Terms and Conditions of Use
Declaration for Independence and the National Advisory Board are dedicated to supporting the latest technologies, as well as provide service to our customers with the most recent, top-level software. We currently support the following browsers on Windows or Apple Operating Systems:
- Internet Explorer 7.0
- Netscape Navigator 9.0
- Mozilla / Firefox 2
- Safari 3
*Please ensure you install a version listed above to ensure compatibility with our web sites.
One of the main factors in determining our standard is the ability of the browser to maintain a high level of security. This is primarily reflected in its encryption code. To ensure the security of valuable and personal information, users may only access our site using a browser equipped with 128-bit encryption or higher.
Use of Material
This web site has Personal Health Information as defined in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. This includes any changes to HIPAA that may apply. By using this information, you agree to follow state and federal laws.
Content of Materials
The materials on this web site have protected information. This means it cannot be used or copied without the owner’s written consent. In most cases the owner is Declaration for Independence and the National Advisory Board. In some cases the owner is a third party.
Declaration for Independence and the National Advisory Board cannot promise that third party content on this web site is correct.
These Terms do not apply to content already in the public domain. Content in the public domain is information that you can find in other places.
Claims Against Declaration for Independence and the National Advisory Board for Computer Errors
Declaration for Independence and the National Advisory Board do not claim that this web site is free of errors, computer viruses and other harmful goods. Declaration for Independence and the National Advisory Board are not at fault for errors or viruses on this site.
Fraud and Abuse
You agree that you will not use the web site and its content to break any laws. This includes fraud and abuse laws. It also includes Medicare and Medicaid laws.
Free from Fault
You agree not to make any claim against Declaration for Independence and the National Advisory Board and staff. This includes third party lawyers’ fees that might result from your use of this web site. It also includes any rights of a third party or laws you might break in using this web site.
The Digital Millennium Copyright Act
Declaration for Independence and the National Advisory Board reserves the right, but not the obligation, to terminate your access if it determines in its sole and absolute discretion that you are involved in infringement activity, including alleged acts of first-time or repeat infringement, regardless of whether the material or activity is ultimately determined to be infringement.
Declaration for Independence and the National Advisory Board and its service providers accommodate and do not interfere with standard technical measures used by copyright owners to protect materials. Declaration for Independence and the National Advisory Board have implemented procedures for receiving written notification of claimed infringements and for processing such claims in accordance with the Act. Our designated agent to receive notification of claimed infringement is:
National Advisory Board on Improving Health Care Services or Seniors and People with Disabilities
Attention: Merrill Friedman
120 Monument Circle
Indianapolis, IN 46204
Any notice regarding any infringement of copyright or of other proprietary rights must include the following information:
- A signature of a person authorized to act on behalf of (i) the owner of an exclusive right that is allegedly infringed or (ii) the person defamed.
- Identification of the copyrighted work claimed to have been infringed, or, if multiple copyrighted works at a single online site are covered by a single notification, a representative list of such works at that site.
- Identification of the material that is claimed to be infringement, or to be the subject of infringement activity, including information reasonably sufficient to permit us to locate the material.
- Information reasonably sufficient to permit us to contact you, such as your address, telephone number, and/or electronic mail address.
- A statement that you have a good faith belief that use of the material in the manner complained of is not authorized by the copyright or other proprietary right owner, its agent, or the law.
If you choose to access www.declarationforindependence.org from outside the United States you do so upon your own initiative and are responsible for compliance with U.S. and local laws, if and to the extent that local laws are applicable. Software is subject to United States export controls. No software may be downloaded or otherwise exported or re-exported (i) into (or to a national resident of) Cuba, Iraq, Libya, North Korea, Iran, Syria, or any other country to which the U.S. has embargoed goods, or (ii) to anyone on the U.S. Treasury Department list of Specially Designated Nationals or the U.S. Commerce Department’s Table of Deny Orders. You represent and warrant that you are not located in, under the control of, or a national resident of any such country or on any such list. You agree to comply with U.S. export control laws and that you will not transfer any software or other content from www.declarationforindependence.org to a foreign national or foreign country in violation of those laws.
Product Descriptions – Not Available in all States
The product descriptions, if any, provided on www.declarationforindependence.org is not intended to constitute offers to sell or solicitations in connection with any products or services. Some products may not be available in all jurisdictions. Anyone interested in a particular product should contact Declaration for Independence and the National Advisory Board to determine whether the product is available in the particular jurisdiction of interest and to request a copy of the applicable policy or prospectus for a complete description of the product.
Links to Other Sites
While visiting this site, you may leave the Declaration for Independence and the National Advisory Board web site and access certain non- www.declarationforindependence.org web sites. Declaration for Independence and the National Advisory Board neither review nor control the content and accuracy of these non- Declaration for Independence and the National Advisory Board web sites, and therefore will not be responsible for their content and accuracy. Your access to non- Declaration for Independence and the National Advisory Board web sites is at your sole risk.
Other web sites on the Internet may contain unedited, sexually explicit, violent, racist or other types of material, which may be offensive to you. Please access other web sites at your own discretion.
All material including any link to other sites and content found at linked sites is provided “as is” and without any express or implied warranties including warranties of merchantability or fitness for a particular purpose. Due to the nature of the Internet, Declaration for Independence and the National Advisory Board do not warrant that access to www.declarationforindependence.org or any of its pages will be uninterrupted or error free. Declaration for Independence and the National Advisory Board do not warrant or make any representations regarding the usefulness of or the expected results of the material contained on www.declarationforindependence.org. Note that some jurisdictions may not allow the exclusion of implied warranties so some of the above exclusions may not apply to you. Please refer to local laws for any such restrictions.
Viruses, Worms, Use of Files
Declaration for Independence and the National Advisory Board cannot and does not guarantee or warrant that files available for downloading from this site are free of viruses, worms, Trojan horses or other code that has contaminating or destructive properties. Declaration for Independence and the National Advisory Board do not make any express or implied warranties, representations or endorsements whatsoever (including without limitation warranties of title, non-infringement or fitness for a particular purpose) with respect to the files available for downloading from this site. In no event will Declaration for Independence and the National Advisory Board be liable to you or to anyone else for any decision made or action taken by you or anyone else in reliance on results obtained from use of files downloaded from this site. These files may be downloaded and/or reprinted for personal use only. Permission to reprint or electronically reproduce any document or graphic in whole or in part for any reason except for personal use is expressly prohibited, unless prior written consent is obtained from the appropriate copyright holder.
The health information on this web site is provided by Declaration for Independence and the National Advisory Board solely for informational purposes as a public service to promote consumer health. It does not constitute medical advice and is not intended to be a substitute for proper medical care provided by a physician or other duly authorized health care provider. Declaration for Independence and the National Advisory Board assume no responsibility for any circumstances arising out of the use, misuse, interpretation or application of any information supplied on this site. Always consult with your doctor for appropriate examinations, treatment, testing, and care recommendations. Do not rely on information on this site as a tool for self-diagnosis.
There are references throughout www.declarationforindependence.org to various trademarks or service marks and these, whether registered or not, are the property of their respective owners.
Limitation of Liability
You agree by accessing www.declarationforindependence.org that under no circumstances or any theories of liability under international or civil, common or statutory law including but not limited to strict liability, negligence or other tort theories or contract, patent or copyright laws, will Declaration for Independence and the National Advisory Board be liable for damages of any kind occurring from the use of this web site or any information, goods or services obtained on this web site including direct, indirect, consequential, incidental, or punitive damages (even if Declaration for Independence and the National Advisory Board have been advised of the possibility of such damages), to the fullest extent permitted by law. Some jurisdictions do not allow the exclusion or limitation of certain damages so some of these limitations may not apply to you.
Minors and the Children’s Online Privacy Protection Act
Except as expressly stated upon initial access to a specific Declaration for Independence and the National Advisory Board web site or section of such site, www.declarationforindependence.org, does not direct content to Minors and does not intend to collect personal information from Minors and therefore is not subject to the Child Online Privacy Protection Act.
If you allow your minor child, or a child for whom you are legal guardian (a “Minor”), to access and use www.declarationforindependence.org, you agree that you will be solely responsible for: (i) the online conduct of such Minor; (ii) monitoring such Minor’s access to and use of www.declarationforindependence.org and (iii) the consequences of any use.
Changes and Applicable Law
Declaration for Independence and the National Advisory Board reserve the right to make changes to www.declarationforindependence.org and its Legal Disclaimer/Conditions of Use at any time, for any reason or for no reason, and with or without notice. Declaration for Independence and the National Advisory Board encourage you to review the web site and these terms periodically for any updates or changes; however, Declaration for Independence and the National Advisory Board are under no obligation to make such updates or changes obvious. Your continued access or use of www.declarationforindependence.org shall be deemed your acceptance of these Legal Disclaimers/Conditions of Use and any changes and the reasonableness of these standards for notice of changes. Use of www.declarationforindependence.org and purchases of products from www.declarationforindependence.org will be governed by and construed in accordance with the laws of the Commonwealth of Virginia, without giving effect to its conflict of law provisions. You agree that any legal action or proceeding between you and www.declarationforindependence.org will be brought exclusively in a federal or state court of competent jurisdiction in or for Virginia Beach, Virginia. If any provision of this agreement shall be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this agreement and shall not affect the validity and enforceability of any remaining provisions.
It is the opinion of this National Advisory Board that the modernized health care infrastructure required to meet the needs of older adults and individuals with disabilities will only come about as others join with us in promoting and furthering the following six foundational principles:
I am 85 years old and have been living with COPD for many years. I have emphysema and chronic bronchitis and am on 3 liters of oxygen 24/7. My husband (87) and I live at an independent living and we are hopeful that we never have to move again. With the help of our children and community staff we are able to cover most of our bases. However, if reductions or drastic changes occur with my oxygen supply or supplier I may be in big trouble! I am able to do most ordinary tasks here in my apartment and if the need arises there is Home Health available, although this is not paid for my Medicare. It is all out of pocket. For instance, recently I had a cancer removed from the side of my nose which really got big and needed a skin graft. I was unable to care for this myself but was expertly assisted by a RN made available through my community. However, even though my daily self-care regime is time-consuming and precise I am able to handle this. I also supervise my husband’s daily regime for dealing with diabetes and a variety of medications including eye drops for glaucoma. We attend doctor’s visits together also. I should be attending classes in pulmonary rehab but I am unable to travel with sufficient oxygen to do this. The Wellness Center here has the machinery but not the pulmonary rehab staff to guide me. I started a support group here called Breath of Life and we meet monthly and have speakers and share information in an attempt to help each other. I also participate in a website COPD-ALERT.com which is very helpful. My computer is my brain. Through it I can get answers to many questions and it keeps my doorway open to the world. There is a quality of life we enjoy now which is very important to us and we do not want to lose anything–especially the oxygen and medications which allow us to function. We can solve most problems ourselves. Please don’t erect barriers we cannot handle!
* Stories may be edited according to web host’s discretion.
Lynn Whitfield has diabetes and is a semi-retired public relations manager who suffered a heart attack late last year and was diagnosed with congestive heart failure (CHF). Following her surgery and prior to discharge, Lynn participated in a Chronic Disease Self-Management program that was developed through a collaboration of federal and state health programs, community health centers, national coalitions and associations of physicians and providers, and private industry. The disease-specific training programs were organized into four training modules: (1) clinical medicine, which provided information on medications, acute illnesses, emergencies, and the types of questions one should ask their physicians and specialists; (2) wellness, which addressed nutrition, physical activity, and emotional and mental health; (3) independent living, which addressed health and human services available in the community; and (4) technology, which detailed the types of technology available to assist with disease-specific self-management techniques. The module also described the process by which certain technologies (such as sub-dermal body sensors) wirelessly transmit health data to a person’s physician so he or she may monitor the individual’s care in a remote location.
Each of the disease-specific training programs contained self-management tools and was available in multiple languages and communication formats. Lynn had access to printed materials, videos, and the Chronic Disease Self-Management program Web site. The Web site offered online interactive health and wellness tools such as nutrition guides, activity logs, diet and meal planning, and disease-specific diaries to record blood sugar levels, heart rate, blood pressure, etc. In the event that Lynn requires a refresher course, she has access to in-person training at various community centers,libraries, places of worship, employer sites or schools.
The training that Lynn received to live with CHF and diabetes also educated her about the types of assistive medical devices available to help monitor her health. In addition to her transtelephonic monitoring system which monitors her pacemaker via the phone, Lynn has a sub-dermal transmitter to monitor and transmit her heart rate, blood pressure, and glucose levels to her Personal Health Tracker on an ongoing basis. The Personal Health Tracker enables Lynn to chart, over time, her blood pressure, heart rate, and blood glucose levels. By viewing daily, weekly, and monthly graphs and charts on her computer, Lynn can determine the times of day when her blood glucose levels or blood pressure spike or dip into a dangerous range. Equipped with this information, Lynn can adjust her diet, activity level, and/or medication to ensure her health status and vitals stay within an acceptable range.
Lynn’s sub-dermal transmitter also wirelessly transmits information to her primary care physician (PCP) who serves as the medical home of Lynn’s health information. The PCP’s staff is alerted of any irregular functioning that requires medical assistance. Lynn and her PCP determined that Lynn would also upload information from her Personal Health Tracker to the PCP’s office on a monthly basis. Lynn’s personal health information becomes part of her quality health record which is coordinated by her physician. Serving as Lynn’s medical home, Lynn’s PCP can coordinate additional follow-up or referral to specialists based on the information received from Lynn and her sub-dermal transmitter. In the event that Lynn’s health requires input from a specialist, Lynn’s PCP can authorize the ancillary provider to have secure access to Lynn’s quality health record.
Please note: These are representations and not actual people.
Leticia Reyes is 27 years old and was recently placed in an intermediate care facility for the mentally retarded (ICF/MR) after the sudden death of her mother. Leticia has autism and participated in a supported employment program through her high school that assisted her to get a job at a local florist. In addition to working part time, Leticia participated in music classes at her neighborhood cultural center playing traditional Spanish music at various festivals. The ICF/MR facility where she was place was located 10 miles away from her job, the community where she grew up, and all of her friends. Since the facility did not provide transportation to and from work, Leticia was forced to quit her job at the florist and could no longer participate in the music classes at her cultural center. During Leticia’s stay at the ICF/MR facility, she experienced stress and anxiety because she couldn’t participate in her music classes. She expressed to her care manager that she wanted to leave the facility and live closer to the florist so that she could continue to work, play music, and see her friends.
The state where Leticia lives received a CMS grant for the Money Follows the Person (MFP) initiative. With the help of a care manager at the ICF/MR facility, Leticia applied to transition out of the facility and move to an independent living home in her old neighborhood. While the MFP initiative would allow Leticia to transfer out of the ICF/MR facility, the state’s Medicaid state plan did not cover personal assistance services in an independent living home. With the right supports and services, Leticia could live in her own apartment. However, Leticia has not been able to accumulate savings and did not have an income that would make housing affordable.
We envision a future in which Leticia is able to live in the environment of her choice and self-direct the services she needs to live independently. The following represents a futuristic scenario of Leticia’s life in a modernized infrastructure.
After the death of Leticia’s mother, one of the state’s Self-Directed Support Coordinators (SDSC), Norma Davidson, contacted Leticia to assist her in her recent life transition of living without her mom. Soon it was determined that Leticia required housing. Leticia chose to live in an independent living home in the community where she was raised. With Norma’s assistance, Leticia developed a Self-Directed Life Plan that listed all of Leticia’s personal goals, objectives, and preferences for the services she required to live in the community. Once Leticia transitioned to her new home, she began to self-direct the personal care services she needed and paid a friend at the cultural center to assist her with laundry, shopping, organizing her daily activities, etc. Since playing music serves as a therapeutic outlet for Leticia, she self-directed a portion of her budget to purchase a new guitar case that enabled her to carry her guitar with less effort to more places. Leticia continues to work part time at the florist, play traditional Spanish music at local festivals and churches around her community, and socialize with her friends in the community where she has lived all of her life.
Please note: These are representations and not actual people.
At 27 years old, Dale Harris suffered a spinal cord injury while fighting in Iraq. His injury caused paralysis from the waist down. Upon returning home to his wife and two-year-old child, Dale required home and vehicle modifications to make his environment more accessible. He also required intensive outpatient counseling and pharmacological regimen to assist with his post traumatic stress disorder (PTSD). Dale’s wife, Julie, went to work full-time to help the family meet its financial obligations. Dale participated in an innovative government-funded program that pulls resources from various programs, such as Ticket to Work, Medicaid, and Veterans Affairs, to create an individualized budget from which he could self-direct the purchase of various services and supports he needed to recover from PTSD, continue home modifications, and become economically self-sufficient. Through the Self-Directed Support Plan (SDS-Plan) program, Dale allocated his budget toward home modifications, online classes to obtain his degree, and PTSD recovery programs. Upon receiving his degree in computer assisted drawing (CAD), he obtained employment with a company that specializes in universal workplace design, development, and reengineering. Dale’s employer works collaboratively with a supportive employment agency that receives state and federal grants to retrofit universal design in existing workplaces that seek to hire persons requiring workplace adaptations. As a universal design CAD-technician, Dale assists employers to design and reconfigure their work places to facilitate accessibility by all individuals, regardless of age or disability.
To ensure that he did not lose his health and long term service and support benefits upon garnering his first paycheck, Dale’s employer created a program that provides cash benefit to employees in lieu of participating in the employer’s health insurance program. Dale utilized this benefit to participate in a reconfigured Medicaid Buy-In program that provides a gradual step-down or partial disability allowance as his income steadily increases. This program enables people with disabilities to enter the workforce and obtain gainful employment without losing health and long term service and support benefits. As Dale continues to work, the Medicaid Buy-In program will enable him to purchase the services he requires to manage his PTSD, continue his home and vehicle modifications, and maintain successful employment.
Please note: These are representations and not actual people.
Payton Johnson is 39 years old, was born with spina bifida, and uses a wheelchair to mobilize. Growing up with computers and technology, Payton realized very soon that he could live anywhere and do anything he wanted to do with improved technological assistive devices. Upon graduating with dual degrees in business management and engineering, Payton aimed his attention at the world of technology to improve assistive devices for persons with disabilities. Payton established a partnership between a wheelchair manufacturer and a vehicle manufacturing company to co-design a hydrogen fuel cell vehicle equipped with an independent mobility device (IMD) that dually serves as the driver’s seat as well as an electric wheelchair. Once in motion, the vehicle automatically charges the lithium-ion battery imbedded in the wheels of the IMD, which can also be charged with alternative power, solar power, or through a regular electric charger.
As the driver’s seat, the IMD can wirelessly transmit data—such as scheduled daily activities and contact lists—from the user’s PDA cell phone to the vehicle’s data system. Both the IMD and the vehicle facilitate voice-activated calling in addition to transcribing voice command to e-mail. The IMD seat fabric is equipped with smart skin technology that monitors body temperature, provides heat or cool relief, detects body hot spots, and memorizes seat positioning. The IMD alerts the user to change positions when it detects heightened pressure on the body and the potential for pain or a decubitus. The IMD is also equipped with peripheral devices such as blood pressure and heart rate monitors that transmit the health data to an on-board data system that can wirelessly transmit the data to the user’s personal health record or physician’s office.
Since the IMD is able to store information from the user’s PDA such as a daily calendar, the voice command capability can remind the user of upcoming appointments or notify the user to take medications at specific times. The IMD’s databank can also memorize the footprint of a house or structure and respond to voice activated commands to maneuver throughout the home or a structure such as a grocery store or shopping center. The IMD can also alert emergency services in the event of an emergency situation.
Please note: These are representations and not actual people.