Energy & Commerce Committee Summary of Health Care Reform Legislation

The House Energy and Commerce Committee released today its outline of health reform legislation. House Majority Leader Steny Hoyer (D-MD) said on Monday, "We hope to pass health care reform by August," adding, "That is a target, not a deadline."

Structural Overview
• Ability to keep what you have and minimize disruption.
• Provide a National Health Exchange for individuals and the smallest employers
• Requires shared responsibility among individuals, employers, and the Federal and State Government.
• Provides affordability credits to low and middle income individuals.
• Implements delivery system reforms to promote efficiency and reduce costs.
• Invests in the health care workforce and public health.
• Slows the growth of health care costs and maintains fiscal sustainability.

National Health Exchange, Affordability Credits, Medicaid Improvements
Role of the Exchange
• New independent entity would make health insurance choices available to those without an employer offer, and smallest businesses (the first year: biz under 10 employees; second year: under 20 employees; etc). It would be open to large businesses over time.
• The Exchange would set and enforce standards for health plans; facilitate enrollment; receive/monitor complaints; and administer affordability credits.

Affordability
• Creates Sliding scale affordability for use in exchange for eligible individuals with incomes between Medicaid eligibility and $88,200 for family of 4 (400% of poverty); everyone would be protected by an annual cap on out-of-pocket spending

Choice
• Ensures choice of private and public health insurance plans; provides new options for employers; and maintains and improves Medicaid for low-income individuals and families.

New Public Health Insurance Plan
• Health exchange includes a new public health insurance plan that would be subject to the same market reforms and consumer protections as private plans.
• Plan would have geographic adjusters for prices.
• Plan would ensure transparency, accountability, cost-containment and competition in the market.
• The public health insurance plan would likely be run by HHS, and would be independent of the Health Exchange.
• It would not have government subsidies-it’ll compete on its own.
Provider Participation and Payment
• The public plan would build on Medicare providers and rates, similar to the practices of private plans today.
Benefits, Insurance Market and Reforms, and Consumer Protections
• A public private independent advisory committee would recommend benefit packages based generally on the Federal Employee Health Benefit Plan.
• Several levels of benefits would be available in the Health Exchange. They would predominately differ by cost sharing but additional benefits would be available in higher cost plans.
• After several years employer sponsored health plans would either have to meet the minimum benefit standard of plans operating within the Health Exchange or allow their employees to purchase coverage in the Health Exchange.

Market Reforms and Consumer Protections
• Health insurers, both inside and outside the Exchange, would be required to adhere to new insurance market reforms and consumer protections.

Shared Responsibility- Individual, Employer & Government Requirements
• Individual Responsibility: Individuals would be responsible for having health insurance.
• Employer Responsibility: employers would have the choice to “play” by offering health insurance to employees, or contribute:
o Play: Employers would offer and contribute towards the health coverage of their full-time employees and their dependents.
o Pay: Employers who do not “play” would “pay” by contributing a percentage of payroll.

Investments in Health Care Workforce
• Expand the primary care, nursing and public health work forces through increased support for key programs.
• Create a broad, inter-disciplinary commission to examine ongoing health workforce issues.
• Support workforce diversity efforts including data collection and expansion of workforce programs.
• Remove barriers so hospitals can more easily train residents in community settings.
• Increase funding for scholarships and loan forgiveness to promote primary and nursing care.

Improving Health & Wellness
Prevention & Wellness Programs
• Reduce disparities by supporting evidence-based, community wide efforts & health empowerment zones to improve health and wellness.
• Incorporate and improve prevention services provided in Medicare, Medicaid.
• Strengthen State Departments of Public Health.
• Substantially increased support for Comm Health Centers.
• Data collection improvements; Health IT providing & collecting data to reduce disparities
Read more!

President Obama’s Council of Economic Advisers (CEA) Releases Report June 2nd Making An Economic Argument for Health Care Reform

The new 56-page report argues that reform would raise Americans’ standard of living, lower the federal budget deficit, reduce the unemployment rate and increase the labor supply, and boost the rate of growth of the gross domestic product. By slowing the annual growth rate of health care costs by 1.5 percentage points, the report contends that it “would increase real gross domestic product”—resulting in $2,600 higher income for a family of four in 2020 and $10,000 in 2030. By focusing on containing health care cost growth and expanding health coverage to the uninsured, the report argues that reform would not only raise the standard of living by freeing up resources now spent on medical care, but would also lower the federal deficit since the government spends a significant amount of money on programs such as Medicare and Medicaid. The report comes as both the Administration and Congress gear up to tackle health care reform legislation this month. Read more!

Congress Returned This Week to Face a Four-Week Ambitious Stretch

Among the items on the agenda for the returning Congress are the following: moving ahead on sweeping health care legislation, progress on writing the 12 annual appropriations bills, and global warming legislation. The House expects to markup its 12 spending bills before the month long August recess. Senate Finance and HELP Committees expect to have their health care legislation and markups before the July 4th week-long recess that begins June 29th. Health care is what is on the front burner is pushing other issues that divide the Democratic majority to the sidelines for now. President Obama has said he wants health care reform passed by the August recess and he is planning for he and his Cabinet officials to take to the airwaves to push reform this year. Read more!

ANCOR Submits Written Testimony on Ticket to Work and Social Security Work Incentives

ANCOR submitted this week testimony on 2009 ANCOR Government Relations Priorities on the Ticket to Work and Work Incentives Improvement Act (TWWIIA). 2009 ANCOR Government Relations Priorities ANCOR strongly supported the passage of TWWIIA) because of the program’s possibility to remove work disincentives that prevent individuals with disabilities from working. Special thanks to Tommy Cox of RHA/Howell Care Centers, Inc. in North Carolina for his assistance in drafting the testimony.
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Secretary Sebelius Announces Appointment of Cindy Mann as Director of the Center for Medicaid and State Operations

U. S. Health and Human Services Secretary Kathleen Sebelius today announced the appointment of Cindy Mann to serve as Director of the Center for Medicaid and State Operations (CMSO), part of the Centers for Medicare & Medicaid Services (CMS). Mann most recently served as a research professor and executive director of the Center for Children and Families at Georgetown University's Health Policy Institute. "Cindy Mann has decades of experience in health care financing at the federal and state level, and vast knowledge of health care policy," said Secretary Sebelius. "She has devoted her career to working on behalf of children and families, the elderly and people with disabilities. She will be an outstanding leader at CMSO, particularly as the nation moves forward with health care reform."

Mann previously served as director of the Family and Children's Health Programs at CMSO from 1999-2001; in that capacity she played a key role in implementing Medicaid and the Children's Health Insurance Program (CHIP).

"Cindy has been instrumental in recent efforts to expand health care coverage in our country," said Sebelius. "Her knowledge of health care issues and management experience will be a great asset to CMSO and to the millions of Americans who rely on Medicaid."

A brief biography is included below:

Cindy Mann, J.D., is a research professor at Georgetown University, Health Policy Institute and the executive director of the Center for Children and Families at the Institute. Her work focuses on health coverage, financing, and access issues affecting low-income populations.
She has written extensively on these issues -- and on how they relate to the Medicaid and CHIP, in particular -- and has worked closely with state and federal policymakers and program administrators on the design and implementation of Medicaid and CHIP. From 1999-2001, Ms. Mann was the director of the Family and Children's Health Program Group at the Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Services. In that capacity, she directed, at the federal level, the implementation and oversight of the Medicaid program with respect to families, children, and pregnant women, and oversaw the implementation of CHIP. Prior to her work at HCFA, Ms. Mann led the Center on Budget and Policy Priorities' federal and state health policy work. She also has extensive state-level experience, having worked on health care, welfare, and public finance issues in Massachusetts, Rhode Island, and New York. She holds a law degree from New York University School of Law.

Read more!

Idaho District Court Issues Temporary Restraining Order April 28th Regarding HCBS Habilitation 15 Minute Unbundling and 55% Reimbursement

See Memorandum Opinion on Granting a Temporary Restraining Order on ANCOR's Medicaid One Stop Litigation web page. Read more!

Senate Finance Committee Releases Third and Final Health Care Discussion Document

The Senate Finance Committee released its third health care discussion document May 20th—Financing Comprehensive Health Care Reform—following the May 14th release of Policy Options for Expanding Health Care.This second document included discussion of Medicaid long-term services and supports and policy options. ANCOR, in conjunction with the Consortium for Citizens with Disabilities, are providing comments on these options, as well as offering additional options regarding issues affecting long-term services. As with the first policy document released on April 29th—Transforming the Delivery System—the Committee’s work followed round-tables by leading experts and closed-door Committee sessions. The documents are intended to spur discussion of proposed options.
Read more!

Take Advantage of Memorial Day Recess and Meet with Your Members of Congress

Members of Congress will be in their home states and districts during recess, May 25-29th, making them accessible to you, their constituents. It is up to you to tell you members of Congress how federal legislation will affect your organization and the people you support and employ. A great way to personalize issues is to introduce them to individuals you support, their families, and Direct Support Professionals. Bring them to your meetings with your members of Congress and have them help tell your story.
There are two great ways to reach out to your members of Congress during recess:

• Schedule a meeting with them in their state and district offices -- Use ANCOR's talking points and Advocacy Tool Kit to help get your message to Washington;
• Attend a town hall meeting hosted by your Representatives or Senators. If your members of Congress are holding town hall meetings, you will receive a notice from ANCOR.

Issues currently being addressed in Washington to discuss with your members of Congress include:

• Supporting health care and long-term supports and services reform-including the Community Choice Act (H.R. 1670 and S. 683), the Community Living Assistance Services and Supports Act--CLASS Act (H.R. 1791 and S. 697), and the Empowered at Home Act (S. 434)
• Opposing The Employee Free Choice Act--Card Check Bill (H.R. 1670 and S. 683)
• Supporting the Direct Support Professional Fairness and Security Act (H.R. 868)
• Supporting Frank Melville Supportive Housing Investment Act (H.R. 1675)

Click here for talking points and more information about these topics.

Visit ANCOR's Advocacy Tool Kit for Information on:

• Finding your Members of Congress and their contact information
• Attending town hall meetings
• Sending feedback to ANCOR through our online feedback form
• Don't forget, ANCOR's new handbook, Effective Communication with Congress: Your Guide to Influencing Capitol Hill is a comprehensive publication designed to help you successfully advocate to Congress on behalf of your organization and the people you support and employ. Visit ANCOR's publications web page to order your copies today.

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Congress Prepares for Four-Month Sprint to Pass Health Care Reform

Two Senate Committees (Finance and Health, Education, Labor and Pensions) and three House Committees (Energy and Commerce, Ways and Means, and Education and Labor) are working on health care reform legislation under their individual committee’s jurisdiction. The Senate is further along in developing its reform packages than the House. In fact, the HELP Committee was expected to introduce legislation by the end of this week. Senate Finance Chairman Baucus (D-MT) still plans to have his committee’s legislative markup completed by the end of June, with a melding of Finance provisions and HELP provisions melded on the Senate floor before the August recess. Read more!

Arizona Court Rescinds Injunction Against State Cuts to DD and Remands Case to Superior Court for Further Proceedings

UPDATE: Yesterday, an Arizona court granted a motion for emergency stay on the injunction issued in March. The state of AZ issued today a notice that provider rates will decrease by 10%.

On April 30, an appellate court in Arizona lifted an order from a lower court blocking the state from cutting funds for disability programs. In a preliminary injunction issued in March, a county Supreme Court moved to block the state from carrying out budget cuts to home and community-based services. The three-judge appellate court ruled unanimously to vacate the lower court’s ruling saying that the plaintiffs had not proven that the budget cuts violate state or federal laws. The judges have remanded the case to a superior court for further proceedings. Read more!

Funding Alert: Two HHS Grant Solicitations under ARRA Including Workforce and Job Training/Recruitment

HHS has just announced two funding opportunities (Strengthening Communities Through Private and Public Partnerships) in which it will make $50 million of American Recovery and Reinvestment Act (ARRA) funds available to eligible applicants, including non-profit and for-profit organizations. Partnering with private and public organizations, HHS will provide one-time, two year grants through two program funds. The focus of these two funding opportunities is to build capacity of nonprofit organizations, whether secular or faith-based, to address the broad recovery issues in their communities, help low-income individuals secure and retain employment, earn higher wages, obtain better-quality jobs, and gain greater access to state and federal benefits and tax credits.

ANCOR encourages its members to consider applying for these federal funds or collaborating with state and local governments or other entities to access these funds.
Read more!

Massachusetts and Kansas Grapple with Proposed Budget Cuts to Disability Services While Nebraska Looks to Increase Funding for Disability Programs

The Massachusetts state Senate may consider increasing the sales tax to avoid deep cuts to human services. The Senate released proposed budget cuts earlier this week that would affect roughly 20,000 individuals with disabilities, cutting nearly two-thirds of all disabilities services according to ANCOR member Gary Blumenthal of ADDP.

Invisible Kansas, an advocacy groups for individuals with disabilities, is speaking out against a budget bill that would cut disability programs. The state legislature has accepted a budget that would further starve an already under funded developmental disability system, according to Invisible Kansas. The budget includes $1.6 million in cuts for Family Support Grants, and a 1% cut from the HCBS DD Waiver. Disability advocates warn that such cuts mean less money to pay providers which could force more individuals with disabilities into institutions.

In Nebraska, the state legislature passed a budget this week that would increase funding for disability programs including $15 million for individuals on a waiting for community-based services. The budget needs final approval from the governor who has not indicated whether or not he will sign it.
Read more!

Michigan, Wisconsin, Louisiana and Maine Face Steep Budget Cuts

Michigan Governor Granholm has ordered a 4% across-the-board spending cut as part of $302 million in budget cuts. Granholm’s plan included $16 million dollars in cuts to Medicaid that have drawn criticism from residents who say the cuts will harm the 1.7 million Michiganders who rely on Medicaid.

In Wisconsin the budget deficit has grown to a historic high of $6.5 billion over three years and Governor Doyle is working on his third budget realignment in five months.

Louisiana’s state health agency issued emergency rules on May 1st cutting Medicaid reimbursement rates by 7%. The state Legislature is deliberating Governor Jindal’s budget proposal which would include $445 million in proposed cuts to human services.

In Maine, Governor Baldacci is proposing to cut more than $35 million from health and human services programs to close a $570 million budget gap. Read more!

California Risks Losing Enhanced FMAP, Seeks $20 Billion Loan

California is in danger of losing billions of dollars in enhanced FMAP if it does not restore wage cuts to home healthcare workers. According to a May 5 opinion by CMS, the cuts, which were passed in February, violate provisions of the ARRA prohibiting states receiving enhanced FMAP from making certain changes to Medicaid programs. In the opinion, CMS determined that California’s proposed cuts to home healthcare workers violate ARRA maintenance of efforts rules by increasing the local government’s share of Medicaid costs. Governor Schwarzenegger sent a letter to HHS Secretary Sebelius urging the government to reconsider rescinding California’s $6.8 billion in FMAP. California will also need to borrow more than $20 billion dollars to close its budget deficit unless voters accept a budget ballot measure on May 19. Without loans and a budget overhaul, the state is expected to run out of cash in July but polls indicate that voters are likely to reject the budget ballot measure. Read more!

Public Emergency Declared Due to Spread of H1N1 Influenza Virus (Swine Flu)

HHS declared a public health emergency April 26th because a strain of the H1N1 Influenza Virus (swine flu) (H1N1) has been diagnosed in people in the United States, Mexico, Canada and elsewhere. In the U.S., the CDC has confirmed 3 deaths as a result of the H1N1 flu virus. View an interactive map of swine flu cases worldwide or a flu tracker. On April 29, the World Health Organization (WHO) raised the influenza pandemic alert from phase 4 to phase 5, meaning that a pandemic may be imminent.

HHS Secretary Sebelius announced April 30th that the federal government will purchase 13 million additional treatment courses to fight pandemic flu and is sending 400,000 treatment courses to Mexico to help slow the spread of the H1N1 flu virus. The Agency has approximately 50 million treatment courses in a Strategic National Stockpile and has released 11 million courses to the states to augment the 23 million treatment courses already in state stockpiles. Read an FDA Patient Fact Sheets on Relenza and Tamiflu. Sebelius and Homeland Security Secretary Napolitano also held a webcast on Thursday, April 29th to answer the public’s questions about the H1N1 flu virus.

CDC recommends taking the following steps to prevent the spread of swine flu:
• Avoid close contact with people who are sick or when you are sick.
• Stay home when you are sick.
• Cover your mouth and nose when coughing or sneezing.
• Clean your hands often.
• Avoid touching your eyes, nose or mouth.
• Practice other good health habits.

The CDC has released H1N1 Q&A, information on occupational health issues associated with H1N1 influenza virus and interim guidance. You can also follow the CDC on its Twitter site.

Visit ANCOR's Emergency Preparedness web page for more information about pandemic flu, emergency preparedness and disaster relief.

Additional resources for preparing for pandemic influenza include:
Ready.gov
American Red Cross
Long-Term Care and Residential Services Checklist
Individual and Family Planning and Checklist
Business Pandemic Flu Planning Checklist
State and Local Planning and Response Activities
State Pandemic Plans
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities
CDC Guidance on Protecting At-Risk Populations During a Pandemic

Related Articles:
State and Federal Governments Prepare for Possible Pandemic
Many States Do Not Meet Readiness Standards for Pandemic Flu

Read more!

Secretary Solis Proposes $104.5 Billion for FY 2010 Department of Labor Budget

In a webcast today, Secretary of Labor Hilda Solis proposed a $104.5 billion FY 2010 budget, with the majority used for unemployment insurance benefits. The total includes $13.3 billion in discretionary funding, but does not include $38.3 billion in Recovery Act funding.

Highlights include:

• $3.6 billion to fund the Workforce Investment Act
• $37 million for the Office of Disability Employment Policy
• $65 million for “National Programs,” which includes Supported Employment
  

Read more!

HHS Presents $879 Billion Budget for FY 2010

President Obama proposed today to “hold flat” budgets for agencies under the Department of Health and Human Services in FY 2010, as the department has already received billions of additional dollars in Recovery Act money. Obama is requesting $879 billion for HHS, including $78.4 billion in discretionary spending. The discretionary amount would be slightly less than the $78.5 billion the department received in FY 2009. The Recovery Act provided HHS with $44.3 billion in funds, including $22.4 billion in discretionary funds. Discretionary funds do not include funding of the entitlement portion of Medicaid because individuals receive the benefit because they meet eligibility requirements set by past legislation. HHS Secretary Kathleen Sebelius announced during the Department’s budget briefing that the FY 2010 budget calls for HHS to receive $311 million to combat Medicaid and Medicare fraud to augment existing mandatory resources, such as the Medicaid Integrity Program. She stated that every additional dollar spent by HHS in fighting fraud will yield $1.55 in savings.

Other Highlights,State Grants and Demonstrations Include:

• $75 million for the Medicaid Integrity Program
• $584 million in HHS-wide emergency preparedness funding, including $276 million for pandemic flu preparedness
• $40 million for Home and Community Services Alternatives to Psychiatric Residential Treatment Facilities for Children
• $474 million for Money Follows the Person Demonstration
• $68 million for Ticket to Work Grant Programs (extending Medicaid benefits to individuals with disabilities obtaining work using the Ticket to Work program)
• $10 billion for the SCHIP program
• $3.2 billion for the Low Income Home Energy Assistance Program (LIHEAP), a decrease of $1.9 billion from FY 2009. The budget also proposes creating a new mandatory account that would increase funding for LIHEAP in response to spikes in energy prices, at a cost of $450 million
  

Read more!

President Obama Releases FY 2010 Budget Proposal

Today President Obama formally released the administration’s FY 2010 budget proposal. Administration officials may make further changes to the budget to respond to changing economic conditions. The roughly $3.7 trillion plan contains the details the House and Senate Appropriations committees need to put together their annual spending bills. White House Budget Director Peter R. Orszag said there would be “some modest” changes in economic assumptions, mostly technical, and projected deficits as a result of changes in the economy since the administration released its budget outline in February.

ANCOR staff attending several budget briefings that outlined proposed funding for the Departments of HHS and HUD. See WICs Live articles for more details on the FY 2010 proposed budgets of those federal agencies and the Departments of Labor and Education and the Social Security Administration. Read more!

Administration Releases FY 2010 Budget Proposal with Section 8 Voucher Increases and Funding for National Housing Trust Fund

The President’s $43.7 billion proposed Housing and Urban Development (HUD) budget for FY 2010 is an 7.4 percent increase from the FY 2009 funding.
Notable line item expenditures include:

• Section 811—Disabled Housing—$250 million proposed for FY 2010, including $114 million to finance the construction and initial rental assistance for new housing.
• Section 202—Supportive Housing for the Elderly--$765 million proposed for FY 2010, the same amount enacted in the FY 2009 Omnibus Appropriations Act.
• Section 8—Housing Vouchers—$8.1 billion proposed for FY 2010, a $1 billion increase from FY 2009 funding levels;
• Community Development Block Grant (formula grants)—$XXX billion proposed for FY 2010, a $XXX billion increase from FY 2009 funding levels;
• HOME Investment Partnerships Program— $1.825 billion proposed for FY 2010, the same amount enacted in the FY 2009 Omnibus Appropriations Act.
• National Low Income Housing Trust Fund--$1 billion, the first year funding after its creation in last year’s housing bill (PL 110-289).
  

Read more!

States Beginning to Receive Recovery Act State Fiscal Stabilization Funds

Over the past few weeks, states have begun submitting their applications to the U.S. Department of Education for their slice of the Recovery Act funding under the State Fiscal Stabilization Fund. Some states may be using these funds to close budget gaps in their disability systems. To date, the following states have received over $7 billion total in funding:

• California - $4 billion
• Illinois - $1.4 billion
• Maine - $130 million
• Minnesota - $547 million
• Mississippi - $321 million
• Oregon - $382 million
• South Dakota - $85.4 million
• Utah - $321 million
• Wisconsin - $587 million
  

See applications for funding online.
Read more!

Three CMS Regs Rescinded--with Partial Rescission of Targeted Case Management

HHS Published a notice in the Federal Register May 6 rescinding the outpatient and school-based health regulations and partially rescinding the targeted case management regulation. The provider tax regulation is being delayed for one year while more information is gathered. Read more!

Texas Legislature Advances Bill to Allow Children with Disabilities Access to Medicaid

The Texas state House approved a bill on April 30 that will allow children with disabilities to enroll in the Medicaid program regardless of the parents’ income. The bill is designed to help families that earn too much to qualify for Medicaid but are struggling with the high cost of their child’s medical treatment. The State Senate already passed the bill and it will now be sent to the Governor for his signature. Read more!

Federal Government Becomes Primary Source of State Revenue

For the first time ever, state and local governments are getting the largest share if their revenue from the Federal government. Economic recovery funds from the federal government replaced sales taxes and property taxes as the primary sources of state and local revenues in the first three months of 2009. The Federal government plans to allocate roughly $300 billion to state and local governments over the next two years. This bump in Federal spending at a time when revenues from sales and property taxes are declining means that the Federal government is now paying about 23% of the approximately $2 trillion that state and local governments spend each year. Read more!

Idaho Judge Blocks Proposed Medicaid Cuts for Disability Programs

A federal judge in Idaho issued a temporary restraining order on April 28 blocking the state from cutting reimbursement rates for disability programs by as much as 55%. The law suit was brought by 16 Idaho providers who claimed that the proposed cuts would put them out of business, thereby forcing individuals with disabilities out of the community and into institutions. See previous WICs Live article on this case. Read more!

Social Security Administration Unlikely to Raise Benefits in 2010-12

The head of the Congressional Budget Office projects that there will be no cost-of-living adjustment (COLA) for Social Security beneficiaries in the next three years under current law. If this occurs, it will be the first time since 1975 that beneficiaries have not received an automatic increase in benefits. The law determines Social Security COLAs based on the consumer price index. Prices fell at the end of 2008 and inflation is expected to remain low for the next few years meaning that an automatic increase will not occur. Read more!

CQL Spring Webinar Series – Strategies for Quality

The Council on Quality and Leadership is holding a series of webinars that reflect the best practices in person-centered services. Visit their website to learn more. Read more!

ANCOR Urges CMS to Review Medicaid Requirements during a Pandemic Emergency

ANCOR sent a letter to CMS on April 30 highlighting challenges that could face providers in the event of a pandemic emergency and urging action to address these challenges.

In the letter, ANCOR outlined specific concerns and questions including:

• Reimbursement rates during hospital stays
• The prohibition against reimbursement for provider direct support staff/personal assistance for hospitalized individuals
• The financial burden to providers when multiple people supported by the same agency are hospitalized
• The possibility that individuals from ICFs/MR that are considered to be 24-hour health care facilities may be prohibited from being admitted to the hospital during a pandemic
• The lack of clear communication to providers from public health officials
• The need for greater in-home supports of community activities are suspended
• Vulnerable Population’s Access to and Coordination with Public Health Resources
  

ANCOR suggested that:

• CMS sponsor a nationwide webinar or conference call(s) that include providers regarding protection of Medicaid beneficiaries, guidance to providers, and CMS clarification, waiving, or suspension of any Medicaid programmatic and payment requirements.
  
• CMS’ State Medicaid and State Operations establish a public and website devoted to the H1N1 flu virus.
• CMS/CMSO include ANCOR in notice of and dissemination of any information forwarded to state Medicaid agencies, national and state MR/DD agencies, and national and state units on aging.
  

ANCOR will continue its dialog with CMS as this situation unfolds. If you have questions about pandemic flu or emergency preparedness, please forward them to Anne Fiala (afiala@ancor.org). Read more!

Social Security Beneficiaries Will Soon Be Receiving One-Time Recovery Act Payments

Beginning in May, the Social Security Administration will begin distributing one-time payments to over 60 million beneficiaries. A provision in the American Recovery and Reinvestment Act provides for a one-time payment to be delivered to Social Security beneficiaries in the same manner they receive their current benefits. See SSA 's Frequently Asked Questions web page for additional information. Read more!

Congress Passes Budget Blueprint Including Instructions on Health Care Reform Legislation

On April 29, the House voted 233-193 and the Senate voted 53-43 to pass a $3.4 trillion 2010 budget resolution. No republicans in either chamber voted for the non-binding budget resolution. Included in the budget blueprint are reconciliation instructions which will allow Congress to pass a health care reform bill with just 51 votes in the Senate rather than the 60 voted usually needed to move legislation through the chamber. Republican leaders have spoken out against these fast-track rules saying they will allow democrats to force through legislation. Democratic leaders have pledged to move forward in a bipartisan manner and hope to pass health care reform using regular procedures before the fast-track rules go into effect October 15. Read more!

Solis Says Department of Labor to Hire 36 New Inspectors

Labor Secretary Hilda Solis said April 28 that OSHA plans to hire 36 additional inspectors and launch new inspection efforts. Solis said OSHA’s new inspectors will provide guidance, training and outreach to employers. As part of the outreach effort, Solis noted that OSHA will unveil a new Web site offering guidance for stimulus fund recipients. Another DOL official stated that the next step will involve addressing health and safety from the industry and corporate level. The agency is also looking at activities that do not solely rely on inspections, but also finding patterns of violations and systemic problems. Read more!

U.S. District Court Orders Arizona to Uphold 2004 Ruling on Ball v. Rodgers Case Against State on HCBS Access and Attendant Worker Wage Increase

A United Stated Distinct Court ruled April 24 that Arizona’s Medicaid program discriminates against disabled and elderly beneficiaries on the basis of their disability, reinforcing a 2004 decision on this case. Ball v. Rodgers was filed in 2000 on behalf of disabled and elderly Medicaid beneficiaries who claimed that they were not being provided with adequate home and community based services. The ruling found that the state is required to give beneficiaries the choice between receiving services in the community or in an institutional setting and that Arizona’s failure to provide this choice violates provisions of the Americans with Disabilities Act the Medicaid Act and the Rehabilitation Act. A hearing has been set for June 1, 2009 to discuss Arizona’s compliance with the injunction.
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Louisiana Providers Fight Budget Cuts

Providers in Louisiana are urging employees and consumers to contact their state representatives about proposed budget cuts to supports and services for individuals with disabilities. Louisiana is looking to close a $2 billion budget gap for 2009-10 and is working on a budget that would cut disability services by 4-9%. These decreases would be in addition to a 3.4% cut to disability programs enacted last year during a round of mid-year budget cuts. Read more!

California Disability Activists March to Protest Budget Cuts

Over 2,000 people gathered at the state Capitol in Sacramento on April 22 to protest budget cuts affecting individuals with disabilities. Participants, including people with disabilities, families, providers and support workers, came from across California for this event. Protesters called for an end to budget cuts for California’s Medicaid program, and urged that earlier funding cuts be restored. Read more!

Pennsylvania Senator Leaves GOP to Join Democratic Party

Senator Arlen Specter of Pennsylvania announced April 28 that he is leaving the Republican Party to join the Democratic Caucus in the Senate and will run as a democrat when he is up for re-election in 2010. His decision could mean that democrats in the Senate will have the 60 vote super majority needed to overcome opposition from the minority if democrat Al Franken of Minnesota is seated. Supporters of the Employee Free Choice Act (Card Check bill) had hoped that Specter would be one of a few republicans to cross the aisle and vote in favor of the bill. Specter announced in March that he would not support the Card Check bill. In announcing his move to the Democratic Party, Specter stated that he would not become a party-line voter for the democrats and would not change his position on Card Check. Read more!

Kathleen Sebelius Sworn in as Head of HHS

The Senate voted April 28 to confirm Kathleen Sebelius to be secretary of Health and Human Services on a vote of 65-31. Sebelius was sworn into office by President Obama just hours after the Senate vote.

The Senate Finance Committee approved the nomination of Kathleen Sebelius on April 21 with a 15-8 vote. GOP Senators Snowe (R-ME) and Pat Roberts (R-KS) joined the panel Democrats in approving Sebelius. The final vote in the Senate was delayed with some Senate Republicans objecting to the nomination.
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Kansas Provider Speaks Out about Waiting List

Tom Laing of InterHab, an ANCOR member and State Association Exec, was published in the Wichita Eagle April 28th with his take on Kansas’ state budget for developmental disability programs. Laing was responding to an earlier editorial in the Eagle praising the state legislature for adding funding to the budget to address the waiting list for services for Kansans with physical disabilities. He called the praise 'premature' because the legislature has done nothing to budget for individuals with developmental disabilities who are on a waiting list for supports and services – a list that could reach 4000 people by July. As Laing so aptly says:

“How would you react if 4,000 Kansas children were told there was now a waiting list for kindergarten? How would you react if your child were told that because of state budget mismanagement, he could not enter the college of his choice for another two or three or four years? … Is it OK that the most important services offered by government for individuals with DD are curtailed, and that people in need may have to wait for up to four years? Of course not. The people of Kansas need to let their elected leaders know the time for action is now.”
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Mathematica Issue Brief on Money Follows the Person

The findings of the January 2009 Mathematica Policy Research issue brief, Transitioning Medicaid Enrollees from Institutions to the Community: Number of People Eligible and Number of Transitions Targeted Under MFP are based on 2004 data. The report includes demographic information, and tables and figures with more information about states, population groups, and age. An estimated 2.2 to 5.9 percent of MFP eligibles moved from institutions to the community in 2004. Read more!

States Turn to Tax and Fee Hikes To Close Budget Gaps

As budget deficits grow to more than $200 billion, states are turning to tax and fee hikes even as federal recovery funds flow to states. More than a dozen states have raised taxes or are considering doing so. States are hoping that increased sales and income taxes, higher fees for a variety of services and the more than $40 billion in cuts already enacted will help close state budget gaps. Read more!

Health Care Groups and Finance Committee Chair Advocate Expansion of Medicaid Program

Families USA, a national consumer health organization, and PhRMA, a pharmaceuticals group, are joining together to promote the expansion of the Medicaid program. On April 21, the groups launched a campaign to make health care more accessible and affordable by reforming Medicaid eligibility. These policy changes are intended to be included with health care reform legislation being developed in Congress. The groups advocate establishing an eligibility floor for Medicaid of 133 percent of poverty and sliding-scale subsidies for those who cannot afford to purchase insurance but do not qualify for Medicaid. Senate Finance Committee Chairman Baucus (D-MT) released a statement on the proposal saying that “increasing Medicaid access is a critical part of health care reform.” Read more!

HHS Releases FMAP Rates for First Two Quarters of FY 2009 Recalculated Based on ARRA Increases

The Federal Medical Assistance Percentage (FMAP) released today in the Federal Register is for the first two quarters of FY 2009 (effective from October 1, 2008 through March 31, 2009). Rates are recalculated pursuant to the American Recovery and Reinvestment Act (ARRA) including 6.2 increase to every state, plus the unemployment adjustment. See ANCOR's National Issues FMAP page to find your state's adjustment.






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Providers in Idaho Sue State Over Budget Cuts

On April 3, 16 providers of supports and services to individuals with disabilities filed a lawsuit against the state of Idaho stating that budget cuts could force 900 people with disabilities to lose residential services. The groups have asked the Judge to grant a temporary order preventing the state from enacting cuts set to begin on May 1. If the state is allowed to continue with the cuts it announced in March, providers will be forced to go out of business because of inadequate reimbursement rates, the plaintiffs say, resulting in more individuals with disabilities being moved to institutional settings. The suit alleges that the cuts are in violation of federal laws that require reimbursement rates to be high enough to ensure that all Medicaid recipients in a state have equal access to community-based programs. Read more!

Florida Residents Fight Cuts to Disability Services

Advocacy groups are protesting budget cuts in 2007 and 2008 which are affecting individuals who receive supports and services in Florida. Read more!

California Legislature Asks Disability Community to Help Make Budget Cuts

California’s legislature is asking state agencies and disability groups to help identify potential budget cuts or face another round of rate cuts for group homes and work programs. Providers of supports and services to individuals with disabilities already fighting to stay in business struggled to find ways to identify the $100 million in budget cuts requested by the legislature. Hundred of suggestions which have been gathered through public forums will be considered by the state legislature in the coming weeks. Read more!

CMS Issues Letter on Implementation of New SCHIP Law

The purpose of the letter, released by CMS on April 17, is to give an overview of the new SCHIP law passed in February 2009. Included in the letter are summaries of key provisions related to funding, eligibility and rates. CMS will release more detailed guidance letters in the coming months. Read more!

HHS Names Henry Claypool as Director of Office on Disability

Henry Claypool currently serves as the policy director for a long-term care provider, has held various advisory positions at HHS, and worked for CMS during the Clinton administration. He has a physical disability and has received Medicaid and Social Security benefits, giving him a unique perspective into these programs. His role as Director of the Office on Disability will be to oversee and advise HHS on policies and programs related to individuals with disabilities.
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Maine to Run Out of Medicaid Funding in Early May

Maine’s Medicaid program is in dire need of stimulus funds to avoid disruptions in services. The state’s Department of Health and Human Services is reporting that the Medicaid program will run out of money May 8th unless it receives federal stimulus funding. The Governor reports that Maine will use the $334 million in enhanced FMAP allocated to the state in the recovery package to close existing funding deficits and to address rising demand over the next two years due to the poor economy. Thanks to Bonnie-Jean Brooks of OHI for this update. Read more!

Take Action on Federal Housing Legislation!

ANCOR continues to support legislation that would increase the availability of affordable, accessible housing—the Frank Melville Supportive Housing Investment Act of 2009 (H.R. 1675), introduced by Representatives Chris Murphy (D-CT) and Judy Biggert (R-IL).

The bill would increase the number of affordable, accessible housing units for people with disabilities by:

• Removing "red tape" and streamlining the HUD Section 811 application process to encourage nonprofit providers to participate in the program.
• Authorizing a new Section 811 Demonstration Program that would make housing units funded through Low Income Housing Tax Credits and the HOME program affordable to individuals who rely on SSI and SSDI.
• Shifting renewal of Section 811-funded Mainstream Vouchers to the Section 8 Housing Choice Voucher Program Budget
  

Use ANCOR’s Action Center to make your voice heard in Congress! Visit ANCOR’s Action Alert to ask your member of Congress to co-sponsor the Frank Melville Supportive Housing Investment Act (H.R. 1675).

ANCOR members are encouraged to use Priced Out in 2008 when personalizing their letter. (see related article on Priced Out in 2008) Use the data in the report to document the housing crisis in your state. Tell your organizations story--personalize the letter attached to the alert with issues you are facing with supporting individuals in the community and the lack of affordable, accessible housing. Include your state’s sobering statistics to illustrate the housing crisis faced by people with disabilities.

If you have any questions, contact ANCOR Staff Jessica Sadowsky (jsadowsky@ancor.org). For more information on housing issues, visit ANCOR’s housing webpage.

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People with Disabilities Priced Out in 2008: Beneficiaries Need 112 Percent of Monthly SSI to Rent One Bedroom

A new report issued Monday, April 13th by the Technical Assistance Collaborative (TAC) and the Consortium for Citizens with Disabilities (CCD) Housing Task force reveals data that illustrates the severe housing affordability problems of people with disabilities who must survive on incomes far below the federal poverty line. This report, Priced Out in 2008, compares the federal Supplemental Security Income (SSI) payments of people with serious and long-term disabilities to U.S. Department of Housing and Urban Development (HUD) Fair Market Rents for modestly priced rental units.

Across the United States in 2008, people with disabilities with the lowest incomes faced an extreme housing affordability crisis as rents for moderately priced studio and one-bedroom apartments soared above their entire monthly income. According to Priced Out in 2008:

• SSI income needed to rent a modest one-bedroom unit has risen 62 percent from 69 percent of SSI in 1998 to 112.1 percent of SSI in 2008. The national average rent for a one-bedroom unit climbed to $749 per month and the studio/efficiency unit rent to $663 per month in 2008 – both higher than $667, the average monthly income of over 4 million people with disabilities.
• In 2008, 219 housing market areas across 41 states had modest one-bedroom rents that exceeded 100 percent of monthly SSI, including 25 communities with rents over 150 percent.
• Between 2006-2008, the number of market areas with modest rents higher than SSI rose from 164 to 219 – a 34 percent increase.
• For the first time, there were 3 housing market areas – Honolulu (HI), Columbia City (MD), and Nantucket County (MA) – where SSI recipients needed to spend over 200 percent of their income for a modest 1-bedroom housing unit.
  

ANCOR members are encouraged to use Priced Out in 2008 when discussing the need for affordable, accessible housing with their federal, state, and local officials. Use the data in the report to document the housing crisis in your state. Share this information with housing officials at the local and state level, who are responsible for developing strategies and plans to use federal housing resources. Respond to ANCOR’s new Action Alert on the Frank Melville Supportive Housing Investment Act of 2009 (H.R. 1675). (see related article on Federal Housing Legislation) Tell your organizations story--personalize the letter attached to the alert with issues you are facing with supporting individuals in the community and the lack of affordable, accessible housing. Include your state’s sobering statistics to illustrate the housing crisis faced by people with disabilities.

If you have any questions, contact ANCOR Staff Jessica Sadowsky (jsadowsky@ancor.org). For more information on housing issues, visit ANCOR’s housing webpage.
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Policy Makers Increasingly View Long Term Care as Crucial to Health Care Reform

The importance of long term care is gaining awareness as members of Congress and health care experts move forward with health care reform plans. Long-time health care champion Senator Kennedy (D-MA) is adamant that a reform bill must include long term care and is pushing for the inclusion of the CLASS Act (S. 697 and H.R.1721), a bill he introduced which would create an optional long term care fund to aid people in paying for long term supports and services. Other groups are pushing for incentives to make long term care insurance more affordable while some have voiced concern that the expansion of government sponsored programs will be too costly. Read more!

TRN Job Coaching Web Course May 7, 2009

Training Resource Network, Inc. (TRN) still has openings for its 2-week, 20-hour Job Coaching web training covering key principles and hands-on tools for effective job design, instructional and behavioral support strategies, and the development of natural and co-worker supports for workers with disabilities.

Registration is $149 US. Participants can start or log on at any time during the course period and participate in the training.

The course is taught by Tammara Geary. Tammara served as Executive Director of APSE: The Network on Employment for 10 years. She has trained and consulted extensively on supported employment, and as a job coach, received an award for Excellence in Direct Service. She is a lead associate for Griffin-Hammis Associates.

Registration is limited, and previous courses have filled to capacity.

Topics include:

• Principles of Job Design: Steps to take after getting the job, including analysis and task design.
• Job Training and Instructional Support: Setting up learning strategies using task analysis, systematic instruction, natural learning and reinforcement, and data collection.
• Natural Supports: Learn to develop supports using natural features of the work site, including co-workers.
• Social-Behavioral Support: Develop strategies to support workers to interact in socially expected ways to enhance job success.
  

Learn more about the training
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States Cut Social Safety Net as Deficits Grow

Widening budget deficits have prompted a majority of states to cut safety net programs including services to the elderly and disabled. The American Recovery and Reinvestment Act (ARRA) passed in February provides $787 billion for a variety of programs but the money is estimated to cover only 40% of losses to state revenues. As a result, at least 34 states have already cut services to vulnerable populations. Read more!

HHS Seeks Public Input on Comparative Effectiveness

The Federal Coordinating Council for Comparative Effectiveness is soliciting public comments on comparative effectiveness programs. The council will hold a listening session on April 14 in Washington, DC to hear public comments that will help shape its recommendations for how funds allocated in the ARRA for comparative effectiveness should be spent. Members of the public who are not able to attend the session can submit their comments electronically and watch the event online. Read more!

States Name Spending ‘Czars’ and Create Websites to Track Stimulus Funding

States are increasingly appointing ‘implementation czars’ to oversee spending of federal dollars allocated through the ARRA. The individuals tapped to act as watchdogs of their state’s stimulus funds come from diverse backgrounds and their responsibilities vary from state to state. In general, these czars are tasked with planning and monitoring how funds are spent. All 50 states have also launched websites tracking how states spend federal ARRA funds.

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ANCOR Sponsors Free Alliance for Full Participation Employment Webinar—ANCOR Members Encouraged to Register

ANCOR is proud to sponsor the first in a series of Alliance for Full Participation webinars on employment of individuals with disabilities. The first of these webinars will be held May 7 at 4:00 pm ET. ANCOR members are encouraged to register and participate. Participation is free, however, participants must register beforehand. Dial in information will be emailed to all registered participants.

The Alliance for Full Participation has recently launched a major initiative to improve the employment infrastructure, services and outcomes for people with developmental disabilities. The primary focus of this initiative is on achieving demonstrable results on a state level. The Alliance is building and will guide state teams that include people with intellectual and developmental disabilities and their families, advocates, service providers, business organizations, state government officials, and members of the general community to explore and transform the environment for employment in all 50 states and the District of Columbia. To support our state teams, and to bring awareness to the cause of increasing employment for people with developmental disabilities, the Alliance is hosting a series of quarterly webinars. For more information on AFP, visit www.allianceforfullparticipation.org, or call 301-706-6252. Join the Facebook group: Alliance For Full Participation.


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Wisconsin Disability Agencies Receive Federal Grants to Increase Community Employment

These new dollars are part of Wisconsin’s state allotment of the $1 billion Community Development Block Grant released by HHS from the American Recovery and Reinvestment Act. Read more!

HHS Announces $1 Billion in Community Development Block Grants for States to Distribute from Recovery Act

The U.S. Department of Health and Human Services (HHS) today announced plans to make $1 billion available for the Community Services Block Grant (CSBG) program. Funded by the American Recovery and Reinvestment Act, the new resources will be allocated to states across the country. States will distribute the new funding to community groups. Eligible organizations must use funds to provide services and activities addressing employment, education, housing, nutrition, and emergency services. (see related article on Wisconsin disability providers)

Services currently provided by community organizations that receive CSBG funds include:

• Job training and placement assistance.
• Financial literacy programs such as credit counseling.
• Housing assistance programs that help keep Americans in their homes.
• Nutrition programs that provide meals for vulnerable families.
• Community agencies that bring public and private resources together to assist families in need.
  

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President Obama Establishes White House Office of Health Reform

The President signed an executive order on April 8 establishing the office and has named former Clinton administration health official Nancy-Ann DeParle to head it.





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Alaska Advances Rate Review Bill

On April 7, the Alaska state Senate unanimously passed a bill creating an equitable and consistent process for rate reviews for providers of home and community-based services. The bill will next move to the state House for consideration.

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South Carolina Attorney General Contends that State Legislature Cannot Bypass Governor to Accept Recovery Funds

The battle for control of recovery dollars will move to the courts if Governor Sanford and the legislature cannot reach a deal. The attorney general's opinion is a blow to legislators who sought control of federal recovery funds that Sanford is rejecting.
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Massachusetts Governor Pledges $21 Million in Enhanced Medicaid FMAP to Partially Restore Cuts to Disability Services

Disability advocates remain concerned about an $8 million cut to employment programs for people with significant disabilities and will continue to push for full or increased restoration of disability services funding. Thanks to Gary Blumenthal of ADDP for this update.
Read more!

Iowa Counties Feel the Squeeze as Wait List for Disability Services Grows in Tough Economy

Thanks to Rod Braun of Christian Opportunity Center for this article.
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Aging Caregivers in Florida Struggle to Find Long Term Support and Services for Adult Children with Disabilities

Florida newspaper cites ANCOR in news article.
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HHS Releases OIG Review of New York State's MRDD Medicaid Indirect Costs

Read the review here.
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Historic Common Ground on Health Care Reform Reached by Diverse Group

An 18-member group including AARP, America's Health Insurance Plans, the Business Roundtable, and U.S. Chamber of Commerce unveiled last week a long-awaited consensus on health care reform principles. Two significant points of agreement from the groups: 1) Establish a nationwide floor for Medicaid eligibility for all adults no lower than 100 percent of the federal poverty level; 2) Provide subsidies to people who are ineligible for public programs. The group also agreed that the ultimate policy goal is to increase value for consumers and the system as a whole. Two groups originally part of the effort (SEIU and AFSCME) did not sign the document because a "public plan option" was not addressed. Read more!

CMS Delays Rule on State Flexibility for Medicaid Benefit Packages

CMS published a notice in the Federal Register today that the agency will delay implementation of a final rule giving states greater flexibility in designing Medicaid benefit packages. The rule was to go into effect April 3, 2009 but has been delayed to December 31, 2009 and the comment period has been reopened through May 4, 2009. The rule implements part of the Deficit Reduction Act of 2005. Read more!

Spotlight Resources - FMAP

• PowerPoint Presentation and Audio Recording from ANCOR's Popular Webinar: Federal FMAP and State Medicaid Programs: What the Stimulus Means for ANCOR Members
• CMS Fact Sheet on Increased FMAP in ARRA
• Kaiser: Health Care and Medicaid -- Weathering the Recession

Read more!

Spotlight Resources - Economic Recovery

• Stateline: Interactive Map of State Recovery Websites and ‘Implementation Czars”
  
• GAO Website for Reporting Waste, Fraud, Abuse or Mismanagement of Recovery Act Funds
• NGA: State Implementation of the ARRA
• Staterecovery.org: Tracking How the Executive, Legislative, and Judicial Branches of State Government are Responding to and Impacted by the ARRA and Medicaid & Economic Stimulus: State by State Web Update Resource
• Kaiser: Health Care and Medicaid -- Weathering the Recession

Read more!

Senate Passes Budget Resolution Including Reserve Fund for Health Care Reform

Senate Finance Committee Chairman Max Baucus (D-MT) hailed its passage as a step towards comprehensive health care reform. Read more!

Department of Education Releases 50 Percent of ARRA VR State Grant Funds to States

The remaining funds will be awarded by September 30th and are allocated to state VR agencies under the program's allotment formula. These funds are in addition to the funds received under the regular FY 2009 appropriation for the VR State Grants program. This month, the Rehabilitation Services Administration (RSA) is planning on conducting a number of webinars on the ARRA VR funding. The guidance, released this week, states that funds should be used for short-term investments that have the potential for long-term benefits, rather than for commitments that the State may not be able to sustain once ARRA funds are expended. State VR agencies are encouraged to: consider serving individuals on waiting lists in agencies currently using an order of selection; increase services to eligible consumers; and expande services to traditionally underserved and unserved populations in the state, including students with disabilities transitioning from school to the workplace. The DoEo also issued a Guidance and Fact Sheet to accompany the release of funds. Read more!

DCA Releases Policy Brief on Using Recovery Act Funds to Improve Direct Care Jobs and the Quality of Direct Care Services

This is the first brief in a series about the direct care workforce issued by the Direct Care Alliance (DCA). It provides an overview of direct care work and discusses how Recovery Act funds can be used to address some of the challenges faced by direct care workers. Read more!

AFP Launches Employment Initiative

The Alliance for Full Participation (AFP) has announced a national effort to increase employment in the U.S. for people with developmental disabilities. The Alliance's initiative includes: networking among state teams; nationally webcast education and town-hall events; national and state-level policy change advocacy; and local efforts to increase and enhance employment for people with developmental disabilities. Also anticipated is an October 2011 national summit to share leading practices, process recommendations and establish national outcomes. This effort stems from goals voiced and agreed upon by self-advocates and advocates participating in the 2005 Alliance for Full Participation national summit in Washington, DC. The AFP is comprised of 13 national nonprofit organizations in the field of intellectual and developmental disabilities. Read more!

Senator Harkin (D-IA) and Representative Davis (D-IL) Introduce Community Choice Act

Introduced last week, the measure's (H.R.1670 and S.683) purpose is to allow people with disabilities, who need an institutional level of care, the choice of receiving their Medicaid supports and services in their own communities, rather than an institution. Read more!

Spotlight Resources - Health Care Reform

• Families USA: Americans at Risk: Report on the Uninsured - State Reports
• Alliance for Health Care Reform Sourcebook: Covering Health Issues
• Obama Administration's Health Care Reform Website
• HHS Report on Feedback Gathered during Health Care Community Discussions
• Kaiser: National Health Insurance - A Brief History of Reform Efforts in the U.S.
• Kaiser: Health Care and Medicaid -- Weathering the Recession

Read more!

House and Senate to Debate Budgets Next Week

The House and Senate Budget Committees each passed this week their version of the FY 2010 non-binding spending blueprint. The Senate is devoting next week solely to consideration of its $3.5 trillion budget resolution, which does not contain any reconciliation instructions. However, Majority Leader Reid (D-NV) said the possibility of using reconciliation is not "off the table." The House will turn its attention to its own version of the $3.5 trillion FY 2010 spending outline. Unlike the Senate version, the House resolution includes reconciliation instructions to help implement the president's health and education policies. Read more!

Section 811 Reform Legislation Reintroduced in House

Representatives Murphy (D-CT) and Biggert (R-IL) Re-Introduced on Monday Section 811 Reform Legislation. The Frank Melville Supportive Housing Investment Act (H.R. 1675) would modernize the Section 811 Supportive Housing for Persons with Disabilities program and create a Project-Rental Assistance Demonstration program to expand the supply of permanent supportive housing for low-income persons with disabilities. The Section 811 program is the only Department of Housing and Urban Development (HUD) permanent supportive housing program exclusively serving persons with disabilities. The new Section 811 legislation (H.R. 1675) was re-introduced with the same language as the Frank Melville Supportive Housing Investment Act of 2008 (H.R. 5772), which passed in the House unanimously in September 2008. For more information, see the ANCOR Fact Sheet on this bill and information on ANCOR's Housing Web page on H.R. 5772. Read more!

CLASS Act Reintroduced in the Senate

Senator Kennedy (D-MA), Representatives Pallone (D-NJ) and Dingell (D-MI) Introduced this week the Community Living Assistance Services and Supports (CLASS) Act. The measure (S. 697), would provide a cash benefit that would help adults with severe functional impairments obtain the services and supports they need to live and work independently in their communities. One of the main purposes of the ANCOR-supported bill is to reduce the number of individuals forced to live in poverty just so they can qualify for Medicaid. For more information, see the CLASS Act Fact Sheet. Text of the bill is not yet available. Read more!

Individuals with Disabilities in Washington Increasingly Struggle to Find Employment During Recession

As unemployment rates rise, the competition for jobs is having an increasingly negative effect on individuals with disabilities seeking employment in Washington state. The state's policy shifted recently to focus more on integrating people with disabilities into the community through individual job placement but the troubled economy has made it difficult to implement this policy. Read more!

Federal Officials Scrutinizing North Carolina's Spending of Stimulus Money

North Carolina is one if sixteen states selected for special federal oversight of stimulus spending. Federal investigators are on the ground in North Carolina to ensure that money is spent for its intended purposes and to examine whether the spending is getting results. North Carolina Governor Perdue says she will focus on transparency and accountability in spending federal relief dollars. Read more!

State Spending Choices Key to Economic Recovery

Stateline reported this week that the way in which states spend stimulus money will determine how effective stimulus dollars are in aiding the economy. Read more!

Senate Committee Examines Long-Term Care Options for Health Care Reform

The Senate Finance Subcommittee on Health Care held a hearing today entitled “The Role of Long-Term Care in Health Reform.” Subcommittee chairman John Rockefeller (D-WV) began the hearing by telling witnesses that long-term care is an essential component of health care reform and must be included in current efforts to reform the health care system. Senator Ron Wyden (D-OR) also spoke of his strong support of home and community based services. Witnesses including Judy Feder, PhD., Senior Fellow at the Center for American Progress Action Fund, and Dennis G. Smith, Senior Research Fellow in Health Care Reform at The Heritage Foundation, discussed the benefits of home and community based services, long-term care financing and options for improving long-term care programs funded through Medicaid. Witnesses emphasized the benefit to people with disabilities of strengthening home and community based services within the Medicaid program. Click here to download a video of the hearing.
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CMS Issues Fact Sheet and Q&A on Medicaid FMAP in the Recovery Package

CMS has released a fact sheet on new FMAP methodology and grant issuance, clarifications on the eligibility maintenance of effort (MOE) requirements, procedures for states to regain eligibility for the increased FMAP, and specific questions raised by states regarding the FMAP increase since the enactment of the ARRA. Read more!

Arizona’s Share of Enhanced FMAP at Risk

Arizona may be ineligible for $1.6 billion in enhanced FMAP funding through the economic recovery package due to state program changes prohibited in the recovery package rules. The state passed legislation in June 2008 that requires some Medicaid recipients to requalify for benefits every six months, rather than annually, beginning in September of 2008. CMS has determined that this rules change violates a recovery package maintenance of effort provision which prohibits states from receiving enhanced FMAP funds if the state tightened eligibility rules or procedures after July 1, 2008. Arizona has until July of this year to change the law and receive the enhanced FMAP. State officials say they will contest CMS’s determination because the new rules were passed into law before the July 2008 deadline. Arizona has already budgeted for $500 million of stimulus money and spent $300 million.

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President Obama Nominates Kathy Martinez to be Assistant Secretary for Disability Employment Policy

Martinez currently works at the World Institute on Disability (WID) where she directs a program to increase employment opportunities for Latinos with disabilities in the United States, and Access to Assets, an asset-building project to help reduce poverty among people with disabilities. She also serves on the State Department advisory committee on disability and foreign policy and the National Council on Disability.
Read the press release.

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Delaware Budget Gap Grows to over $600 Million As Projected Revenues Decrease, Governor's Budget Rolls Back Medicaid Increase Enacted in January. Thanks to Terry Olson of Mosaic for this update. Read more!

State Stimulus Updates

Report Finds Legislatures Cannot Accept Stimulus Funds Rejected by Governors.

President Obama Rejects Request by South Carolina Governor Sanford to Use $700 Million in Stimulus Money to Pay State Debt.

Pennsylvania Legislature Disagrees with Governor on Law Governing Who Determines How Stimulus Funds are Spent Read more!

CMS Calls on States to Increase Data Collection to Strengthen Long Term Care Services

The National Direct Service Workforce Resource Center has released a report suggesting that states should enhance data collection on workforce issues as a first step towards addressing workforce challenges. The report recommends that, at a minimum, states should collect data on:

• Numbers of direct service workers (full time and part time)
• Stability of workforce (turnover and vacancies)
• Average compensation of workers (wages and benefits)
  

According to the report, this data will help states to better assess workforce problems, create policy responses and evaluate outcomes over time. Read more!

Washington Community Residential Providers, Self-advocacy Groups, and Parent Coalitions Rally for Disability Programs at State Capitol

Several hundred people turned out on March 11th to urge support of independant living programs. Thanks to Scott Livengood of Alpha Supported Living Services for this update. Read more!

Provider Rates Restored in Arizona Under Preliminary Injunction

On March 11th Arizona providers, advocacy groups, consumers and their families won a court injunction to restore all provider rates to their pre-reduction levels. As a result 4,000 children and adults with developmental disabilities will not lose their services. The Arizona Department of Economic Security, Division of Developmental Disabilities plans to appeal the court decision. Thanks to Wendy Sokol of Soreo for keeping us updated on this case.

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1,500 Gather at Minnesota Capitol to Protest Cuts to Disability Services

Providers, advocates, individuals with disabilities and their families rallied at the state capitol March 7th to protest proposed cuts to disability supports and services. Individuals shared personal stories of how cuts would effect them and the Minnesota Consortium for Citizens with Disabilities sent a letter to legislators urging them to prevent devastating cuts to the essential disability services. Thanks to Tim Nelson of Hammer for this update. Read more!

ETA Releases Guidance on WIA and Wagner-Peyser Recovery Act Funding

Today, the Employment and Training Administration (ETA), which is part of the Department of Labor, issued guidance on implementation of the Workforce Investment Act and Wagner-Peyser Act funding in the ARRA. The guidance also includes state planning requirements for program year FY 2009. This funding provides $3.9 billion to the workforce investment system to increase employment and training services. The guidance pertaining to the Wagner-Peyser Act notes that “states have flexibility to use Wagner-Peyser funds to support targeted services to individuals with disabilities, such as the disability navigator program similar to those currently operated in many one-stop centers” and to “purchase assistive technology and other devices to support providing services to individuals with disabilities.”
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Maine Medicaid Program to Fill $65 Million Gap with Recovery Funds

Governor Baldacci announced in March an additional $65 million deficit facing the MaineCare program over the next three months. The state plans to use federal ARRA funds to cover the shortfall through the end of the fiscal year June 30. An additional $40 million in ARRA funds is expected to be used to fill deficits anticipated for FY2010 and 2011. Read more!

Senate Aging Committee Hearing Brings Commitment to Include Long-Term Supports and Services in Health Care Reform

Thank you to ANCOR members responding to the national phone-in alert on long-term services -- it worked! Senate Select Committee on Aging Chair Kohl (D-WI), Ranking Member Martinez (R-FL), and Senator Wyden (D-OR) on Wednesday, March 4 committed to carrying forth the message in the next day's White House Forum on Health Care, and to Congress, that long-term supports and services for individuals of all ages must be included in health care reform. Witness Judy Feder identified the need to expand support for Medicaid home and community-based services and urged support for CLASS Act and Community Choice Act legislation, while Henry Claypool testified on behalf of both also underscored the need to build and strengthen the workforce to provide services.

Read more!