Panther.]

My son’s night nurse just told me she’s leaving home health care. Through tears. She cried as she told me how much she loves us all and how hard she tried to make this work. She cried as she told me that the health insurance she is offered doesn’t cover her or her daughter’s monthly medications, and she just can’t go on without making ends meet. 

Isaac’s nurse began working with him two years ago, stepping in to become his regular day nurse, which helped him attend school – which he often missed. When his needs changed and we needed a night nurse, she quickly shifted gears to fill that spot. In Virginia, where I live, the median wage for home health care workers is $10 per hour. That’s right, $10 per hour. Nationwide, the median wage is $12 per hour. A living wage is at least $15 per hour. 

Isaac’s nurse cried as she promised to stay on as long as it takes to train someone new to do her job because she is so upset with herself for leaving us like this, even though it’s her family that’s been paying the price. 

My son Isaac is a hilarious, somewhat mischievous twelve year old. He loves all things Marvel and Mario Kart. He can’t wait to get home from school each day to get outside and play with his friends. Building forts in the woods is one of his favorite things to do.

Isaac had a tracheotomy to help him breathe until June of this year. He still has an open hole in his neck where the tracheotomy was. He also has a feeding tube that delivers nutrition directly to his intestines at night. He requires overnight care as his airway is still being assessed, and his tube feeding requires supervision. Without nighttime care he could dislodge his feeding tube, and it can only be replaced during a hospital stay. 

I am exhausted. Beyond exhausted, if that’s possible. I am so tired of working full-time to be the only financial support for my two boys, while juggling their needs, Isaac’s medical needs, and FIGHTING my government for BASIC needs. 

For my family, the home health care nurses funded by Medicaid’s Home and Community-Based Services (HCBS) are basic needs. When Isaac has a nurse, I can sleep at night. I know that somebody who is qualified is monitoring Isaac and keeping him safe.  Because of this I can be prepared to work the next day, and provide stability and much-needed health insurance for my children.  

The U.S. Capitol Dome illuminated at night—in the foreground are a bank of pale blue lights spelling out “Care Can’t Wait.

The Better Care Better Jobs Act (BCBJA), part of the President Biden’s Build Back Better agenda, is currently waiting for a vote in Congress. This bill would raise wages for the direct care workforce, create more jobs, and eliminate state waiting lists for HCBS programs. Over 800,000 Americans are on waiting lists nationwide, and this legislation would create 500,000 new health care jobs, which would, in turn, allow 1.1 million family caregivers to return to work. A September 2021 analysis by Moody’s Analytics shows that passing the BCBJA will have a positive impact on the economy, boosting our GDP and creating more jobs. 

Why can’t Congress act to pass this vital legislation? Why can’t Congress provide full HCBS funding of $250 billion we need to make sure that my son, my family, and millions of other Americans have the care we need?

My son needs nursing care so that I can work and support my family. My son’s nurse needs better pay so she can support her own family. But some members of Congress are fighting funding for the Better Care Better Jobs Act and the Build Back Better Act because, they say, the cost is too high. For who? I’m part of the economy, too. 

I need your help, because we will all need care at some point. Call your representatives NOW. Demand that they stand up and fight for our families. Tell them our care infrastructure is in crisis. Pass the Build Back Better Act, because Care Can’t Wait.

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Kim Crawley is a single mom to two amazing boys, Isaac (12) and Elijah (9). She has been a full-time special education teacher for 20 years, born and raised in Northern Virginia, and she loves raising my boys there. Kim became an accidental activist when her son Isaac lost his health insurance after hitting a lifetime maximum at the age of 15 months. Her family has been proud members of Little Lobbyists since shortly after its inception.

Elvina’s daughter Colby. [image description: A young woman with light-colored skin smiles at the camera; she is seated in a family kitchen. Her brown hair is pulled back from her face. She has braces on her teeth, and wears a gray hoodie.]

My daughter Colby has turquoise braces and a dimple in one cheek. Her blue eyes are turning green, just like mine did as a teenager. She wears her luxuriant brown hair pulled back to frame her differently shaped ears. The photographer Mary Ellen Mark called her ears, “her signature.” She loves the word “shoes.” She loves Lana Del Ray, Clairo, and Cat Power. Her body is rocked often and deeply by intractable epilepsy. 

During her first EEG as an infant she was regarded as a miracle. That she could not only survive the massive and frequent seizures, but could smile and breath and breast feed and pincer grasp at blueberries--she should not have been able to do any of this, given the severity of her seizures. Over the following 16 years, she has had brain surgery and multiple orthopedic surgeries.

Colby has apraxia and is nonspeaking. She has a series of sounds and gestures that people close to her can understand in context. She reaches toward the shelf with crackers when she is hungry. She holds your hand when she wants you to stay near. She pushes away the shirt she wants to wear when you give her a choice between two. 

Colby receives Medicaid Home and Community-Based Services (HCBS) through New York State, where we live. She qualifies for nearly 24/7 care. We have never been able to staff those hours. It’s the same story as everywhere else: low wages and complex work leads to a nearly non-existent labor pool. Add to that the high cost of living in a college town, such as Ithaca, and people cannot afford to live on current wages prescribed by state policies. 

 Colby is 16 years old now.  She has never slept through the night. She needs emergency meds administered. She needs care and attention before, during and after seizures. Colby needs full assistance to eat, attend to personal hygiene, and get around. Her independence will always require significant support from other people. 

Colby and Elvina. [image description: A black and white photo of a mother and daughter. The daughter, to the left, looks away from the camera, smiling. The mother looks directly at the camera.]

The first few years of Colby’s life I stayed home and my husband worked. His work required traveling for long periods of time. Then I took a turn returning to work, which was great for a while. Eventually though, the care of a medically complex child became impossible for me to balance with full-time work outside the home. We could find no other qualified caregivers to work for what New York State’s Medicaid HCBS paid, nor could we, as parents, be compensated for her care. In the hours I work that someone else could be employed to perform, I feel that I am not a parent. I am a caregiver, and caregiving is not the same as parenting. Colby is not work, but her care is work. 

It was a rapid descent from leaving full-time work to the food stamp application. Being unpaid caregivers meant our family qualified for $400 or so per month in SNAP benefits, and $600 or so per month in SSI based on Colby’s permanent disability. For a family of four. With a Grammy Music Award and a Smith College education between the parent heads of household, this was a shocking turn. 

But instead of deciding this was impossible, which it is, I dug my heels in.  We did what we had to do, like put dental care and car repairs on credit cards. Truly, what were our choices? Put our daughter in a permanent institutional placement? So I can work and afford life? Where are Colby’s person-centered choices in that equation?

My daughter deserves the dignity of excellent care that humankind, and a wealthy nation, are capable of providing. Our country needs to treat caregiving labor as infrastructure. And caregiving labor needs to be paid no matter who is doing the work. Colby’s care should not equal poverty for us, or for a direct support worker trying to subsist on current substandard wages. Raising wages for all care work would be a net positive to our economy. It would raise the GDP, lower poverty, and raise savings. The dignity of a liveable wage is within our capacity as a country and economy.  

A Message from Little Lobbyists:

Caregiving is infrastructure. Our kids, and all people with disabilities, have a RIGHT to access the services and support they need to survive and thrive in their own homes and communities. But in order to make that civil right a reality, we need funding to support better jobs for caregivers and improve the quality and quantity of care for our families. That's why Little Lobbyists support the Better Care Better Jobs Act! Please call your senators and tell them why YOUR family needs them to pass full funding for this historic bill in the reconciliation package!

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Elvina Scott is a mother, writer, and athlete. She has two children, one with disabilities, including intractable epilepsy. This parenting experience informs her writing and advocacy work. Elvina is an ultra distance runner. She is a graduate of Smith College. 

Cailyn out in her community, assisted by a direct support aide. [image description: A young disabled teen wearing pink sunglasses and a bright pink outfit sits on an adapted red bike. An aide assists her moving through a sensory “tunnel” (an open pipework on which various objects are suspended).]

The Better Jobs Better Care Act would provide desperately needed funding for Home and Community-Based Services (HCBS) for thousands of disabled children and adults nationwide. Through Medicaid waivers, HCBS provides skilled nursing services, direct support professionals, and equipment and supplies not covered by private insurers to people with disabilities so that they might live where they choose and remain in their homes and communities, rather than be sent to institutions. 

HCBS is an essential part of disability rights. However, some in Congress don’t understand these rights. Uninformed decisions by lawmakers threaten the lives of disabled people and those who care for them. Jen Reese, mom to Little Lobbyists Cailyn, shares her story. 

Tell us about your family.

My husband and I have two daughters, ages 9 and 13, and we live in Virginia. My husband is a software developer, and I work in a role supporting families like mine--with kids with disabilities. 

Explain your daughter Cailyn’s complex medical needs and disabilities.

My daughter Cailyn is 13 and a happy, smiley girl. At five days old we noticed her having seizures, and at a week old she spent her first week in the hospital. She was diagnosed at 4 years old with a rare genetic anomaly that affects proteins in her brain. Years of uncontrollable seizures have left her with intellectual and developmental disabilities. Due to these, she needs total care, including her liquids and medication via feeding tube. Cailyn does not communicate verbally and uses a wheelchair for mobility.  

When did Cailyn first get access to HCBS? How many years did you wait?

When Cailyn was about 16 months old, an early intervention therapist convinced us to apply for a Medicaid Waiver. She qualifies due to her disabilities and need for nursing home level of care. There was no waitlist for the entry-level Medicaid Waiver in Virginia, and it was life changing. We were able to have caregivers come into the house because a regular daycare could never take care of her. Plus she’d be super-susceptible to any germs from the other kids. We have good private health insurance that covers a lot, but sometimes medical equipment or services aren’t fully covered. Our out-of-pocket costs were tremendous before the waiver. Medicaid is Cailyn’s secondary health insurance and helps her stay in our home instead of an institution. 

If we didn’t have Medicaid, I would not have been able to keep working, we would not still own our home, and having another child would not have been possible, given the financial limitations. Cailyn waited almost 10 years for Virginia’s Developmental Disability Medicaid Waiver, a second Medicaid Waiver in Virginia that includes supports for employment and group homes. There are still approximately 12,000 people on that waitlist in Virginia, and they are given the waiver based on priority. Sadly, some adults have to be facing homelessness before they are awarded a Medicaid waiver. 

How do HCBS help your child and your family survive and thrive?

Without Home and Community-Based Services, our daughter would not be home with us. She would live in an institution. 

Our extended family has a history with institutions, and I saw it break my Grandmother’s heart. Her youngest son, my uncle John-John, had cerebral palsy and severe seizures. I remember him and have pictures of me as a little kid on the day we had to take him to an institution.

I can’t imagine my Grandmother’s guilt and fear. Guilt that she couldn’t care for her son anymore and fear of what would happen when strangers were responsible for his well being. Over the years, I remember stories of him getting severe burns because no one checked the temperature of the bath water before putting him in, and of someone dropping him and breaking his arm. But at that point, my Grandfather had passed away and my Grandmother had a bad back injury from having taken care of my uncle for as long as she could at home. 

The system has changed, and Home and Community Based Services will help my husband and I keep Cailyn home. We’re able to have nurses come into the house and help care for her, and we’re able to focus on activities with her little sister, keep up with household chores, or just take a break. 

Some members of Congress don’t think HCBS are real infrastructure. How do you respond to that? 

Infrastructure is defined as the basic physical and organizational structures and facilities needed for the operation of a society or enterprise. 

Seriously, you’re living in a bubble if you think Home and Community-Based Services aren’t infrastructure. Societies are required to take care of their disabled people, and we haven’t been doing a good enough job. If I didn’t have help for my child, I’d be out of the workforce. Caring for Cailyn also provides jobs for others. Infrastructure is not just bridges and roads. 

There are HUGE waitlists for HCBS, there aren’t enough providers for services, and the reimbursement rates are so low it’s despicable. A babysitter in my area for a child without disabilities costs about $20 an hour. Medicaid pay rates for caregivers for people with disabilities in my area has just hit $13.60 an hour--even Target starts its workers at a higher rate of pay than that. 

What would happen to your child and to your family if the HCBS you receive were reduced or even taken away?

Threats to Medicaid under the Trump Administration pushed my anxiety levels through the roof. If HCBS were taken away, my family would be broken. How would we come up with $6,000 extra dollars a month to pay for the feeding tube supplies and special formula Cailyn needs, plus diapers, plus medications, plus wheelchairs, plus a hospital-style bed, plus a modified van for transportation etc., plus, plus, plus …

How would we be able to keep her home? We’d be financially devastated. Bankruptcy would have to be a consideration, including selling our house, cars, and raiding our retirement fund--it’s a nightmare I’ve had many times. It is all overwhelming and makes me want to vomit at the thought of it. 

Do you know of families in Virginia who are still waiting for HCBS? What would you urge them to do?

I know many families who are still waiting--12,000 in Virginia alone. Waiting for our government to do the right thing and provide funds for disabled people to have a life like everyone else. Everyone should be able to live where and with whom they want. If they need supports, we have to make sure they are in place--healthcare, transportation, housing, and job supports. Please do the right thing. President Biden’s funding recommendations are a wonderful start and it’s really just the right thing to do!

Describe the power of HCBS in a single sentence. 

HCBS help keep my daughter happy, healthy, and safe. 

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Jen Reese is a member of Little Lobbyists from Virginia.

Dear Senator Warner,

There is a particular feeling, a whole set of sensations, ranging from shakes, sweats, feeling of rawness inside my body, aching bones, swollen lymph nodes under my chin and arms, nausea and weak/painful muscles that I get when my body is dumping thousands of white blood cells all at once from my lymph system into my bloodstream. It is awful and exhausting. This morning, even after a night's sleep, my legs and neck and arms ache badly and I feel a physical weakness that is hard to describe.

I say this here, in public, because today I have to care for my adult son who is disabled, and lifting him will be dangerous for us both, painful and exhausting for me. I will cook for my son, feed him, and assist with every single thing most people do without a thought. Today I will also support my daughter, who has a disability, too. I have done this in one way or another for nearly 30 years, and since the pandemic began, returned to supporting full time, every single day, one or both disabled family members. Since April, I have done this while also being treated for cancer, and I have continued to work throughout.

This was initially going to be an apology for not continuing later into the night last night, reaching out to people who might contact Senator Mark Warner about his intention to leave caregiving out of the infrastructure bill. But, no. I will not apologize.

Jill Jacobs with Senator Warner

Senator Warner, you may not remember me, but we worked together a whole lot when you were Governor of Virginia on Medicaid Home and Community Based Services (HCBS). Here is a photo of us together in your office one day when I came with my friend Keith to talk about HCBS. That day we talked about the value of caregiving, of caregivers, to disabled folks and their families, to communities, to society, to the economy. My family and I ask that you recognize again now that Caregiving is Infrastructure.

Since Covid began we have faced an ever-increasing caregiver crisis in this country. For my family, we are now finally 60% staffed. 60%. With my years and years of experience navigating the system, we are finally 60% staffed. Why? Because there are no caregivers anymore. Why should there be? We Americans disrespect caregivers. We called them 'heroes' during Covid, yet demonstrate by our actions, how we really feel. We view caregivers as worthless. We do not pay them fairly nor properly, offer zero health insurance benefits, no leave, no training, no career advancement. The pandemic's added risk of death finally broke the system. We need to fix this now.

The caregiving crisis is real and will only get more real as we face the daily care needs of an aging population and added numbers of Covid survivors.

I realize there is huge pressure now to make this Infrastructure bill pass and I appreciate and honor your work in a bipartisan way to get to that point. However, doing it on the backs of disabled people and their families, by not supporting caregivers, is taking a serious risk with human lives, the very people who have suffered and lost so much during Covid. And it harms the whole community, our country, our economy because this is a huge area of need right now, of potential employment, of people working and paying taxes, buying products, spending money, in every city and town in this country. Caregiving allows family members and many disabled folks to work, too, which diversifies our investment and increases our tax payments and spending. The caregiving spending in this bill is an economic investment in people, in cities and towns and states in a real, solid, human way.

Senator Mark Warner, find another way to reduce the amount of this Infrastructure bill. Keep caregiving in the bill and let's see HCBS flourish, create jobs, create community activities and living and spending.

Let's talk Senator.

Your constituent,

Jill Jacobs

P.S. For anyone reading this, I ask you to reach to Senator Warner, too, as well as anyone who represents you, and let this be known.

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Jill Jacobs has been working for disability justice for 28 years. She’s the Executive Director of the ENDependence Center of Northern Virginia (ECNV), one of the oldest Centers for Independent Living in the Country. Jill is a Social Worker with 22 years of experience in health and human service policy, programming, analysis and service delivery systems. She is a graduate of University of Texas and was trained by US Army Social Work Services at Fort Hood, Texas. Jill is also an activist, artist, mother of four, grandmother of three, and a resident of the Commonwealth of Virginia.

On June 17, 2021, the U.S. Supreme Court issued a decision on a group of cases from several states that challenged the constitutionality of the Affordable Care Act (ACA). The Supreme Court ruled 7-2 that the plaintiffs lacked standing to challenge the health care law. This was the third challenge to the ACA rejected by the Court, and a huge relief for many families. Peter Witzler, a member of Little Lobbyists, reflects on this momentous day.

Peter Witzler and his family. [image description: A white-appearing father, mother and two young boys pose with their black dog in a wooded area near a stream. All are smiling.]

Today felt like an immense weight had been lifted from my shoulders. Like a nagging voice in my head had finally been silenced. Like our family could continue to dream, plan, love, and laugh without making a series of impossible choices linking our family’s finances to the well-being of our son Jackson: Could we afford to do what's medically best for Jackson? What would give him the best chance at a healthy, independent life? Without bankrupting our family?

That's because today, the Supreme Court once again affirmed that the Affordable Care Act and Patient Protection and Affordability Act (the ACA) is the law of the land. An effort led by Republican Attorneys General to overturn a key provision, the ACA’s protection for pre-existing conditions, has been defeated. 

Jackson was born with a pre-existing condition. Despite excellent prenatal care, his extremely rare form of Spina Bifida went undetected. When he was born, a hush fell across the room as doctors, nurses, his mom Lisa and I saw a mass the size of a softball on his lower back. After being transferred to Children's National Medical Center, we began the first of several long stays in the neonatal intensive care unit (NICU). During his first six months of life, Jackson totalled four months in hospitals, three brain surgeries, and a whopping multi-million dollars in medical bills. Thanks to the protections of the ACA that were confirmed again today, as well as my union-negotiated health insurance, we were able to do what was best for Jackson. 

Peter and Lisa with Jackson just before his first surgery at three-and-a-half months. [image description: Two white-appearing parents hold their infant son, who wears a Superman cape.]

The ACA is something we constantly benefit from. We made investments in care, therapies, treatment, and supports for Jackson early on in his life. When he started turning blue and gasping for air, we were able to seek specialists, a diagnosis, and learn to use a feeding tube so he could continue to grow strong. He’s had two additional surgeries, and we know there are more in his future to correct his severe scoliosis. We can plan for this and more with the security of knowing he cannot be denied care for simply being born. 

These significant investments in his health early on have made him into a mischievous, independent six-year-old who loves getting into trouble with his big brother Teddy. These early investments mean he is on track for independence, lower intensity supports, and fewer healthcare costs as he grows older and stronger.

As a fourth-generation union member, my job gave my family the means of wages, job security, and benefits to achieve the American Dream. But even collective bargaining was unable to protect working families from an insurance executive who wanted another yacht. When Jackson was born, we could have been knocked right off track. Instead, we relied on the protections of the ACA to keep moving. Instead, we’re still working toward our American Dream.

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Peter Witzler lives in Gaithersburg, Maryland, with his wife Lisa, his two kids, Teddy (9) and Jackson (6), and their pandemic-adopted dog Gabby. He enjoys sharing his love of nature and food with his family, and enjoys brewing a new batch of beer with the East Rockville Brewers Guild.  

Sierra as a child during a hospitalization. [image description: A young white girl with short black curly hair stands holding onto an IV pole mounted with various medical devices. She wears a black pajama shirt and pink patterned pajama bottoms.]

“Fortunately, your daughter will still be eligible for a kidney transplant even though she has developmental disabilities,” the doctor said.

I sat there stunned. It had never occurred to me that my daughter’s intellectual disabilities could be a reason to deny her the lifesaving kidney transplant she needed.

Sierra was nicknamed “The Mayor” at her middle school because my tiny daughter has a big personality and always knows what should be happening and who should be where, and is not shy about sharing that information. She confounds doctors who review her medical records and labs and, based on that, expect to see a very sick girl when they walk into the room and instead find this energetic person who is living large and loving life. 

My spunky, loving, sweet daughter Sierra was born with a rare genetic condition called cystinosis which causes progressive damage to organs and tissue throughout her body. Only 500 people in the United States have cystinosis. After presenting with failure to thrive as an infant and seeing numerous specialists and undergoing every diagnostic test you can imagine, she was diagnosed with cystinosis, developmental disabilities, and verbal apraxia which means she has difficulty forming words. Cystinosis eventually leads to kidney failure, and Sierra’s kidneys began to fail when she was about four years old. 

People diagnosed with cystinosis did not usually survive beyond age 10 before kidney transplants became possible. Kidney transplants were a game changer for the cystinosis community, meaning children had a future. Not just a future, but a bright future in which they could have a good quality of life and live a more typical life span. 

As our family struggled to digest and adapt to the reality of our beloved Sierra having this chronic disease, we were mortified, terrified, sickened, and angry at the thought that her intellectual disabilities would ever be used as a reason to deny her any type of medical care, especially a lifesaving organ transplant. 

Sierra today. [image description: A young white woman with long curly blonde hair is seated outdoors. She wears a scoop-neck burgundy top and a burgundy and black checked skirt.]

Sierra, who is now 25 years old, loves to sing and dance, attend concerts, take care of people, volunteer in the community, and gives the best hugs, has survived cystinosis, a kidney transplant at age 6, lymphoma at age 10, a second round of kidney failure caused by the cancer treatment, a year of dialysis, heart failure, a second kidney transplant at age 12, and most recently, a stroke. Yet she comes through it all and continues to carry a spark that ignites joy in everyone she meets. Sierra is love on legs. 

Our family got lucky in that we have been working with an institution that did not include developmental and intellectual disabilities as part of their criteria to determine who would and would not be eligible for organ donation. 

But it shouldn’t be about luck. Sierra’s worth should not be measured by her IQ. She is invaluable.

We need to make sure all the Sierras out there are protected and able to get the organ transplants they need to preserve their valuable and precious lives. U.S. Representatives Jaime Herrera Beutler (D-WA) and Katie Porter (D-CA) have recently reintroduced the Charlotte Woodward Organ Transplant Discrimination Prevention Act (H.R.1235), “which will prohibit using an individual’s mental or physical disability as the sole basis of determining their eligibility for an organ transplant.” 

While 13 U.S. states have passed legislation forbidding discrimination in organ transplant surgery on the basis of disability, bias persist. H.R. 1235 would ensure that disabled people in the remaining 37 states can have their health needs met without fear. In December 2020, the American Academy of Pediatrics issued a policy statement warning physicians and hospitals that denying transplants to people with disabilities could be both discriminatory and illegal.

You can help protect people with disabilities like Sierra by emailing or phoning your U.S. House and Senate representatives directly to support H.R. 1235. You may also call the U.S. Capitol Switchboard at (202) 224-3121 and ask to be connected to a particular office. 

If you or someone you love has encountered discrimination in obtaining an organ transplant because of a disability, please share your story with Little Lobbyists! 

---

Julie Ayers is is the Service-Learning Specialist for the Maryland State Department of Education where she oversees Maryland’s ground breaking service-learning graduation requirement. She’s taught at the Florida Institute of Technology and been an adjunct instructor at Loyola College of Maryland. She has also worked in the Maryland non-profit poverty solutions sector and was responsible for developing the Kids Helping Kids anti-hunger curriculum. Julie has created many publications supporting, and several articles on, Maryland’s service-learning program. But most importantly, she is mother to two wonderful humans, Sierra and Sawyer.

Abby had a history of seizures, but this one was very different. 

The snow had been falling steadily outside the window as another winter storm moved in over our rural town in western Pennsylvania. My husband, a pilot, was away on a business trip, and I was just getting my preschooler ready for bed after a long warm bath. It felt like a perfectly cozy winter night. I laid her down on her bed, wrapped in a soft bath blanket, while I picked out some pink pajamas with little polar bears on them. As I looked back at her I saw it. Her body was stiffening and shaking while her eyes were vacant. It only lasted about 30 seconds, but it felt like an eternity. 

After that night, Abby’s team started documenting more and more seizures. Her neurologist believed she was having upwards of 30 seizures a day that we just weren’t able to see. Her team started to warn of seizure progression. So we hopped on the merry-go-round of medication trials. One after the other. Carefully weaning onto and then off of each one. One made her sleep all day, and the next showed no seizure control at all. A third made the seizures worse, and so on. 

Abby lived her life in the fog of the nearly continuous seizures, combined with the medication-induced fog of whichever drug we were trying now. We finally settled on one, but we had to continually increase the dose and Abby lost weight and seemed regularly more tired, as the medication stole her appetite and energy. 

Photograph of Abby, a 6 year old girl wearing an Elsa nightgown, glasses and bandages around her head wrapping up EEG wires while sitting in a chair next to a hospital bed holding Mickey Mouse and Minnie Mouse dolls.

As Abby’s seizures progressed, we decided to add CBD, and, later, THC, the two main components of cannabis. The effect was dramatic. The seizures all but disappeared. A year and a half after adding THC, her team at a world-renowned medical center decided to try taking her off of her pharmaceutical medication. In order to do this safely, she had to be admitted as the medicine slowly worked its way out of her system. They kept her hooked up to IVs and a continuous EEG for the entire admission--just in case, they told me. They wanted to be able to intervene quickly. They slowly titrated down and eventually stopped her medication. Then we watched and waited. 

Stopping a pharmaceutical epilepsy medication can be very similar to weaning someone off of heroin or other opioids. These medications are powerfully addictive, and the risks of stopping them suddenly include triggering massive seizures or even death. Cannabis is not physically addictive. You can safely stop taking it without any adverse reactions. Once Abby’s team felt satisfied that it was safe to discharge her, they sent her home with instructions for only one medication--the one that they said was the safest and most effective for her--medical cannabis. 

With the pharmaceutical drug out of her system, she became more alert, got her appetite back, and friends and teachers immediately started commenting on how different she was-- more engaged, more alert, happier, and more energetic. After spending half of her life on a medication that was sapping her of energy, we were suddenly treated to the full feistiness of our spunky little one, and it was amazing.

We cannot cross state lines with Abby’s cannabis while it is federally illegal. When we started her on THC, it was with a letter from the state of Pennsylvania guaranteeing safe harbor inside state lines, but nowhere else. Many families, including ours, use cannabis not just as a regular daily medication, but often a rescue dose during a seizure. Leaving it at home is not always an option.

Traveling with medical cannabis presents a host of legal challenges--especially if you happen to cross state lines. Documentation requirements vary from state to state and can be a major barrier to care for many families due to the fees, required background checks, and even banking rules involved. These requirements exist because medical cannabis is still illegal at the federal level. The irony is that all that documentation isn’t required for far more potent medications. Without medical cannabis being legalized at the federal level, there is simply too much legal grey area for families--especially those who are already marginalized and at risk during a traffic stop as we have seen too often. 

Families often have to balance the benefit of a potentially life-saving medication with the risk of losing custody of their medically complex child, and, in some cases, even going to jail.  

No family should have to choose between their child’s health and unjust legal consequences. It is time for our legislators to legalize medical cannabis at the federal level so that our children can have full access to the medication they need to not only survive, but thrive. 

Erin Gabriel is the National Director of Advocacy for Little Lobbyists, and State Chapter Leader for Little Lobbyists Pennsylvania. This story was shared with Abby’s permission.

Photograph of Abby, a little girl with brown hair and glasses, now age 11, wearing a pink life vest, seated in the front of a boat on a river, with her hands up in the air and laughing excitedly as though on a roller coaster ride.

Amadou, Zana, and Amy. [image description: A Black family poses on a couch. The dad wears a black & white plaid shirt, the son wears a colorful striped shirt, and the mom wears a gray shirt, her hair pulled back into a bun.]

We must end police violence against Black Americans, and against all people of color, and people with disabilities. The U.S. House of Representatives recently passed the George Floyd Justice in Policing Bill of 2021, which, if enacted, would ban chokeholds and end qualified immunity for police officers. Police violence affects communities of color disproportionately. Data from Mapping Police Violence shows that about a third of those who died in police custody were Black. 

Police violence also has a disproportionate effect on the disabled community--estimates suggest that between 25 and 50 percent of those killed in police custody had a disability. Autistic children and adults are especially vulnerable to police violence due to the common behavior of elopement, which is wandering off to escape anxiety, overwhelming sensory stimuli, or to simply seek out enjoyment such as interesting places or the sensation of running. 

Little Lobbyists Zana’s mom, Amy Koné, explains why she and her husband Amadou fear for their son, a Black Autistic five-year-old. (Zana calls his daddy “DaHee”):

Hiya village.

This one is deep. Like you might need a tissue deep.

 Amadou works outside for a living. He is in a lot of neighborhoods and sees a lot of things.

Today he was in the right place, at the right time.

A little four-year-old boy escaped his house and was running down the street. Amadou pursued him and was able to return him safely home.

So Zana’s DaHee is a superhero!

DaHee would not agree. He would say “I was just taking care of a little kid” and that when he saw this little boy he saw our Zana. 

I am sharing this story because as a parent to a child with Autism, Amadou knew elopement when he saw it. (It is different from a child who is a runaway.)

I also am sharing this story to try to bring some awareness to our society. 

First, If Zana were to ever elope I would NEVER call the police. I am a Black woman, married to a Black man, looking for a little Black boy. We are all three targets. 

I’ll let that sink in.

Our being Black is not surprising to anyone, but I mention it because I need people to appreciate how persistent tensions between the blue people and citizens impact us. I’m sure not all of the blue people are shady but I simply cannot take a chance.

Second, the poor mother was in a state of denial/shame. Amadou shared our story with her and now she knows she is not alone.

The stigma of having a child on the spectrum is sometimes so heavy that parents prefer to not address the condition at all.

Folks, the pressure is at times immense.

I cry myself to sleep many a night despite my acceptance of Zana’s diagnosis from the very beginning (his diagnosis was a relief to me because I could FEEL that something was different).

I can only imagine the storm brewing in a Black parent in denial AND facing the responsibilities of caring for a child on the spectrum.

There are many bright spots of being a parent to a child with Autism. One of them is that our little Zana is a sensory seeker. Extreme behavior makes him ecstatic; he feels ALIVE when he is living on the edge.

Since DaHee loves sports, the two of them have an extra deep bond. Zana loves to be thrown all around.

Folks, let me remind you that hubs is 6’5” and frequently mistaken for a pro football player. Imagine a man this big flinging your 55 lb. “baby” through the air, only to have him land safely on a mattress.

And both are filled with glee. 

I’m thankful Zana has his DaHee.

And that Zana’s DaHee can dig deep (all athletes understand this) when he is absolutely spent from a day of working outside in unpredictable weather to rough house with Zana.

Thanks, as always, for listening and caring about us. This village is phenomenal.

---

Amy Koné is parent to a child with Autism and a member of Little Lobbyists. She currently resides in her hometown, Baltimore MD, with her husband and son. Their family now spans three continents, five countries, and an ever growing circle of friends.

A montage of hand-decorated Little Lobbyists DIY holiday cards.

Like all of us, Laura Hatcher, our Director of Design & Communications, and Jeneva Stone, our Blog Manager, have had to figure out how to make these December holidays as jolly and bright as possible, given the challenges of the present moment. We had some ideas we wanted to share, and we’d love to have you share your ideas for making the season bright, and participate in Little Lobbyists’ advocacy by sending your legislators one of our printable DIY holiday cards or coloring sheets (details below)! 

Laura: This year has definitely been challenging - juggling Little Lobbyists, working full-time, adjunct teaching part-time, virtual home school/therapy and caregiving, while trying to be a good (sane) mom/wife/daughter/friend/human has been ... tricky. I often feel I'm dropping more balls than I'm keeping in the air. BUT, I'm also trying to find ways to appreciate the slow down and be grateful for the blessings I have. For my family, for work I love, for small progress and periods of good health, for yoga videos at home and (socially distant) walks outside with friends, for the ability to keep food on my table and afford extra to share with our weekly community food drive. When I count my blessings I really do feel better. I even try to start my classes by asking my students to share one thing, however tiny, bringing them joy in that moment. 

Laura’s snowflakes. [image description: Above a table set with glasses, flowers and dishes are two windows decorated with paper snowflakes.]

My best pandemic-safe tip for this holiday season - decorate! Add lights, color, greenery, whatever makes you happy inside and outside the home. It doesn't need to be fancy or complicated - just a visible expression of joy, light, and love to surround yourself with and share with each passerby. My favorite decorations are paper snowflakes. They cost practically nothing and I make dozens to tape to the windows each winter. My neighbors say they look forward to seeing them, so I made extra and slipped them into their mailboxes to share a little more joy. Unfolding them is a tiny gift unto itself.

As a Catholic, I observe Advent - a period of anticipation before Christmas. This year, as I count my blessings and make paper snowflakes, Advent feels more meaningful to me than ever before. We've been waiting in darkness for so long - through social and political unrest, economic uncertainty, and a pandemic. But I have faith that with a new administration and a vaccine on the way, 2021 will bring us all great light. 

Jeneva: I second Laura on lights (and decoration)! Over the years, my family has found that getting our outdoor and indoor lights up has helped our spirits. Both Hanukkah and Christmas are celebrations of light. I’m grateful that we’re all together for an extended time this year, as our youngest, Castin, is home from college now until February. 

Jeneva reads holiday stories to her children Castin (l) and Rob (r) in 2012. [image description: Seated on a couch, with a brightly lit wreath in a window above, a mom reads a book to two young children.]

Recently, Castin and I went up to our attic to find a toy from my childhood, which was waaaaay back behind lots of boxes. Making our way through the mess, I began opening some of those boxes and found them filled with artwork and toys my children had outgrown. But these raised happy memories for Castin, so I had a couple of ideas to combat money, isolation and melancholy. Nostalgia can really clear away the blues.

First of all, we’ll be redecorating my 50+ year-old dollhouse as we proceed through Advent, using some scrap materials from around the house, plus some items I’ve ordered online. 

Second, I’m giving some thought to cleaning and wrapping up a few of those old toys and using some for Hanukkah or putting them under the tree as “Blast from the Past” gifts. Even grown-ups love their old toys! And we’ll have something to talk about.

Laura and her son Simon. [image description: A mom and her son, both wearing nay blue Little Lobbyists t-shirts, stand in front of an American flag. The mom points proudly to her son.]

Third, I once read somewhere that you should snap photos of your kids’ early artwork. I’ll make some photo scrapbooks of those masterpieces Rob and Castin made years ago. Online photo services are great resources for books, calendars and photo plaques, which might even make good gifts for far-away relatives (and photo services can ship them out directly).

What has raised my spirits most of all these last months? I’ve felt buoyed by advocacy. While I can’t meet with legislators and others in person, my own volunteer work for Little Lobbyists helps me feel I’m still making a difference.

You, too, can help--print and send a Little Lobbyists’ holiday card to your legislators! There are lots of ways your child can participate: they can color and decorate the card, or write or tell you their own message to include, or you can snap a photo of their beautiful face and paste it in the card’s illustrated frame.

The card bears the message, “Wishing you a New Year filled with health and care when you need it, opportunities to learn and grow, and to be included in your community as the valuable person you are. (The same things kids with complex medical needs & disabilities wish for every day.)”

In our hearts, ALL of you bring us joy! Keep sharing your stories and spreading your truth. However you celebrate, we’re wishing you a very happy holiday season!

My son Sam is a superstar.  He’s outgoing, athletic, loves basketball, sings country music, is learning how to play guitar, and he’s enthusiastic about comedy, conversation, and history. In 2009, I learned Sam was autistic. With a background in social work and child welfare, I imagined I was well prepared. Instead, I had a lot of work to do. 

Sam has blonde hair and is wearing a sweatshirt. He is outdoors, looking at the camera and smiling.

Throughout elementary school and 5th grade, Sam was thriving and enjoying life more than ever. My superstar became a high scoring shooter on a rec league basketball team and was well loved in the community for his outgoing and friendly greetings and comedic conversations.

When Sam started middle school, all of the changes increased his anxiety, and he began to shut down during math class. Unfortunately, his teachers didn’t recognize his high level generalized anxiety, including a physical somatic response, even though it was expressly mentioned in the IEP.

In March of 2015, Sam’s anxiety was at peak level, and he refused to go into the math classroom. At first, teachers offered him time in the “resource room” with the behavioral interventionist. While being escorted to the resource room, Sam “eloped” – he broke away from staff and was immediately restrained on his back on the floor, by four adults – only one of whom had behavior intervention training.

Here is what Sam had to say about this experience five years later (for the full conversation, see  the video):

Daya: So when you were restrained after you ran away, how many adults restrained you? 
Sam: Four.
Daya: How did that make you feel?
Sam: Worried. Just just a little worried, worried, sad, really upset. 
Daya: Then, how did it make you feel the next day?  
Sam: I was having trouble remembering stuff: eating, drinking, playing, learning about the presidents, talking.

The day after that one-time restraint, I lost my child as I knew him. Sam couldn’t speak, couldn’t feed himself, was aggressive and self-injurious, and appeared to have regressed to a pre-kindergarten reading level after testing at the 4th grade level prior to the restraint.

Restraint and seclusion changed our entire family’s life, in fact, set it on fire for years. What followed were three years full of aggression, fear, and anger. Sam needed psychiatric medication for the first time ever. He became destructive and even lashed out physically. He was changed overnight because the teachers and staff I trusted to care and educate Sam didn’t have the tools they needed to appropriately and empathetically help him through a mental health crisis.

It’s clear that we need legislation to prevent more children from being harmed in school. On May 26, 2021 Congress unveiled the “Keeping Students Safe Act” to protect students from dangerous seclusion and restraint discipline practices in school introduced by Senators Murphy (D-CT), Murray (D-WA), Casey (D-PA), Durbin (D-IL), Kaine (D-VA), Warren (D-MA), Sanders (I-VT), Baldwin (D-WI), Van Hollen (D-MD), Brown (D-OH), Blumenthal (D-CT), Wyden (D-OR), and Duckworth (D-IL):

“The Keeping All Students Safe Act would make it illegal for any school receiving federal taxpayer money to seclude children and would ban dangerous restraint practices that restrict children’s breathing, such as prone or supine restraint. The bill would also prohibit schools from physically restraining children, except when necessary to protect students and staff. The bill would better equip school personnel with the training they need to address school-expected behavior with evidence-based proactive strategies, require states to monitor the law’s implementation, and increase transparency and oversight to prevent future abuse of students.”  

Today, even during these Covid-19 days, Sam is beginning to thrive again. He’s now in the 11th grade, and has mostly rebuilt the skills he lost while he navigates his world academically and socially with autism. He continues to play basketball (when there’s no pandemic), and has regained most of his verbal skills. He’s a growing self-advocate who wants to help ensure laws are passed to make restraint and seclusion illegal. 

Once again, in Sam’s own words: 
Daya: So what would you tell Congress about restraining in school;
remember we're talking about the bill called Keeping All Students Safe Act.
So what would you tell Congress about laws they could pass to protect kids like you?
Sam: Students should not be restrained at school especially.
Daya: How come? 
Sam: Because adults should train better. Should be trained better to help kids.
Daya: And so tell me about your rights: Do you have the right to be safe at school? 
Sam: Yeah.
Daya: Do you want to stop this from happening to other students?
Sam: Yes.
Daya: How come?
Sam: Because they should be trained better.

It’s our wish that other families be protected by federal law from such a traumatic course of events. We have all been changed by this experience, and in hindsight, the trauma caused by the restraint could have been prevented by such easy and deliberate choices such as employing better practices in crisis intervention – just as KASSA provides. Federal legislators have introduced restraint and seclusion bills since 2009! The Keeping All Students Safe Act was first introduced in 2011, with  iterations reintroduced in 2015 and 2018 without passage in the Senate. It’s time to see this pass!

To advocate for Keeping All Students Safe Act, Sam recounts the story of his restraint and seclusion.
Transcript:
Daya: Alright, how old were you when you were restrained?
Sam:  12
Daya: what grade was that?
Sam: Sixth.
Daya: How come you were restrained?
Sam: I was being dangerous and ran away.
Daya: Oh! You ran away. 
Sam: Yeah.
Daya: Okay so you ran away from where?
Sam: The resource room. 
Daya: Why were you in a resource room?
Sam: Because I didn't want to go to math with Mr. Parker.
Daya: What were your feelings about math?
Sam: Hard. 
Daya: Okay, so when you were restrained after you ran away, how many adults restrained you? 
Sam: Four.
Daya: How did that make you feel?
Sam: Worried. Just just a little worried, worried, sad, really upset. 
Daya: Then, how did it make you feel the next day?  
Sam: I was having trouble remembering stuff: eating, drinking, playing, learning about the presidents, talking.
Daya: All the stuff you learned from kindergarten, right?
Sam: Right. 
Daya: So what would you tell Congress about restraining in school; remember we're talking about the bill called Keeping All Students Safe Act. So what would you tell Congress about laws they could pass to protect kids like you?
Sam: Students should not be restrained at school especially.
Daya: How come? 
Sam: Because adults should train better. Should be trained better to help kids.
Daya: And so tell me about your rights: Do you have the right to be safe at school? 
Sam: Yeah.
Daya: Do you want to stop this from happening to other students?
Sam: Yes.
Daya: How come?
Sam: Because they should be trained better.
Daya: Okay, well thank you very much for this interview. I appreciate you talking about such a hard thing. 
Sam: Bye-bye.

---

Daya Chaney Webb is a Little Lobbyists Ambassador and Sam’s mom. She has a background in social work and child welfare, and is an expert in special education law and IEP development and implementation. She has helped other parents as a volunteer family advocate. The absence of legislation protecting kids with disabilities in school led her to lobbying work, most recently with The Alliance Against Seclusion & Restraint as Legislative Director.

Laura Leeman and her son Vic. [image description: Two people pose in front of a black & white background printed with the words “Avant Chamber Ballet.” A woman with short dark hair & a yellow print shirt stands next to a young man with short dark hair and glasses who sits in a wheelchair. The woman places her hand lovingly on the back of the young man’s head.]

We were in the middle of my son’s homebound Webex class when a sound stimulus triggered a seizure. Vic’s teacher could only watch as I suctioned him, pumped up his supplemental oxygen to four liters, leaned him back, and let him fall asleep. That's how a number of our classes end. Just prior to this, he was smiling and ready to participate in class. 

Vic is currently 15 years old, and in his first year of high school. He has always been a very happy guy. His infectious laugh brings smiles to anyone near him. He loves all types of music and being outdoors, especially at the beach where he used to feel the wind on his face. Vic’s uncontrolled seizures went largely undiagnosed until last year, when he was found to have a rare genetic syndrome linked to epilepsy called GRIN2A. Also, we discovered a year ago that Victor’s lymphatic system is breaking down. While we’ve learned more about Victor’s medical health, having a genetic diagnosis does not give us a complete picture of the reason for his many seizures. 

What I do know is that Victor’s seizures are a pre-existing medical condition. As an infant and into early childhood, Vic had up to 50 or more seizures per day. Today he averages one to five. As he's aging, his daily seizures are more intense, but lower in number. Vic takes three costly seizure medications per day along with many other medical interventions for all of his medical conditions.

While Vic’s medical journey began before the Affordable Care Act (ACA) was passed, I know how important the ACA is and I know that I am not fighting with insurance companies the same way I did pre-ACA. To be direct--Vic is alive today because of the many benefits the ACA provides: Victor may remain on our health plan until the age of 26 with no lifetime limit on the high costs of his medical care. 

It is not an overstatement that the ACA has been pivotal in Victor's care as it has extended his life, living with our family in our loving home. If it were not for the ACA, there is no question that our lives would be very different!  At age three, prior to the ACA’s passage, Vic was nearing his lifetime insurance limit of $2 million. I remember opening and worrying about every bill and reading each insurance explanation of benefits (EOB) form. The words, "Lifetime limit total is now X," were printed at the bottom of each EOB until the ACA passed and those words disappeared along with my financial worries.

Vic's 105-day hospital admission one year ago included medical travel to have surgeries out-of-state, as well as a return admission back to Texas. These bills were well over $2 million and I have the EOBs to prove it!

I cannot fathom to think whether Vic would be alive today if we didn't have ACA protections. These prevent Vic from being denied coverage for his many expensive medications, medical treatments, specialist appointments, hospital admissions, therapies, home health equipment (feeding supplies, syringes, tubing, and IV pumps, etc.), and his durable medical equipment (wheelchair, suction machines, Hoyer lift, hospital bed, cough assist, etc.).

Laura Leeman stands next to Vic (who is in his bed) & speaks with former congressman Beto O’Rourke. [image description: A woman with a “Health Care Voter” t-shirt faces a a man in a suit and tie. They are talking. Next to them, a young disabled man lies in a bed, attached to several pieces of medical equipment. On the walls are mounted toy trains, certificates and railroad memorabilia.]

Through all of this, I know that we are not alone. Millions of families are just like us and have the same worries as we do while the Supreme Court considers the November 10, 2020, ACA oral arguments, a case that will not be decided until April or May of 2021.

As for now? November is Epilepsy Awareness Month! Please join me in spreading both epilepsy awareness and positive vibes as millions of Americans remain in limbo, hoping to keep the health care they have. As the new Congress considers what’s at stake for our kids, we hope they will improve the ACA  by making it more affordable and providing more coverage to every American. Health coverage is essential to sustaining life without worrying  about or facing the high costs of medical bills.

Some Quick Epilepsy Facts 

• 65 million people around the world have epilepsy.

• 3.4 million people in the U.S. have epilepsy.

• 470,000 U.S. children have epilepsy.

• 1 in 26 people in the U.S. will develop epilepsy at some point in their lifetime.

• Between 4 and 10 of every 1,000 people on earth live with active seizures at any one time.

• 150,000 new cases of epilepsy are diagnosed in the U.S. each year.

• One-third of people with epilepsy live with uncontrollable seizures because no available treatment works for them.

• 6 of 10 people have no known cause for their epilepsy.

No parent should have to worry about medical costs when their child is faced with multiple medical conditions---Life is stressful enough!

Please take time to learn more about Epilepsy Awareness Month, GRIN2A, and what may happen next with the ACA. 

---

Laura Leeman is a stay-at-home mother of two boys. She and her family live in North Texas. Laura is guided by her older son's medical journey, which began when he was 12 days old. Laura has been a speaker at several events, including a livestream in her home with former congressman Beto O'Rourke in 2017, during which she shared her story and educated him and others on health care concerns and disability rights. She has earned Bachelor's and Master's degrees, and is a recent graduate of Texas Partners In Policymaking.

Jamie Davis Smith speaks in front of the Supreme Court. [image description: A woman wearing a face mask stands in front of a microphone. Protestors carrying signs supportive of health care stand in a line to her left & right. In the background is the U.S. Supreme Court, bright white marble against a flawless blue sky.]

My daughter Claire is 14 and loves ice cream, being in water, and has spent much of the pandemic snuggled on the couch with her three younger siblings. Claire spent the first few weeks of her life in the Neonatal Intensive Care Unit receiving the best medical care available. There we learned that nearly every part of Claire’s body was formed differently than most. She is missing parts of her brain and her heart is not in the typical place. She has epilepsy, asthma and intellectual disabilities. 

Like Amy Coney Barrett’s son Benjamin, who was born with Down Syndrome, Claire was born with pre-existing conditions. But Claire was born in 2006, four years before the Affordable Care Act (ACA) was passed. This meant that every test she had, every procedure, every hospital stay, every doctor’s appointment, every therapy visit, every canister of oxygen was a tick mark against her annual and lifetime caps on care. Every step I took to help Claire stay healthy felt like a step closer to the day she would not be insurable – at any cost – because of the way she was born.

Because Justice Barrett’s son was born after the ACA passed, she never had to worry that her child would suffer (or worse) because his health insurance benefits ran out. And she never experienced the relief that came to parents like me when the ACA passed, and we could tuck our children in at night with peace of mind, knowing that, while they might still face challenges, those challenges would not be a lack of access to health care. Justice Barrett never felt this relief because she never carried the worry that came along with having a disabled child before the ACA became law. 

After the ACA was passed, we no longer worried that Claire would lose her health insurance because an insurance bureaucrat decided what her life was worth and that she was too expensive to keep alive. Friends who received pre-natal diagnoses of illness or disability felt confident that after their children were born they would never have to go without health care because of pre-existing conditions, or because they could not afford to pay for the care their children needed.

Yet Justice Barrett is clearly on record as being opposed to the ACA and is poised to be the decisive vote to overturn the law. She takes this position knowing that without the ACA’s mandates millions of Americans, like her son, with pre-existing conditions could lose their insurance and access to health care.  

Justice Barrett now has a secure, life-time job with access to some of the best health benefits offered in the country. Few other Americans are so lucky. While I certainly believe that every Supreme Court Justice and their family should have access to quality healthcare, I do not believe that this right should be guaranteed only to the wealthy and the powerful. Neither does Joe Biden, whom Americans just elected with a record number of votes – many of those votes cast before Justice Barrett was confirmed. I, too, believe that everyone deserves the right to access healthcare, even if they were born with pre-existing conditions.

It is stunning that after making so much progress toward achieving this goal we are now on the cusp of limiting access to health care, rather than taking steps to expand Medicaid and other programs that ensure that everyone has the care they need. I believe the voice of the American people should be heard. Americans just voted in overwhelming numbers to support these ideals: compassion and that every life has value. 

After four years, no viable alternative to the ACA has been proposed. The ACA must stand!

Claire deserves better. We all do.

[Adapted from Jamie’s remarks delivered on the steps of the U.S. Supreme Court during oral arguments on the future of the ACA, November 10, 2020.]

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Jamie Davis Smith is a mother of four who lives in Washington, DC. She is an attorney, writer, and disability rights advocate. Jamie is a member of Little Lobbyists, and her articles about her family's experiences with disability and advocacy are frequently featured in national publications.

Walewska and her son Aire. [image description: A mother & son pose in front of a bookcase. The mom has long black hair & wears blue-frame glasses. The son has short dark hair.]

Walewska y su hijo Aire. [descripción de la imagen: Una madre e hijo posan frente a un librero. La madre tiene cabello largo negro y usa espejuelos de montura azul. El hijo tiene pelo corto y oscuro.]

Let me tell you about my son: His name is Aire, which is Spanish for air. He loves soccer, piano, acting, drawing, biking, silly jokes, and math. 

Like more than 100 million others in the U.S., Aire has pre-existing medical conditions—including autoimmune and adrenal disease, severe allergies, and an Autism Spectrum diagnosis—that insurance companies would prefer not to cover, in order to protect and increase their multibillion dollar annual profits.

When I first moved to Virginia some years ago, I had just sold my first home, because our family simply could not afford to pay the mortgage and all the deductibles, co-pays, and out-of-network fees associated with numerous medical treatments and therapies for my son. Although we had health insurance, we had to spent $80,000 in out-of-pocket expenses in just one year. 

Unlike most other children in the US, my son is lucky enough to be part of a family full of lawyers willing to fight our health insurance companies. But this is outrageous! No one’s health should be tied to their wealth, or to their ability to retain a small army of attorneys to advocate for them.

That is why Aire and I became members of the Little Lobbyists, a family-led organization advocating for health care for children with complex medical needs and disabilities. Little Lobbyists also speaks up for our children’s rights to an education and community inclusion.  

We all came together because we rejected the repeal of the Affordable Care Act, as well as any health initiative based on the idea that health care is a privilege that can be rationed like potatoes or bread.

Aire first met Congresswoman Jennifer Wexton (VA-10) when she held her first meeting as a sitting congressperson after the 2018 election with a group of our Little Lobbyists families. Since then, she has met with our families at one of our local parks and at a local library, and she has welcomed us as we went trick-or-treating in Congress last year. My son and I had the honor of attending the 2020 State of the Union address as guests of Congresswoman Wexton. 

Walewska Watkins speaking at Rep. Wexton’s Election Night celebration. [image description: A computer screenshot with blue graphics and featuring a tall woman with long black hair at a podium, wearing a Little Lobbyists t-shirt.]

Walewska Watkins hablando durante la celebración de la noche de elecciones de la representante Wexton. [descripción de la imagen: una captura de pantalla de computadora con gráficos azules, que muestra a una mujer alta con cabello largo y negro en un podio, vestida con una camiseta de Little Lobbyists.]

Congresswoman Wexton has listened to our grievances and our friends’ grievances regarding the rising costs of health care, the continuing challenges that keep disabled children from full community inclusion, and the need to eliminate from all publicly funded schools the practices of restraint and seclusion that so frequently target minority children.  

She understands that Virginia’s District 10 families need Congress to strengthen and correct the Affordable Care Act health insurance market exchanges and to expand Medicaid. She is also clear that we must not allow Medicaid block grant limits, like those currently imposed on the territorial possessions of the United States—including my native island nation of Puerto Rico.  

But Congresswoman Wexton has done more than just listen to Little Lobbyists’ families about their fears that their children would become uninsurable and their lives cut short if the Affordable Care Act were repealed by Congress or overturned by the U.S. Supreme Court.

She has consistently voted to pass legislation that would lower the costs of prescription drugs, reduce insurance premiums, eliminate junk health insurance plans, and increase funding for educational services and mental health professionals to serve our youth. 

I have felt proud, inspired, and delighted to be Congresswoman Jennifer Wexton’s constituent, and to be a member of Little Lobbyists.

[These remarks were adapted from Watkins’ speech at Rep. Wexton’s Election Night party on November 3, 2020.]

Permítanme contarles sobre mi hijo: Su nombre es Aire[.] Le encanta el balompié, ​​el piano, la actuación, el dibujo, el ciclismo, los chistes y las matemáticas.

Al igual que más de 100 millones de personas en los EE. UU., Aire tiene condiciones médicas preexistentes—incluyendo enfermedades autoinmunes y adrenales, alergias graves y un diagnóstico del espectro autista—que las compañías de seguros de salud preferirían no cubrir para proteger y aumentar sus multimillonarias ganancias anuales.

Cuando me mudé por primera vez a Virginia hace algunos años, acababa de vender mi primera casa, porque nuestra familia simplemente no podía pagar la hipoteca y todos los deducibles, copagos y tarifas fuera de la red asociados con numerosos tratamientos médicos y terapias para mi hijo. Aunque teníamos seguro médico, tuvimos que gastar $ 80,000 de nuestro bolsillo en solo un año.

A diferencia de la mayoría de los niños y niñas en los Estados Unidos, mi hijo tiene la suerte de ser parte de una familia llena de abogados dispuestos y dispuestas a luchar contra nuestras compañías de seguros médicos. ¡Esto es indignante! La salud de nadie debe estar ligada a su riqueza ni a su capacidad para retener un pequeño ejército de abogados y abogadas para defenderle.

Es por eso que Aire y yo nos convertimos en miembros de Little Lobbyists, una organización familiar que aboga por un cuidado de salud asequible y calidad para los niños y niñas con necesidades médicas complejas y discapacidades. Little Lobbyists también defiende sus derechos a la educación y la inclusión comunitaria.

Nos unimos porque rechazamos la derogación de la Ley de cuidado de salud asequible (Affordable Care Act) así como cualquier iniciativa de salud basada en la idea de que la atención médica es un privilegio que se puede racionar como las papas o el pan.

Aire conoció por primera vez a la congresista Jennifer Wexton (VA-10) cuando ella celebró su primera reunión como congresista en función después de las elecciones de 2018 con un grupo de nuestras familias de Little Lobbyists. Desde entonces, se ha reunido con nuestras familias en uno de nuestros parques locales y en una biblioteca local, y nos dio la bienvenida cuando fuimos a pedir dulces en el Congreso durante Halloween el año pasado. Mi hijo y yo tuvimos el honor de asistir al discurso del estado de la unión 2020 como invitados de la congresista Wexton. 

La congresista Wexton ha escuchado nuestras quejas y las quejas de nuestras amistades sobre los crecientes costos de la atención médica, los continuos desafíos que impiden a los niños y niñas discapacitadas una inclusión comunitaria plena y la necesidad de eliminar de todas las escuelas financiadas con fondos públicos las prácticas de restricción y aislamiento con frecuencia se dirigen contra los grupos minoritarios.

Ella comprende que las familias del distrito 10 de Virginia necesitan que el Congreso fortalezca y corrija los intercambios del mercado de seguros de salud de la ley de cuidado de salud asequible (Affordable Care Act) y que expanda Medicaid. También tiene claro que no debemos permitir la reforma de Medicaid a través de subvenciones en bloque, como las que actualmente se imponen a las posesiones territoriales de los Estados Unidos— incluyendo a mi nación natal, Puerto Rico.

Pero la congresista Wexton ha hecho más que simplemente escuchar a las familias de los Little Lobbyists sobre el temor de que sus hijos e hijas se vuelvan no asegurables y que sus vidas se trunquen si el Congreso deroga la Ley de cuidado de salud asequible (Affordable Care Act) o si la Corte Suprema de los Estados Unidos la anula. 

Ella ha votado constantemente para aprobar legislaciones que reducirían los costos de los medicamentos recetados, reducirían las primas de los seguros, eliminarían los planes de seguro médico basura y aumentarían los fondos para los servicios educativos y los profesionales de la salud mental para servir a nuestra juventud.

Me he sentido orgullosa, inspirada y encantada de ser una constituyente de la congresista Jennifer Wexton y de ser miembro de Little Lobbyists.

[Estos comentarios fueron adaptados del discurso de Walewska Watkins durante celebración de la noche de elecciones de la representante Wexton el 3 de noviembre de 2020.]

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Walewska Watkins is an Eviction Prevention/Housing Attorney at the Legal Services of Northern Virginia. She received her Juris Doctor from Georgetown University Law Center and her LLM in Environmental Law from Tulane University Law School. She is licensed to practice law in New York, California, Puerto Rico, the District of Columbia, and the Commonwealth of Virginia. Prior to joining Legal Services of Northern Virginia, the native Puerto Rican islander gained experience working for the Chief Magistrate Judge in the U.S. District Court for the District of Puerto Rico (Hon. Justo Arenas) and as a litigator and administrative counsel focused on civil rights, environmental regulation and environmental justice, gender discrimination, and First Amendment rights. Ms. Watkins is a Partner in Policymaking TAA member at the Virginia Board for People with Disabilities, a member of the Virginia Latino Advisory Board, and a member of the Fairfax County Community Action Advisory Board, which advises the county’s Board of Supervisors on the needs of limited-income persons and recommends policies to promote meaningful change.

Walewska Watkins es abogada de prevención de desalojos y materias de vivienda en Legal Services of Northern Virginia. Recibió su grado en leyes Georgetown University Law Center y su maestría en derecho ambiental de la Facultad de Derecho de Tulane University. Tiene licencia para practicar la abogacía en Nueva York, California, Puerto Rico, el Distrito de Columbia y Virginia. Anteriormente, en su país natal de Puerto Rico, adquirió experiencia trabajando para el Juez Magistrado Principal en el Tribunal de Distrito de los EE. UU. Para el Distrito de Puerto Rico (Honorable Justo Arenas) y como litigante y abogada administrativa enfocado en derechos civiles, regulación y justicia ambiental, discriminación de género y derechos bajo la primera enmienda constitucional. Ms. Watkins es miembro del TAA de los Partners in Policymaking de la Virginia Board for People with Disabilities, miembro de la Virginia Latino Advisory Board y miembro de la Fairfax County Community Action Advisory Board, que asesora a la Junta de Supervisores del Fairfax County sobre las necesidades de personas de ingresos limitados y recomienda políticas para promover un cambio significativo.

Amanda Upton (l) and her family. [image description: From left to right, a mom, a young daughter, a dad, and another young daughter, all with colorful t-shirts, light hair, and each wearing a face mask, pose outside.]

I am the mom to two wonderful daughters who love to pretend to be princesses and fairies. They love spending time with friends and are two of the most compassionate people I know. Some of that compassion for others comes out of their empathy and life experiences. While we are still searching for the name of their genetic disorder, their symptoms tell us that multiple body systems need extra support with things like feeding tubes, oxygen, leg braces, and most recently an intravenous infusion port for my oldest, all to support their bodies with low muscle tone and dysautonomia symptoms. 

My kids have been covered under ACA for their entire lives; however, part of why I’m so passionate about making sure the law remains in place for them is because I had to deal with health insurance before the ACA went into effect. 

I married my high school sweetheart in college. We had always been under our parents’ employer-based insurance, so it was our first time buying insurance on our own. I had been diagnosed with asthma and ovarian cysts. My husband had an exercise-induced asthma diagnosis when he was a kid, but no issues with it as an adult. On the other hand, in the year before our wedding, I had an asthma attack that landed me in the hospital for several days. I also ended up in the ER with a cyst that was problematic. My husband's underwriting process was fast. Mine took forever: I kept getting calls and paperwork. 

We were finally granted insurance; however, my premium was about double that of my husband's. The first time I went to the pharmacy with this policy, I was informed that the drugs Singulair and  Advair prescribed for my asthma, and birth control pills prescribed to stop my ovarian cysts would not be covered. Not because we had more to pay toward our out-of-pocket max, but because--no matter what--these would never be covered because they were considered to be treatments for pre-existing conditions. Thus, in underwriting, my insurer had written them out. 

A few months after our policy was active, I went to a walk-in clinic for a sinus infection, and later received the full bill because the visit had been denied. I called the insurance company, and they explained my policy: If any illness I had involved my reproductive system, lungs, or sinuses, it would not be covered at all, even if it had no relation to my asthma or ovarian cysts. At this point I was having some joint issues, but I felt like seeing a doctor for those concerns was not wise. I couldn't afford one more pre-existing condition if we needed to switch insurance for some reason. 

It hit a point where we made the choice to become uninsured because the policy we had would literally not pay any bill submitted to them. The insurer claimed “pre-existing condition” for everything, and we were paying hundreds of dollars per month as college students for a plan that was garbage. 

The ACA went into effect while my husband and I were still in college, and we were both able to go back onto our parents’ insurance plans. My joint issues have now been diagnosed as Ehlers-Danlos Syndrome, so I really should have done something about it then. But insurance stood in the way. My girls have more pre-existing conditions than I do, so I don't want them to be paying for junk insurance as I had to do. There’s no way that if the ACA is overturned they would be able to buy commercial insurance. They would also have very likely hit their lifetime max by now due to the amount of hospital stays and specialists they have seen. 

In the words of my seven-year-old, “The ACA is important because it keeps people alive.” She understands the reality that insurance pays for her medications and medical supplies; because those are covered, she is able to just be a kid. The fact that anyone would want to repeal the Affordable Care Act is shocking to her; her compassionate heart just does not understand why people would be OK with insurance companies not covering her and her friends. 

I do not want her generation to be in the same shoes I was in for insurance. Junk healthcare plans only help the insurance companies and take advantage of average Americans. My pre-existing conditions will always be a part of me: I believe we need healthcare in this country that cares for the whole person. If we really believe that we all are created equal, then we need our healthcare laws to reflect that. 

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Amanda Upton is a midwestern mom and a licensed teacher for children from birth to age eight in both regular and special education. After several years in the classroom, her teaching license is now being used at home to homeschool her daughters. She loves all things Disney Parks and experimenting in the kitchen. Amanda has also written several articles for Complex Child. 

Erin & her daughter Lucia. [image description: A mom with long dark hair, wearing sunglasses, poses with her disabled daughter.

These past few weeks as our country teeters on a precipice, and despite what I was taught in kindergarten, I find myself fantasizing about having a bully on my side, being as cruel as it takes to cut down my fiercest opponent.

I should know how good that sounds, because in this political climate, my family is considered weak and needy. 

My husband and I are both highly educated and work at fulfilling jobs. Our daughter is six, and she lights up any room with her wide smile and her infectious laugh. Lucia has a progressive, genetic disease of the brain, but with the proper medical care, therapies, equipment, and treatment, she can have a high quality of life. 

When I started telling my family’s story four years ago, about how our private insurance didn’t cover what my disabled and medically complex daughter needed to survive and thrive (so we rely on Medicaid), our vulnerability was on full display. Yet, I was pleasantly surprised to find most people understanding, empathetic, even grateful to be informed about an injustice they simply did not know existed.

A few years later, when this Administration and Republicans tried to repeal the Affordable Care Act (ACA) through legislation and my daughter’s Medicaid was on the chopping block, people seemed willing to acknowledge how scary that was for my family. Even if they had qualms about universal healthcare, or it didn’t seem to affect them directly, they understood why I was worried. They could see it from my point of view.

But this year, when my medically complex daughter’s healthcare still hangs at the mercy of this Administration, Congress, and the Supreme Court, it seems like people have stopped listening.

Perhaps they’re tired of hearing me advocate and worry. But more often these days, they actively deny my fears, and they casually brush off my concerns, telling me that there’s nothing to worry about. I’m over-reacting, they chide. Everything will be okay.

It seems harmless, even good-natured, to tell someone they don’t need to worry. But there’s a calculated disdain and distancing in these comments that makes me fearful. I wonder how people can diminish my concerns when they know my daughter’s healthcare has been under threat for two-thirds of her short life. How can they tell me not to worry when they support legislators and an Administration that have kept her healthcare in jeopardy in the midst of a global pandemic? How can they think I’m overreacting, when all I’ve ever wanted was to keep my daughter safe and healthy?

I worry that I’m witnessing the making of a nation of bullies.

Bullies aren’t born cruel, they’re made that way. Over time, as they grow callous to other people’s fears and feelings, they engage in gaslighting and victim-shaming, numbing themselves to reality. That numbness lets them imagine the world otherwise.

No one thinks they’re a bully, even those who support one. But if you’re cheering one on so loudly that you can’t hear the cries of distress coming from your neighbors above the noise, just who is it that you have actually become?

Lucia Raffety-Schneider. [image description: A young disabled girl wears a pumpkin costume for Halloween. Her wheelchair has been turned into a pumpkin patch costume, with a white picket fence, green vines & additional pumpkins.]

I’ve struggled with how to continue to advocate for my daughter in this abusive political climate. How many times will we stick our necks out, believing it will be different, only to be told by someone that it’s not as bad as we think it is? Everyone tells you that the best way to deal with a bully is to turn around and walk away, but how do you do that when they’ve got you by the neck?

It was only this evening that I realized, maybe I can’t walk away, but you can.

You can stop cheering on a bully. You can walk away from apathy. gaslighting, aggression, and cruelty.  

When you walk away from a bully, you can walk back toward those people in need in your life and in our country, and you can pull up a chair and listen. You can move toward people who matter to you, and try to understand and accept their pain, their hurt, and their fear.

When you see someone else’s fear and pain, you forget yourself because you start seeing them more clearly, maybe for the very first time.

Walk away from the bully, come closer to your neighbor. We will need each other to turn this country around.

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Rev. Dr. Erin Raffety is a Presbyterian pastor and a Research Fellow at the Center of Theological Inquiry where she studies congregational ministry with people with disabilities. Besides her academic work, Raffety has published with The Huffington Post and Church Anew.

Savannah as an infant. She is strapped to a gurney for medical transport, with a hospital blanket under her head and a rainbow-striped blanket over her torso. A supplemental oxygen cannula has been inserted in both nostrils. She is gripping a bright red stuffed lobster with her left hand.

My daughter, Savannah, loves Disney princesses, dolls, dancing, and outer space. She has heterotaxy syndrome, which literally means “different arrangement.” Her body organs are misplaced, missing, and/or malformed. She has issues with her heart, lungs, airway, intestines, kidneys, and liver. She is missing her spleen entirely. Her most severely impacted organ is her heart. Today, she’s doing pretty well. But five years ago this month, Savannah rapidly declined and crashed at home. She was not yet two. 

By the time we got her to the ER, her oxygen was dipping into the low 40s, when it should be in the 90s. Savannah’s grandfather, a paramedic, met us at the doors and grabbed her out of the car. Her skin was blue, and her eyes were rolling back in her head. He barreled past triage and into the not-yet-totally-clean room, snatched oxygen off the wall and clamped it to her face.

It took eight liters of flow to raise her oxygen saturation levels back into the 80s. Normally when she struggled, even after open heart surgery, she only needed a half liter or less. My husband and I stayed with her, and her grandfather went to the nurses’ station. He knew who was best for Savannah and the situation, and he sent those doctors and nurses in fast.

The room absolutely erupted in activity. I paged cardiology at Savannah’s primary hospital (150 miles away) and handed the doc my phone. They dispatched helicopter transport for Savannah immediately, and her team began dictating what to do over the phone.

In a flurry, we sent someone to our house to grab some extras that we needed, including Savannah’s pacemaker transmitter in case she had had an arrhythmia or heart attack. (Our go bags for admission are ALWAYS packed and with us). Savannah’s grandma joined us in the ER so we could make a plan.

Savannah was given x-rays, was administered IV diuretics and heart medications, and gave blood for labs. Thankfully, she maintained herself better on that eight liters of oxygen.

When transport arrived, we sent Savannah up to the helipad with her grandparents. We couldn’t ride with her, so we kissed her goodbye after the paramedics strapped her in. 

We started driving as fast as we could. Once we got in the car, I called family, I updated friends, and I cried and prayed my baby would stay stable so we could see her again as the helicopter she was in flew over our car.

Do you know what I did not do?

• I didn’t ask if the ER doc was in-network.

• I didn’t ask if the labs were covered on our insurance plan.

• I didn’t get a prior auth for the $40,000 critical care helicopter flight.

• I didn’t worry about hitting any kind of limits or restrictions on our insurance. 

My baby was dying. In that moment, it didn’t matter.

The problem is, later it does matter. That year, Savannah’s medical bills were roughly $1.7 million. Insurance was eager to deny anything they could. Our private insurer line-item denied critical care items from her two-month hospital stay and forced me to appeal them one by one.

I had to fight and appeal and be relentless, all while sitting beside my daughter’s hospital bed, far from home, in the days after she had had open-heart surgery. 

During a medical emergency, no one should be expected to think about prior authorizations or which hospitals and specialists are in-network. Let me correct myself: They shouldn’t be expected to think of it at ALL.

If someone requires emergency or even routine medical care, their primary concern should be getting what they need to best attain and maintain their maximum level of health. That means more health insurance reforms: 

• No step therapy

• No prior authorizations

• No prescription formularies

• No networks

• No caps on care

Savannah today. She is wearing glasses and smiling. Savannah is dressed in a bright orange NASA space costume, including a space helmet. She is clutching an American Girl doll with her right arm, which is dressed identically.

The Trump Administration’s unprecedented attack on health care, and the Republican Party’s hostility to the Affordable Care Act (ACA) threaten my daughter and threaten us all. The U.S. Supreme Court has scheduled oral arguments on the ACA for November 10, just days after the presidential election.

What most people don’t understand is that the ACA is, literally, why my child is alive. She is well past the lifetime caps that used to be on health insurance policies pre-ACA. She couldn’t change insurance plans easily because insurance companies would decline her outright, charge her an unaffordable premium, or refuse to cover her extensive list of pre-existing conditions.

When you go into the voting booth or sit down with your mail-in or absentee ballot, vote like someone’s life depends on it. Because for so many like my daughter, it does.

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Lori Hensler is a member of Little Lobbyists. She is also a jewelry designer, and she lives in Indiana.

Emma Staggs, a young girl with blond braids and a blue dress with a watermelon slice pattern, holds her AAC device in its bright pink case. Emma is seated on play equipment in a backyard.

I love the sound of my daughter's voice. Like any mama who adores her kiddos, the sweet, small sound of their voices are music to my ears.

My twin girls, Emma and Sara, will celebrate their 7th birthday later this month. They are happy, rambunctious, curious and remarkably loud! Our family, like millions of others across the country, is navigating distance learning in all its online glory. Also, like millions of families whose kids have complex medical needs and disabilities, we have been at home since March. Our visits with aunts, cousins, and grandparents have been via video calls. In a world that leans into technology, we are more immersed than most, for an incredibly important reason: Emma speaks through an Augmentative and Alternative Communication (AAC) device.

Among the list of pre-existing conditions that arose from extremely premature birth and prolonged intubation (months on a ventilator), Emma has idiopathic bilateral vocal cord paralysis (iBVCP), which means that her vocal cords are essentially stuck together, so they do not produce sound. She has a breathing tube and a feeding tube that were surgically implanted when she was 3 months old. These procedures saved her life and offered a path to hospital discharge so I can raise her in our home, with our family. 

Apart from a breathy exhale or gurgly, boisterous belly laugh, she doesn't produce any sound.  And sure, she's under the care of multiple specialists. There is always hope and, in fact, 75% of children with iBVCP gain their voice by age three. Can you imagine? They just wake up one day, singing like a bird! Again, Emma and her sister will be 7 this month, so she is part of the remaining 25% that haven’t gained their natural speech.

My husband and I have done what all parents do for their children. We find the tools they need to meet their fullest potential. For Emma, and kids with a similar diagnosis, a big part of that is her AAC with voice output. It looks like a pumped-up iPad, but with specialized hardware and software and a pink protective case so she can safely carry it everywhere she goes. It has a series of pages, with grids and pictures on each page. When she taps each individual grid, the software causes an approximation of a young girl’s voice to speak the word associated with the picture. Thankfully, technological advances allow the voice to sound more assimilated and much less robotic. It literally sounds like her (or what I imagine to be her voice)!

Emma’s AAC device, which resembles an iPad and is in a pink case. The screen displays icons for various colors, and below it is a sketch pad on which Emma has drawn colorful flowers with markers and written her name.

Here's the thing, it's AWESOME! As she learns to navigate this tool, her world expands. She can better communicate her wants and needs, her likes and dislikes. She can touch buttons that sing her favorite songs in sections. She can greet her family and nurses, tell us when she wants to take a break or needs her breathing tube suctioned. It even helped with potty training! When her teacher asks questions during online learning, she can respond. In conjunction with American Sign Language (ASL), she is included in the learning and social exchanges that happen throughout the school day.

As she grows, the device will grow with her, which is fortunate because it came with a $6,000 price tag, covered by Medicaid after months of paperwork, letters of medical necessity, and therapeutic justification from her therapists. The difficulty is worth it: I think most of us agree that communication is a necessity, a human right, and something we should make all attempts to provide. I would argue that vulnerable and marginalized people need to use their voices even more.  

We are preparing Emma to be a successful self advocate. On that glorious day when her proficiency, tools and abilities to speak her wants and needs to a society with the grace to listen, nobody will be more relieved or excited than her family.

But I have to admit, my favorite part is when she pushes the button that gives the voice command to say, "Hi Mommy. I love you." That is music to my ears.  

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Stacy Staggs is Little Lobbyists’ National Director of Community Outreach and its North Carolina Chapter Leader.

Rico Winston and his son Israel

I am the proud father of an amazing little boy, created and designed by God, individually and perfectly, who has a diagnosis on the autism spectrum, and whose name is Israel. As a man of color raising a little boy of African ancestry who has a diagnosis on the autism spectrum, I worry about my son's future.

I'm concerned about how America and the world will look at him--what inequality and racial divides will be awaiting him? There are two things that Israel cannot change, and these are the color of his skin and the fact that he has a diagnosis on the autism spectrum.

As a parent it is my responsibility to Israel to recognize these two facts that he cannot change. These realities do not make him lesser or greater than another. The only thing that will make him great is the content of his heart and his willingness to accept and find value in others, no matter what differences they may have. I'm teaching him that individuality is a gift, and to accept and appreciate the individuality in each human being.

Each of us has had our pleasant, and I'm sure not so pleasant, experiences during the COVID-19 pandemic. One of the positive factors for me has been the opportunity to learn and observe Israel's strengths and weaknesses, as related to his education. Israel, will be entering the fifth grade this upcoming school year. He is accustomed to being in a physical classroom environment with his teachers and peers. Virtual schooling has created an uncomfortable and unfamiliar learning environment, accompanied with anxiety, not only for Israel, but myself as well. 

While Israel has had a tendency of being easy to please, during the pandemic, he has been a good self-advocate. Israel has been very clear with his occupational and speech therapists about his dissatisfaction with virtual learning, and that he needs in-person instruction. Israel would like to return to school in the fall, but, of course, how the Baltimore schools will proceed is not yet clear. 

As a parent and an advocate for my son, I am committed and obligated to find what fits and works for Israel's educational and spiritual development so that he may develop into the best human being he was created and designed to be. There has been a dirty, ugly reality swept under America's rug for so long, which some cannot see and some continue to ignore, and that is "the wrong color of skin," which has led to racial disparity and injustice. 

However, there has been a resurgence of the awareness that black lives matter, and that black disabled lives matter. I was a little boy when one of the amazing heroes who fought against social injustice and disparity for black lives, people of color, was  murdered. This magnificent hero and man was Dr. Martin Luther King.

In Washington D.C., on 28 August 1963, at the Lincoln Memorial, there was a timeless speech given by Dr. King, entitled,  "I Have a Dream." The sad reality--which makes this remarkable speech timeless – is, as a whole, America and every American hasn't reached that "mountain top," so it's still a dream, Dr. King's dream, and now my dream.

"I have a dream that one day on the red hills of Georgia, sons of former slaves and sons of former slave-owners will be able to sit down together at the table of brotherhood … I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character.”

If I had the opportunity to add anything to the “I Have a Dream” speech, this is what I would add:

“I have a dream that...little black boys and black girls will be able to join hands with little white boys and white girls” and that all children, no matter the color of their skin, or if they have autism, are in a wheelchair, visually impaired or hearing impaired, no matter what challenges or differences, that they will be accepted and recognized as individuals, and valued for their unique individuality.

I am raising Israel so that he will be accepting of the color of someone's skin, and accepting of the differences and challenges of others. Some of these differences are apparent, and some are not. 

Tolerance, acceptance, advocating for self and others are gifts that I am sharing with my son. What gifts are you, as a parent sharing with your child? Prejudice and bigotry start at home. Like an inheritance or an heirloom, they are taught and passed down through generations. We all need to ask ourselves, what are we passing down?

There is only one race and we all belong to that one race. No matter our unique individual differences, we all belong to the same race, the only race, the human race.

I want to extend my appreciation and gratitude to Little Lobbyists, for all that they have done and continue to do for my son Israel and all children and individuals who have unique challenges and obstacles, as well as the support they have given me as a parent.

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Rico Winston is a commitee member of the Friends of C.A.R.D (Center for Autism at The Kennedy Krieger institute), a member of The Spark for Autism Community Advisory Council, and the founder & director of The Israel Winston Family Empowerment Corp., a nonprofit organization. He is currently completing the Arc of Maryland’s Partners in Policymaking course to increase his advocacy skills for people with disabilities.

Israel Winston enjoys horseback riding and is currently a student of the martial arts.