Community First Choice Option Included in Senate Finance Committee Legislation

The Community First Choice Option was proposed by Senator Harkin (D-IA) as a way to include the Community Choice Act (CCA) in health care reform. The option would encourage states to provide Medicaid home and community based attendant services (rather than require them as the original CCA would do).

Senator Charles Schumer (D-NY) introduced the language of the CFC Option as an amendment, but Chairman Baucus (D-MT) included it in modifications to his original mark.

Language on the Community First Choice Option from the Chairman’s Mark:

Insert ―The Chairman’s Mark would establish the Community First Choice Option, which would create a state plan option under section 1915 of the Social Security Act to provide community based attendant supports and services to individuals with disabilities who are Medicaid eligible and who require an institutional level of care. These services and supports include assistance toindividuals with disabilities in accomplishing activities of daily living and health related tasks. States who choose the Community First Choice Option would be eligible for enhanced federal match rate of an additional six percentage points for reimbursable expenses in the program. The option would sunset after five years.

―The Community First Choice Option also would require data collection to help determine how states are currently providing home and community based services, the cost of those services, and whether states are currently offering individuals with disabilities who otherwise qualify for institutional care under Medicaid the choice to instead receive home and community based services, as required by the U.S. Supreme Court in Olmstead v. L.C. (1999).

―The Community First Choice Option would also modify the Money Follows the Person Rebalancing Demonstration to reduce the amount of time required for individuals to qualify for that program to 90 days.

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Two New Housing Voucher Reports Available

The Center on Budget and Policy Priorities published this week two new reports about Section 8 Housing Choice Vouchers. The first report outlines the Section Eight Voucher Reform Act and how the bill would update and streamline the Section 8 voucher program. The second report addresses shortages of Section 8 vouchers in FY 2009. Read more!

Remember: October is National Disability Employment Month

This year’s theme for National Disability Employment Month is Expectation + Opportunity = Full Participation. This annual October celebration as designated by Congress is an opportunity to highlight the contributions and skills of Americans with disabilities to the workforce.NDEM is a time not only to acknowledge the struggle people with disabilities endure to obtain employment, but also to celebrate the strides made by those who have overcome the many barriers to employment. It is also an opportunity to recognize employers, who have hired people with disabilities and are tapping into new sources of creativity in this existing source of employees. NDEM is an excellent opportunity for ANCOR providers of employment and vocational supports to host events and activities that recognize employment accomplishments and draw attention to the 70 percent of unemployed people with significant disabilities —a huge untapped portion of the labor force.

Activities to Recognize National Disability Employment Awareness Month:

• Employer recognition events
• Share successes with the media
• Identify employers who hire people with disabilities to the media
• Host events highlighting employers and individuals
• Meet with and form partnerships with local workforce investment boards and one stop centers
• Work with your governor’s office to issue a proclamation


The Department of Labor’s Office of Disability Employment Policy has made available the NDEM 2009 Poster. The posters are available in one size, 20” x 15,” at no cost to you. Please enter your online order here. The maximum order is 100 posters. You may also download PDF versions of the posters.

ANCOR joins with providers of employment and vocational supports in celebrating NDEM and appreciates all of your efforts to expand opportunities for employment for people with disabilities. Please share any NDEM activities or ideas your agency or state association is sponsoring with Jessica Sadowsky at jsadowsky@ancor.org.
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HIPAA Breach Rule Update—Discount for ANCOR Members

Gilliland & Markette in partnership with ANCOR has developed materials to assist providers comply with the HIPAA Breach Notification Rule. It is a 40+ page document consisting of comprehensive Questions & Answers concerning the Rule, a template Breach Notification Policy, sample breach notification language for business associate contracts, and a copy of the Breach Notification Rule, itself.

The price is $49.50; however, ANCOR members are eligible for a 10% discount. You can order by phone at (800) 894-1243 with a credit card. Just tell the folks at Gilliland & Markette that you are an ANCOR member.

Gilliland & Markette LLP
3905 Vincennes Road, Suite 204
Indianapolis, Indiana 46268

Telephone: (317) 704-2400
Toll Free: (800) 894-1243
Fax: (317) 704-2410
Mail to: thefirm@gillilandmarkette.com
http://www.gillilandmarkette.com
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House and Senate Continue Health Care Debate

House leaders are set to meet today to discuss many of the details of their health care overhaul, including whether to include a public insurance option in the package, while Senate Finance Committee’s health care markup now appears likely to spill over into next week. Speaker Nancy Pelosi (D-CA.) has been reluctant to disclose details about the shape and timing of the bill.

The Senate Finance Committee’s health care markup now appears likely to spill over into next week, due in large part to the sheer number of amendments filed against Chairman Max Baucus’ (D-MT) bill. The markup continued apace Thursday, with Finance members bracing for a third consecutive late night of amendment consideration, as well as a Friday session. But Baucus, who had hoped to conclude the markup by week’s end, hedged when asked if that goal would be met. Still, the Finance chairman said he was happy with the progress on his $900 billion plan so far.

The “public option” remains a major point of contention as Senator Charles Schumer (D-NY) is set to offer an amendment to replace the bill’s nonprofit health insurance cooperatives with a public insurance option. Senate Minority Whip Jon Kyl (R-AZ) said Republicans would likely offer more than 100 amendments before the markup concludes.
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Kaiser Family Foundation Resources

Be sure to take advantage of the resources provided by the Kaiser Family Foundation on their Health Reform page. Specifically, look at their Side-by-Side Comparison of Major Health Care Reform Proposals. Read more!

Massachusetts Appoints New Senator

The Massachusetts state legislature voted to give Governor Deval Patrick authority to appoint someone to fill Former Senator Ted Kennedy’s seat until the special election is held in January. Today Governor Patrick appointed former Kennedy aide Paul Kirk to fill the seat. Kirk will be sworn in tomorrow at 3:15 p.m. by Vice-President Biden. Read more!

H1N1 Vaccine Update

HHS officials have recently announced 3.4 million doses will now be available the first week of October however they will all be in the nasal spray form. The nasal spray, FluMist, contains a weakened live virus, while injections contain a killed and fragmented virus. The spray gives a stronger immune reaction but carries a small risk that the virus will multiply too quickly in people with compromised immunity. The normal side effects of FluMist include fever, headache, muscle aches, runny nose, vomiting and wheezing. These side effects mimic the flu, leading to the rumor that flu vaccines cause the illness. Nevertheless, health agencies say the side effects cannot expand into a life-threatening infection. The nasal spray is not recommended for pregnant women, people over 50, and individuals with asthma or heart conditions. This still allows other target groups to receive immunity faster than expected.

Contrary to what experts expected, clinical trials now show the H1N1 vaccine is effective for adults and children ages 10 to 17 with one dose, not two. Children 9 and under will need two doses. Clinical trials have not yet finished for pregnant women. Studies have concluded that once vaccinated, a person develops immunity to the virus within 8 to 10 days. This recent change means that the vaccine supply will go twice as far, which will allow all people within the CDC’s high risk groups to receive vaccination before the flu’s midwinter peak. Read more!

Kaiser Family Foundation Releases Two HCBS Documents

Kaiser Family Foundation released two documents pertaining to home and community-based settings.

The first, entitled Advancing Access to HCBS discusses how in order for more individuals to be served in home and community-based settings, greater attention to workforce development is necessary.

The second attachment, entitled Efforts in States to Promote Medicaid CBS discusses how to strengthen the long-term service workforce through community based services. Read more!

U.S. Chamber Releases H1N1 Flu Guide to Keep Businesses in Business

The U.S. Chamber of Commerce’s National Security and Emergency Preparedness Department announced the release of It’s Not Flu as Usual: An H1N1 Business Preparedness Guide to provide businesses with suggestions on how to keep employees healthy and maintain business operations during the upcoming flu season. The document is designed for businesses of all sizes and includes a 10-point preparedness checklist in addition to information on topics such as federal guidance for workplace planning, vaccines, antiviral drugs, face masks, and respirators.

More information from the U.S. Chamber of Commerce is available at their pandemic planning website. Read more!

Card Check Legislation Won’t Happen Until After Health Care Reform

UPDATE: See ANCOR's background piece on "card check" from the Governmental Activities Seminar.

One of labor’s most prized legislative goals will take a backseat to the Administration’s most pressing priority—health care reform—for the meanwhile. Reports are that President Obama and White House Chief of Staff Rahm Emanuel told labor on Monday that they will not bring up the Employee Free Choice Act (EFCA) known as “card check” until after Congress completes its work on health care reform. Congress does not plan on picking up formal action until September 15th—the date that Finance Chairman Baucus (D-MT) has set for his committee’s draft and date that House Energy and Commerce Chairman Waxman (D-CA) has set to take up more than 40 amendments to finish his committee’s part of the final House bill. Read more!

New H.R. 868 Co-sponsors

Congressman Dennis Moore (D-KS), Congressman Brett Guthrie (R-KY), and Congressman Maurice Hinchey (D-NY) have signed on as co-sponsors to H.R. 868. Thank you to everyone who sent messages and visited their offices during the Governmental Activities Seminar. Read more!

Federal Judge Blocks Cuts September 9th to Adult Day Health Care Services

In a major victory for disability and senior rights advocates, a federal district court judge September 9, 2009 issued an order blocking California’s budget reductions to Adult Day Health Care services, saying that the cuts would likely be in violation of the federal Americans with Disabilities Act and Section 504 of the federal Rehabilitation Act. Federal District Court Judge Saundra Brown Armstrong issued a preliminary injunction – or temporary order – to stop the cuts until appropriate replacement services are in place. For a copy of the 24 page order, go to www.cdcan.us .
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Post ANCOR 2009 Governmental Activities Seminar Wrap-Up

Thank you to everyone who attended ANCOR's 2009 Governmental Activities Seminar and made it such a wonderful event. Please see ANCOR's website to access presentations and hill visit materials from the Seminar.


Please remember to fax your Hill Visit forms to ANCOR at (703) 535-7860 or use ANCOR's electronic feedback form if you do not have a copy of the form from the Seminar.
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Senate Finance Chairman Baucus Releases Chairman's Mark

Senate Finance Committee Chairman Baucus released his anticipated health reform bill entitled America’s Healthy Future Act of 2009. The bill received praise from the House Blue Dog Coalition but was criticized by both some Democrats and Republicans. Check back on WICs Live for more information as the process continues. Read more!

New Co-Sponsor for H.R. 868

Congresswoman DeGette (D-CO) recently signed onto H.R. 868 as a co-sponsor. We thank Sharon Walters from Mosaic who spent a great deal of time communicating with Congresswoman DeGette's office. Read more!

ANCOR Releases H1N1 Issue Brief

ANCOR has recently released an H1N1 Issue Brief.The issue brief will be updated as new information comes in. To ensure you have the most updated copy check our Pandemic Flu Website. For questions contact Mary Pauline Jones. Read more!

Washington state court case

U.S. District Court Judge in Washington Rules State Violated Rights of Individuals with Disabilities in Cutting Adult Day Health Programs. Cuts to a Washington program that provides rehabilitative therapy and skilled nursing services to disabled individuals living in community-based residential settings must be restored, a federal trial court ruled Sept. 4 (Ryan v. Dreyfus, W.D. Wash., No. 2:09-cv-908, 9/4/09). The U.S. District Court for the Western District of Washington said a class of Medicaid-eligible individuals who had been receiving benefits under Adult Day Health programs were entitled to an injunction against the Washington Department of Social and Health Services (DSHS) and its secretary, Susan N. Dreyfus, because the benefits were terminated without notice. Termination without notice and an opportunity for a hearing violates the due process rights of the individuals who, until July 1, were receiving services through the ADH programs, the court said. The class representatives are entitled to an injunction because they showed they would prevail on their claims that the state violated the 14th Amendment of the U.S. Constitution, as well as the Medicaid Act, and demonstrated an injury that could be redressed by such relief, the court said. The class-wide case management activities that DSHS has undertaken since the commencement of this litigation have provided for post-termination hearings for those individuals who request them. The court ruled: “The class members were entitled to a pre-termination hearing, not a post-termination hearing. Pending a hearing, the class member's ADH services are reinstated. Thus, in order to remedy the due process violation, the class members' ADH services must be immediately reinstated and then DSHS can provide the notice and opportunity to be heard that it should have provided before July 1.
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HIPAA: HHS Issues Rule Requiring Individuals Be Notified of Breaches of Their Health

The breach notification notice of proposed rule making requires HIPAA covered agencies to give notification to affected individuals of breaches of unsecured protected health information (PHI). Business associates of HIPAA covered agencies are required to notify the agency following discovery of a breach of unsecured protected health information maintained by the business associate. The requirement for breach notification applies only to breaches of “unsecured protected health information,” which means PHI that has not been secured by use of a technology or methodology specified in guidance of the Secretary of HHS. That guidance essentially requires encryption or destruction of the PHI. The rule is effective September 23, 2009. However, HHS specifically states, "...we will use our enforcement discretion to not impose sanctions for failure to provide the required notification for breaches that are discovered before 180 calendar days from the publication of this rule, or February 22, 2010. During this initial time period - after this rule has taken effect but before we are imposing sanctions - we expect covered entities to comply with this subpart and will work with covered entities, through technical assistance and voluntary corrective actions, to achieve compliance." ANCOR is working to develop products and other information to assist members with this new development.
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Senate Health Care Update

Senate Finance Chairman Baucus released a draft framework Tuesday and expects to have his Chairman’s report out by September 15th and proceed to a mark-up of a Finance bill the week of September 21st. Read more!