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
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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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