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MR Update #06-11: Federal Issues
August 3, 2006

ADA Anniversary
The Americans with Disabilities Act (ADA) was 16 years old on July 26. President Bush issued Proclamation 8037 in recognition of this important legislation which was signed into law by his father, President George H.W. Bush, in 1990.

Smart Homes
The Oregon Department of Human Services has used a Centers for Medicare and Medicaid Services Real Choice System Change grant to address technology for housing for seniors and persons with disabilities. Using “Smart Home” remote monitoring and assistive technology, the project will focus on developing a plan for system change that provides tools to promote the potential of assistive technology and to incorporate these components in the individual planning process. There is a lack of infrastructure capacity which creates significant barriers to integration of assistive technology into affordable housing development and long-term supports. Information and training materials will be developed for consumers, housing developers, case managers, families, contractors, and others. For additional information access www.technologyforhousing.org.

College Options
The Institute for Community Inclusion (ICI) has launched a web site for high school students with developmental disabilities who would like to go to college. Resources at www.ThinkCollege.net include a database of programs offering educational opportunities.

ICI has added data on individuals completing vocational rehabilitation services in every state to their web site. Details include the number of persons finding jobs, number of hours worked, number using supported employment, and the average cost per individual. Access www.StateData.info for details. A guide for vocational rehabilitation consumers is also available at www.communityinclusion.org.

Money Follows the Person
The Centers for Medicare and Medicaid Services (CMS) has issued a grant application for the 2006 Money Follows the Person Rebalancing Initiative Demonstration Program. States may apply for a total of $1.75 billion over five years to help shift Medicaid from its historic emphasis on institutional long-term care services to a system that offers more choices for seniors and persons with disabilities from all age groups, including home and community-based services. This rebalancing initiative was included in the President’s New Freedom Initiative and the Deficit Reduction Act of 2005.

Additional information on the new application is available at www.grants.gov. Information regarding the state’s current initiative is available at www.ohcr@state.pa.us.

Supreme Court Decision
Maine, Missouri, New Jersey, Kentucky, and Texas asked the US Supreme Court to issue an injunction against the Medicare Part D prescription drug program. The lawsuit challenged the legality of the new program and argued that the clawback requirement is an unconstitutional tax on the states. The court rejected the requests without explanation.

Market Basket Index
CMS has proposed increasing Medicare payment rates to home health agencies for calendar year 2007 by 3.1 percent. Home health payment rates are updated annually by either the full home health market basket percentage or by a percentage as adjusted by Congress. The index measures inflation in the prices of an appropriate mix of goods and services included in home health services. PCPA has been working with the Pennsylvania legislature to pass legislation that would use the Home Health Market Basket Index as the inflationary index marker for providers of mental health and mental retardation services. House Bill 1813 passed the Pennsylvania House of Representatives in January and is currently with the Senate Appropriations Committee. Companion Senate Bill 1006 was reported out of the Public Health and Welfare Committee and is currently with the Senate Appropriations Committee.

MA Integrity Plan
CMS has published its five-year Comprehensive Medicaid (MA) Integrity Plan as required by the Deficit Reduction Act of 2005. The act increases the resources available to CMS to combat fraud, waste, and abuse in the Medicaid program. A copy of the plan is available at www.cms.hhs.gov/DeficitReductionAct.

Dual Eligibles
CMS has announced a set of important steps to keep coverage and sustainability of care options for people with both Medicare and Medicaid (dual eligibles). These policies include new incentives for people to purchase private long-term care insurance and improved coordination of care for dual eligibles in managed care plans. For a copy of the press release access www.cms.hhs.gov/apps/media/press/release.asp?Counter=1911.

SOS Act
US Senate Budget Committee Chair Judd Gregg’s (R-NH) Stop Over Spending (SOS) Act of 2006 (S.3521) is gaining momentum and is an issue for disability services. This legislation may be accessed at http://thomas.loc.gov. Problematic issues include:

  • Fixed deficit targets enforced by automatic across the board cuts to all entitlement programs other than Social Security, including Medicaid, Medicare, and food stamps;
  • A pay-as-you-go provision that would prevent the Senate from considering any bill with increased spending for entitlement programs unless the increase is offset by cutting from other entitlements or increases in revenue; and
  • Creation of a separate commission on Medicare and Medicaid solvency which could force states to shoulder greater health care costs with insufficient federal funding, potentially meaning increased premiums, deductibles, and co-pays for seniors and people with disabilities.

US Deficit
The administration projects the Fiscal Year 2006 federal budget deficit to be $296 billion or $127 billion less than predicted in February.

Workforce
US Secretary of Labor Elaine Chao has announced that the official theme for October’s National Disability Employment Awareness Month will be “Americans with Disabilities: Ready for the Global Workforce.” Information is available at www.dol.gov/opa/media/press/odep/odep200660804.htm.

State Legislatures
The National Conference of State Legislatures’ web page (www.ncsl.org/programs/employ/disab-leg05.htm) provides state-level legislation disability information related to:
• Assistive technology,
• Education,
• Employment,
• Medicaid Buy-in, and
• Olmstead/Independent Living.

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