Disability Policy News In Brief

August 15, 2016

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August 15, 2016   |   Vol. XV, Issue 85
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Congressional Schedule

Both the House and Senate are on recess until September 6.   

Health Care


On August 11, the Centers for Medicare and Medicaid Services (CMS) released a report (brief analysis and full report) showing that per-enrollee medical costs in the Affordable Care Act (ACA) individual market remained essentially unchanged from 2014 to 2015 despite increasing costs in the broader insurance market (i.e., costs for the broader insurance market increased, while costs in the ACA individual market remained the same). Additionally, states with the highest growth in enrollment during that period saw large reductions in per-enrollee medical costs, suggesting that the ACA individual risk pool is changing positively. This reflects increased enrollment of healthier, lower-cost consumers in the Marketplace.

Zika Virus

The first death of a newborn infant with Zika virus-linked microcephaly in the United States was reported last week. The infant died in Harris County, Texas. The death follows the CDC's imposition of a travel warning to the district of Wynwood in Miami, the only area of the U.S. where mosquitoes are confirmed to be currently spreading the virus. The CDC has reported that there are now more than 1,800 travel-related cases of Zika in the mainland United States. In addition to President Obama, both major presidential candidates have called for Congress to approve additional funding to address the Zika virus, although they support different means of appropriating funding (see also July 18 In Brief).

Following last week's warning that emergency funding to combat Zika will run out by September 30, unless Congress authorizes additional support, Health and Human Services (HHS) Secretary Sylvia Mathews Burwell sent an open letter to Congressional leaders announcing that the Obama Administration will reallocate $81 million from HHS in order to sustain parts of the Zika. Accordingly, the HHS Department will shift $34 million within the NIH and give $47 million to the Biomedical Advanced Research and Development Authority (BARDA) so they may continue ongoing work to develop vaccines and improve means of diagnosing Zika quickly and accurately. As these funds come entirely out of existing HHS appropriations, other projects that address areas such as mental health and opioid addiction will be forced to forego approved funding and curtail their activities. Secretary Burwell also warned that the offset funds will not be enough, and that if Congress does not approve additional spending in September, the government will be forced to severely diminish its anti-Zika activities, including in Texas and Florida, where the virus is spreading actively and the greatest number of cases have been reported.  While AUCD supports funding for Zika, we are concerned that, without appropriating new dollars, money is being diverted from other public health priorities.  AUCD is a member of the Coalition for Health Funding which issued the following press release stating our concerns.

On August 12, the Secretary also declared a public health emergency for Puerto Rico, where there have been 10,690 laboratory-confirmed cases of Zika, including 1,035 pregnant women. The declaration allows the Commonwealth to temporarily reassign personnel who implement Public Health Service Act programs in Puerto Rico to emergency response activities. Additionally, the declaration enables Puerto Rico to apply for funding to train and hire health workers through the Department of Labor's National Dislocated Worker program.

USAID Combating Zika Grand Challenge

The United States Agency for International Development (USAID) announced the results of its Combating Zika and Future Threats Grand Challenge, an initiative which provides $15 million in awards to researchers around the world who are working on innovative solutions to fight the spread of the virus. USAID awarded funding to 21 research teams at universities and companies located in the U.S., U.K., Australia, Brazil, and Tanzania. The various award nominees' projects include cheaper forms of household protection against mosquitoes, chemicals to control the mosquito population, and new ways to diagnose the virus and locate areas where it is being transmitted more quickly.

Please let AUCD staff know if your university center is working on activities in response to Zika.

Home and Community Based Services (HCBS) Rule

Comment Periods

Several Statewide Transition Plans are now open for public comment related to the HCBS Rule:

This information is also posted on the hcbsadvocacy.org site along with other resources for state advocates.  AUCD strongly urges its member organizations to review and provide comments on the transitions plans and to partner with other state advocates to ensure that the Rule is being implemented using evidence-based and best practices.

Delaware is now the third state to receive Initial Approval of its Statewide Transition Plan. This letter is the communication CMS sends notifying the state that public comment, input, and summary requirements are met, the STP is sufficient.  However, the letter also states the systemic and/or site-specific assessments are not yet completed.  The response to the state will vary depending on whether the state has or has not identified settings that are presumed to have institutional characteristics and any information the state may wish CMS to consider under the heightened scrutiny process.

For more information related to the new HCBS settings rule, please contact Christine Grosso.

Civil Rights

On July 7, the House Judiciary Committee approved H.R. 3765, the ADA Education and Reform Act of 2015 on a partisan vote of 15-6. The bill, introduced in 2015 by Reps. Poe (R-TX), Collins (R-GA), amends the Americans with Disabilities Act to limit the ability of people with disabilities to enforce their rights under the Americans with Disabilities Act (ADA) to access places of public accommodation.  The bill would effectively eliminate businesses' responsibility to fulfill ADA accessibility requirements and would further put the onus on the individual for understanding the law and for determining whether a business is not in compliance. The bill also this bill blames people with disabilities for public accommodations' failure to comply with the ADA. (See also DREDF letter opposing the bill).  This bill is strongly opposed by AUCD.  While it is unlikely this bill will get enough support to pass the full Congress and be signed into law, AUCD encourages advocates to educate those Members of Congress that cosponsored the bill.


On Thursday, the U.S. Department of Education's Office of Special Education and Rehabilitative Services (OSERS) issued guidance in the form of a Dear Colleague Letter to states to ensure students with disabilities attending public virtual schools are getting the special education and supports that they deserve and is their right. The guidance focuses on specific requirements in the Individual with Disabilities Education Act (IDEA) for public virtual schools. IDEA is the law that guarantees the right to a public education for America's nearly 6.7 million students with disabilities. The press release on the ED website provides more detailed information.


AUCD signed onto a coalition letter urging the Congress to pass H.R. 3229 and S. 2196, which would permanently exempt Complex Rehab Technology (CRT) wheelchairs and components for people with disabilities and chronic conditions from Medicare's Competitive Bidding pricing, thus protecting Medicare beneficiary access to both power and manual complex rehab technology, as well as essential components known as wheelchair "accessories."  The letter was developed by the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, a coalition dedicated to protecting access to assistive and other technologies for individuals with disabilities. The coalition believes CRT wheelchairs and accessories (both power and manual) are not suitable for Competitive Bid pricing. For more information, see the draft letter and encourage your Member of Congress to support this legislation.


The Marrakesh VIP Treaty, which creates exceptions to copyright law in order to make it easier to create accessible versions of books for blind or print-disabled individuals, is set to go into effect at the end of September in the 20 nations that have ratified or acceded to it. Collectively, more than 22 million blind or visually impaired individuals live in these countries. When put into effect, the Marrakesh Treaty will remove copyright obstructions that prevent published materials from being reproduced freely in accessible formats such as Braille, large print and audio editions. The United States has signed the Marrakesh Treaty, but it will not come into force in the U.S. unless it is fully ratified by the Senate. President Obama formally recommended that the Senate do so in February.

Tuesdays with Liz: Disability Policy for All

During this week's edition of Tuesdays with Liz: Disability Policy for All, Liz interviews Shannon Hayworth, (AUCD's Public Health Program Manager) about the Public Health Workforce Competencies. In case you missed last week's edition, Liz interviewed Dianne Dressler (Senior Associate with Community Life Resources) about housing and housing issues.


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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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