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New Administration News
Donald Trump was sworn in at noon by Supreme Court Chief Justice John G. Roberts Jr. as the 45th president of the United States.
Several news outlets reported last week that Dr. Francis Collins will be staying on as the Director of NIH until further notice. Read more from STAT News. Dr. Tom Frieden stepped down as CDC Director at noon on Jan. 20. Deputy Director Dr. Ann Schuchat will serve as Acting Director.
Tomorrow, the HELP Committee will hold a hearing on the nomination of Tom Price to serve as Secretary of Health and Human Services. The Finance Committee held a hearing on his nomination last week.
Budget and Appropriations
On Jan. 19, The Hill reported that the Trump Administration is preparing a budget that would reduce federal spending by $10.5 trillion over ten years. Calling it a "skinny budget", the plan is expected to be lighter on details that previous President's budgets but that it hews closely to plans put forward by the Heritage Foundation and the Republican Study Committee. The President's budget is expected to be transmitted to Congress in mid-February.
Education
Betsy DeVos Nomination
On January 18, the Senate HELP Committee held a hearing on the nomination of Betsy DeVos for the position of U.S. Secretary of Education. During the hearing DeVos did not enforcing the federal requirements under the IDEA and other federal education statutes. In response, AUCD sent a letter to Chairman Alexander and Ranking Member Murray urging the Committee to postpone any votes on her confirmation until the nominee has clarified her support for the federal role in ensuring that every child with a disability receive a free, appropriate public education consistent with federal law. Chairman Alexander announced today that the committee vote that was scheduled for tomorrow will be postponed until January 31. The reason for the delay, it was stated, is so that committee members may have time to review the ethics committee report.
Health Care
Affordable Care Act
Less than 24 hours after being sworn in, President Trump issued an executive order directing members of his administration to take steps that will facilitate the repeal and potential replacement of the Affordable Care Act. Its language instructs all federal agencies to "waive, defer, grant exemptions from, or delay" any part of the law that imposes a financial or regulatory burden (which would cover consumers, doctors, hospitals and other providers, as well as insurers and drug companies) in preparation to afford States "more flexibility and control to create a more free and open healthcare market". Though the executive order may not have much impact for 2017 (since government rules for this year have already been incorporated into contracts signed with insurance companies) last week, the Congressional Budget Office published its estimate of what would happen under a law that eliminated certain ACA mandates and other provisions: "18 million people would lose their insurance next year alone". However, new regulations cannot be issued overnight, and would have to follow a legally established process that requires public notice and an opportunity for interested parties to comment on the administration's changes, which could take several months or years.
Accessibility Requirements
On January 9, the Access Board released a final rule that updates accessibility requirements for Accessible Diagnostic Medical Equipment (DME) & Information and Communication Technology (ICT), which will take effect on February 8. The standards for medical diagnostic equipment (MDE Standards) contain minimum technical criteria to ensure that medical diagnostic equipment, including but not limited to, examination tables, examination chairs, weight scales, mammography equipment, and other imaging equipment used by health care providers for diagnostic purposes are accessible to, and usable by, individuals with disabilities to the maximum extent possible. The rule further restructures provisions so that they are categorized by functionality instead of by product type due to the increasingly multi-functional capabilities of ICT products. Revisions are also made to improve ICT usability, including interoperability with assistive technologies, and to clarify the types of ICT covered, such as electronic documents.
Home and Community Based Services
Independence at Home Demonstration Performance Results
The Independence at Home Demonstration, which is authorized by Section 3024 of the Affordable Care Act, provides chronically ill patients with a complete range of primary care services in the home setting. Medical practices led by physicians or nurse practitioners provide primary care home visits tailored to the needs of beneficiaries with multiple chronic conditions and functional limitations. The Demonstration also tests whether home-based care can reduce the need for hospitalization, improve patient and caregiver satisfaction, and lead to better health for beneficiaries and lower costs. Demonstration Results: in the second performance year of the demonstration show that 10,484 beneficiaries were enrolled in the 15 participating practices. All 15 improved performance from the first year in at least two of the six quality measures for the demonstration; four practices met the performance thresholds for all six quality measures. Further, the analysis found that in Year two, this demonstration saved $7,821,374 combined (an average of $746 per beneficiary), and seven participating practices earned incentive payments in the amount of $5,093,105.
Zika
On January 18, the Centers for Medicare & Medicaid Services (CMS) announced $66.1 million in funding to health departments in American Samoa, Puerto Rico, the U.S. Virgin Islands, and Florida to help combat the Zika virus. Congress authorized this funding in the Continuing Appropriations and Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and Zika Response and Preparedness Act (P.L. 114-223). Through these awards, $66.1 million is available over a three-year period, with $60.6 million directed to Puerto Rico, which has the highest incidence of locally transmitted Zika cases. Allocations of funds are based on the percent of active and local Zika cases reported by the CDC and the size of the populations in these areas. Funds will support prevention activities and treatment services for health conditions related to the Zika virus, including improving provider capacity and capability.
ABLE Plans
With the recent launch of more ABLE plans, the ABLE National Resource Center (ANRC) would like to invite potential ABLE participants, their families, and all other ABLE stakeholders, to attend a free webinar focused on introducing you to four of the most recent plans to launch. The webinar, taking place January 31, will feature presentations from representatives on behalf of the STABLE Kentucky Program, Michigan's MiABLE Program, the Oregon ABLE Savings Plan, and Virginia's ABLEnow Program. Register here.
Tuesdays with Liz: Disability Policy for All
This week's edition of Tuesdays with Liz: Disability Policy for All Liz interviews Stephanie Merrith (Information and Dissemination Coordinator at the Kentucky UCEDD) about why the Affordable Care Act (aka "Obamacare") is so important to her family. In case you missed last week's episode, Liz interviewed Bethany Lilly from Bazelon Center for Mental Health about the Affordable Care Act.
For more from AUCD, follow @AUCDNews and like AUCD on Facebook
For updates from our Executive Director Andy Imparato, follow @AndyAUCD.
For more policy news, follow Kim on Twitter at @kmusheno
For definitions of terms used in In Brief, please see AUCD's Glossary of Legislative Terms
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