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Dear ANCOR Members,

Next week, some Members of Congress will be back in their districts, making it the perfect time to meet with them and urge them to protect Medicaid funding for home and community-based services (HCBS).

The newly released House budget framework calls for 1.5 trillion in cuts over ten years and directs the House committee with jurisdiction over Medicaid to cut at least $880 billion in spending. While the details have not yet been finalized, these reductions would likely result in deep cuts to Medicaid funding. Even if proposals do not specifically target funding for I/DD services, the resulting pressure on state budgets from Medicaid cuts creates an elevated risk of further limits and cuts to services for individuals with I/DD. In-district meetings and site visits are some of the most effective ways to educate lawmakers and their staff on how these cuts would harm people with intellectual and developmental disabilities (I/DD), providers, and families.

To help you prepare, we’ve put together key advocacy resources, including:

Why Your Action Matters:
Studies show that constituent messages are the most effective way to influence lawmakers. When they see firsthand the impact of Medicaid-funded services in their communities, they are far more likely to protect funding.

Take this opportunity to reach out to your Members of Congress while they’re home next week or check their website for an email list signup to make sure you don’t miss any opportunities to engage while they are home — let’s make sure they understand why Medicaid funding must be protected.

Thank you for your advocacy.

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NOTE TO INSPECTOR: The word "iridium" on the pen's nib is not a brand: it's the name of the metal of which the nib is made. Thanks. Inky old fountain pen on a $100 bill.

The Medicare Payment Advisory Commission (MedPAC) held their regular public meeting on January 16 – 17, 2025. During one of their presentations, “Assessing Payment Adequacy and Updating Payments: Skilled Nursing Facility Services; Home Health Agency Services; Inpatient Rehabilitation Facility Services; Outpatient Dialysis Services; and Hospice Services,” there was a draft recommendation specific to inpatient rehabilitation facilities (IRF). The draft recommendation was for fiscal year 2026 and noted that Congress should reduce the 2025 Medicare base payment rate by 7 percent. The PowerPoint presentation is available here.

During this public meeting, MedPAC voted to finalize this recommended payment reduction to fiscal year 2026 IRF Prospective Payment System (PPS) payments. Both AMRPA and other national hospital stakeholders, on behalf of IRFs, strongly opposed this proposed payment cut (prior to the public meeting). However, MedPAC advanced the recommended cut with limited discussion about the potential impacts on patient access and IRF operations.

MedPAC’s recommendations do require Congressional action. As a result, advocacy will be planned to continue to voice concerns with this recommendation. Members will be kept apprised of any upcoming changes.

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Capitol hill building in the morning with colorful cloud , Washington DC.

On December 21, President Biden signed into law the 2025 American Relief Act, a stopgap funding bill passed by Congress on December 20 that funds the federal government through March 14, 2025, and includes over $110 billion for disaster relief.

The bill extends certain Medicare telehealth flexibilities through March 31, 2025, under Section 3207, including the six-month in-person requirement for mental health services, the expanded originating sites, and coverage of audio-only services.

The bill also extends funding for several expiring health care programs through March 31, 2025, including the National Health Service Corps at $85 million and the Teaching Health Center Graduate Medical Education Program at $43 million, both under Section 3101.

In addition, the stopgap bill delays scheduled reductions to the Medicaid Disproportionate Share Hospitals allotments, which are currently set to result in a total reduction of $32 billion between 2025 and 2027. Under Section 3401, the bill delays these cuts through April 1, 2025.

You can read the bill text and a summary of the health care provisions.

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RCPA received notification today from the Brain Injury Association of America (BIAA) and the National Association of State Head Injury Administrators (NASHIA) that the Traumatic Brain Injury (TBI) Act was included in Congress’s proposed year-end package. Key provisions included in this bill include:

Administration for Community Living (ACL)

  • Reauthorizes the State Partnership Program and Protection & Advocacy Program.
  • Allows grants to be used to support systems of care for people of any type of acquired brain injury.
  • Allows a state to request a waiver of the match requirement if they cannot meet the match to carry out the grant purposes. The match decrease can only be for that fiscal year, and states must maintain at least the match that they have had during the previous fiscal year.
  • Requires ACL in awarding State Partnership Program grants to take into consideration populations that may be at higher risk for brain injury.

Centers for Disease Control and Prevention (CDC)

  • Reauthorizes the CDC’s TBI Programs, including the National Concussion Surveillance System.
  • Renames the TBI Program to honor Congressman Bill Pascrell.
  • Requires an examination of brain injury as a chronic condition that may impact someone across the lifespan. CDC plans to accomplish this through work with the National Academies of Science, Engineering, and Medicine.
  • Requires CDC to review those who may have higher impact of brain injury, including due to their occupation and from interpersonal violence.

RCPA encourages providers, staff, and families to reach out to their members of Congress through email or phone call by COB Thursday, December 19, 2024. The message can be simple. For example:

As a constituent, I encourage you to support the year-end continuing resolution, which includes the TBI Act. The TBI Act is pivotal to create systems of care for people of brain injury. [Feel free to share any personal impact] Thank you for your support of this important bill.

In Pennsylvania, our current state Senators are:
Casey, Robert P., Jr. and
Fetterman, John

Additional information for contacting your Senators can be found here.

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A message from our national partner ANCOR:

As you know, Congress is winding down, and we only have a few more opportunities to pass the legislation to help create a standard occupational classification for DSPs. We are so close to getting this bill across the finish line–it has passed in the Senate and has also passed in House Education and Workforce Committee. The final stop is passage in the full House of Representatives.

Please help us in reaching out to your Representative and ask them to support the Recognizing the Role of Direct Support Professionals. You can use our action alert to send that message.

We especially ask that you reach out if you have any connections with House leadership offices: Speaker Johnson, Leader Jeffries, Rep. Scalise, or Rep. Emmer. The message to those offices is to put the bill on the calendar for a vote next week.

Thank you so much for all you do and for your strong advocacy efforts. If you have any questions, please do not hesitate to reach out.

Thanks!

Elise Aguilar
Senior Director of Federal Relations
American Network of Community Options and Resources
Alexandria, VA
(703) 535-7850

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Image by David Mark from Pixabay

President Biden signed the Further Consolidated Appropriations Act, 2024 into law on March 23. This Act includes the Labor, Health and Human Services, Education, and Related Agencies Appropriations Act, 2024. Notable FY 2024 funding totals for mental health and substance use include:

  • $385 million for Certified Community Behavioral Health Clinics (level with FY 2023);
  • $986,532,000 for the Mental Health Block Grant, which includes maintaining the existing 5% of the total set aside for evidence-based crisis care programs that address the needs of individuals with serious mental illnesses, children with serious emotional disturbances, or individuals experiencing a mental health crisis (level with FY 2023);
  • $153 million for the Behavioral Health Workforce Education and Training Program, including $40 million for the Substance Use Disorder Treatment and Recovery Loan Repayment Program (level with FY 2023);
  • $1,575,000,000 for State Opioid Response Grants (level with FY 2023); and
  • $1,928,879,000 for Substance Use Prevention, Treatment, and Recovery Services Block Grants (level with FY 2023).

Additionally, key provisions of the Act include an $18 million increase in funding for the 988 Suicide & Crisis Lifeline and a $1 million increase for the Primary and Behavioral Health Care Integration grant technical assistance program. There is also a $75 million increase for mental health research conducted by the National Institute of Mental Health. Various mental health and substance use programs maintained funding levels similar to those of FY 2023. For more information, you can access the full explanatory text as well as the comparative highlights table.

If you have any questions, please contact RCPA Policy Director Jim Sharp.

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