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Three CMS Regs Rescinded--with Partial Rescission of Targeted Case Management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

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!