Volume 15, Issue 24
June 21, 2010
Action Alerts
Targeted alert for constituents of the
62 Senators that voted for a bill that contained a provision for an extension of the increase in the federal share of Medicaid:
Huge Medicaid Cuts are Still at Stake. Make sure your Senator(s) continue to support extending the increase in the federal share of Medicaid.
Major Events Last Week
Medicaid
The Senate failed twice last week to pass the tax extender bill which extends expiring tax breaks, and contains domestic spending including the six month extension of the American Recovery and Reinvestment Act's temporary increase in the federal share of Medicaid spending (FMAP). The debate has been about how much of the bill is paid for by raising other revenue or cutting spending and the overall size of the bill. After the first test vote on the bill failed on June 16th the leadership modified the bill and reduced the cost. On Thursday, after the Senate failed by four votes to end the debate on the bill, the Democrat leadership decided to separately pass a bill to delay the 21% cut in pay to Medicare doctors. Delaying the cut in pay enjoys widespread political support but removing that provision may lessen overall support for the tax extender bill.
CLASS Act
DPC staff participated in a roundtable on the implementation of the Community Living Assistance Services and Supports (CLASS) Act which was enacted as part of health reform. Sponsored by AARP, the roundtable brought together experts from the disability and aging communities, the Obama Administration, human services resource managers, the insurance industry, think tanks, and marketing industry to discuss numerous aspects of implementation of the new program which must be taken into account as the program is designed and developed. Development of the CLASS program is expected to take months and will require significant regulation. The DPC staff will remain an active participant and monitor progress as the program develops.
Emergency Preparedness
The House Committee on Homeland Security's Subcommittee on Emergency Communications, Preparedness, and Response held a hearing concerning the Federal Emergency Management Agency's (FEMA) ability to rescue people with disabilities, those living in institutions, and the aged in the event of an emergency. Committee members questioned Marcie Roth, the Senior Advisor for Disability Issues at the US Department of Homeland Security, about how her agency, that has a budget of only $150,000 and one full-time paid staff member, could execute an effective rescue plan. Ms. Roth replied that her efforts have been to help FEMA and its Federal partners, states and local communities shift away from viewing people with disabilities as "special" or "vulnerable" toward integrating the needs of people with disabilities into general emergency management planning and response efforts. When asked about creating a voluntary registry of potential disaster victims who have disabilities so that rescuers could help them evacuate, Ms. Roth said that she did not have the budget for such a registry. She said that a registry without funding to provide services would only give people false hope. FEMA is developing several written frameworks that integrate the needs of people with disabilities into disaster mitigation, response and recovery plans.
Quality Assurance
DPC staff participated in the first in a series of workgroup meetings of the Long Term Quality Alliance, an organization devoted to improving the effectiveness and efficiency of care and the quality of life of people receiving long term services and supports by fostering person- and family-centered quality measurement and advancing innovative best practices. Three workgroups have been established: Quality Measurement/Key Indicators; Quality Improvement/Best Practices; and Outreach/Public Awareness. Initial short-term goals of the LTQA include reducing unnecessary hospitalizations and effective transition planning.
Obama Administration Bans Lobbyists
On Friday, the Obama Administration announced more details of the President's desire to exclude registered lobbyists from federal advisory boards and commissions. Advisory boards and commissions have been told not to re-appoint any current members who are lobbyists and to not appoint any new members who are lobbyists. The Administration's strategy reflects a desire to open the boards and commissions to "fresh faces and engaging more Americans in our governing process". Some lobby groups are concerned that the Administration is limiting itself from the expertise that lobbyists have on issues.
Major Events Ahead
U. S. Congress
The Congress returns to action after the one week Memorial Day recess. It will meet for four weeks until the beginning of the Independence Day recess. This time frame is seen as a crucial for the Congress to make progress on bills it intends to bring to completion before the November elections. Its priority agenda should include legislation to keep federal programs operating at the start of Fiscal Year 2011 which starts on October 1. Few, if any, Fiscal Year 2011 appropriations bills are likely to be signed into law before the fiscal year begins. Passing key bills will be a huge challenge for Members of Congress, especially in the Senate, who are caught between saving jobs and increasing the federal deficit.
Medicaid
The Senate is expected to return to debate on the tax extender bill towards the end of the week. A new version of the bill has not been released as the Senate leadership tries to determine what combination of provisions can gain enough support to reach 60 votes. The FMAP extension has been in previous versions of the bill but may be a target for reduction or removal from the package as key moderate Senators have suggested that scaling back the extension would make the bill more fiscally responsible.
Fiscal Year 2011 Budget
Neither House of Congress appears capable of producing a FY 2011 Budget Resolution. A Budget Resolution (BR) sets the spending caps on discretionary programs such as defense and human services programs. With no anticipated support from House and Senate Republicans, the Democratic leadership is wary of obtaining sufficient support from among its fiscally conservative members. A BR would also shed a brighter light on the rising federal debt when the nation seems reluctant to increase federal spending. Without a BR, the Congress would have to pass a "budget enforcement resolution" that would set the cap on discretionary spending for the new fiscal year that begins on October 1. With the Congress slated to be in session only nine weeks prior to the start of the new fiscal year, it is virtually assured that the majority of the twelve appropriations bills will not be enacted before October 1, thus forcing the Congress the adopt a Continuing Resolution to keep the federal government operating on October 1. In any case, human services discretionary spending is not expected to increase for many programs. The Obama Administration has recommended a three year freeze on discretionary spending.
ADA and Olmstead Enforcement
The Senate Health, Education, Labor and Pensions Committee (Chairman Harkin, D-Iowa) will hold a hearing on enforcement of the Americans with Disabilities Act (ADA) and the US Supreme Court's Olmstead decision on Tuesday, June 22 at 2:30 p.m. Scheduled to testify are Tom Perez, Assistant Attorney General for the Civil Rights Division of the US Department of Justice, Cindy Mann, Director, Center for Medicaid and State Operations, U.S. Department of Health and Human Services, Robert Bernstein, Executive Director, Bazelon Center for Mental Health Law, Nancy Thaler, Executive Director, National Association of State Directors of Developmental Disabilities Services, Kelly Buckland, Executive Director, National Council on Independent Living, and Jeffrey Knight, an individual who recently moved to the community from a nursing home. The hearing will focus on ensuring community opportunities for individuals with disabilities.
Health Reform
The White House expects to launch its web portal to the Pre-Existing Condition Insurance Plan on July 1. The Plan is the temporary high-risk pool established by the new health reform law to be run by the federal government for those states which choose not to run their own programs. The Plan is designed to cover those individuals with pre-existing conditions who have not been insured for the 6 months prior to application. Twenty states have elected to have the Department of Health and Human Services run the high risk pool program in their states: AL, AZ, DE, FL, GA, HI, ID, IN, KY, LA, MN, MS, NE, NV, ND, SC, TN, TX, VA, and WY. (UT and RI are undecided.) The temporary plan will continue until 2014 when access to the health insurance exchanges becomes available. The DPC will provide more details as they become available, including information on access to the plans in states which choose to run their own pre-existing conditions high-risk pools.
Education Funding
House Appropriations Committee Chairman David Obey (D-WI) is hoping to include a $23 billion emergency increase for education as part of the supplemental war spending bill. The education funding is meant to avoid anticipated massive layoffs of school personnel as the American Recovery and Reinvestment Act education increases expire this fall. Support for this funding will likely depend on finding offsetting revenues so that the new spending will not increase the federal debt.
IDEA Maintenance of Effort
The Individuals with Disabilities Education Act (IDEA) contains a provision that allows states to seek a waiver from the federal government from the law's maintenance of effort (MOE) requirement. The MOE prohibits states from reducing the state and local government's share of IDEA financing, except when a waiver is granted for "exceptional and uncontrollable circumstances". Major revenue shortfalls and escalating special education costs have placed a number of states in financial jeopardy. Four states: Kansas, Iowa, South Carolina and West Virginia have recently submitted MOE waivers. The U.S. Department of Education has approved the Kansas and Iowa waiver requests. The South Carolina and West Virginia requests are under review. When granting a waiver, the Department does so on a case by case basis considering a number of factors. The Office of Special Education and Rehabilitative Services (OSERS) released a memorandum today that explains the factors it is considering, including the requirement that every IDEA student continue to receive a free appropriate public education (FAPE) during the time the MOE waiver is granted. To access the OSERS document, use this link
http://www2.ed.gov/policy/speced/guid/idea/moe-waivers.pdf.
Announcements
Voting
The Election Assistance Commission (EAC) launched a new website (http://www.eac.gov) with many enhancements. A video about the new site is available at
http://www.eac.gov/multimedia. EAC says that the website allows users to find information more easily and has an Election Resource Library that allows users to find materials easily. Users can sign up for email alerts about upcoming meetings, new reports, and agency news. The multimedia center has training videos on voting accessibility and voting system testing and certification.
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Previous issues of the Capitol Insider may be viewed at www.ucp.org under "Public Policy." If you have any questions, feel free to contact Annie Acosta at
acosta@thedpc.org.
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