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.
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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
  

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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!