California: Lawmakers Pass Bill Increasing Medi-Cal Hospital Rates So State Qualifies for Enhanced FMAP. The complex measure is designed to ensure the state continues to qualify for its temporary 11.59% enhancement in federal medical assistance percentage (FMAP), which is the state’s share of $87 billion allocated as part of the American Recovery and Reinvestment Act (ARRA). The bill, which is currently awaiting Governor Arnold Schwarzenegger (R) would increase the upper payment limit by imposing a “quality insurance fee” for outpatient and inpatient services at hospitals that quality for other state health funding other than Medi-Cal. The fee would be levied through December 31, 2010 and is projected to raise $2 billion annually. Revenue from the fee also would offset the impact of an April 6 emergency order by the U.S. Court of Appeals for the Ninth Circuit staying a 10% reduction in hospital Medi-Cal reimbursement rates. It is unclear if Schwarzenegger will sign the legislation; he has stated the bill is fatally flawed and will not receive federal approval.
In other news, lawmakers September 12th also approved legislation to temporarily unemployed Medi-cal beneficiaries with disabilities participating in the state’s Working Disabled Program to remain on Medi-cal for up to 26 weeks as long as federal funding is available. The extension would take effect 30 days after the temporary ARRA-funded increase in the state's Medicaid FMAP is no longer available. The bill was also sent to the governor for signature.
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Saturday, October 3, 2009
Friday, October 2, 2009
House Eyeing What the Senate Does on Health Care.
The House appears “eerily quiet” regarding moving its tri-committee health care bill. The three committees of jurisdiction in the House are working on finalizing details in its combined bill HR 3200, but the leadership has provided no timeframe for bringing that bill to the House floor for a vote. The word is that the House Democratic leadership is waiting before pushing its majority party members to vote on its health care bill until it sees what emerges from the Senate. For example, while the House bill includes a public health care option and employer mandate, the Senate Finance bill does not include either, but the HELP bill includes both.
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New Co-Sponsors for the Direct Support Professionals Fairness and Security Act
Eleven Representatives signed on as co-sponsors to the Direct Support Professionals Fairness and Securitye Act (H.R. 868). Those members are Rep. Mark Souder (R-IN), Rep. Lloyd Doggett (D-TX), Rep. Albio Sires (D-NJ), Rep. Patrick Murphy (D-PA), Rep. Shelley Berkley (D-NV), Rep. Carolyn McCarthy (D-NY), Rep. John Yarmuth (D-KY), Rep. David Loebsack (D-IA), Rep. Chellie Pingree (D-ME), Rep. Ben Chandler (D-KY), and Rep. James Langevin (D-RI). Thank you to everyone who contact these members urging them to sign on
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Senate Finance Chairman’s Mark and Amendments Include Long-Term Supports and Services.
While the “dust” has yet to settle on all of the provisions included in the Senate Finance Committee’s health care plan, several important provisions regarding long-term services and supports backed by ANCOR were included. Senate Finance Chairman Baucus modified his original health care mark by including committee member amendments in the health care plan that the Committee began deliberating two weeks ago that provide additional federal assistance to states for Medicaid’s HCBS waiver services, for changes in Medicaid’s 1915(j) HCBS state plan option, and a new Medicaid personal attendant state plan option.
ANCOR staff made Capitol Hill visits on these and other long-term services’ issues this week in addition to its ANCOR grassroots alert. ANCOR and other disability and aging groups will do another round of Capitol Hill visits and grassroots phone-in on Thursday, October 8th following Senate Finance Committee adoption early next week of its health care plan.
Several important long-term supports and services provisions were included: (1) Senator Schumer’s (D-NY) Community First Choice state option; (2) Senator Cantwell’s (D-WA) Home and Community Balanced Incentives Act that temporarily increases the federal matching rate for HCBS for states that undertake structural reforms over five years to increase diversion for nursing homes, ICFs/MR, and other institutions through either a HCBS waiver or state plan amendment; (3) Senator Kerry’s (D-MA) provision to improve access to HCBS under the Medicaid’s 1915(j) state option –that would let states seek approval from HHS that place services on a par with nursing home and HCBS waiver eligibility criteria to offer “additional services” under the HCBS state and to offer these HCBS to individuals who make more than 150 percent of the federal poverty level (FPL) but no more than 300 percent of the supplemental security income (SSI) level, and (4) Senator Rockefeller’s (D-WV) Sense of the Senate that this Congress should address long-term services and supports in a comprehensive way that guarantees elderly and disabled individuals requiring the Department of Justice to perform an annual evaluation of state compliance with federal Olmsted laws. Work still continues on ANCOR’s NAC efforts to get language regarding the direct support professional workforce issue included in the Committee’s final bill as we did with the HELP Committee bill.
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ANCOR staff made Capitol Hill visits on these and other long-term services’ issues this week in addition to its ANCOR grassroots alert. ANCOR and other disability and aging groups will do another round of Capitol Hill visits and grassroots phone-in on Thursday, October 8th following Senate Finance Committee adoption early next week of its health care plan.
Several important long-term supports and services provisions were included: (1) Senator Schumer’s (D-NY) Community First Choice state option; (2) Senator Cantwell’s (D-WA) Home and Community Balanced Incentives Act that temporarily increases the federal matching rate for HCBS for states that undertake structural reforms over five years to increase diversion for nursing homes, ICFs/MR, and other institutions through either a HCBS waiver or state plan amendment; (3) Senator Kerry’s (D-MA) provision to improve access to HCBS under the Medicaid’s 1915(j) state option –that would let states seek approval from HHS that place services on a par with nursing home and HCBS waiver eligibility criteria to offer “additional services” under the HCBS state and to offer these HCBS to individuals who make more than 150 percent of the federal poverty level (FPL) but no more than 300 percent of the supplemental security income (SSI) level, and (4) Senator Rockefeller’s (D-WV) Sense of the Senate that this Congress should address long-term services and supports in a comprehensive way that guarantees elderly and disabled individuals requiring the Department of Justice to perform an annual evaluation of state compliance with federal Olmsted laws. Work still continues on ANCOR’s NAC efforts to get language regarding the direct support professional workforce issue included in the Committee’s final bill as we did with the HELP Committee bill.
Read more!
Senate Finance Wraps Up Health Reform Mark Up Early This Morning and Planning Committee Vote Next Week
The Senate Finance Committee wrapped up its debate on more than 600 amendments to its health care “conceptual” overhaul early Friday. After working through hundreds of amendments to Baucus’ original $900 billion health care bill over the past two weeks, the Finance Committee is expected to review preliminary CBO scoring on the amended Chairman’s mark before a final vote by the on Tuesday. When the marked up bill comes up for vote next week in the committee, it is expected to pass along party lines with Senator Olympia Snowe (R-ME) as the only Republican who may align with the Democrats in favor of the Committee’s bill.
The next phase of moving toward a floor vote on health care reform in the Senate involves merging the Finance bill with a bill previously passed by the Health, Education, Labor and Pensions Committee (HELP). Senate Majority Leader Harry Reid (D-NV) will be directing the melding of the Senate Finance and HELP versions of health care reform in his office along The word is that his efforts will also include top White House officials and Finance Chairman Baucus, HELP Chairman Harkin (D-IA) and Senator Chris Dodd (D-CT) who was the acting the acting HELP Committee Chair with his work on a health reform bill. That “merged” health reform bill require that a Senate bill be drafted in actual “statutory language,” requiring another CBO scoring which may take up to two weeks. This timeframe conflicts with Majority Leader Reid’s announcement that the Senate will forgo its annual Columbus Day week-long recess beginning October 12th because the final Senate bill will be brought to the floor that week.
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The next phase of moving toward a floor vote on health care reform in the Senate involves merging the Finance bill with a bill previously passed by the Health, Education, Labor and Pensions Committee (HELP). Senate Majority Leader Harry Reid (D-NV) will be directing the melding of the Senate Finance and HELP versions of health care reform in his office along The word is that his efforts will also include top White House officials and Finance Chairman Baucus, HELP Chairman Harkin (D-IA) and Senator Chris Dodd (D-CT) who was the acting the acting HELP Committee Chair with his work on a health reform bill. That “merged” health reform bill require that a Senate bill be drafted in actual “statutory language,” requiring another CBO scoring which may take up to two weeks. This timeframe conflicts with Majority Leader Reid’s announcement that the Senate will forgo its annual Columbus Day week-long recess beginning October 12th because the final Senate bill will be brought to the floor that week.
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Thursday, October 1, 2009
Drug Store Groups Sue Three States Over Medicaid Reimbursement Rates.
The National Association of Chain Drug Stores, the National Community Pharmacists Association and other smaller groups filed lawsuits Wednesday in New York, California and Washington State because the Medicaid reimbursement rates are not based on how much it costs the pharmacies to buy the drugs. The three states were charged with violating the Social Security Act and failing to get the new drug prices approved as required by the Centers for Medicare & Medicaid Services.
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President Obama Issues National Disability Employment Month Proclamation
Today President Obama marked the beginning of National Disability Employment Month with a Proclamation recognizing the strides individuals with disabilities have made in achieving employment, acknowledging the work that remains, and calling Americans to celebrate the contributions of individuals with disabilities in the workplace and communities.
As Americans, we possess a range of vocational opportunities to make the most of our talents and succeed in a chosen career; those with disabilities are entitled to the same opportunities.
I call on all Americans to celebrate the contributions of individuals with disabilities to our workplaces and communities, and to promote the employment of individuals with disabilities to create a better, more inclusive America, one in which every person is rightly recognized for his or her abilities and accomplishments.
This year’s theme for National Disability Employment Month is Expectation +
New Kaiser 50-State Survey Reports Sharp Increase in Medicaid Enrollment and Spending Amidst Worst Recession in Decades.
The annual Kaiser Commission on Medicaid and the Uninsured 50-state survey of state Medicaid officials found that the increased federal, temporary Medicaid assistance (FMAP) was critical to states. However, the survey results also find that the number of people on Medicaid and state spending on the program are climbing sharply as a result of the recession, straining state budgets and pressuring officials to curb costs. Total Medicaid spending growth averaged 7.9 percent in FY 2009, the highest rate in five years, well above the 5.8 percent projected growth. For FY 2010, states estimate Medicaid enrollment will grow by 6.6 percent over FY 2009 levels, with Medicaid spending across states expected to grow by an average of at least 6.3 percent in fiscal 2010.
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Wednesday, September 30, 2009
States Move to Require Some Health Care Workers to Receive H1N1 Vaccination
With the H1N1 pandemic spreading rapidly, many doctors, nurses, and other U.S. health-care workers for the first time are being required by their states to get flu shots, drawing praise from many public-health authorities but condemnation from some employees, unions and other critics who object to mandatory vaccination. Check with your state and local government to find out if they require direct support professionals to receive the H1N1 vaccine.
What's at Issue?
An increasing number of doctors, nurses and other health-care workers for the first time are being required to get flu shots, in part because of concerns that the swine flu pandemic may overwhelm the U.S. health-care system.
Who's Objecting and Why?
Some health-care workers are objecting for a variety of reasons, including concerns about the safety of the vaccine, the sentiment that being vaccinated should remain voluntary and, in some cases, the mistaken fear that the vaccine itself can cause the flu.
For Example...
States: New York this year became the first state to require flu shots, a policy that affects about 522,000 employees.
Hospitals: The Hospital Corp. of America, known as HCA, in Nashville, the nation’s largest private hospital chain, is also requiring the shots this year, a policy that affects an estimated 120,000 employees in 20 states.
Providers: MedStar Health, the largest health-care employer in the Washington region, is requiring flu shots this year for the first time for all 25,000 of its employees and 5,000 affiliated physicians. Read more!
What's at Issue?
An increasing number of doctors, nurses and other health-care workers for the first time are being required to get flu shots, in part because of concerns that the swine flu pandemic may overwhelm the U.S. health-care system.
Who's Objecting and Why?
Some health-care workers are objecting for a variety of reasons, including concerns about the safety of the vaccine, the sentiment that being vaccinated should remain voluntary and, in some cases, the mistaken fear that the vaccine itself can cause the flu.
For Example...
States: New York this year became the first state to require flu shots, a policy that affects about 522,000 employees.
Hospitals: The Hospital Corp. of America, known as HCA, in Nashville, the nation’s largest private hospital chain, is also requiring the shots this year, a policy that affects an estimated 120,000 employees in 20 states.
Providers: MedStar Health, the largest health-care employer in the Washington region, is requiring flu shots this year for the first time for all 25,000 of its employees and 5,000 affiliated physicians. Read more!
GAO Releases Report on VR Funding Formula
The report, Vocational Rehabilitation Funding Formula: Options for Improving Equity in State Grants and Considerations for Performance Incentives: (1) examines the extent to which the current formula meets generally accepted equity standards, (2) presents options for revising the formula, and (3) identifies issues to consider with incorporating performance incentives into the formula.GAO presents three options for revising the formula to illustrate a range of possibilities: the first distributes funds based on states’ disability populations, the second also accounts for costs of providing services, and the third further accounts for state resources beyond per capita income. Because any formula change would redistribute funds among states, potentially disrupting services to individuals, GAO also presents options for establishing a transition period.
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Monday, September 28, 2009
New Mexico Families Feel Betrayed By Unkept Promise and Funding to Address DD Waiting Lists
Mexico’s Health Department decided not to spend $9.4 million — approved by the Legislature and signed by the governor — to bring 400 children and adults off the 4,800 person waiting list. The worsening economic crisis is the reason the Health Department cites for holding off on spending the funding. Thanks Mona McGee of Mosaic for this update.
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Friday, September 25, 2009
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.
Read more!
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.
Read more!
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.
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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.
Read more!
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.
Read more!
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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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
Read more!
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.
Read more!
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.
Read more!
Thursday, September 24, 2009
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!
Tuesday, September 22, 2009
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!
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!
Monday, September 21, 2009
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!
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!
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