AUCD Legislative News InBrief
April 7, 2008
House and Senate Action
The House is expected to consider the Newborn Screening Saves Lives Act of 2008, S.1858, and the Traumatic Brain Injury Act of 2008, S.793, today. Both bills, supported by AUCD, were marked up in the Energy and Commerce Committee last month and passed the Senate in December. The Senate is expected this week to pass its housing-stimulus package. A vote on the bill, which would provide tax breaks to spur home-buying and help builders along with grants to help cities buy up foreclosed properties, is expected to occur Tuesday.
FY 2009 Budget Resolution
House Majority Leader Hoyer (D-MD) said last week that congressional Democrats are working to get the budget resolution completed by April 18 in order to bring it to the floor the following week. House and Senate negotiations continue as Democrats seek to demonstrate that they can govern well and pass the blueprint for appropriations. AUCD staff, along with several other CCD leaders met with senior appropriations staff of House Leader Pelosi on Friday. Her staff said that differences remain on whether to include reconciliation instructions and on the overall discretionary spending levels but they feel confident that they can work out a deal.
Appropriations
AUCD staff is helping to prepare a Hill briefing sponsored by the Consortium for Citizens with Disabilities and the Bipartisan Disability Caucus for April 16. The briefing will highlight CCD's FY 2009 recommendations for funding disability programs.
Medicaid Rules Moratorium
Last Thursday the House Energy and Commerce Health Subcommittee held a hearing on Protecting the Medicaid Safety Net Act of 2008 (H.R. 5613) introduced by Energy and Commerce Committee Chairman Dingell (D-MI) and Representative Murphy (R-PA). The bill would place a one-year moratorium on 7 Medicaid regulations that CMS has taken action on over the past year. States estimate that these regulations would shift costs, upwards of $50 billion, to states over five years. All 50 governors signed a letter of support for H.R. 5613. The Committee has also received numerous letters of support from organizations, including AUCD's, which are posted on the Committee website. The bill currently has 58 co-sponsors, including 5 Republicans. Under "pay as you go" rules it would costs approximately $1.65 billion to do moratoriums on all regulations. Last week, Senators Rockefeller (D-WV), Snowe (R-ME) and Kennedy (D-MA) introduced the Economic Recovery in Health Care Act of 2008, S. 2819. The bill includes a similar one-year moratorium on the 7 Medicaid regulations. The bill also includes a moratorium on a CMS SCHIP directive issued last year that limits the ability of states to cover children in families above 250% of the federal poverty level. In addition, the bill includes $12 billion in targeted Medicaid fiscal relief to states -equally split between a temporary increase in the Medicaid matching rate and grants to states. The AUCD Action Centers has alerts to gain addition co-sponsors for the bills: http://www.aucd.org/template/capwiz.cfm. Ultimately, pieces of the bills will likely need to be broken off and placed on "must-pass" legislation, such as the war supplemental appropriations or the Medicare physician payment fix.
Medicaid Rule on Community Based Option
Last week CMS also issued proposed regulations on implementing the new Medicaid home and community-based state plan option that was included in the Deficit Reduction Act (DRA) of 2005. Section 1915(i) establishes a new option for states to provide home- and community-based services (HCBS) without requiring that states use a waiver process. However, there are several issues with the new option that need to be addressed to make it more attractive to states. Three major issues the disability community would like to see fixed are: 1) allow states to provide the full range of services that can currently be provided under the HCBS waiver (including "other" services approved by the Secretary); 2) remove the limit on coverage of people with incomes up to 150 percent of poverty and allow the full range of income eligibility allowed for people in facility-based settings; and 3) eliminate the states' ability to limit services to certain sections of the state. Members of the CCD Long-Term Services and Supports Task Force are providing input into a new bill being developed by Senator Kerry (D-MA) to address some of the these issues.
Autism
Autism Caucus Co-chairs Reps. Chris Smith (R-NJ) and Mike Doyle (D-PA) held a press conference on April 2 to commemorate World Autism Awareness Day and to build support for legislation that would provide needed autism services in the U.S. and around the world. In February 2008, a bipartisan group of Representatives joined with Smith and Doyle to introduce the Global Autism Assistance Act (H.R. 5446). The bill authorizes $10 million over three years through a grant program for service providers and advocacy organizations in other countries to raise autism awareness and to create ways to share best practices. Up to two countries would be selected in the first year. Smith and Doyle also promoted the Expanding the Promise for Individuals with Autism Act (H.R. 1881), a bill they introduced together last Spring, to provide services and supports to individuals with autism. Lee Grossman, Autism Society of America and Randall Rutta, Easter Seals, also provide remarks during the press conference. AUCD's press statement commemorating April as Autism Awareness month is posted on the Association's website: www.aucd.org.
No Child Left Behind
On April 1, U.S. Secretary of Education Margaret Spellings announced she will take administrative steps to ensure that all states use a uniform federal formula to determine graduation and dropout rates. Currently, the inconsistency among states makes it difficult to accurately capture how many students are graduating from high school and how many are dropping out. For example, some states count students as graduating if they exit high school but promise to go back and get a GED. The uniform formula would allow national comparisons of the graduation rates among subcategories; for example, dropout rates of students with disabilities compared to their nondisabled peers. Chairman Miller (D-CA) of the House Education and Labor Committee and other committee members support the initiative and plan to continue to work to prevent students from dropping out of high school.
Mental Health Parity
House and Senate sponsors of the mental health parity bills worked hard over the Spring recess to resolve differences between the two bills and still have enough votes in the Senate to pass. Some of the issues that they are working on concern the House bill's mandates that insurers cover all conditions listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV); out-of-network parity; medical management practices; and how to pay for the roughly $3 billion over 10 year estimated cost of implementing the new policy. Key negotiators feel confident that they will be able to work out a compromise and have it signed into law before the end of this Congress.
Family Medical Leave Act
On April 10 the House Education and Labor Workforce Protections Subcommittee will hold a hearing on "The 15th Anniversary of the Family Medical Leave Act: Achievements and Next Steps." Witnesses include former Rep. Pat Schroeder (D-CO), original sponsor of the Family and Medical Leave Act; Chante Lasco, new mother form Easton, Md., who will testify on the limitations of FMLA; Jennifer Hunt, airline attendant who will discuss how many attendants do not qualify for FMLA protections; and Debra Ness, president of the National Partnership for Women and Families.
Veterans and Disabilities
On April 10, the House Veterans Affairs Health Subcommittee will hold a hearing on several bills including H.R.2818, a bill to provide for the establishment of Epilepsy Centers of Excellence in the Veterans Health Administration of the Department of Veterans Affairs; H.R.5554, the "Veterans Substance Use Disorders Prevention and Treatment Act of 2008"; H.R.5595, to provide dental care to veterans with service-connected disabilities; a bill to expand Spina Bifida program; and a draft bill authorizing the Veterans Affairs Department to provide mental health treatment to families.
SCHIP Hearing
On April 9, the Senate Finance Health Care Subcommittee will hold a hearing on "Covering Uninsured Children: The Impact of the August 17 CHIP (Children's Health Insurance Plan) Directive." The Centers for Medicare and Medicaid (CMS) issued a directive last year that limits the ability of states to cover children in families above 250% of the federal poverty level.
UN Convention on the Rights of Persons with Disabilities
The International Convention on the Rights of Persons with Disabilities (CRDP) will enter into "legal force" on May 3, 2008 as Ecuador became the 20th country to ratify the treaty. The Convention will now be legally binding for the twenty countries, and any other country who ratifies the Convention by then, and immediately for any country who ratifies the Convention after that date. Unfortunately, since the United States did not ratify the Convention, it will have no voice at the Convention meeting and no vote for the members of the committee. For more information visit: http://ratifynow.org/
Electronic Health Records
The Department of Health and Human Services Department (HHS) announced in the Federal Register a meeting of the Office of the National Coordinator for Health Information Technology; American Health Information Community Personalized Healthcare Workgroup today to discuss possible common data standards to incorporate interoperable, clinically useful genetic/genomic information and analytical tools into Electronic Health Records (EHRs) to support clinical decision-making for the clinician and consumer. [Note: The meeting will be available via Web cast at http://www.hhs.gov/healthit/ahic/healthcare/phc_instruct.html
