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  • Supports governmental advocacy at the local, state and national level

  • Dohn Hoyle, Executive Director for The Arc Michigan, is a registered lobbyist with the State of Michigan.

  • The Arc Michigan employs Wiener and Associates as a full service, bipartisan, governmental affairs law firm located in Lansing, Michigan.

Action Alerts (State and Federal)
Comments Sought on Health Care Reform Regulations

The Departments of Health and Human Services, Labor, and Treasury released several regulations to implement a new Patients’ Bill of Rights under the Patient Protection and Affordable Care Act. The regulations will prohibit discrimination based on pre-existing conditions for children; ban lifetime limits on coverage, as well as place restrictions on annual limits; forbid unfair rescissions of coverage; restrict cost-sharing for emergency services; and put into place many other patient protections.

Comments are due by August 27, 2010 and the rules go into effect September 23, 2010. You can either comment directly to HHS or share your comments and concerns with Families USA by emailing us at stateinfo@familiesusa.org.

And, if you have not already commented on previously released regulations, you still have time! The interim final rules on dependent coverage and grandfathered plans are still open for comment until August 11 and August 16, respectively. Information on all the rules can be found here. Families USA has compiled our comments on dependent coverage, and we’ll be posting our comments on other regulations to our website as we complete them.

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US Labor Department seeks public input to strengthen disability regulations

The U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) is seeking input from the public on ways to strengthen its regulations requiring federal contractors to take affirmative action to employ and advance in employment qualified individuals with disabilities. In an Advance Notice of Proposed Rulemaking to be published in the Federal Register July 23, the agency invites the public to help revise the regulations implementing Section 503 of the Rehabilitation Act of 1973.

Topics on which comment is requested include:

  • What employment practices have been effective in recruiting, hiring, advancing and retaining qualified individuals with disabilities.
  • What data are available that could be used to establish hiring goals and conduct utilization analyses of individuals with disabilities.
  • How linkage agreements between federal contractors and organizations that focus on the employment of qualified individuals with disabilities can be strengthened to increase effectiveness.

 

Comments must be received by OFCCP within 60 days of the ANPRM's publication. To read the ANPRM or submit a comment, go to Federal eRulemaking Portal at www.regulations.gov. The deadline for receiving comments is September 21, 2010   

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Take Action! What will happen to Medicaid?

We are all anxious about Medicaid. Most states start their 2011 fiscal years this week and they are desperate for funding to keep their programs running. And Congress has just failed again to pass an extension of the increase in the federal medical assistance percentage (FMAP).

 

Without swift enactment of a six-month Medicaid FMAP extension, states may be forced to cut BILLIONS from their programs, including home and community based services, supported employment, dental care and even basic health care.

 

Advocates must make their voices heard to get the FMAP extension passed very soon.

 

Please call your Senators' district office during the Independence Day recess (July 2-12). The phone numbers and sample talking points are provided when you click on the Take Action! link and enter your zip code in the "Call Now" box.                      top

Seclusion and Restraint          

 
Representative Deb Kennedy has introduced legislation based on the report released by Michigan Protection and Advocacy Service, Inc. (MPAS) about restraint and seclusion practices in the State. The MPAS report was released and the legislation announced at a press conference on Wednesday, December 2, 2009.
 
The legislation was introduced as HB 5639 with 17 co-sponsors. It was referred to the Committee on Education. The bill seeks to amend section 1312 of "The revised school code" in PA 451 of 1976 as amended by PA 461 of 2000.
 

Read about and listen to the Michigan Radio news report on the introduction of restraint and seclusion legislation by Representative Kennedy.

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Help Pass the ABLE Act in This Congress!

Contact Your US Representative to Convene a Hearing and Vote on the ABLE Act Today

 

The ABLE Act will give individuals with disabilities and their families the ability to have a savings account which could fund a variety of essential expenses for the individual, including medical and dental care, education, community based supports, employment training, assistive technology, housing, and transportation. The funds from the account would accumulate interest tax-free.

 

Another important aspect of this bill is that the funds in the Able Account will not count as assets of the individual with a disability when determining their eligibility for important and life-sustaining federal benefit programs such as Social Security and Medicaid.

 

The legislation is supported by both parties. Currently, H.R. 1205 has 180 cosponsors, including 19 members of the important House Ways & Means Committee.

 

Although Sander Levin is Acting Chair of the Ways & Means Committee, neither he nor nine other US Representatives from Michigan are co-sponsors. Those others are Dave Camp, John Conyers, Jr., John Dingell, Carolyn Kilpatrick, Candice Millar, Gary Peters, Mike Rogers, Bart Stupak and Fred Upton. Among the co-sponsors are five US Representatives from Michigan:  Ehlers, Hoekstra, Kildee, McCotter and Schauer.

 

Please contact your US Representatives to urge their support or thank them for their support. Encourage them to convene a hearing and vote on the ABLE Act today!

 

Talking Points 

  • Please help pass Achieving a Better Life Experience Act (ABLE) of 2009 (S 493/HR 1205) by encouraging House leadership to schedule a vote on the bill this Congress.
  • This is bi-partisan legislation is being led by the following Members: Representatives Crenshaw (R-FL), Meek (D-FL), Kennedy (D-RI), McMorris Rodgers (R-WA), and McDermott (D-WA)  
  • The House bill has 180 cosponsors, including 19 members of the House Ways & Means Committee.

If your US Representative or staff member has any questions or is interested in cosponsoring the bill, contact Dustin Krasny (202-225-2501) in Representative Ander Crenshaw's office

 

The Senate version, S 493, is sponsored by Sen. Robert Casey, D-Penn. and now has 21 co-sponsors, none from Michigan. It and has been referred to the Committee on Finance since February 26, 2009. Michigan’s US Senators are Carl Levin and Debbie Stabenow.             top

UPDATE on  Bill That Limits Patients' Rights
 
The number of co-sponsors for HR 1255 introduced by US Representative Barney Frank (D-MA) has grown from 63 to 71, happily still none from Michigan. HR 1255 would limit the rights of agencies who receive federal funds, such as the state Protection and Advocacy agencies for persons with developmental disabilities to file class action lawsuits against institutions. 
 
The bill would limit the ability of lawyers to protect individuals with developmental disabilities who live in large group settings. Contrary to its intent, the bill is titled "To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident."
 
A great deal of the progress for the rights of individuals with disabilities to live independent and productive lives in the community have been made as a result of class action lawsuits against states for the denial of individual rights in institutions.
 
You may wish to contact your US Representative and thank him/her for NOT co-sponsoring HR 1255. Call the US Capitol switchboard 202-224-3121 and ask for your Representative's office.
 
Talking points are:
  • This legislation is not needed and would harm individuals with disabilities.
  • It would harm the efforts of parents and advocates to work for community services and supports needed to live in the community.
  • It would limit the efforts of lawyers to represent their constituency.

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Doing Advocacy
Open For Questions Wrap Up

The trial run of Open for Questions has wrapped up with the President answering several of the most popular questions during a special online town hall. Click here to view the online town hall or read questions that have been submitted.

www.whitehouse.gov/OpenForQuestions/

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State Issues/Updates
Governmental Affairs Update (pdf) rtf or doc  12/21/09

Governor's Budget Recommendations Solve Deficit, Protect Critical Priorities

Job-Creation efforts, schools, health care protected from cuts

 

August 18, 2010 - Governor Granholm released her recommendations for addressing shortfalls in the current (FY 2010) and upcoming (FY 2011) fiscal years.

 

Among the Governor's Recommendations:

For FY 2010, education funding shifts and utilization of additional federal funds totaling $302 million to address the shortfall remaining in the fiscal year

For FY 2011, a combination of spending cuts and one-time, non-tax revenues. Spending cuts include undetailed reductions of $50 million each in the Departments of Community Health, Corrections, and Human Services; a 3% administrative reduction in all state agencies; and a restructuring of long-term debt obligations. New revenues are a tax amnesty program; reform of the state’s abandoned property laws; and changes to the liquor regulation and distribution system. The Governor also proposes that $50 million in one-time grants through the School Aid Fund be awarded to encourage school services consolidation or sharing. Finally, the Governor also proposes a $100 million deposit into the Budget Stabilization Fund.

Click here to read more. Additional information is available at: www.michigan.gov/budget

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The Arc Michigan Supports House Bill 6195

 

Numerous senior and disability rights groups, including The Arc Michigan, are urging the Michigan Legislature to pass House Bill 6195. The bi-partisan bill would strengthen options for more than 60,000 Michigan seniors and persons with disabilities who receive care in their own homes as an alternative to institutionalized care.

 

The Arc Michigan supports this important legislation for three main reasons:

 

  • It will strengthen homecare and allow seniors and persons with disabilities to remain healthy and independent in their own homes instead of forcing them into expensive nursing homes.
  • It will strengthen background checks, rigorous screening and training to ensure that seniors and persons with disabilities receive safe, high-quality care.
  • It will save taxpayers millions of dollars each year by avoiding expensive nursing home costs. 

The Arc Michigan played a crucial role in creating the Michigan Quality Community Care Council, a pilot program that oversees a cutting-edge registry that matches Medicaid recipients who require assistance with qualified homecare providers in their area. These providers undergo background checks and rigorous screening. They also have access to critical training on issues such as first aid, CPR, how to lift properly, nutrition, and working with those who have Alzheimer’s and dementia.

 

House Bill 6195 would transform this successful pilot program into a permanent program. The Arc Michigan supports this critical legislation because it will provide choice for seniors and persons with disabilities, strengthen background checks and training for homecare providers, and save taxpayers money.

 

To read the bill, visit www.tiny.cc/MQC3.

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State House passes bi-partisan bill to strengthen nursing home alternatives

 

LANSING — Senior and disability rights groups today hailed the House passage of legislation that would strengthen care for seniors and persons with disabilities who receive daily living assistance in their own homes. The bill now moves on to the state Senate.

 

In a bi-partisan vote, the House passed House Bill 6195, co-sponsored by state Rep. Bert Johnson (D-Highland Park) and state Rep. Tory Rocca (R-Sterling Heights), which aims to strengthen the Michigan Quality Community Care Council (MQC3) by transforming it from a pilot program into a permanent entity.

 

The cornerstone of the legislation is strengthening the MQC3’s cutting-edge registry program, which conducts background checks on home care providers and allows patients to choose a provider who fits their specific criteria and needs.

 

“Michigan seniors and persons with disabilities deserve peace of mind knowing that home care providers in their area have been screened and trained,” said Mary Ablan, executive director of the Area Agencies on Aging Association of Michigan. “Transparency, accountability and high standards are all concepts that legislators from both parties can support. I applaud the House for passing House Bill 6195 in a bi-partisan fashion, and I urge the Senate to follow suit to ensure these critical consumer protections can continue.”

 

In addition to strengthening the quality of care, House Bill 6195 will also save taxpayers money. It costs less than $5,000 in Medicaid funds per year to provide in-home care to seniors and persons with disabilities, compared with nearly $52,000 per year for those in nursing homes, according to a study by the Anderson Economic Group. That means it costs 10 times as much to place a loved one in a nursing home as opposed to allowing them to stay in the comfort of their own home.

 

“Legislators from both parties understand that strengthening and making permanent the MQC3 will save taxpayer dollars at a time when we need to conserve every dollar we can,” said Dohn Hoyle, executive director of The Arc Michigan, a statewide disability rights organization. “Lots of people talk about government reform and saving taxpayer money — the MQC3 actually does it. On behalf of persons with disabilities throughout Michigan, I commend our state representatives for passing House Bill 6195.”

 

Groups supporting House Bill 6195 include: the Area Agencies on Aging Association of Michigan; AARP Michigan; the Michigan Disability Rights Coalition; The Arc Michigan; the MS Society of Michigan; United Cerebral Palsy of Michigan; Disability Network of Michigan; ADAPT Michigan; PHI of Michigan; lawmakers from both parties; and many more.

 

The current Senate version, substitute SB 731, strips out funding for the Michigan Quality Community Care Council, restricts the advisory council to the Home Help program and prohibits unionization of home help workers.

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Wiener Associates Year End Legislative Summary

Federal Issues/Updates

Home and Community Based Services to be Accessible to More Individuals

 

The Center for Medicaid, CHIP and Survey & Certification has released a letter to State Medicaid Directors in our series of guidance on implementation of the Affordable Care Act of 2010. This letter provides information about several changes to  Section 1915(i) of the Social Security Act as a result of the passage of the Affordable Care Act. These changes, which become effective October 1, 2010, include revised and new options for offering home and community-based services (HCBS) through the Medicaid State plan. Among other things, section 1915(i) removes the requirement that individuals meet an institutional level of care in order to qualify for HCBS through Medicaid. Section 1915(i) provides States an opportunity to offer services and supports before individuals need institutional care, and also provides a mechanism to provide State plan HCBS to individuals with mental health and substance use disorders. In order to promote State utilization of 1915(i), the Affordable Care Act includes changes that enable States to target HCBS to particular groups of people, to make HCBS accessible to more individuals, and to ensure that individuals receive high quality care.       

Improving Access to Home and Community-Based Services

From Steve Gold's Information Bulletin # 319 (8/2010).

 

Nearly five years ago, Congress amended Medicaid by adding Section 1915 (i), intending to increase community-based services instead of institutional Medicaid services by permitting greater flexibility than Waivers permit. Unfortunately, only a few states took advantage of this.

 

In enacting the Affordable Care Act in 2010, Congress made a number of additional changes which are extremely important to the disability community. However, unless your State opts to take advantage of these changes, they will not happen. These amendments take away many excuses the States have used in the past. 

 

On August 6, 2010, CMS wrote a "Dear State Medicaid Director" encouraging States to take advantage of the ACA 2010 amendments. Here are the changes:

 

1. The ACA strengthened Section 1915 ( i ) to remove the requirement that individuals had to meet an institutional level of care in order to qualify for home and community-based services. Unlike eligibility for Medicaid Waivers which require a person meet an institutional level of care, the 2010 amendments permit your state to provide community-based  services for people who are not otherwise eligible for institutional care. Heh - makes sense to provide services before a person loses more ADLs.

 

2. Another big change is that the Affordable Care Act amended this Section to permit States to provide community-based services to persons with chronic mental illnesses and/or substance use disorders. Services for this population are defined extremely broadly. This is  long overdue and will help a portion of the disability community that has been shortchanged too long.

 

3. States now have the option to provide thee community-based services to persons whose incomes are 300% of the SSI income benefit.

 

4. Benefits can be targeted either to specific population groups without violating Medicaid's comparability requirements. Alternatively, States could target by functional needs. This permits States to have multiple programs, each targeted at specific populations, e.g., one for persons with physical needs and another benefit package targeted at persons  with chronic mental illnesses. It permits your State to define populations' needs with great precision and specifics.

 

5. Services can be narrowly defined, e.g., personal care or home health aide, instead of the Waiver package of services. There goes a big excuse States have used with Waivers, i.e., they had to provide a broad range of services to everyone on the Waiver.

 

6. States have the option to offer consumers "self-direction." In the 8/6/10 Dear State Medicaid Director letter, it states that "CMS urges all States to afford participants the opportunity to direct some or all of their HCBS. Self-direction permits participants to plan and purchase their HCBS under their direction and control or through an authorized representative." Well, how about that?

 

These changes become effective October 1, 2010.

 

You and your State Medicaid officials have to begin this process now! 

Let's not let this slip away. There could be great financial savings if these provisions are used creatively.

 

Steve Gold, The Disability Odyssey continues

http://www.stevegoldada.com

Restraint And Seclusion Bill Hits Bumpy Road On Path To Senate

From Disability Scoop

 

A bill that would limit restraint and seclusion in the nation’s schools is on shaky ground amid concerns in the Senate over a provision barring the practices from being included in a student’s individualized education plan, or IEP.

The qualms are largely due to pushback from the American Association of School Administrators, which opposes the bill. The group, which represents 13,000 superintendents and other school leaders, says the IEP is the best place for parents and school officials to discuss restraint and seclusion preemptively in cases where students have known behavior issues.

“We see it as a discussion to be had in advance with the expectation that you never have to use it,” says Noelle Ellerson, assistant director of policy analysis and advocacy for the organization. “We would hopefully only be using it in emergency situations, but instead of being reactive you would be proactive.”

However, disability advocates, who have been pressing for the legislation, argue that including restraint and seclusion in an IEP encourages its use.

“To put it in an IEP elevates it to acceptable practice, which it’s not,” says Barb Trader, executive director of TASH who’s taken the lead in advocating for the bill. “If you plan to rely on these interventions then staff rely on them more and use goes up.”

Under the proposed bill, restraint and seclusion could not be included in a child’s IEP. In addition, the tactics would only be allowed in situations where there is imminent danger and when administered by a trained staff member. Mechanical restraints and any method that restricts a student’s breathing would also be barred. (Read all of Disability Scoop’s coverage of restraint and seclusion >>)

The current impasse comes with the clock ticking. The legislation was approved by the House of Representatives in March, but if it does not receive Senate approval before the end of this year the process will have to start over again.

Meanwhile, Sen. Chris Dodd, D-Conn., who is sponsoring the legislation, is not seeking reelection and will leave the Senate when his term expires at the end of the session.

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The Urgent Need for Better Care

 

Health reform is law, but the hard work of fixing our health care system is just beginning. For those with multiple health problems, our current health care system can be a huge challenge.

 

Consider this: 78% of Americans age 55 and older are dealing with at least one chronic health condition like diabetes, heart disease or arthritis. And older adults with five or more chronic health conditions have an average of 37 doctor visits, see 14 different doctors, and get 50 separate prescriptions each year.

 

If we can make our health care system work for them, we can make it work for everyone. Doctors should work together as a team, medical records should be at our fingertips, and patients and families should not be left to fend for themselves.

 

We get it. There is a better way. It's what the Campaign for Better Care is all about.

Learn more » (pdf) or (rtf)

 

The Arc of the United States is a member of the Campaign's National Consumer Coalition.

Justice Department Cracking Down On ADA Violators

From Disability Scoop

 

Federal officials are adding two more states to their list of targets in a string of legal actions to ensure community living options for people with disabilities.

Briefs filed this week in Illinois and California bring the number of actions to 18 over the last year alleging that states are failing to provide community living options as required under the Americans with Disabilities Act.

Specifically, in a brief filed supporting a lawsuit against Sacramento County, Calif., the Justice Department says that planned cuts to outpatient mental health services will put people at risk of institutionalization.

Meanwhile in Illinois, the Obama administration is supporting efforts to gain class action status for a group of young adults with severe disabilities who lived in the community until age 21, but are facing forced institutionalization because of more limited adult options in the community.

Under the Obama administration, the Justice Department’s Civil Rights Division has made enforcement of the Supreme Court’s decision in Olmstead v. L.C. — which favored the option of living in the community whenever possible — a top priority. The government has filed suit against Georgia, Arkansas and New York on such matters. In addition to the briefs filed this week, the administration has also supported cases in Connecticut, North Carolina, Florida, New Jersey, Pennsylvania and Virginia.

“Unnecessary institutionalization deprives individuals of the opportunity to live their lives as they choose,” said Thomas E. Perez, assistant attorney general for the Civil Rights Division. “The department is committed to ensuring that community-based services are provided to enable individuals with disabilities to live fully integrated lives in their communities.”

 

The moves come ahead of the 20th anniversary of the ADA on Monday.

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ACLU Sues Over Medicaid Waiver, Food Stamp Dispute

From Disability Scoop

 

An Indiana man with autism says the state illegally cuts his Medicaid benefits anytime his food stamp allocation increases. And he’s probably not alone.

In a lawsuit brought by the American Civil Liberties Union earlier this month, Michael Dick’s family alleges that the practice is widespread and seeks class action status for those affected.

Dick, 26, has autism and is nonverbal, functioning at the level of a first or second grader, his family says. He relies on support from Medicaid and food stamps to survive. But last year, when he received a $1.25 per day cost-of-living increase in food stamps, Dick’s family says the state Medicaid program docked his payments by the same amount, leaving Dick no better off financial despite rising costs.

According to the lawsuit, federal law prevents food stamps from being considered as income. The ACLU is asking a judge to prohibit Indiana officials from including food stamp funds when computing a person’s benefit for the Indiana Developmental Disabilities Waiver Program.

State officials insist they’re just acting as good stewards of taxpayer dollars, reports 6News, the Indianapolis ABC affiliate. To read more click here. top

Rule to Expand Medicare Preventive Services, Access to Primary Care

 

CMS Issues Proposed Rule to Expand Medicare Preventive Services and Expand Access to Primary Care

The new rule proposes to make two significant improvements to preventive care benefits under Medicare: Beginning January 1, 2011, Medicare will cover annual wellness visits so that doctors and patients can develop a personalized prevention plan that takes a comprehensive approach to improving the patient's health. Also beginning January 1, 2011, Medicare beneficiaries will no longer have to pay any out-of-pocket costs for most preventive services - including the annual wellness visit.  
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Connecting on Issues with the White House 

You can go to this White House website to check on progress or lack of progress on issues important to you: www.whitehouse.gov/issues 

For example, it has issue areas such as Civil Rights, Disabilities, Health Care, Seniors and Social Security, and more. Each issue area lists Progress as well as Guiding Principles. By clicking on 'Contact Us' in the upper right corner, you can send a message to the White House. (posted 5/14/10)                                 top

The Arc of the United States Public Policy Fact Sheets Available on Web site

Fourteen fact sheets on public policy issues from the ABLE Act to the federal budget, employment, housing and Social Security concerns that were utilized during the April 12-14, 2010 Disability Policy Seminar in Washington, DC are available on the Web site of The Arc of the United States. www.thearc.org/NetCommunity/Page.aspx?pid=1904

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End 2-year Wait for Medicare Update
 
S. 700, a US Senate bill aimed at putting an end to the two-year waiting period that people with disabilities must endure before getting help from Medicare currently has 19 co-sponsors, including US Senator Debbie Stabenow of Michigan. The bill, “Ending the Medicare Disability Waiting Period Act of 2009,” was introduced in the Senate by Senator Jeff Bingaman (D-NM).
 

This primarily benefits people under the age of 65, when most become eligible for Medicare, who suffer from a severe and costly disability. S. 700 was referred to the Finance Committee on March 25, 2009.

 

The US House version, H.R. 1708, was introduced by US Representative Gene Green (D-TX-29) and now has 103 co-sponsors including Kildee, Kilpatrick, Levin, and McCotter from Michigan.                              top

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2008 Arc Michigan Annual Report  (pdf) 

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