Federal

NJACP monitors and responds to issues affecting people with intellectual and developmental disabilities at the federal level.

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Federal Updates

The Centers for Medicare & Medicaid Services (CMS) seeks public input on reducing the regulatory burdens of the Patient Protection and Affordable Care Act (ACA)

The Centers for Medicare & Medicaid Services (CMS) has issued a Request for Information (RFI) seeking recommendations and input from the public on how to create a more flexible, streamlined approach to the regulatory structure of the individual and small group markets. The goal is to identify and eliminate or change regulations that are outdated, unnecessary, or ineffective; impose costs that exceed benefits; or create inconsistencies that otherwise interfere with regulatory reform initiatives and policies.

The Department of Health and Human Services (HHS) is looking for feedback on regulations under the ACA to determine whether each rule advances or impedes priorities for stabilizing the individual and small group health insurance markets; empowers patients and promotes consumer choice; enhances affordability; and returns regulatory authority to the states. Regulations under review include Essential Health Benefits and Actuarial Value, among others. Feedback can include providing input to improve rules, maintain rules, change rules, remove rules, and more. Some areas for specific requested feedback, include:

  • Empowering patients and promoting consumer choice.  What activities would best inform consumers and help them choose a plan that best meets their needs?
  • Enhancing affordability.  What steps can HHS take to enhance the affordability of coverage for individual consumers and small businesses?
  • Protecting individual independence. How can HHS enhance the opportunities of older adults and people with disabilities to participate in their communities and access the supports they need?

Aging and disability community-based organizations and other groups may wish to provide feedback for these populations and their caregivers and/or family members.  The RFI will be open for public comment for 30 days.  View the Request for Information and details for submitting public comment.

 TRUMP’s MEDICAID OVERHAUL IS FACING TOUGH TEST IN TRUMP COUNTRY

The administration is likely to approve Kentucky Gov. Matt Bevin’s plan requiring poor adults to work to enroll in Medicaid in a first test of the GOP idea. That could spark a domino effect in other Republican-led states.  But the plan could backfire on many Trump voters, as POLITICO’s Rachana Pradhan found when she traveled to coal country in Kentucky – and found a county of 17 percent unemployment and persistent poverty.

‘How do you force poor people to work for health coverage when there aren’t any jobs?’ – That’s the question that Rachana encountered again and again, with unemployed adults telling her they wouldn’t even know where to look if they needed a job to get health coverage.  “Most people would work if they could find a job,” said the mayor of one small town (who also runs its health department). “I have people come in here every day wanting a job.” As reported by Politico.

U.S. Senate Returns from Recess Facing Continuing Challenges to Health Care Reform

Senators back in session after the 10-day Memorial Day recess are reportedly increasingly pessimistic about passing a health care bill that would repeal and replace the Affordable Care Act (ACA). The House passed the American Health Care Act (AHCA) just over a month ago, and the Senate has been scrambling to rewrite and rework the bill into something that will keep enough Senators’ votes to pass. (See ANCOR article, “House Narrowly Passes AHCA, All Eyes Shift to Senate,” May 5, 2017). Given the current makeup of the Senate, Republicans can only afford to lose two votes, assuming all Democrats vote against the measure as expected. Because the bill is being advanced as a budget reconciliation bill rather than through regular order, there are additional considerations the Senate must account for that do not apply on the House side, specifically the “Byrd Rule” which does not allow extraneous provisions that do not directly impact spending in a budget reconciliation bill. It is expected that Democrats will challenge pieces of the House-passed AHCA under the Byrd rule, requiring the Senate Parliamentarian to make determinations and rulings on the content of the Senate bill prior to floor proceedings.

Several Republican Senators have expressed skepticism about coming to agreement on the bill, including Richard Burr (R-NC) who said it’s “unlikely that we will get a health care deal” and Jeff Flake (R-AZ) who said he doubted a bill could pass before the August recess. Despite the skepticism, party leaders and others see the high stakes involved and are determined to push a bill through. Senate Majority Whip John Cornyn (R-TX) said the Senate will have a bill voted on no later than July. Vice President Mike Pence has also put pressure on the Senate, saying that a health care reform measure must be completed by the end of the summer. As reported by ANCOR.

ANCOR has a toolkit and resources available online to help you set up in-district meetings and events, and urges you to call in to your Senators’ offices to tell your story of the importance of the Medicaid program to the services you offer. More details and resources are available on their website, www.disabilitysos.org

 ABLE Act Update

 The legislation to alow ABLE Act accounts, accounts that can assist individuals with disabilities and their families save for their disability expenses while keeping benefits such as Supplemental Security Income and Medicaid, was approved in New Jersey (each state must pass enabling legislation to comply with the federal statute). However, the regulatory structure to implement the accounts has not yet been completed. Regulations that were with the Department of Treasury are now with the Department of Human Services for completion. Some are hopeful the process will be finalized before the end of the calendar year, however, the DHS has not announced a timeframe. NJACP continues to monitor developments and will inform members of any updates.

DOL Seeks Feedback on Rescinding Persuader Rule

 On June 12, the Department of Labor (DOL) filed a notice of proposed rulemaking (RIN 1245-AA07) that asks for public comment on whether the Department should rescind the “persuader” rule, a rule issued last year that requires employers to report on arrangements they have with labor-management consultants to develop communications and otherwise influence employees during union organizing campaigns. The rule requires disclosures for any actions, conduct, or communications that could impact an employee’s decision regarding collective bargaining rights, whether the actions are direct or indirect. Prior to this rule, such disclosure was only required if the outside consultants made direct contact. Critics of the rule were concerned that it would have a “chilling effect” on free speech and could prevent employers from seeking legal counsel for labor issues.

The DOL said in its notice that it is considering rescinding the rule to allow for additional engagement in statutory analysis and give greater consideration to whether a revised interpretation will have a chilling effect on client-attorney communications.  Comments on the proposed rule are due August 11, 2017. As reported by ANCOR.

Tennessee Closes Institution

 The final two people living at Greene Valley Developmental Center transitioned to their new homes last week, effectively closing the state institution after more than 50 years of operation, state officials announced. “People who lived at Greene Valley are now living rewarding lives in their communities,” Department of Intellectual and Developmental Disabilities Commissioner Debra K. Payne said in a news release. “We are closing an important chapter in the history of supporting people with disabilities in Tennessee. It’s important to celebrate the huge advancements we’ve made, while remembering the important role Greene Valley played for 56 years.”

Over the past two years, DIDD has transitioned 84 people into community placements. Private providers in East Tennessee constructed 15 four-person homes for people living at Greene Valley whose families wished for them to transition to an intermediate care facility for people with intellectual and developmental disabilities. “I want to take this opportunity to thank all Greene Valley employees for the excellent care they have provided to people with disabilities for more than 50 years,” Payne said. “Also, the entire Greene County community has supported the facility and the people who live there, and we are extremely grateful for their continued partnership as we support people with intellectual disabilities in the community.”

Closure of Greene Valley Developmental Center was the final provision of an agreement allowing DIDD to resolve a federal lawsuit. The suit was brought by People First of Tennessee and the U.S. Department of Justice in 1995, over conditions at Clover Bottom Developmental Center, Greene Valley and Nat T. Winston Developmental Center. Nat T. Winston shut its doors in 1998. Clover Bottom was closed in late 2015. In January 2016, a federal judge issued an order vacating injunctive relief and partially dismissing the long-standing lawsuit following an exit plan entered by the U.S. district court in January 2015. To read more, click here.

 

CCD Fact Sheet on Housing Resources

On August 2, 2016, the Consortium for Citizens with Disabilities’ (CCD’s) Housing task force released an fact sheet on the National Housing Trust Fund (NHTF) and the Department of Housing and Urban Development’s (HUD’s) new Affirmatively Furthering Fair Housing (AFFH) rule. The fact sheet outlines why the NHTF and AFFH are vital for people with disabilities, and how state and local disability advocates can get involved in these new initiatives. Click here for the fact sheet.

ADA Amended Regulations Strengthen Disability Rights

On August 11, 2016, the Department of Justice (DOJ) issued final rule RIN 1190-AA59 which amends current regulations implementing the Americans with Disabilities Act (ADA) to incorporate statutory changes to the law that went into effect on January 1, 2009. Congress enacted the ADA Amendments Act in 2008 to restore the understanding that the definition of “disability” should be broadly construed and applied without extensive analysis. In the final rule, the DOJ adds new sections to Title II and Title III ADA regulations to clarify the proper meaning and interpretation of the definition of “disability” and to make other related changes required by the ADA Amendments Act. NJACP will inform members as additional info and analysis become available.

TAC Releases Section 8 Resource Guide

The Technical Assistive Collaborative (TAC), an organization that focuses on affordable housing solutions for vulnerable populations, has released “Section 8 Made Simple – Special Edition: Using the Housing Choice Voucher Program to End Chronic Homelessness“. This guide offers step-by-step guidance on finding and securing housing through the Housing Choice Voucher program, with a special focus on helping those who are experiencing chronic homelessness. Though the guide is not disability-focused, it contains valuable information for anyone interested in learning more about how the voucher program works.

 Disability.gov Updates Website

Disability.gov, which is designed to be a one-stop shop for government disability resources, sent the following notice of website updates on July 12, 2016:

You Asked. We Acted. — Disability.gov’s New “Quick Links”

Visitors to Disability.gov have asked for a series of “quick links” to use as a way to find the information they need faster. Many have also requested a list of toll-free numbers they can call to learn about disability-related programs and services in their own communities. In response to your requests, we have developed a new webpage of “quick links” and phone numbers so you can easily access the information and resources Disability.gov’s visitors are most often seeking. Please share this email with family members, friends and colleagues you believe may benefit from these important resources.  For more information visit: https://www.disability.gov/disability-govs-quick-links

State Minimum Wage Chart

Attached is a chart detailing each state’s minimum wage and, if adjusted annually, the date of the adjustment. New Jersey’s minimum wage is 8.38 and is adjusted each year in January depending on the rate of inflation each year. If of interest, please click here.

CMS Issues Guidance on Strengthening and Stabilizing Medicaid Home Care Workforce

On August 3, the Centers for Medicare and Medicaid Services (CMS) issued an informational bulletin that highlights steps available to states, providers, and others to strengthen the home care workforce, defined in the document as encompassing individuals furnishing home and community based services (HCBS). The document is split into subsections, with recommendations under each. The subsections are:

  • Workforce Identity
  • Provider Qualifications and Basic Training
  • Wage Analyses
  • Related Prior Guidance

Notably, in the “Wage Analyses” section, the guidance says, “When developing payment rates for home care services, states should also consider business costs incurred by a provider – whether a home care agency or an individually employed worker – associated with the recruitment, skills training, and retention of qualified workers.” This is an important acknowledgement that states should ensure that rates will be sufficient to provide adequate compensation for workers. There is also a direct reference to the Department of Labor’s Home Care rule, with the guidance noting that states should take into account geographic differences in wages within a state and keep in mind any joint-employer obligations the state may have.

DOL Issues Guidance Regarding Implementation and Enforcement of WIOA Including 14c Certificates

On July 27, 2016, the Department of Labor (DOL) Wage and Hour Administrator Dr. David Weil issued Field Assistance Bulletin No. 2016-2 and released Fact Sheet #39H regarding implementation of the Workforce Innovation and Opportunity Act (WIOA) and Wage and Hour Division enforcement of WIOA limitations on payment of subminimum wages under section 14(c) of the Fair Labor Standards Act (FLSA), effective July 22, 2016.

In conjunction with this guidance, Branch Chief Helen Applewhaite wrote a letter to current section 14(c) certificate holders about the new limitations mandated by WIOA. Under WIOA: 

  • Employers may not continue to pay a subminimum wage to persons with disabilities under section 14(c) of the FLSA unless each worker, regardless of their age, has been provided with career counseling and information about self-advocacy, self-determination and peer mentoring training opportunities in their local area at specified intervals. 
  • Employers are prohibited from hiring workers who are age 24 or younger unless the employer obtains, verifies, and maintains copies of documents proving that these workers have completed specific requirements (transition services, vocational rehabilitation and career counseling) designed to improve their access to competitive integrated employment.

DOL maintains a website dedicated to housing information regarding employment for workers with disabilities, which is available here.