February 2011

A United States District Judge for the District of Columbia, Gladys Kessler, determined that the individual insurance requirement does not infringe on a person’s religious beliefs - a claim made by the plaintiffs of the lawsuit. This is the third federal judge to rule the Affordable Care Act (ACA) constitutional. Two others in Florida and Virginia have ruled the ACA to be unconstitutional. The matter is expected to be decided by the Supreme Court, or a compromise bill by the 112^th Congress.

FY 2011 Appropriations

The United States House of Representatives Appropriations Committee released a short term Continuing Resolution (CR) to keep the government operating until a compromise can be reached on a bill for the remainder of FY 2011. The CR includes $4 billion in spending reductions, the majority of which were already targeted for elimination by the Obama Administration. Fortunately, major disability programs are not targeted for reduction in the CR. All FY 2011 appropriations still need to be negotiated with the United States Senate and signed by the President.

Medicaid  - Maintenance of Effort Provisions

CMS released a letter providing guidance on “the maintenance of effort” (MOE) provisions in the Affordable Care Act (ACA) of 2010. Some states have been seeking ways to avoid the ACA’s MOE – the requirement to maintain their current Medicaid eligibility criteria and services until 2014. The letter and the enclosed Q&As address the ACA’s MOE provisions for Medicaid and the Children’s Health Insurance Program (CHIP) generally. It also answers specific questions related to the non-application of the MOE provisions for certain adult populations in states with a budget deficit, section 1115 waivers and demonstration projects, and the treatment of premiums. See the letter at:

http://nasuad.org/documentation/newsroom/friday_updates/MOE%20Letter%20for%20Display.pdf.

Federal Budget – FY2011

The House of Representatives completed work on a FY 2011 Continuing Resolution (CR) that would make landmark cuts to domestic discretionary funding. Most of the $100B in cuts were to domestic programs, though $19 billion did come from security-related cuts. The Senate is expected to work on a CR the first week in March.  If the Senate and House are unable to occur, a federal government “shut-down” is possible.

Cuts in the House approved budget includes:

•       Health Care:  Nine amendments were accepted aimed at blocking implementation of the Affordable Care Act (ACA), prohibiting funds to pay the salary of employees or contractors working on implementation and prohibiting the Internal Revenue Service from enforcing the individual responsibility section of the ACA.
 

•       Employment:  The House bill eliminates the State Supported Employment grant program and the Projects with Industry grant program.  Also the overall amount of funding to states for employment and training was cut by nearly $1.4 billion.
 

•       Housing: Housing for Persons with Disabilities would be cut by 70%. The Section 811 Supportive Housing for Persons with Disabilities program budget would be cut from the FY 2010 level of $300 million to $90 million for FY 2011.

•       Special Olympics: All funding would be eliminated.

Federal Budget – FY2012

Even while legislative debate continues on appropriations for Federal Fiscal Year (FFY) 2011, the President is required and has introduced his budget proposal for FFY 2012.  The President’s proposal includes a five-year freeze on domestic discretionary spending, saving an estimated $400 billion over 10 years.  Within the overall freeze, some programs were viewed as investments and given an increase, others faced significant cuts, and many programs were proposed to be consolidated with other programs. The White House budget would reduce overall spending by 2.7% from the $3.8T President Obama proposed a year ago for FY 2011. 

Below is a summary of changes to disability-related programs in the President's Budget proposal:

•       Employment: New funding proposals for:


•       Targeted program for youth receiving SSI ($30M);

•       Mentoring program for individuals with intellectual disabilities ($5M); and,

•       National activities to improve VR ($8M).

•       Developmental Disabilities Act: DD grant programs would remain level funded; however, funding for Projects of National Significance would be cut to $8M from $14M.
 

•       Special Education: The Department of Education would receive a $200M increase for special education and $50M for programs for infants and toddlers.
 

•       Special Olympics: The President’s Budget would provide level funding of $8M.
 

Federal Budget – FY2012 (cont.)

•       Housing: The President’s Budget calls for $196M for the Section 811 Housing for Persons with Disabilities Program, a cut of 35% from FY 2010. Under the new Frank Melville Housing program, housing developers would be able to leverage the Section 811 dollars in more efficient ways. The anticipated number of accessible housing units would be 3-4,000 compared with the 1,000 new units annually under the current system.
 

•       Respite: The President’s Budget calls for $10M for the Lifespan Respite program, a 400% increase over the current funding level ($2.5M). It also provides $192M for the Family Caregiver Support program which is 500% increase over the FY 2010 level ($38M).
 

•       New Programs: The Department of Education would receive $5M to create a Mentoring for Individuals with Intellectual Disabilities; NIDRR would receive an additional $10M to investigate cloud computing for making computer technology accessible; and several departments would jointly receive $30M to create a transition program called PROMISE for youth who receive SSI benefits.

Community First Choice

The Centers for Medicare & Medicaid Services (CMS) announced the release of a proposed rule regarding implementation of the Community First Option, which is a provision of the Affordable Care Act of 2010.  If adopted, the rule would take effect October 1, 2011 and provide 6% enhanced federal match for the provision of person-centered home and community based services that help increase community living.  Covered services include attendant services and supports for assisting individuals with activities of daily living, as well as costs involved moving individuals from on institutional setting to the community.  It is not clear how this proposed federal regulation might impact Ohio’s new SELF-Waiver, planned for a July 1, 2011 implementation.

Economic Outlook

Gross domestic product is projected to grow 3.5% in 2011, up from 2.9% in 2010.  Standard & Poor’s 500 stock index is approaching a 100% gain over a two-year period.  In addition, 80% of surveyed CEO’s expelled increases in sales and 45% expected to increase employment.  All of those statistics point to an improving economy and a balanced, steady growth will help stabilize tax revenues.  These economic indicators are important for Board Members, Superintendents and Business Managers as they engage in long range planning.  Federal Stimulus funding took the sting out of the economic recession; the absence of those funds during the next fiscal year point to a bleak financial picture that may make it difficult to see brighter days ahead.

Employment

The TEAM Empowerment Act (H.R. 603) seeks to increase coordination between state educational agencies and state I/DD authorities to successfully transition youth with significant disabilities from high school into meaningful employment and post-secondary education opportunities. The bill establishes an optional Transition Planning and Services Division within each State I/DD agency to provide the necessary capacity and expertise. It also provides $50,000,000 in funding beginning in FY 2012.  

Olmstead Enforcement

The Department of Justice (DOJ) continues to hammer states on the enforcement of the U.S. Supreme Court’s Olmstead decision.  Virginia becomes the most recent state to receive a letter of findings about its failure to provide services to people with disabilities in the community.  DOJ said that the state is in violation of the Americans with Disabilities Act and Olmstead because it fails to provide community-based services to prevent unnecessary institutionalization for people, especially those with the most complex needs, and because it fails to have a workable transition process in place for people who could leave the institution. In order to avoid litigation, DOJ recommended that Virginia obtain additional waivers and expand community services; develop crisis services; provide integrated day services, including supported employment, and move away from relying on sheltered workshops; create systems to monitor community services; provide true discharge planning for people in institutions; work with families who are opposed to community placement so they can make informed choices, and prevent new admissions to institutions unless that placement is the most integrated setting appropriate to serve the individual’s needs. 

Developmental Disabilities Act

In preparation for the reauthorization of the Developmental Disabilities Assistance and Bill of Rights Act (DD Act), The National Council on Disabilities (NCD) issued a report entitled, “Rising Expectations: The Developmental Disabilities Act Revisited.”  NCD found that people with DD continue to wait for services in the community, services vary from state to state, and the DD system is fragmented. The report also found that perceptions about people with DD are outdated in our country. To read the report, see:

http://www.ncd.gov/newsroom/publications/2010/rising_expectations_02-15-11.html.

Joseph P. Kennedy Public Policy Fellowship Program

The Joseph P. Kennedy, Jr. Foundation is seeking exemplary professionals and/or family members of persons with intellectual or developmental disabilities who are currently working or volunteering in the field of inclusive services and supports for people with intellectual and developmental disabilities for an intensive one-year Public Policy Fellowship in Washington, D.C.  The purpose of the Fellowship is to prepare both early career and seasoned leaders to assume leadership in the public policy arena in their home state and/or nationally. The application deadline for 2011-2012 is March 15, 2011. For more information, see:

http://www.jpkf.org/images/FellowshipAnnouncement2011-2012Disseminated2.pdf

National Perspective is a publication of the Ohio Association of County Boards of DD, designed to update Association members on national and federal issues of interest.