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Budget & Appropriations
On March 22, the House approved the $1.3 trillion FY18 omnibus spending package by a vote of 256-167; the following morning, the Senate also approved the bill by a vote of 65-32. The bill was then sent to the White House which was signed into law by the President, avoiding a government shutdown. The bill will fund the government through the fiscal year ending September 30.
Action Item: Please contact your Members of Congress and thank them for their support - our online email system makes it easy to send a template email or personalize your own! The system also includes a letter for Members who did not vote in favor of the bill.
Money Follows the Person (MFP)
Though MFP was not included in the Omnibus spending package, advocates are encouraged to continue educating your Members of Congress on the importance of this program - particularly those members on the House Energy & Commerce Committee - in order to ensure that MFP is reauthorized and people with disabilities have access to their community. Please use this toolkit to help with your advocacy. Please see joint letter by the National Association of Medicaid Directors, the National Association of State Directors of DD Services, and the National Association of States United for Aging and Disabilities, which requests Congress to extend MFP and allocate additional funding so that states can continue this valuable and cost-effective program.
Health Care
"Regulation to Alleviate State Burden"
On March 22, the Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking (NPRM) that would "provide state flexibility from certain regulatory access to care requirements within the Medicaid program". Specifically, the NPRM would exempt states from requirements to analyze certain data and monitor access when "the majority of beneficiaries receive services through managed care plans". CMS regulations separately provide for access requirements in managed care programs. Additionally, the NPRM would provide similar flexibility to all states when they make nominal rate reductions to fee-for-service payment rates. The NPRM proposes the following changes:
- States with an overall Medicaid managed care penetration rate of 85% or greater (currently, 17 States) would be exempt from most access monitoring requirements.
- Reductions to provider payments of less than 4% percent in overall service category spending during a State fiscal year (and 6% over two consecutive years) would not be subject to the specific access analysis.
- When states reduce Medicaid payment rates, they would rely on baseline information regarding access under current payment rates, rather than be required to predict the effects of rate reductions on access to care, which states have found very difficult to do.
To make a comment regarding the proposed rule, please visit CMS website here.
Hearing
On March 20, the Subcommittee on Health, Employment, Labor, and Pensions, chaired by Rep. Tim Walberg (R-MI), held a hearing on "Expanding Affordable Health Care Options: Examining the Department of Labor's Proposed Rule on Association Health Plans (AHPs)." A list of witnesses and archived webcast can be accessed here
IMPACT Comment Period
The Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International and Abt Associates to develop cross-setting post-acute care transfer of health information and care preferences quality measures in alignment with the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act - PL 113-185). As part of its measure development process, CMS requests interested parties to submit comments on two draft measure specifications: 1) Medication Profile Transferred to Provider and 2) Medication Profile Transferred to Patient. The call for public comment period closes on May 3, 2018. View the public comment webpage for more information.
Education
Budget Hearing
On March 20, the House Committee on Appropriations held a hearing on the Department of Education FY 19 Budget. Secretary DeVos was the only witness. The recording can be accessed here.
Administration Updates
On March 20, Senate Finance Committee (Chairman Orrin G. Hatch, R-Utah) held a hearing on the nominations of John Bartrum to be an assistant HHS secretary, and Lynn Johnson to be an assistant HHS secretary for family support. Final decision has not yet been posted.
On March 19, the President announced his intent to nominate Sharon Fast Gustafson (VA), to be General Counsel of the Equal Employment Opportunity Commission for a term of four years; and Ann Begeman (SD) to be to be the Chair of the Surface Transportation Board.
Leadership
Mark Schultz of Nebraska, has been named the Commissioner of the Rehabilitation Services Administration, Department of Education. Mark Schultz has 34 years of experience in providing and developing disability-related services. For the last six years, he has been the Director of Nebraska VR focusing on training and employment for individuals with disabilities. He was the Assistive Technology Partnership Director for twenty years prior to his current role. More information on the announcement can be found on the White House Website. Schultz will have to be confirmed by the Senate before he can officially hold the position.
Dr. Robert Redfield has been selected as the next director of the US Centers for Disease Control and Prevention, the Department of Health and Human Services announced . The CDC Director position does not require Senate confirmation. Dr. Redfield will take his post on March 26.
Opioids
On March 19, the President unveiled new policies for tackling the opioid epidemic during a speech in New Hampshire, one of the states hit hardest by the crisis. This plan is outlined in three parts: 1) "Reduce drug demand through education, awareness, and preventing over-prescription", 2) "Cut off the flow of illicit drugs across our borders and within communities", and 3) "expand opportunities for proven treatments for opioid and other drug addictions". A main focus of this plan includes law-enforcement-focused policies that aim to increase penalties for drug dealing and trafficking, including mandatory minimums and the death penalty as well as cutting back on opioid prescriptions, hoping to reduce them by as much as one-third over three years. Many experts to the contrary have called for public health efforts focused on boosting access to treatment, adopting harm reduction strategies, and curtailing prescriptions to opioid painkillers while keeping the drugs available to patients who truly need them. They have also deemphasized punitive criminal justice approaches, which are, based on the research and past experiences, largely ineffective. AUCD will continue to monitor this proposal.
ADA Education and Reform Act
The ADA Education and Reform Act (H.R. 620), passed out of the House on February 16, by a vote of 225-192. AUCD is very concerned with how this bill would impact people with disabilities and the efforts to ensure communities are inclusive and accessible. Action Item: Continue to contact both your Senators and share the critical importance of the ADA and ask for their public support. Also see additional back ground/resources:
2018 Disability Policy Seminar
Please remember to register for the Disability Policy Seminar (DPS) and the AUCD Trainee Summit, which takes place on Sunday, April 22! DPS is a great opportunity to learn about disability policy, advance the grassroots movement for people with intellectual and developmental disabilities, advocate for access to health care, community living supports and civil rights, share your story with Members of Congress, and more. Remember to schedule meetings with your Senators and Representatives before you come to DC (tips sheets on how to do this will be shared soon).
Also, please remember to register for the Trainee Orientation webinar taking place on April 2nd at 3:3opm EST, which will highlight what you can expect, how you should prepare, an opportunity to ask questions, and more!
Voting
In 2016, according to Rutgers University, people with disabilities accounted for 35.4 million eligible voters. When you add family members in the same household, that number increases to 62.7 million eligible voters, or 25% of the total electorate. The US Census reported voter turnout for people with disabilities was 6.3% lower than among citizens without disabilities. You can be heard by registering to vote, updating active registration, and educating yourself about the electoral process.
Tuesdays with Liz: Disability Policy for All
The Tuesdays with Liz series is taking a break while Liz Weintraub is on detail working with the Senate Aging Committee. Tuesdays with Liz will return to a regular taping schedule and new episodes will air in the late Spring when Liz returns to AUCD. Until then, we will be highlighting some of our favorite Tuesdays with Liz episodes from this past year here and on social media at @AUCDnews.
This week we are taking a look back at Liz's interview with Sara Var Geertruyden who spoke about engaging patients at every level of their healthcare services, empowering them to make informed and independent decisions about their own healthcare, and policies that can threaten this type of person centered care.
For more from AUCD, follow @AUCDNews and like AUCD on Facebook
For updates from our Executive Director Andy Imparato, follow @AndyAUCD.
For definitions of terms used in In Brief, please see AUCD's Glossary of Legislative Terms
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