Housing Briefs

Section 811 reform legislation and FY 2010 T-HUD appropriations continue to move through the House and Senate. HUD released a letter on Section 8 Housing Choice Voucher shortages to Public Housing Authorities and the Technical Assistance Collaborative released a new Opening Doors on using the Neighborhood Stabilization fund from the Recovery Act to help create permanent, supportive housing.

House Passes Section 811 Reform Bill

The House of Representatives passed last week the Frank Melville Supportive Housing Investment Act of 2009 (H.R. 1675) which will significantly reform the Section 811 program. This ANCOR-supported bill would implement a new demonstration program that would triple the number of units to be built through use of other federal or state funds. The legislation was initially introduced by Reps. Christopher Murphy (D-CT) and Rep. Judy Biggert (R-IL). In addition, Senators Robert Menendez (D-NJ) and Mike Johanns (R-NE) introduced an identical companion version of the Frank Melville Supportive Housing Investment Act of 2009 (S. 1481).

FY 2010 HUD Appropriations

The Senate Appropriations Committee Thursday voted 30-0, after no debate, to approve a $122 billion spending bill for transportation and housing programs for fiscal 2010. The Senate and House (passed July 20) versions also differ slightly.

The Senate bill would provide $265 million for the Section 811 program, compared to $350 in the House version. The Section 202 program fares better in the House at $1 billion than the Senate's $785 million. The Senate bill would provide $18.1billion for Section 8 tenant-based vouchers, compared with $18.2 billion in the House bill, and $8.1 billion for the Section 8 project-based rental assistance account, compared with $8.7 billion in the House bill.

The Senate bill includes $4 billion for formula grants through the Community Development Block Grants program, compared with $4.2 billion in the House bill.

HUD Releases Letter on Section 8 Voucher Shortfall

The letter, sent July 30th to Public Housing Authorities (PHA), updates them on steps HUD is taking to minimize the effects of the Section 8 Housing Choice Voucher shortfalls some PHAs are experiencing and how to prevent termination of vouchers.

New Opening Doors from the Technical Assistance Collaborative

This issue of Opening Doors provides an overview of HUD’s new Neighborhood Stabilization Program (NSP), documents the purpose and history of the program, discusses how the funds are distributed, describes the ways that NSP can be used to create permanent supportive housing, and suggests strategies that can be used by the disability community to work with NSP grantees.








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August Recess Begins Next Week--Request Meetings or Site Visits with Your Members of Congress

The House begins their district work period on Monday and Senate begins theirs on August 10th--both chambers resume business on September 7th. District work periods or congressional recesses are a great time to meet in person with your members of Congress. In fact, meeting with them in their local, district offices or having them visit your organization is the most effective way to educate your Members and their staff on issues important to you. This allows Members and staff to hear and see how you carry out your important mission of providing supports to people with disabilities, to visit with direct support workers, to hear about the challenges you face, and to even gain some local media attention and goodwill. Eventually your persistence will pay off and you will be given the opportunity to help Members and their staff understand how federal policies impact your work. Please let ANCOR know when you have scheduled your visits by filling out a short webform. Read more!

Resolution Highlights Service of Direct Support Professionals

In a show of bipartisan support, the U.S. Senate unanimously approved Senate Resolution 228 designating the week beginning September 14 as "National Direct Support Professionals Recognition Week." Sponsored by Senator Ben Nelson (D-NE), the resolution recognizes the invaluable supports Direct Support Professionals (DSPs) provide and the difference this workforce makes in the lives of Americans with disabilities.

As part of the National Advocacy Campaign, ANCOR worked with Senator Nelson and key ANCOR members on this resolution to coincide with the annual Governmental Activities Seminar taking place September 13-15 in Washington, D.C.

The resolution received considerable attention in the Senate and gained nine co-sponsors including, Senator Sam Brownback (R-KS), Senator Jim Bunning (R-KY), Senator Thomas Carper (D-DE), Senator Susan Collins (R-ME), Senator Christopher Dodd (D-CT) Senator Edward Kennedy (D-MA), Senator John Kerry (D-MA), Senator Charles Schumer (D-NY), and Senator Olympia Snowe (R-ME). Thank you to all of the state teams so instrumental in gathering these original co-sponsors!

Along with the passage of this Resolution by the U.S. Senate, ANCOR has worked with key members in the states to successfully have gubernatorial DSP Recognition Week proclamations issued in Colorado, Maine, Nebraska, New York and Virginia. We hope to add more states in the coming weeks!

Click here for more information about DSP Recognition Week and ways you can celebrate and advocate for DSPs.
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H1N1 Virus Webcast and Update

Join HHS Secretary Sebelius, DHS Secretary Napolitano and Education Secretary Duncan for an important webcast on emergency preparedness related to the flu epidemic.

Participants will be able to learn about: the latest information on vaccine development; vaccine planning and preparedness efforts; federal funding support for sate efforts and ; progress on planning and preparedness for schools, child care centers, businesses and communities.

Registration is not required. To view the Webcast, visit www.flu.gov at 3:00 pm EDT on Tuesday, August 4. Please note, you will need Flash (http://www.adobe.com) installed on your computer in order to view the live video stream.

Other Questions? Please email HHSIGA@hhs.gov

Flu Panel Creates Priority List for Vaccine
A 15-member panel of experts met Wednesday at the Centers for Disease Control and Prevention in Atlanta to create a list of who should get the pandemic flue vaccine first. When the vaccine is available in September, the first to receive it will be pregnant women, the caretakers of infants, children and young adults ages 6 months to 24, people with chronic illness ages 25 to 64, and health-care workers.

Unlike most flu strains, people over the age of 65 are rarely contracting this strain. Speculation is that it is due from exposure to similar flu strains that circulated years ago. Children under 6 month are not able to receive the vaccine due to their immune system not being developed.

The vaccine will come in two forms: the traditional flu shot and a “live” vaccine squirted into the nose. The question of whether one or two shots is needed has still not been answered and the vaccination program is expected to start before an answer is found.

For More information please visit www.flu.gov.
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California Enacts Revised Budget with Additional $1.4 Billion in Medicaid Cuts

Governor Arnold Schwarzenegger (R) signed a revised budget July 28 containing $1.4 billion in new spending reductions for the state's Medicaid program, Medi-Cal. According to the revised budget from Schwarzenegger’s Department of Finance, most of the cuts to the state Medi-Cal program ($1 billion) is expected to be restored by increased federal Medicaid funding from waivers and payments of past due amounts. The California Medical Association called this money “shaky revenues” that would lead to further cuts if the federal government does not agree.

•a line item veto reducing county funding to administer Medi-Cal ($60.5 million)
•expanded efforts to combat fraud, waste, and abuse within the Medi-Cal program ($46.8 million)
•and limiting adult day care visits to three days per week and freezing program rates as of Aug. 1, 2009 ($28.1 million)
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Scan Foundation Report on Long-Term Care in Health Care Reform

The Scan Foundation released a policy brief entitled “Long-Term Care in Health Care Reform: Policy Options to Improve Both”. The policy brief discusses four options to improve the current health care system.

The first two proposals seek to improve long-term care in Medicaid through improving long-term care for people with low incomes and limited financial resources. Option one, is to “expand Medicaid support for home and community-based services”. This would fix the limited and variable access through Medicaid to personal assistance in home and community settings. Option two would “improve coordination of medical and long-term care for Medicare-Medicaid Dual Eligibles”. This proposal promotes the development and testing of integrated care programs for dual eligibles with the hope of improving the quality and cost-effectiveness of services for people who rely on both Medicare and Medicaid.

The second two proposals are to improve long-term care for the broader population. Option three aims to “improve coordination of medical and long-term care for Medicare enrollees with chronic conditions”. The proposal would promote innovation and distribution of service delivery and payment models designed to improve quality and efficiency by coordinating the full range of medical and long-term services people with chronic condition may need. Option four is to “establish public insurance protection for long-term care for the broad population”. This last proposal would create a public insurance program, financed by participants through premiums or taxes, which would spread the risk across a broad population and offer protection to participants of all ages and incomes.
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$220 Million DOL Grant Program Targets Health Workers

The U.S. Department of Labor launched a $220 million grant program aimed at training new workers for health care and other high-growth industries. The American Recovery and Reinvestment Act of 2009 provides funding and the Employment and Training Administration (ETA) will administer the program. The purpose of the program is to promote economic recover through assisting individuals impacted by the recession receive training and employment opportunities.

A DOL fact sheet was released explaining the details and requirements to qualify for the program. The Federal Register published the notice for the grant on July 22nd.
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International Convention on the Rights of Persons with Disabilities

On July 24, 2009, President Obama announced during a speech celebrating the anniversary of the Americans with Disabilities Act that the United States will sign the International Convention on the Rights of Persons with Disabilities. United States Ambassador to the United Nations Susan Rice will sign the treaty on Thursday, July 30th. Until the Senate ratifies the treaty with a 2/3 majority the United States is not legally bound to the treaty. There is no official word yet as to when President Obama will submit the treaty to the Senate. Read more!

White House Revises Lobbying Restrictions

On July 24, 2009, the White House revised their policy on banning lobbyists from meetings on the stimulus projects and funds. Lobbyists will once again be allowed to meet with and have telephone conversations with staff members and provide their expertise to help members make “merit based” decisions for stimulus projects. The American League of Lobbyists (ALL), Citizens for Responsible Ethics in Washington, and the American Civil Liberties Union (ACLU) partnered together to achieve these revisions. Read more!

Ohio State Budget Update

Governor Strickland signed the Ohio budget on July 24, 2009. After a tough process, the Waiver program rates will be frozen for 2 years unless. Throughout the budget process, the ICF/MR program went from a 1% increase each year, to a $50 million cut, to a slight increase. To avoid the $50 million cut the providers agreed to delay payment of 2 weeks at the end of the next biennium to save millions in this current budget. Within the next 2 years, providers will need to address their cash flow.

Thank you to Ohio state association member, Than Johnson, for providing ANCOR with this information.
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Health Reform Updates

Health Care Reform Likely Delayed in the House; Floor Votes Not Likely Before August Recess

House Democrats spent this week negotiating their health reform overhaul and making little progress. Blue Dog Democrats on the Energy and Commerce Committee continue to raise concerns about certain provisions, particularly the public plan. Frustrations with not having enough votes to pass the Energy and Commerce Committee may cause Democratic leaders to send the bill directly to the floor without that committee's input.

President Obama Thursday said he can accept that his August deadline will pass without an overhaul of the health care system, but he insisted that a bill reach his desk this fall.

Energy and Commerce Committee Includes CLASS Act in Health Reform Bill Mark Up

The Energy and Commerce Committee Monday approved by voice vote the CLASS Act as part of their mark up, which has not been completed. However, if the Democratic leadership decides not to wait for the committee to complete its mark up, the long term supports and services provisions will not be in the bill voted on the floor.

Health Reform Resources
See other WICs Live articles on Health Reform!

Kaiser: Side-by-Side Comparison of Major Health Care Reform Proposals
This interactive side-by-side compares the leading comprehensive reform proposals by the President and members of Congress across a number of key characteristics and plan components.
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Minimum Wage Increases to $7.25 Per Hour

The U.S. Department of Labor’s Wage and Hour Division announced this week that the federal minimum wage increases to $7.25 today. With this change, employees who are covered by the federal Fair Labor Standards Act will be entitled to be paid no less than $7.25 per hour. This increase is the last of three provided by the enactment of the Fair Minimum Wage Act of 2007. A revised Federal minimum wage poster is now available for viewing, downloading, and posting. Every employer of employees subject to the Fair Labor Standard Act’s minimum wage provisions must post, and keep posted, a notice explaining the Act in a conspicuous place in all of their establishments so as to permit employees to readily read it.
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ANCOR State Share Survey

ANCOR is collecting information in preparation for this year’s State Share, with a particular focus on the results of states’ budgets and their effects on ANCOR providers.

State Share information will be collected using a web-based survey instrument and will include the entire ANCOR membership to ensure information from as many states as possible is collected and presented at the Government Activities Seminar in September.

State Share Survey

You only need to fill it out once; however, if your state's information changes you please complete it again with the updated information. ANCOR will track the submissions and report using the most up-to-date information.

If you have any questions when filling out this survey, please contact ANCOR staff Jessica Sadowsky.

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Senators Introduce Section 811 Reform Bill

Senators Robert Menendez (D-NJ) and Mike Johanns (R-NE), members of the Senate Banking, Housing and Urban Affairs Committee – today introduced legislation aimed at ensuring that low-income disabled Americans have access to affordable housing options. The Frank Melville Supportive Housing Investment Act increases the availability of affordable housing for persons with disabilities and helps provide them with rental assistance.

“It is often hard for those who are disabled to find affordable housing that allows them to live independently, and that is particularly true during these tough times,” said Menendez, who is Chairman of the Banking Subcommittee on Housing, Transportation and Community Development. “We are working to help ensure that disabled members of our communities can keep a roof over their heads and can get some relief for their personal finances. We can do this by helping to increase the availability and reduce the cost of their housing, and we look forward to working with our colleagues to get this done.”

“I take very seriously our responsibility to ensure people with disabilities have the opportunity to contribute to our communities and this legislation is an important step,” Johanns said. “In a time when many are facing difficult struggles, it is our duty to see that no one is overlooked. This legislation helps people with disabilities to find affordable places to live, which is often key to their independence.”

The legislation would improve HUD’s Section 811 program by:
• Increasing the number of available housing vouchers for people with disabilities and ensuring that vouchers continue to be used to help people with disabilities.
• Encouraging the integration of mixed-used developments into the program and allowing funds from Low Income Housing Tax Credits and the HOME program to be used.
• Extending the length of rental assistance contract terms from 20 years to 30 years for projects using Low Income Housing Tax Credits.
Thank you to Mona McGee of Mosaic for reaching out to Senator Johanns’ office and other ANCOR members instrumental in getting this bill introduced in the Senate.
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Massachusetts Budget Results in Cuts to Disability Services

Massachusetts Governor Deval Patrick (D) signed the state’s budget June 29th, which makes $36 million in cuts to disability services, including residential, day, vocational, and family supports. In addition, $3.2 million was cut from the Mass Rehabilitation Commission, reducing a training program primarily for developmentally disabled individuals and $3.7 million was cut from early intervention programs.

Thank you to Massachusetts state association member, Bob Richards for informing ANCOR of this development.
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House Ways and Means, Education and Labor, and Senate HELP Committees Pass Health Reform Bill Along Party Lines; Senate Finance Delays Consideration

The three House committees with jurisdiction over health care reform and the Senate HELP committee continued to move their health reform bills this week, while the Senate Finance committee continues to delay their mark up in order to continue bi-partisan negotiations. The House Education and Labor took their final vote this morning and approved 26-22 the America’s Affordable Health Choices Act (H.R. 3200). Ways and Means took their final vote on the bill at 1:16 a.m. today, more than 16 hours after the markup started Thursday morning. The House Energy and Commerce Committee also began its mark up on Thursday, but do not expect final votes until later next week. Ways and Means and Education and Labor has yet to include long term services and supports (see below) in their mark up.

The Senate Health Education Labor and Pensions (HELP) committee passed its health reform bill by a 13-10 party-line vote Wednesday morning, leaving the Senate Finance Committee as the most likely arena for a bipartisan compromise. The bill contains the Community Living Assistance Supports and Services (CLASS) Act, which creates a voluntary opt-out payroll deduction that would provide people experiencing functional impairments with tiered benefits if they have contributed a monthly premium over five years.

Meanwhile, a bi-partisan group of Senate Finance committee members led by Ben Nelson (D-NE) is pushing back against the rush to complete a health reform bill by mid-August. Nelson, joined by Sens. Joe Lieberman (ID-CT), Mary Landrieu (D-LA), Ron Wyden (D-OR), Susan Collins (R-ME) and Olympia Snowe (R-ME), today released to Senate leaders a suggestion that the chamber adopt a more reasonable time frame in order to ensure the measure actually saves money in the long run. Nelson said on Thursday that getting the Finance Committee to report a bill may be achievable before lawmakers return to their home districts for the August recess. Amid pressure from President Obama, the Finance panel had been rushing to put out a bipartisan bill this week, but Chairman Max Baucus (D-MT) said Thursday that he needed a few more days of negotiation.


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CMS Places Moratorium on Alaska Waiver Services

CMS issued Tuesday a moratorium on all new Medicaid waiver services in Alaska, effective immediately, and putting services on hold for over 1000 individuals.
A CMS team spent a week in a “focused site visit” reviewing implications of a an assessment backlog of about 2000 people waiting for service. CMS left the site visit instructing Alaska to immediately address the backlog and other issues of non-compliance and followed with a written report reiterating those instructions and additional corrective action, including the moratorium on new admissions or enrollments into Alaska’s four HCBS waiver programs. Alaska must now send a detailed report to CMS by September 1st. According to the Anchorage Daily News, the moratorium is expected to last four or five months. Thank you to Emily Ennis, Executive Director of Fairbanks Resource Agency for providing additional information on this issue. Read more!

ANCOR’s 2009 Government Activities Seminar

Join your provider colleagues at ANCOR’s 2009 Government Activities Seminar September 13-15 at the Washington Court Hotel in Washington, DC. Register Today!

Also, register for a special 3-hour pre-conference on Surviving a World of Increased Medicaid Accountability and Scrutiny: A Proactive Primer for Providers Amid Severe Budget Challenges featuring Barbara Edwards, principal in Health Management Associates, former interim director of the National Association of State Medicaid Directors, and former Ohio State Medicaid Director. Ms. Edwards will:

• walk participants through the basics of a federal Medicaid audit,
• discuss what factors that determine whether provider audit findings result in financial recoveries, and
• explore how providers can best prepare for audits.
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Understanding and Implementing Active Treatment, Preparing for an ICF/MR Survey and Navigating the ICF/MR Assessment

Need Help Understanding and Implementing Active Treatment, Preparing for an ICF/MR Survey or Navigating the ICF/MR Assessment Process? ANCOR and H&W Independent Solutions have three books that can help you:
o Positive Outcomes: A Provider's Guide to Active Treatment
o The Surveyors Are Coming: Now What? A Guide to Survey Expectations and Preparations
o ICF/MR Assessments: From Admission to Discharge - What is Expected?

Purchase all three books together and save! For a limited time ANCOR is offering the set of three books for $120 (plus shipping). Purchased individually, these books are valued at $175 giving you a savings of $55!

Call Dana Calisi at 703 535-7850 ext. 101 to take advantage of this offer!
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WICS Live: Around the States

California: Federal Court of Appeals Ruling Blocks State from Implementing Medi-Cal Provider Cuts: The U.S. Court of Appeals July 8th upheld a lower court ruling, preventing the state from reducing Medicaid provider reimbursements by 10% that was to take effect in July 2008. The appeals court ruled that the state violated federal Medicaid law by failing to consider how the across-the-board provider rate cuts would affect quality and access to care. The court said a state budget crisis could not be used as a justification for illegal cuts in the Medicaid program. California can appeal the ruling or ask for an en banc ruling. However, the ruling could cost the state $56 million in retroactive payments; it could be more if providers are entitled to interest. This ruling now jeopardizes a second-round of rate cuts that took effect March 1st and are also before the 9th Circuit. As part of its budget compromise, the state is implmenting a rate freeze, beginning August 1st. Read more!

State Budget Updates

Following the passage of the Indiana state budget, Family and Social Service Agency Secretary Anne Murphy has assured Indiana provider association, INARF, that there would not be a 5% reduction in Medicaid rates, although no written language was included in the budget. Other senior officials indicated the ability to continue aggressively taking people off the waiting list.

Colorado ended their 2008/2009 legislative session with no reduction to community services for individuals with developmental disabilities.

Both Indiana and Colorado note that their budgets would not have been preserved with out the temporary increase in FMAP from the Recovery Act. Indiana received $2.4 billion in Recovery Act funding. The total stimulus revenue available for the state budget is $2.4 billion, $1.4 billion for Medicaid and one billion dollars for fiscal stabilization.

ANCOR staff would like to thank State Association Executives Jim Hammond with INARF from Indiana and Chris Collins with Alliance from Colorado for these updates.

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CMS Issues ICF/MR Clarifying Memo on “Client Right to Manage Financial Affairs and Money Management Training”

CMS issued the letter on July 10th. ANCOR offered comments prior to the letter publication and many suggestions were incorporated. The letter puts the assessment and determination for the need for formal money management programs in the hands of the interdisciplinary team (IDT). Providers who are cited will want to have this letter handy – as long as their IDTs review the comprehensive functional assessment (CFA) and discuss the need for a formal program for each client (who is the chronological age to utilize money) and document their reasoning when there is no formal objective. If the surveyors find that the CFA and the individual’s skills (and age) support the need for a formal program, and there is not one, they can cite a deficiency during the survey process.

ANCOR suggestions incorporated into the letter:
· Added the use of the “formal objective” vs. just saying money management program
· Changed several “must be” to “is” to show that the standard regarding use of CFA continues and is not new
· Softened what must be included in the assessment from dictating - “Assessment findings should include at a minimum:” and changed it to “Assessment findings to be considered by the team include skills that can be cross-utilized in training programs such as:”
· Took out the use of the work “transferable” but changed it to “cross-utilized”.
· Added that the CFA must be reviewed at least annually, but did leave in that the annual review “should always include an update to the CFA and take into consideration any changes in the individual’s circumstances since the last IDT.”

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FY 2010 Appropriations Likely to Take Center Stage on House and Senate Floors in July

With three months remaining in FY 2009, Congress has yet to pass all twelve FY 2010 appropriations before the October 1st start of the fiscal year. The House has passed four of its bills, the Senate none. The House is scheduled to vote on four more this week while the Senate hopes to complete action on two. The House Appropriations Labor-HHS-Education Subcommittee approved by voice vote today a FY 2010 spending bill that would provide $160.7 billion in discretionary spending, about $5 billion more than the 2009 enacted level and $52 million below what the president requested. Housing and Urban Development has not yet been considered. Labor-HHS-Education and T-HUD are tentatively scheduled for action on the House floor before the summer recess. Read more!

Administration Releases Grants to States and Calls on Nation to Prepare for Fall Flu and H1N1 Virus

HHS July 7th sent out a press release asking the public to prepare for the fall flu season and ongoing H1N1 flu outbreak. Secretary Sebelius asks the “American people to become actively engaged with their own preparation and prevention. It’s a responsibility we all share.” HHS launched a new website www.flu.gov to help centralize communications about the H1N1 flu as well as a Public Service Announcement campaign to encourage the public to become more involved.

UPDATE July 10, 2009: States Now Eligible to Receive $350 Million for H1N1, Seasonal Flu Preparedness Efforts--Grants Will Support Work to Protect Public Health, Prepare for H1N1 and Seasonal Flu

Secretary Sebelius today announced the availability of $350 million in grants to help states and territories prepare for the H1N1 flu virus and the fall flu season. The grants were funded by the recent supplemental appropriations bill that was passed by Congress and signed into law by the President on June 24, 2009.


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Send State Budget and Medicaid Updates to ANCOR

Don’t forget! ANCOR wants to hear from you on state specific news related to Medicaid, budgets, or other issues of importance to providers. Sharing this information with ANCOR gives you the opportunity to inform ANCOR membership about what is happening in your state—your news will be published in WICs Live! Send updates to ANCOR staff, Mary Pauline Jones at mpjones@ancor.org.
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States Continue to Face Short Falls as FY 2010 Budgets Wrap Up—Watch for ANCOR Survey

At least 48 states addressed or are facing shortfalls in their budgets for the upcoming year totaling $166 billion or 24 percent of state budgets. The Center on Budget and Policy Priorities reports that a majority of states expect shortfalls in 2011 as well. Most states start their fiscal year July 1st and have either adopted budgets for fiscal year 2010 or will do so shortly. Combining those new shortfalls with the fiscal year 2010 gaps already addressed, and those faced by states that have not yet completed their budgets, the total amount for fiscal year 2010 is at least $166 billion.

Watch for a survey late next week from ANCOR that asks members about the effect of their states’ budgets on providers. Read more!

Judge Decertifies Class Seeking Rights of Illinois Institutional Residents to LIve in the Community

On July 7, a federal district court issued an order decertifying an Illinois class in Elias v. Maram, a lawsuit seeking to provide individuals with developmental disabilities in Illinois the opportunity to live in the community.Advocates in Illinois had reached a settlement with the state to place 6,000 people in the community over a multi-year period. The suit, filed four years ago, alleges that Illinois does too little to offer community-based living options to people with disabilities as guaranteed in the Supreme Court’s 1999 Olmstead ruling. Under that decision, the court said that states have an obligation to provide care for people with disabilities in a community setting, where medically possible. However, according to the American Association for People with Disabilities, the Voice of the Retarded (VOR) rallied objections, leading the judge to decertify the class. The VOR stated their family members are best cared for in institutions and feared the settlement would divert funding from those facilities.
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Please Welcome Our New Government Relations Staff Member Mary Pauline Jones

Mary Pauline Jones comes to us from the House Oversight and Government Reform Committee where she worked under former Congressman Tom Davis (R-VA). Previously, she has worked for the U.S. Department of Education Office of Special Education and Rehabilitative Services and has done political consulting in Virginia. Mary Pauline is ANCOR members’ direct contact on state budget and Medicaid, Emergency Preparedness, and ANCOR’s grassroots efforts. Mary Pauline can be contacted at mpjones@ancor.org.

Please join ANCOR in welcoming Mary Pauline!
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Braddock Releases Study on Illinois Developmental Disability Services and Funding

Dr. David Braddock today released Services and Funding for People with Developmental Disabilities in Illinois: A Multi-State Comparative Analysis, an analysis of services and funding for people with developmental disabilities in the state of IllinoisThe study compares the performance of Illinois with five other Midwestern states of Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Data for this report is drawn from the seventh edition of the State of the States in Developmental Disabilities and supplemented with data from the state of Illinois.
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Franken Takes Seat in Senate and on HELP Committee

Al Franken (D-MN) was installed as Minnesota’s junior Senator. With Franken’s swearing-in, the Democratic caucus would now have a filibuster-proof, 60-vote majority, if Senators Kennedy (D-MA) and Byrd (D-WV) were not absent for health reasons. Franken will serve on the HELP committee, relieving Senator Whitehouse (D-RI) of his temporary duty on that committee. Franken will also serve on the Aging, Indian Affairs, and Judiciary committees. Read more!

HUD Releases 4000 Section 8 Housing Choice Vouchers

July 10, 2009 Reminder: Comments on the Section 8 Housing Choice Voucher Notice of Available Funding are due Monday, July 13th. ANCOR will be commenting on the notice. See below for a link to the notice from HUD.

On July 1st, HUD joined President Obama's commemoration of the tenth anniversary of the Supreme Court's Olmstead decision by announcing that it will offer rental assistance to 4,000 non-elderly families with disabilities, including 1,000 vouchers specifically targeted to those transitioning out of nursing homes and other facilities. Through its funding notice, HUD is seeking comment from public housing authorities and others to ensure this critically needed assistance is distributed and administered in the most effective manner possible.

Today's announcement coincides with the tenth anniversary of the Supreme Court's ruling in Olmstead v. L.C. & E.W. which affirmed the rights of individuals with disabilities to live independently. To commemorate this landmark decision, President Obama declared 2009 the Year of Community Living.(see related article)

"As individuals with disabilities leave institutional care, it is essential that they have housing options that will allow them to live independently," said HUD Secretary Shaun Donovan. "As we prepare to launch this initiative, we also want to make certain that we get input from local housing experts, disability rights advocates and others who can help us target this assistance to those who need it most. We also recognize how important it is for HUD and HHS to coordinate our resources to enable community-living for those individuals that live with disabilities."

HUD's Notice of Funding Availability (NOFA) will make $30 million in voucher assistance available to support approximately 4,000 Housing Choice Vouchers for non-elderly disabled families. HUD is making a 1,000 of those vouchers available specifically for individuals transitioning out of nursing homes and other institutions. These vouchers directly support a $1.75 billion initiative of the U.S. Department of Health and Human Services (HHS) to help persons who reside in health care settings move to community-based living. While HHS' Money Follows the Person (MFP) program offers health care, case management and other services to qualified families, it does not include funding for housing. HUD's funding initiative is designed to fill that gap.

The remaining 3,000 Housing Choice Vouchers are available to assist any non-elderly disabled family. The Department is encouraging local housing authorities to give strong consideration to using some or all of these vouchers to provide housing for those non-elderly persons that are living in the community, but are at-risk for institutionalization. Comments on the NOFA are due Monday, July 13th. ANCOR will be submitting comments. Read more!

CMS Releases New FMAP Frequently Asked Questions

Today, the CMS released one of a series of Medicaid Frequently Asked Questions (FAQs) designed to provide guidance on the implementation of the American Recovery and Reinvestment Act of 2009 (ARRA), Public Law 111-5.The FAQs address questions that have been submitted to the ARRA mailbox, CMSOARRAQuestions@cms.hhs.gov. Future Medicaid FAQs letters will be issued in the coming weeks and months. This CMS document, along with other CMS documents on the FMAP increase under the ARRA stimulus legislation is available on ANCOR’s Economic Recovery web page. Read more!

Long Term Services Provisions Gain Bi-Partisan Approval in Senate HELP Committee Health Legislation Mark Up

The Senate HELP Committee today finished marking up long-term service provisions, also known as the Community Living Assistance Supports and Services (CLASS) Act, included in the panel's healthcare overhaul. The measure received bi-partisan support from the committee after members agreed by voice vote to add a provision that would ensure the program’s solvency. ANCOR supports the CLASS Act, which creates a voluntary opt-out payroll deduction that would provide people experiencing functional impairments with tiered benefits if they have contributed a monthly premium over five years. The Congressional Budget Office estimated the program will save the government $58 billion over the first 10 years—taking pressure off Medicaid as the primary financier of long-term care. In addition, the program would be a new, private source of funding for ANCOR members and others that provide long-term supports and services. The Obama administration supports including the long-term care measures in healthcare reform. In a letter sent to Senate Democrats today, HHS Secretary Sebelius called the plan "innovative."

Thank you to ANCOR members that urged their Senators to support the CLASS Act and the inclusion of long-term services and supports in health reform legislation.


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Secretary Sebelius Releases New State by State Reports Highlighting Urgent Need for Health Reform

HHS Secretary Kathleen Sebelius today released a series of new reports on the health care status quo that highlight the urgent need for health reform across the nation. The new reports are available at www.HealthReform.gov and include information on health care cost and quality in all fifty states. Read more!

Make Appointments to Meet with Your Member of Congress During July 4th Recess

Make appointments to meet with your members of Congress during the July 4th Congressional recess (June 30th -July 3rd)! Watch for Town Hall Meeting notices from ANCOR that list other opportunities to reach out to members of Congress and their staff. Read more!

DOL Annouces Disability Employment Month Theme: Expectation + Opportunity = Full Participation

The U.S. Department of Labor today announced “Expectation + Opportunity = Full Participation” as the official theme for October’s National Disability Employment Awareness Month. It is intended to urge employers, as they seek to fill positions, to embrace the richness of America’s diversity by considering the talents of all workers, including workers with disabilities.

This year’s theme emphasizes the vision of the Labor Department’s Office of Disability Employment Policy (ODEP): a world in which people with disabilities have unlimited employment opportunities. Early selection of an annual theme for upcoming National Disability Employment Awareness Month helps the private sector; federal, state and local governments; and advocacy organizations plan events and programs that showcase the abilities and skills of job seekers and working Americans who have disabilities.

ODEP is the nation’s first assistant secretary-led office that addresses policies that impact upon the employment of people with disabilities. The office provides national leadership on disability employment policy by developing and influencing the use of evidence-based disability employment policies and practices, building collaborative partnerships, and delivering authoritative and credible data on the employment of people with disabilities.

As background for National Disability Employment Awareness Month, Public Law 176, enacted by Congress in 1945, designated the first week in October as “National Employ the Physically Handicapped Week.” President Harry S. Truman designated the (now former) President’s Committee on Employment of People with Disabilities to carry out the law. Congress changed the name to “National Disability Employment Awareness Month” in 1988. The responsibility for leading the nationwide recognition was transferred to the newly created ODEP in 2001. Read more!

Six New Co-Sponsors in June for Workforce Bill

Representatives Betty McCollum (D-MN), Pete Sessions (R-TX), Rosa DeLauro (D-CT, and Steve Isreal (D-NY) have recently signed on to the Direct Support Professional Fairness and Security Act (H.R. 868)! Thank you to ANCOR members in Minnesota, Texas, Connecticut, and New York for reaching out to these members.

See all 23 members of Congress supporting the bill so far! Read more!

Questions About Pan Flu?

ANCOR will continue its dialog with CMS as this situation unfolds. If you have questions about pandemic flu or emergency preparedness, or information on what your state is doing to prepare providers, please contact Jessica Sadowsky (jsadowsky@ancor.org) Read more!

CMS June 17th Letter to Medicaid Directors Summarizing ARRA

This letter is one of a series designed to provide guidance on the implementation of the American Recovery and Reinvestment Act of 2009 (ARRA), Public Law 111-5. It summarizes most sections of ARRA that impact titles XIX (the Medicaid program) and XXI (the Children’s Health Insurance Program, or CHIP) of the Social Security Act (the Act) and provides detail on the sections specific to payments that should not be counted for purposes of eligibility for Federal programs. This letter includes information on the FMAP and disregard of one-time only SSI $250 check for purposes of all federally funded programs. Read more!

State Revenues Plunge

Personal income taxes paid to the states plummeted 26 percent, or $28.8 billion, in the first four months of 2009, compared with the same time period last year, the Nelson A. Rockefeller Institute of Government said in its June 18 report.
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President Proclaims Year of Community Living

Marking the 10th Anniversary of the U.S. Supreme Court’s Olmstead decision, President Obama launched a new effort to assist Americans with disabilities—The Year of Community Living. The President directed Health and Human Services Secretary Kathleen Sebelius and Housing and Urban Development Secretary Shaun Donovan to work together to identify ways to improve access to housing, community supports, and independent living arrangements. In joining the President in commemorating the anniversary of the Olmstead decision, HHS Secretary Sebelius announced that agencies within her department would begin aggressively addressing barriers that prevent some Americans with disabilities from enjoying a meaningful life as part of their community.

Throughout this “Year of Community Living,” HHS will hold listening sessions, giving stakeholders an opportunity to come together for a common purpose: overcoming barriers to community-based living for people with disabilities and the elderly. These forums will help HHS craft the agenda to improve federal programs and better support the efforts of state and local government.

HUD announced that it will make1,000 housing vouchers available for individuals with disabilities transitioning from institutions to the community—targeting states operating Money Follows the Person Demonstration programs. HUD will award an additional 3,000 housing vouchers to serve non-elderly people with disabilities and encourage Public Housing Authorities to form working relationships with state Medicaid agencies interested in addressing community living needs of beneficiaries.
See the next issue of LINKs for more information. Read more!

CMS Issues Advance Notice of HCBS Waiver Rulemaking

The June 22nd Federal Register included a CMS Advanced notice of proposed rulemaking on the Medicaid 1915(c) waiver. The notice invites advanced public comments by August 21, 2009. The “advanced” notice is an announcement of CMS’ intention to publish a proposed rule and solicit public comments on the changes. Last year, ANCOR provided CMS with comments on the areas it is now asking for public comments on in this advanced notice. CMS is seeking to make changes in several areas: providing states with the option of designing 1915(c) waivers to serve more than one targeted population based on functional need rather than diagnosis or condition: recommendations to strengthen person-centered principles in HCBS waiver; requirements related to identifying home and community-based character of HCBS settings; and standards for defining home and community under waivers and CMS approval of a state’s definition. ANCOR will be submitting comments to CMS. Read more!

Senate Health Reform Proposals Hit Bumps

The HELP committee began marking up this week its version of health care reform as scheduled. The incomplete proposal, according to the CBO, has an initial price tag of $1 trillion. HELP and Finance originally planned to mark up their bills this month and then merge negotiations after the July Fourth recess. However, Senate Finance Chairman Baucus (D-MT) announced that the Finance committee’s scheduled markup next week would be delayed until after July Fourth due to his determination to bring the $1.6 trillion Finance proposal down to less than $1 trillion AND make it deficit neutral. Read more!

House Plan for Health Care Reform Unveiled

House Democrats released today an 852-page discussion draft of their health care reform proposal. The three House committees that worked together on the proposal(Ways and Means, Energy and Commerce, Education and Labor) will begin debate on the measure in hearings next week. They are expected to mark up the bill soon after the July Fourth recess. Watch WICs Live and ANCOR's web for more information next week. Read more!

Iowa Makes Good on Pledge to Use Enhanced FMAP Exempt Providers from Across Board Cuts

Iowa Governor Chet Culver implemented an across-the-board cut of 6.5% in his FY09 budget. For FY10 beginning July 1, 2009 there was an additional across-the-board cut of 4.8% on top of the previous 6.5%. The good news for Iowa providers is that the Governor made a commitment to them that they would be exempted from the across-the-board cuts if Congress came through with the enhanced FMAP funding via the American Recovery and Reinvestment Act (ARRA) of 2009. The Governor kept his commitment and providers were exempt. Thanks to Rod Braun of Christian Opportunity for this update. Read more!

Federal Sick Leave Bill Introduced

Senator Kennedy (D-MA) and Representative DeLauro (D-CT) introduced The Healthy Families Act (S.1152 and H.R. 2160) which would require employers with 15 or more employees to accrue paid sick leave (with up to 56 hours of paid sick leave) for every 30 hours worked. The paid sick leave could be used after 60 days for an employee to care for the medical needs of a child, parent, spouse, or any blood relative, or for their own medical needs including those resulting from domestic violence. The HFA mandated sick leave would be in addition to leave required under the Family Medical Leave Act or state workers compensation laws, and employers' leave policies would have to be meet the HFA requirements should it be enacted. The Senate bill has 20 cosponsors and the House bill has 105 cosponsors. ANCOR will provide members with additional information on the HFA. Read more!

Bill Watch: The Community Choice Act

The Community Choice Act would provide Americans with equal access to community-based services and supports. This ANCOR-supported bill would provide individuals with disabilities in nursing homes and other institutional settings with options to receive community-based services.Senators Tom Harkin (D-IA) and Arlen Specter (R-PA) along with Representative Danny Davis (D-IL) introduced the Community Choice Act (S. 683; H.R. 1670) on March 23, 2009. The legislation has bi-partisan support. The Community Choice Act has been referenced in testimony at hearings concerning long-term services and supports within the context of health care reform. For more information visit www.passthechoiceact.com. Read more!

Senate Schedule Calls for a Single Bill to Come to Floor in July

Earlier this year, Senators Baucus (D-MT) and Kennedy (D-MA), chairmen of Senate Finance and HELP committees respectively (the Senate committees with jurisdiction over health care), established a joint process to lead a single health care bill to be merged on the Senate floor. Following committee mark-ups, the plans are to take one to two weeks to combine the two bills after the July 4th recess. Type rest of the post here. Read more!

Finance Committee to Release Health Care Reform June 17th

Senate Finance Chairman Baucus (D-MT) is expected to release his health care document in time for a June 18th committee mark up. Finishing touches are being made this weekend on the reform.Baucus said earlier this week that he will keep on schedule, despite still needing cost information from the Congressional Budget Office. The word is that the Finance Committee document will include several of the Medicaid long-term options discussed in an earlier document and supported by ANCOR. Read more!

HELP Committee Releases Health Reform Bill That Includes Long Term Services

Senate HELP Committee Chairman Kennedy (D-MA) released the Affordable Health Choices Act Tuesday which includes the following five major elements: choice, cost reduction, prevention, health system modernization, and long term services and supports. The committee will begin consideration of the 615-page bill, Tuesday, June 16th. The Chairman’s inclusion of his CLASS Act (S. 697), supported by ANCOR, would create a new national insurance program to help adults who have or develop functional impairments to remain independent, employed, and stay a part of their community, is incorporated. This new program, self-funded and actuarially sound, would provide significant savings to the Medicaid program, relieving state and federal budgets as the primary funder of long-term services. It would offer a new funding resource for providers of home and community-based services. Senator Dodd (D-CT), second in Democratic seniority on the committee, is managing the day-to-day work of the HELP Committee during Chairman Kennedy’s absence. Read more!

Celebrate Landmark Olmstead Decision 10th Anniversary

June 22, 2009 marks the 10th anniversary of the U.S. Supreme Court Olmstead decision that upholds the Americans with Disabilities Act requirement that states serve people with disabilities in community settings, rather than segregated institutions. June 22, 2009 marks the 10th anniversary of the U.S. Supreme Court Olmstead decision that upholds the Americans with Disabilities Act requirement that states serve people with disabilities in community settings, rather than segregated institutions. Read more!

Campaign for Disability Employment Announces Video Contest

The Campaign for Disability Employment, a newly-formed collaborative of leading disability organizations funded by the Office of Disability Employment Policy of the U.S. Department of Labor, has announced an online video contest to promote the talent and skills that people with disabilities bring to America's workforce and economy. Videos received by July 15, 2009 will be judged by a panel of representatives from member organizations of the Campaign for Disability Employment. Type rest of the post here. Read more!

Did You Know?

A record 10,552 fair housing discrimination complaints were filed in fiscal year 2008, according to a report released by the U.S. Department of Housing and Urban Development (HUD). The report shows that a large portion of the complaints, 44 percent, were filed by persons with disabilities. Type rest of the post here. Read more!

Chairman Pallone Introduces Senate Version of Empowered at Home Act

House Energy and Commerce Subcommittee on Health Chairman Frank Pallone (D-NJ) introduced today the House version of the Empowered at Home Act (H.R. 2688). This bill would improve the state plan amendment option (1915i) for providing home and community-based services under the Medicaid Program. The state plan amendment option was passed as part of the DRA. Senators John Kerry (D-MA) and Charles Grassley (R-IA) introduced the Senate version in July. Read more!

Survey Shows Weak Fiscal Outlook for States

Although federal Recovery Act dollars have helped states avoid the most drastic budget cuts, state fiscal conditions declined for nearly every state during fiscal year (FY) 2009, according to the latest Fiscal Survey of the States from NGA and the National Association of State Budget Officers (NASBO). Overall, NGA and NASBO found that while general fund expenditures and revenue collections increased for many states in FY 2008, the ongoing recession is adversely affecting states' fiscal outlook for the next several years. Between FY 2009 and 2011, states must fill more than $183.3 billion in budget gaps, after previously closing gaps totaling $46.2 billion.
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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.

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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.
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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.
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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

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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
  

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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).
  

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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.
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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!