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VOR's Weekly News Update
VOR is a national non-profit organization
run by families of people with I/DD and autism
for families of people with I/DD and autism.
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VOR's 2024 Legislative Initiative
MAY 7 - 9, 2024
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This week, the Biden Administration, via the Department of Health & Human Services' Administration for Community Living (ACL) and the Center for Medicare and Medicaid Services (CMS) released new rules covering long-term care services to people with I/DD, autism, and the aging community.
While we applaud increasing services to people with disabilities, we are discouraged to see that, once again, intermediate care facilities and those individuals requiring the highest levels of care were conspicuously absent from these benefits.
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Feds Finalize New Rules For Medicaid Home And Community-Based Services
By Michelle Diament, Disability Scoop, April 25, 2024
Federal officials are reshaping the rules surrounding Medicaid home and community-based services for people with disabilities in an effort to improve access and strengthen the direct support professional workforce.
Under a final rule released this week, the Centers for Medicare & Medicaid Services is establishing minimum payment thresholds for direct care providers, requiring that states regularly reevaluate the needs of those receiving home and community-based services and much more.
The regulation known as “Ensuring Access to Medicaid Services,” or the Access Rule, comes in response to the increasing shift toward people with disabilities living in the community as opposed to institutions.
With the rule, CMS said it sought to address significant variations across states in terms of quality and reporting requirements while also tackling the national shortage of direct care workers.
“The Access Rule is the most consequential, comprehensive regulation related to Medicaid-funded HCBS in a decade,” said Alison Barkoff who is performing the duties of the administrator at the U.S. Department of Health and Human Services’ Administration on Community Living. “It will strengthen the HCBS that make it possible for people to live in their own homes, stay connected to friends and family, and participate in the community in ways that are meaningful to them.”
The regulation clarifies that states must reassess the needs of each person receiving home and community-based services annually and revise their service plan accordingly. In addition, states will have to maintain an electronic incident management system and respond to incidents within specified timeframes. They also will need to establish a grievance process so that beneficiaries in traditional Medicaid plans can file complaints against a provider or state if they experience issues receiving the home and community-based services called for in their plan much like the process that already exists for those with managed care plans.
Under the measure, at least 80% of Medicaid payments for homemaker, home health aide and personal care services must go toward compensation for direct care workers as opposed to administrative overhead with limited exceptions. States will have to disclose the average hourly rate paid to workers for these services. And, states will face new requirements to report on a standardized set of quality measures as well as how they establish and maintain their waiting lists and the timeliness of service delivery.
Jennifer Lav, senior attorney at the National Health Law Program, said she’s optimistic that the changes will improve the availability of services for people with disabilities.
“Nationally, there is a critical direct care workforce shortage. All too often, people eligible for HCBS, which allow people with disabilities and complex medical needs to live in their homes and communities, cannot actually find anyone to provide these essential supports,” Lav said. “The HCBS Access Rule creates a mechanism to address historically insufficient rates and establishes that a fair share of state and federal Medicaid dollars go directly to wages for direct care workers, a workforce that is largely composed of immigrants and people of color. Ultimately, we hope this will increase access to critical HCBS services that let people with disabilities live in their own communities while also improving historical inequities in how this workforce is paid.”
The new rule will take effect 60 days after it is published in the Federal Register, but states will have years to comply with many of the requirements.
In addition to the Access Rule, CMS is also finalizing regulations instituting minimum staffing standards for nursing homes and a rule imposing new requirements for managed care plans.
“Everyone should have equal access to the critical care they need,” said Secretary of Health and Human Services Xavier Becerra. “We are taking important steps to strengthen care provided through Medicaid and CHIP, and establishing national staffing standards for nursing homes to enhance care for residents while improving conditions for workers. This will help ensure that millions of people have access to high-quality health care and that the dedicated workers who provide care to our loved ones are fully valued for their work.”
Read the full article here
Everyone should have equal access to the critical care they need,” said Secretary of Health and Human Services Xavier Becerra.
Yes, Mr. Secretary. Everybody means everybody. And "equal access to the critical care they need" should include those who choose intermediate care facilities as well as any Home- and Community-Based Services.
Read the statement from Alison Barkoff of the ACL here
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CMS also released minimum staffing standards for Nursing Homes this week. While we applaud a determination to improve the quality of care, the administration appears not to realize there is a nursing shortage in this country, akin to the DSP shortage. We are concerned that CMS may decide to apply these same measures to ICFs, which are also struggling under the nursing shortage.
Medicaid long-term care services for the elderly and intellectually disabled pay lower rates to nurses than hospitals and other providers. They have difficulty competing for quality caregivers even when their is no shortage in the workforce.
Providers: Staffing Rule a CMS ‘Fairy GTale’ that will ‘Exacerbate’ Nursing Home Access Issue
By Kimberly Marselas, McKnight's Long-Term Care News, April 23, 2024
Despite minor concessions in a nursing home staffing mandate issued Monday, many providers were stunned by federal regulators’ intractable stance on minimums at a time when nearly all US facilities are confronting labor shortages.
The Centers for Medicare & Medicaid Services released a long-awaited final rule that increased the time operators must provide per-patient per day from a proposed 3.0-hour standard to a 3.48-hour standard.
The first three hours must be covered by registered nurses (0.55 hours per patient, per day) and certified nurse aides (2.45 hours per patient, per day). Facilities can use “any combination of nurse staff,” including licensed practical nurse and licensed vocational nurses, to meet the remainder of the time requirement, a CMS fact sheet said.
CMS also pressed forward with a 24/7 RN standard, though the agency said it would exempt nursing homes from having registered nurse coverage for up to 8 out of 24 hours a day “under certain circumstances.” A director of nursing also can count toward the rule’s 24/7 RN requirement, CMS said, noting a change that providers should embrace given a national RN shortage expected to persist through 2031.
Still, those adjustments were of little consolation to providers, many of whom were dismayed to see that CMS had embraced concerns voiced by consumer groups and unions but largely ignored provider warnings about their inability to comply with the mandate.
Nowhere are most more concerned than on the RN front.
“RNs are leaving the workforce, leaving the profession and those who are working typically choose to work in environments that are not long-term care,” LeadingAge President and CEO Katie Smith Sloan said in a statement late Monday. “The final rule does not include additional funds to pay RNs comparable or higher wages to work in long-term care.”
She noted that this element alone will require an additional 3,267 additional nursing home RNs.
“The final rule does not include any support for recruitment and training of needed staff,” she added. “While the phase-in provides some necessary time for recruiting, how can providers hire more RNs when they do not exist?”
‘Extinction event’
Few providers held back in their criticism Monday, after months of hoping that CMS would deliver some changes to make the rule, the first of its kind, more palatable.
“The extra increase in staffing hours and the 24/7 RN requirement are not even possible with growing patient numbers and a shrinking talent pool. It’s a fairy tale. They don’t exist,” Neil Pruitt, Chairman and CEO at Georgia-based PruittHealth, told McKnight’s Long-Term Care News.
“We invest heavily in programs to recruit and retain nursing staff with higher wages and referral bonuses. We’ve even set up a program to attract international nurses. It is still not enough to meet the demand,” he added. “Rural communities will eventually bear the brunt of this final rule forcing health care centers to turn away patients because there simply are not enough caregivers in the workforce to meet the mandated staffing requirements.”
Before the rule’s release Monday afternoon, Good Samaritan Society CEO Nate Schema told McKnight’s the only things that would make it more feasible for his organization’s 132 facilities would be the option to provide some RN coverage via remote services and federal funding to cover the cost of hiring more staff — and more expensive agency staff when local workers are unavailable.
Just 5% of the largely rural provider’s facilities meet the 24/7 RN rule currently. At the proposed standards, a Good Sam analysis showed the provider would need 207 additional RNs and 400 new aides. Monday’s rule would drive those numbers up.
“It’s impossible to imagine how a skilled nursing facility in a town of 1,500 people will be able to find 24/7 coverage for an RN when they already have open RN positions they can’t fill today,” he said. “Instead of requiring an RN to be in a rural nursing home 24 hours a day, why not create a pathway to complement care with virtual RN services? Virtual care is a common-sense, forward-looking approach to support resident care needs while protecting access to care. It’s disappointing that CMS seemingly looked backwards by not including this flexibility in the final rule.”
In New Hampshire, 89% of providers surveyed by the New Hampshire Health Care Association Monday said they’d be unable to meet the 24/7 RN rule without hiring agency. Some 69 of the state’s 74 nursing homes participated, demonstrating the urgency with which operators view the issue.
“It’s perverse that the Biden Administration has decided to further enrich staffing agencies, and put more strangers by the bedside,” said association President and CEO Brendan Williams. “It’s aimed a regulatory Death Star at nursing homes. This news is Christmas in April for predatory staffing agencies. For many nursing homes, it’s an extinction event.”
Read the full article here
Read a related article from KFF Health News here
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Statement from the American Health Care Association / National Center for Assisted Living (AHCA/NCAL):
"An Unfunded Mandate"
he American Health Care Association (AHCA), representing more than 14,000 nursing homes and other long term care facilities across the country that provide care to approximately five million people each year, released a statement today in response to the Biden Administration's announcement about the Nursing Home Minimum Staffing Final Rule.
The following statement is attributable to AHCA President and CEO Mark Parkinson:
“We are extremely disappointed and troubled that the Biden Administration is resolved to issue this unfunded staffing mandate despite overwhelming concerns from experts, stakeholders, and policymakers on both sides of the aisle. While it may be well intentioned, the federal staffing mandate is an unreasonable standard that only threatens to shut down more nursing homes, displace hundreds of thousands of residents, and restrict seniors' access to care.
"It is unconscionable that the Administration is finalizing this rule given our nation's changing demographics and growing caregiver shortage. Issuing a final rule that demands hundreds of thousands of additional caregivers when there's a nationwide shortfall of nurses just creates an impossible task for providers. This unfunded mandate doesn't magically solve the nursing crisis.
“Staffing minimums are a 20th Century solution for a 21st Century problem. Now the Administration has gone ever farther than originally proposed, making these requirements even more out of touch and out of reach. At the end of the day, the agency is overstepping with a one-size-fits-all enforcement approach that is deeply flawed.
“This fight is not over. We will vigorously defend our nursing home members, those they serve, and those they employ. Momentum against the mandates continues to build among both Democrats and Republicans, and we hope to work with lawmakers on more meaningful solutions that would help boost the long term care workforce. For the sake of our nation's seniors and their caregivers, we must find a better way."
Read the statement here
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Follow up on last week's news:
Disneyland Excludes Disabled People with Discriminatory Policy, Group Says
By Brady MacDonald, Los Angeles Daily News, April 22, 2024
A group representing the disabled community is urging Disneyland and Disney World to reconsider recent “discriminatory” changes to the Disability Access Service program that exclude people with a wide array of disabilities.
A DAS Defenders letter addressed to Disney CEO Bob Iger, Disney Parks Chairman Josh D’Amaro and Disneyland Resort President Ken Potrock and a Change.org petition with 9,000 supporters call on Disney to revise its Disability Access Service policy and reverse recent updates to the program.
“Historically, Disney has been a symbol of inclusion, acceptance and joy for disabled individuals who often face discrimination, lack of access and challenges in managing complex conditions,” according to the DAS Defenders letter. “However, with these recent changes, Disney has eroded that legacy by rolling back accommodations that have existed for years, leaving many disabled people feeling abandoned.”
In early April, the Disneyland and Walt Disney World resorts updated the Disability Access Service programs to limit assistance to only theme park visitors with developmental disabilities like autism and other neurodivergent disorders.
According to DAS Defenders, recent revisions to Disneyland’s DAS program excludes disabled people with cancer, Post-traumatic stress disorder (PTSD), Multiple sclerosis, Parkinson’s disease, Amyotrophic lateral sclerosis (ALS), and rare diseases, among other conditions.
Read the full article here
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Direct Support Professionals Help People with Disabilities. Arizona has So Few, It's A Crisis
By Kirsten Dorman, Fronteras, April 24, 2024
For the roughly 159,000 Arizonans living with an intellectual or developmental disability, having someone to help with things from teeth brushing to job hunting is vital. But direct support professionals — DSPs, as they’re known in the industry — are struggling.
Low wages, high turnover rates and chronic understaffing plague the workforce, leaving both caregivers and those they support in a precarious position.
'We can barely pay them above minimum wage'
Recent survey data shows that workforce issues are leading provider agencies to shutter programs, or close down completely.
Even in states like Arizona, where there are no official waitlists, the lack of available service providers or limited space in programs means many people end up stuck without what they need, sometimes for months.
Kelli O’Toole is CEO of Opportunity Tree, an Arizona nonprofit and service provider that focuses on people with intellectual and developmental disabilities.
She said staff turnover has grown in recent years, and it’s fueled by chronically low pay rates that don’t reflect how intensive a DSP’s work can be.
“They do anything from changing diapers, passing meds, job coaching,” said O’Toole. “And they're doing all these things, and we can barely pay them above minimum wage.”
O’Toole said the reality is, many people realize that they could earn more at a fast food restaurant for less strenuous work.
Since the pandemic, burnout is another issue that has only gotten worse.
“Last year our agency had $1 million in overtime because of all the open positions we have,” said O’Toole. “And people get burnt out. Like, we have some individuals that work 80, 90 hours of overtime in a two-week period.”
But pay rates are tied up in complex state funding processes, and are largely paid based on reimbursement through Medicaid.
'It's just seen as another expense to the state'
Jon Meyers is director of the Arizona Developmental Disabilities Planning Council. He said that for years, advocates have been asking lawmakers to work with the state’s Division of Developmental Disabilities and the Governor to raise DSP pay rates.
“We literally face a crisis,” said Meyers, “and Arizona is not alone. I would venture to say every state in the nation has this same issue, because there isn't a single state that is meeting the full need of investments in the DD service system.”
Still, he said it comes down to how the Legislature values investing in the wellbeing and dignity of people with disabilities.
“It's seen as a cost,” Meyers said. “It's not seen as an investment. It's just seen as another expense to the state.”
Read the full article here
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Illinois - Opposition Grows to Legislation Targeting 14C Workers’ Jobs
Press Release from Rep. Charlie Meier, April 16, 2024
Since 1938, the United States Department of Labor has provided opportunities through Section 14(c) certificates to provide every American with a chance to work. These certificates allow employers to hire intellectually and developmentally disabled individuals at wages below the federal minimum and set up “workshops” to provide support for these workers. Despite the incredible strides our nation has made to promote inclusivity and dignity in the workplace for Americans with disabilities, new legislation in Illinois threatens to eliminate these programs entirely. As a result, many concerned legislators are speaking out.
In the 2023 spring legislative session, House Bill 793, sponsored by Rep. Theresa Mah, was first heard on the House Floor. The Bill, titled the “Dignity in Pay Act”, contained several provisions, most prominently, text that would end the issuing of Section 14(c) certificates to employers. Rep. Mah and several other legislators have suggested that, instead of supporting the 14(c) programs cherished by so many disabled workers, these programs should be eliminated and employers should be required to pay workers with intellectual and developmental disabilities according to normal minimum wage standards.
The argument against 14(c) programs is primarily based on the assertion that paying workers with intellectual and developmental disabilities a subminimum wage is discriminatory. U.S. Senator Tammy Duckworth (D-Illinois), who co-sponsored similar legislation at the federal level, went as far as to say that 14(c) programs allow for a “really terrible practice of paying workers with intellectual and developmental disabilities.” While the calls to increase wages for workers with intellectual and developmental disabilities are likely well-intentioned, ending the issuance of 14(c) certificates could be catastrophic.
The issue with forcing programs that hire individuals with intellectual and developmental disabilities to pay them a minimum wage is that it is not economically feasible. “A lot of the workers work at 12% of what a normal worker works. In a 10-hour time, they’ll pay that worker $140 where one college student could do that same work in 1 hour,” said Representative Charlie Meier (R-Okawville). Rep. Meier, who has long been an advocate for those with intellectual and developmental disabilities, has highlighted that requiring minimum wage pay would ultimately harm workers with these disabilities. “There are 3,591 clients, we believe, in the state of Illinois. Where this has been done in other states, a lot of times, 70 to 80% of these residents never work again.”
Rep. Meier’s claims are substantially supported by research done at the federal level. When analyzing Senate Bill 2488, legislation proposed at the federal level intended to eliminate 14(c) certificates, the Congressional Budget Office stated that “larger mandated wage increases would cause larger increases in joblessness. The increase in joblessness might also be relatively large because the disabled workers affected by this section are less productive.”
Opponents of 14(c) programs often insist that expensive day programs are better alternatives for adults with these disabilities and cite that the programs have job trainers to help disabled individuals find work. However, despite promoting these programs, Illinois has cut the number of job trainers in recent years by nearly 14% according to Rep. Meier. Moreover, the Illinoisans who would be funneled into these day programs would much rather stay where they are. “They don’t want a day program five days a week,” said Rep. Meier. “They want to work. They want to be proud of their jobs”
HB793, if passed, would also negatively impact disabled workers who do find themselves working minimum wage jobs. Many workers with intellectual and developmental disabilities receive Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). If these workers are paid a standard wage, they could lose a percentage of their supplemental income. If they quit or lose their job, they would have to start over with the Social Security Administration to have their benefits reinstated, a process that typically takes 6 to 9 months according to Rep. Meier.
While earning a wage for one’s work is important, many advocates of 14(c) workshops cite that the benefits they provide are often less tangible. These workshops allow intellectually and developmentally disabled people to gain useful skills, learn how to be independent, and most importantly, feel a sense of purpose, belonging, and accomplishment. “They need to see how happy our clients are; how proud they are,” said Rep. Meier. “They’re trying to take this away from them.”
Read Rep. Meier's Statement here
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Nebraskans Excited, Worried as Pillen says he can Finally End the Wait for Disability Services
By Martha Stoddard, World-Herald Bureau via York News Times, April 24, 2024
For decades, Nebraskans with intellectual and developmental disabilities have waited years for services like job coaching, training workshops, group homes, independent living support and respite care.
Just a month ago, more than 2,700 people were on the state’s waiting list.
So advocates were excited — but also confused and even skeptical — when Gov. Jim Pillen suddenly announced on March 28 that he was going to eliminate the waiting list to “better support” Nebraskans with disabilities.
The governor did not offer details about how the state planned to accomplish the task — or pay for it. All he said was that it would enhance the continuum of care, involve new models of staffing and be rolled out over the next 12 to 18 months.
“This is a breakthrough way to reimagine how services are offered to individuals with IDD (intellectual and developmental disabilities) in Nebraska and save taxpayer dollars,” Pillen said. He touted the waiting list elimination as “a huge step forward to ensure all Nebraskans have the opportunity and support to live the good life.”
Alana Schriver, executive director of the Nebraska Association of Service Providers, which represents entities that provide developmental disability services, said she hopes Pillen’s new policy will prove to be good news for those who have been on the waiting list.
Her own 12-year-old has been on the list since age 9.
“I want to be optimistic and I want to believe this is a good thing, but how do we do this without funding?” she asked. “We don’t know what their plan is.”
Tony Green, developmental disabilities division director for the Nebraska Department of Health and Human Services, said officials intentionally left some details to be worked out later. He said the idea is to develop those details through the discussions across the state.
“The new approach to serving families as they need support will fundamentally change the way we do business,” he said. “Our goal has been, and will continue to be, providing supports that are needs-based, cost-effective and in the least restrictive environment.”
Nebraska has long had a waiting list for developmental disability services, despite repeated efforts to provide enough services for all. The list has persisted despite a 1991 state law that promised services for everyone needing them. That was followed by another law that called for serving everyone by July 1, 2000. Four years after missing that target, lawmakers pushed back the goal to July 1, 2010. Nebraska missed the new goal as well.
The only time the state eliminated the waiting list — briefly — was in 1995. Then-Gov. Ben Nelson pushed a plan under which services were offered to everyone on the list as of July 1 that year. But a new list began on July 2, and by the end of August 1995, there were 400 people on it.
That number has grown over the years. A total of 2,704 people were on the list as of March, according to Kristen Larsen, executive director of the Nebraska Council on Developmental Disabilities.
Read the full article here
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[Please click on blue link to view information about the bill]
VOR SUPPORTS:
S.4120 / H.R.,7994 - This bill would increase FMAP and offer grants to all DSPs and caregivers for the elderly and for people with I/DD and autism.
S.1332 / H.R.2941 - Recognizing the Role of Direct Support Professionals Act
Sen Maggie Hassan (D-NH) / Rep. Brian Fitzpatrick (R-PA) This bill requires the Office of Management and Budget to establish a separate category within the Standard Occupational Classification system for direct support professionals (i.e., individuals who provide services to promote independence in individuals with an intellectual or developmental disability) for data reporting purposes.
H.R.7267 - Disability Community Act of 2023 To amend title XIX of the Social Security Act to provide a temporary higher Federal medical assistance percentage for Federal expenditures under the Medicaid program that are associated with the cost of compliance with certain Federal regulations with respect to services furnished in certain intermediate care facilities or home and community-based services furnished to individuals with intellectual and developmental disabilities.
H.R.485- Protecting Health Care for All Patients Act of 2023
Rep. Cathy McMorris Rodgers (R-WA-5) - This bill prohibits all federal health care programs, including the Federal Employees Health Benefits Program, and federally funded state health care programs (e.g., Medicaid) from using prices that are based on quality-adjusted life years (i.e., measures that discount the value of a life based on disability) to determine relevant thresholds for coverage, reimbursements, or incentive programs.
S.7302 - The Credit for Caregiving Act of 2024 Sen. Michael Bennett (D-CO) This bill would amend the Internal Revenue Code of 1986 to provide a nonrefundable credit for working family caregivers. In the case of an eligible caregiver, there shall be allowed as a credit against the tax imposed by this chapter for the taxable year an amount equal to 30 percent of the qualified expenses paid by the taxpayer during the taxable year to the extent that such expenses exceed $2,000. The tax credit is not to exceed $5,000 per year.
H.R. 553 - Workplace Choice and Flexibility for Individuals with Disabilities Act
Rep. Glenn Grothman (R-WI-6) - This bill would amend the Rehabilitation Act of 1973 to clarify the definition of competitive integrated employment.
H.R.1296 - Restoration of Employment Choice for Adults with Disabilities Act Rep. Glenn Grothman (R-WI-6) - To amend the Rehabilitation Act of 1973 to ensure workplace choice and opportunity for young adults with disabilities.
H.R.670 - Think Differently Database Act
Rep. Marcus Molinaro (R-NY-19) - This bill would amend title IV of the Public Health Service Act to direct the Secretary of Health and Human Services to establish a clearinghouse on intellectual disabilities, and for other purposes. Such clearinghouse shall include information on individual community-based services and long-term support services available to individuals eligible for medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act.
S.1298 - Supporting Our Direct Care Workforce and Family Caregivers Act
Sen. Time Kaine (D-VA) A bill to award grants for the creation, recruitment, training and education, retention, and advancement of the direct care workforce and to award grants to support family caregivers.
H.R.2965 / S.1333 - Autism Family Caregivers Act of 2023
Rep. Grace Meng (D-NY) / Sen. Robert Menendez (D_NJ) To award grants for providing evidence-based caregiver skills training to family caregivers of children with autism spectrum disorder or other developmental disabilities
H.R.3380 - HEADs UP Act of 2023
Rep. Seth Moulton (D-MA) This bill authorizes the Department of Health and Human Services (HHS) to award grants to support health centers that provide services for individuals with developmental disabilities, including dental care. Grant recipients must provide specialized treatment to individuals with developmental disabilities as necessary.
VOR OPPOSES:
H.R.8109 - To Make Permanent the Money Follows the Person Rebalancing Demonstration Program. MFP has been used to erode the ICF system. We call for congressional hearings, studies by the GAO, and audits by the Congressional Budget Office before any action should be taken to reauthorize this program.
S.533 / H.R.1263 Transformation to Competitive Employment Act
Sen. Bob Casey (D-PA) / Rep. Bobby Scott (D-VA 3) - This bill would support employers who wish to transform their facilities to provide only competitive integrated employment while forcing the elimination of programs that offer employment opportunities under Section 14(c) of the Fair Labor Standards Act. This bill would be unlikely to create a significant increase in employment for people with I/DD and autism, but would deprive over 120,000 individuals of the opportunity to work, develop skills, and be part of their community.
S. 1148 - The Guardianship Bill of Rights
Sen. Bob Casey (D-PA) - A bill to establish rights for people being considered for and in protective arrangements, including guardianships and conservatorships, or other arrangements, to provide decision supports. This bill would give ACL power to create a Guardianship Council and appropriate more money to P&As so they may encourage people to leave guardianships and move to Supported Decision Making. Dangerous over-reach in response to media hype on Britney Spears, et al.
S.1193 / H.R.2708 - The Latonya Reeves Freedom Act of 2023
Sen. Michael Bennett (D-CO) / Rep. Steve Cohen (D-TN) Allegedly written and strongly supported by ADAPt and other self-advocacy groups, this is a watered-down version of the Disability Integration Act. It is strongly biased against care in larger congregate facilities, and falls just short of seeking the elimination of ICFs.
VOR HAS SIGNIFICANT CONCERNS WITH:
S.100 / H.R.547- Better Care Better Jobs Act
Sen. Bob Casey (D-PA) Rep. Debbie Dingell (D MI) This bill establishes programs and provides funds for state Medicaid programs to improve home- and community-based services (HCBS), such as home health care, personal care, case management, and rehabilitative services.
The bill also makes permanent (1) the Money Follows the Person Rebalancing Demonstration Program (a grant program to help states increase the use of HCBS for long-term care and decrease the use of institutional care), and (2) certain provisions regarding Medicaid eligibility that protect against spousal impoverishment for recipients of HCBS.
S.762 / H.R.1493 - The HCBS Access Act
Sen. Bob Casey (D-PA) Rep. Debbie Dingell (D MI) While this bill purports to eliminate waiting lists and provide more Home and Community-Based Services for people with I/DD and autism, it favors the aspirations of those individuals who are most independent and neglects the very real needs of those most dependent on Medicaid Long-Term Services and Supports. It would not distribute funds appropriate to the varying needs of individuals, but to providers of HCBS programs. It fails to recognize the severity of the DSP and Nursing Crises, and paints an unrealistic picture of a simplistic solution. This is a purely political bill that would ultimately fail to make the extensive changes that the DD/A system needs.
S.3118 - The HCBS Relief Act of 2023
Sen. Boby Casey (D-PA) A bill to provide for an emergency increase in Federal funding to State Medicaid programs for expenditures on home and community-based service. This bill, like others above, only provides funding for people receiving Long-Term Services and Supports through HCBS, denying any support for people in nursing homes or ICFs.
VOR supports increasing funding for people with I/DD, but we have concerns that the above bills, in their current form, would discriminate against people with the most severe I/DD and autism and jeopardize the higher-care facilities that are most appropriate to their needs.
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Please share this offer with your loved one's
Direct Support Professionals!
VOR ❤️s OUR
DIRECT SUPPORT PROFESSIONALS!
Our loved ones' caregivers are essential to their health, safety, and happiness.
In appreciation of their good work and kind hearts, VOR offers free digital memberships to any DSP who would like to receive our newsletter.
We encourage our members to speak with their loved ones' caregivers to extend this offer of our gratitude.
If you are a Direct Support Professional interested in receiving our newsletter and e-content, please write us at
info@vor.net
with your name, email address, and the name of the facility at which you work. Please include the name of the VOR member who told you of this offer.
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What's Happening In Your Community?
Is there an issue in your loved one's home that you need help with?
Do you have information or a news story you would like to share?
Is there legislation in your state house that needs attention?
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