Last week, the Centers for Medicare & Medicaid Services (CMS) announced several changes to the Medicaid.gov website including a new home page with quick links including federal policy guidance and other new technical assistance resources. Additionally, they have expanded State Medicaid and CHIP profiles to provide a more complete picture of the many policy and programmatic features that make up each state’s Medicaid and CHIP programs. New elements include a state-specific list of approved state plan amendments and waivers and links to detailed Medicaid managed care profiles.
On November 14, the White House released a new public service announcement on the Affordable Care Act and people with disabilities. It explains how individuals with disabilities can no longer be denied health coverage because of health history. The public service announcement was released to coincide with open enrollment, which began on Saturday, November 15, and ends on February 15. This time period will be a chance for individuals already enrolled in healthcare to re-enroll and for individuals not yet enrolled to sign up to begin receiving healthcare. To see the new announcement view it on The White House YouTube page. For additional information on coverage, please visit www.healthcare.gov.
The midterm elections are over and many wonder how they will impact the disability community. As of this writing, Republicans gained at least 7 seats in the Senate, giving them control of the chamber. They also gained at least 10 seats in the House, further strengthening their majority. A few states still have elections results pending, and Republican gains could increase in both houses.
Majority control in Congress has a significant impact on the legislative agenda. Committee chairpersons (from the majority party) determine a committee’s priorities based on their interests, sense of national needs, and political judgment. The two most important Senate committees for the disability community are the Finance Committee and Health, Education, Labor & Pensions (HELP) Committee. The Finance Committee has jurisdiction over Social Security, Supplemental Security Income (SSI), Medicaid, and Medicare, among other issues. HELP has jurisdiction over other federal programs related to health, education, and employment.
According to press report, Senators Lamar Alexander (R-TN) and Orrin Hatch (R-UT) are expected to take over the HELP and Finance Committees, respectively. However chairmanships won’t be finalized until early 2015.
The election results provide an opportunity to enlist new supporters in Congress who can be made aware of the interest of people with I/DD and what is required for meaningful, independent living. See new Members at: http://www.nationaljournal.com/almanac/114th-congress-new-members
On October 22, 2014 the Social Security Administration (SSA) announced a 1.7 percent cost-of-living increase for 2015. This modest increase will help preserve the buying power of Social Security benefits for nearly 64 million Americans, including many people with intellectual and developmental disabilities who receive benefits under our nation’s Social Security system. According to SSA, the average monthly Social Security retirement benefit will increase by $22, from $1,306 in 2014 to $1,328 in 2015. The average monthly benefit for a Social Security “disabled worker” beneficiary will increase by $19, from $1,146 in 2014 to $1,165 in 2015. Higher Medicare premiums will offset some of this increase. Changes in Medicare premiums for 2015 are available at Medicare.gov. To read more, visit The Arc’s blog.
On October 1, 2013, the Wage and Hour Division of the U.S. Department of Labor (DOL) released “Application of the Fair Labor Standards Act to Domestic Service; Final Rule”, 78 FR 60454, (Final Rule) which extended minimum wage and overtime protections to most home care workers. Under the rule, most home care workers will have the same protections provided to the majority of U.S. workers under the Fair Labor Standards Act (FLSA), including many direct support professionals (DSPs) who provide supports and services to individuals with intellectual and/or developmental disabilities (I/DD).
The rule goes into effect on January 1, 2015. However, DOL has received requests for a deadline extension from state agencies, national and state associations, and advocacy organizations, citing the need for additional time to secure budgetary, programmatic, and operational adjustments. In response to these requests, on October 8, 2014, DOL announced the adoption of a time-limited, non-enforcement policy which applies to all employers. In a blog post, DOL stated the following:
“After careful consideration, the department decided to adopt a time-limited non-enforcement policy. This approach will best serve the goals of rewarding hard work with a fair wage while not disrupting innovative direct care services. For six months, from January 1, 2015 to June 30, 2015, the department will not bring enforcement actions against any employer who fails to comply with a Fair Labor Standards Act obligation newly imposed by the rule. During the subsequent six months, from July 1, 2015 to December 31, 2015, the department will exercise its discretion in determining whether to bring enforcement actions, giving strong consideration to the extent to which states and other entities have made good faith efforts to bring their home care programs into FLSA compliance. Throughout 2015, we will continue to provide robust compliance and technical assistance”.
Despite the deadline extension, DOL officials have pointed out that while as of the effective date DOJ may not bring enforcement actions, employers may be subject to a private right of action by an employee who believes s/he has been harmed by the employers’ actions.
DOL is maintaining a website dedicated to the Final Rule containing information related to the Final Rule, a series of webinars, FAQs, and Fact Sheets to assist employers, employees, and consumers navigate requirements of the Final Rule.
As part of National Bullying Prevention Awareness Month, the U.S. Education Department’s Office for Civil Rights (OCR) issued guidance to schools reminding them that bullying is wrong and must not be tolerated—including against America’s 6.5 million students with disabilities. The guidance explains how schools must respond when students with disabilities are bullied in order to meet their civil rights obligations under Section 504 of the Rehabilitation Act and Title II of Americans with Disabilities Act. For more information, see the Department of Education website.
On Sept 19, The Department of Defense’s TRICARE program published its new Autism Care Demonstration guidance. While the program includes several improvements, it also includes a nearly 50% reduction of reimbursement rates for board certified behavior analyst (BCBA) delivered therapy and more. The program was subsequently launched on Oct. 20; however, after strong opposition from advocates, the BCBA reimbursement policy has been delayed by 180 days. Learn more at Autism Speaks.
Congress returns this week to begin its post-election session of Congress (called the lame duck session). Issues that are expected to take priority are spending bills to fund the government after the current continuing resolution expires on December 11, including additional funding to address Ebola outbreak, and measures to combat the Islamic group ISL, and confirmation of the next Attorney General. Given the impending shift in Senate control, some members of Congress are urging that the session be limited to keeping government functioning and other must-pass legislation. Other lawmakers and some outside interests are pushing to get more things done, including renewal of dozens of already-expired tax breaks. Disability advocates meanwhile are working to have Congress pass the ABLE Act and for the Senate to ratify the U.N Convention on the Rights of Persons with Disabilities (CRPD) during the lame duck session.
Now is the time for individuals who are uninsured or looking for affordable health insurance to investigate the private health insurance plans available through state marketplaces (to find your state information visit the health care website. During “open enrollment”, a person can purchase private health insurance through the marketplace in each state. There may also be financial assistance to help with health care costs available for low and moderate income. It is also important for people who currently have insurance through the marketplace, to look at the plan and determine if it will continue to meet the needs of the person, or select a better plan. Individuals who do not take action will be automatically re-enrolled in the current plan. Re-enrollment is also an important opportunity for people to report any changes in income.
2015 Open Enrollment
November 15, 2014 – Open enrollment begins
December 15, 2014 – Enroll before this date to have coverage January 1, 2015
February 15, 2015 – Open enrollment ends
For more information and where to get help, read more on The Arc’s blog.
A three part webinar series, hosted by nine national disability organizations, was launched in October. This series is intended for anyone wanting to learn more about education policy and how it impacts students with disabilities. Upcoming sessions are: 1) High Expectations, Assessments, Quality of Education on Nov 20, 2014 at 2:00 pm eastern time and 2) Graduation 101 on Dec 11, 2014 at 2:00 p.m. eastern time. Visit http://copaa.webex.com and select the “Upcoming” tab to register. Space is limited, but all webinars will be recorded and posted at www.higherexpectationsforall.org.