Action Alerts

Ongoing: None.

Major Events Last Week

Obama Administration

The Senate, by a vote of 65-31, confirmed Gov. Kathleen Sebelius (D-KS) as Secretary of the U.S. Department of Health and Human Services. All of the members of President Obama's cabinet have now been confirmed and sworn-in.

Congress

Senator Arlen Specter (PA), a Republican of 28 years, announced he would switch his party affiliation and begin caucusing with the Democrats. Majority Leader Reid (D-NV) has signaled that he doesn't intend to change existing committee membership and leadership, but Specter's move to the other side of the aisle may give Democrats an added majority in key committees: five more seats than Republicans on the Appropriations Committee, and a four-seat edge on Judiciary, Environment and Public Works, Veterans' Affairs and Special Aging. Democrats are now 1 vote away from the 60 votes needed to stop a filibuster, if they remain united, while they await the outcome of Minnesota's Senate seat. Meanwhile, Republicans will begin to contemplate who will replace Specter as Ranking Member of the Judiciary Committee.

Budget Resolution

As President Obama marked his first 100 days in office, Congress adopted a Fiscal Year 2010 Budget Resolution that sets the stage for action on his top legislative priorities. The House adopted the conference report on the resolution by 233-193. No Republican voted for the budget; 17 Democrats - nearly all of them fiscal conservatives - voted against it. The Senate vote about six hours later was 53-43. Again, no Republicans voted for the budget, while three Democrats voted against it. The Budget Resolution (S Con Res 13) is non-binding, but it sets the framework for Congress to make legislative decisions on taxes, appropriations and entitlement programs later in the year. The $3.56 trillion budget resolution includes reconciliation instructions that would allow Obama's proposed health care overhaul to move through Congress immune from a Senate filibuster. The Budget Resolution has a cap on discretionary spending that is $10 billion less than the Administration's request. This is a strong indication that funding for domestic discretionary programs like education, employment, rehabilitation and housing will likely be tight.

Medicaid

The Department of Health and Human Services announced that the Bush Administration's school based administration/transportation and outpatient regulations have been rescinded, and that the targeted case management rule has been partially rescinded:

• The school based administration/transportation rule eliminated Medicaid reimbursement for administrative costs such as those associated with enrolling school aged children in Medicaid. School administrators estimated that these cuts would have forced them to severely reduce related services (e.g. physical, occupational and speech and language therapies) and classroom aides provided to students with disabilities in special education.
• The outpatient rule narrowed the scope of services that can be provided to poor people under Medicaid's outpatient hospital benefit, such as dental and vision care.
• The targeted case management rule was required by the Deficit Reduction Act (DRA). The Bush Administration had issued a regulation that went far beyond the requirements of the DRA, including making it significantly more difficult for individuals transitioning from institutions to the community by reducing federal reimbursement for transitional case management from the last 180 days of an individual's institutional stay to the last 60 days. In many cases, due to the lack of affordable and accessible housing and challenges in securing support services, it is difficult to impossible to transition to the community in 60 days. The partial rescission removes all provisions that went beyond the requirements of the DRA.

These rescissions are a great victory for the The Arc and UCP.

The rehabilitative (or "rehab") services option rule is a proposed rule and cannot be implemented at this time. The disability community is urging HHS to formally withdraw it. The Rehab option rule would restrict the scope of eligible rehabilitation services and eliminated coverage for day habilitation services for individuals with developmental disabilities.

An official announcement will appear in the Federal Register on May 6 and can be accessed at:
http://www.federalregister.gov/OFRUpload/OFRData/2009-10494_PI.pdf

Health Reform

Senate Finance Committee Chairman Max Baucus (D-MT) and Ranking Member Charles Grassley (R-IA) released policy options for healthcare delivery reform entitled "Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs." It is anticipated that these proposals will form the basis of the delivery system component of the Finance Committee's health reform bill. The proposals include recommendations for:

• Reform - Improving Quality and Promoting Primary Care
• Payment Reform - Fostering Care Coordination and Provider Collaboration
• Health Care Infrastructure Investments - Tools to Support Delivery System Reform
• Medicare Advantage - Promoting Quality, Efficiency and Chronic Care Management
• Public Program Integrity - Combating Fraud, Waste and Abuse

See the report at:
http://finance.senate.gov/sitepages/leg/LEG%202009/042809%20Health%20Care%20Description%20of%20Policy%20Option.pdf

International Rights

At the 2009 Disability Policy Seminar, Kareem Dale, Special Assistant to the President for Disability Policy, confirmed that the UN Convention on the Rights of Persons with Disabilities was "important to the President and a priority of the President." The President can make the U.S. a signatory of the Convention, but it takes an act of Congress to ratify the Convention. There are eight guiding principles that underlie the Convention and each one of its specific articles: 1) Respect for inherent dignity, individual autonomy including the freedom to make one's own choices, and independence of persons, 2) Non-discrimination, 3) Full and effective participation and inclusion in society, 4) Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity, 5) Equality of opportunity, 6) Accessibility, 7) Equality between men and women, and 8) Respect for the evolving capacities of children with disabilities and respect for the right of children with disabilities to preserve their identities. For more information see:
http://www.un.org/disabilities/

Victimization

H.R. 1913, commonly referred to as the Hate Crimes bill, passed the House on April 29 by a vote of 234-190. The day before, the Senate introduce the Matthew Shepard Hate Crimes Prevention Act of 2009 (S. 909), sponsored by Senator Kennedy (D-MA). The Senate's companion bill currently has 35 cosponsors. This legislation, which has the support of President Obama, would expand the federal definition of hate crimes to include disability, gender, gender identity and sexual orientation. It would also provide federal grants to state and local agencies for hate crimes investigations, prosecution, and training for enforcement officers.

Disability Policy Seminar

The 2009 Disability Policy Seminar took place last week. Five hundred and fifty persons participated from 48 states, plus the District of Columbia, the U.S. Virgin Islands, and Puerto Rico, in addition to international participants from Norway and Canada. The event culminated in over 150 visits to Congressional offices to advocate for key disability programs and issues. See the program, Key issue fact sheets, and overhead presentations at:
http://www.thearc.org/NetCommunity/Page.aspx?pid=1709

Major Events Ahead

FY 2010 Budget

This Thursday, the President is expected to release the detailed budget request for FY 2010. In February the Administration had released a budget request that included overall spending levels and priorities but not detailed line items for individual programs. The budget request includes the funding levels the Administration would like to see for individual programs within the federal government.

Employment

The Senate Health Education Labor and Pensions Committee will hold a hearing on the nomination of Seth Harris to be Deputy Secretary of Labor on May 7. Harris was most recently the Obama Transition Project's Agency Working Group Leader for the labor, education, and transportation agencies. He is a Professor and the Director of Labor & Employment Law Programs at New York Law School. He was also a Senior Fellow of the United Cerebral Palsy's Life Without Limits Project.

Health Care Reform

On Tuesday the Senate Finance Committee will hold a Roundtable Discussion on "Expanding Health Care Coverage". Next week Finance Committee members will meet in a closed Executive Session to develop policy options on the issues discussed at the Roundtable. A webcast of the Roundtable can be accessed at:
http://finance.senate.gov/sitepages/hearings.htm

On Wednesday the House Ways and Means Committee will hold a hearing titled, "'Health Reform in the 21st Century: A Conversation with Health and Human Services Secretary Kathleen Sebelius." See:
http://waysandmeans.house.gov/hearings.asp?formmode=detail&hearing=676

Health Care

On Wednesday the Senate Special Aging Committee will hold a hearing on "Medicare and Medicaid Fraud." See:
http://aging.senate.gov/

On Thursday the House Education and Labor Committee will hold a hearing titled, "Ensuring Preparedness Against the Flu Virus at School and Work." See:
http://edlabor.house.gov/hearings/2009/05/ensuring-preparedness-against.shtml

Employment

On Tuesday the House Education and Labor Committee will hold a hearing titled, "New Innovations and Best Practices under the Workforce Investment Act." See:
http://edlabor.house.gov/hearings/2009/05/new-innovations-and-best-pract-2.shtml

Announcements

Swine Flu Information

The federal government and public health organizations have made available several resources on the H1N1 flu, also known as swine flu:

• The Centers for Disease Control and Prevention (CDC) page containing the latest information about H1N1 Flu, including activities currently underway to deal with the situation, daily updates on affected areas and numbers of cases, and precautions you can take to protect yourself and your family: http://www.cdc.gov/swineflu/.  You may also contact the CDC at 800-CDC-INFO (800-232-4636) English/Spanish TTY: (888) 232-6348, 24 Hours/Ever Day -- cdcinfo@cdc.gov.
• An HHS report, Home Health Care During an Influenza Pandemic: Issues and Resources, based on the findings of an expert panel meeting, including representatives of home health care, emergency and disaster planning, professional organizations and federal and state government agencies:
  http://www.pandemicflu.gov/plan/healthcare/homehealth.html
• A report published by Association for State and Territorial Health Officials (ASTHO), At Risk Populations and Pandemic Influenza: Planning Guidance for State, Territorial, Tribal, and Local Health Departments.
  http://www.astho.org/pubs/State_local_review_Final.pdf
• Considering the Needs of Employees with Disabilities During a Pandemic Flu Outbreak at
  http://www.jan.wvu.edu/media/employmentpandemicflufact.doc

Stimulus Reporting Requirements for Education

The Department of Education has provided a brief summary of Federal Agency and State's Reporting requirement for agencies distributing or receiving up to 100 billion in aid for education: Federal agencies (including the Department of Education) must:

• Host their own recovery.gov web sites
• Report "major communications" such as press events
• Report weekly on stimulus funding obligations and outlays
• Report weekly on major actions
• Craft a formal plan on how the department will manage stimulus funds overall and detailed plans to be approved by the Office of Management and Budget by May 15.

States must:

• Submit quarterly reports, starting October 10, accounting for how funds were spent, the programs' programs, and the number of jobs created or saved.
• Submit annual reports on how the state fiscal stabilization money was used, how many jobs were saved or created, and how much progress was made in key education reform areas (such as reducing teacher quality inequities).

Social Security Benefits

Economic forecasts by the Obama Administration and the Congressional Budget Office show that Social Security recipients will not get an increase in their benefits next year. Cost of living adjustments (COLA) that beneficiaries receive are calculated under a formula set by law. The low inflation rate resulting from the economic crisis is what is keeping the Social Security amounts from rising. This will be the first time since 1975 beneficiaries do not receive a COLA.

Please note that you can view previous issues of the Capitol Insider, at UCP.org anytime by choosing "Capitol Insider" under "Public Policy."

Read previous Capitol Insider issues now.

If you have any questions, feel free to contact me at acosta@thedpc.org.

Sincerely,

Annie Acosta
Director of Communications and Grassroots
Disability Policy Collaboration