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Federal Legislative Update CAAI Meeting 2009


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Presented by Kim Musheno

Published in: Health & Medicine
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Federal Legislative Update CAAI Meeting 2009

  1. 1. Federal Legislative Update CAAI Meeting
  2. 2. Combating Autism Act Authorizes $210 million in FY2010: 143.5 for NIH research into causes, diagnosis, early detection, intervention, and treatment $19.5 million for the CDC’s Disabilities Surveillance and Research Program $47 million to HRSA to increase awareness, reduce barriers to screening and diagnosis, promote evidence- based interventions for individuals with autism, and train professionals to utilize valid and reliable screening tools to diagnose autism and provide evidence-based interventions For LENDS - $28.2 or +$2 million expected 2
  3. 3. FY 2010 Appropriations House passed 12 bills; Senate passed 3 Continuing resolution at FY 09 levels Labor, HHS, Education Appropriations bill passed by House but not full Senate Likely to be included in omnibus – split difference between H&S bills Hope to have bill by end December! 3
  4. 4. Combating Autism Act (PL 109-416) Signed De. 16, 2006 The law authorized expansion of interdisciplinary training to increase number of sites able to diagnose or rule out ASD or other DD; and To expand existing or develop new maternal and child health interdisciplinary leadership in neurodevelopmental and related disability programs in States that do not have such a program 4
  5. 5. Now 39 LENDs in 33 states FY 2008 four new LENDs in Arkansas, Colorado, Connecticut, and Illinois and awarding 18 supplemental grants to existing LENDs FY 2009 increase of $2 million provided partial expansion to 17 LENDs that had not received the previous year’s expansion dollars and to establish one more LEND in the state of Minnesota. FY2010 appropriations will provide $2 million to establish up to two new LENDs and to complete the award of supplemental grants for existing programs. 5
  6. 6. CAA Reauthorization CAA expires in 2011 and must be reauthorized Each section contains sunset provision Discussions likely to begin next year…. After health care reform Start educating your members on the Senate HELP and House Energy and Commerce Committees 6
  7. 7. Health Care Reform 7
  8. 8. What’s Happening? House passed HR 3962 Nov. 7 on vote of 220 – 215 with one GOP Senate in second week of debate Major outstanding issues are public option, abortion, and cost of the bill Hope to have Senate bill by Christmas Must then conference the bill and pass final bill by both chambers 8
  9. 9. Health reform critical provisions Exchange or market place for people without insurance to shop for plans Expansion of Medicaid to households earning less than 133-150% FPL Cannot deny coverage based on pre- existing conditions Elimination of annual and lifetime caps Employer mandates Individual mandate and subsidies 9
  10. 10. Critical provisions Rep. Doyle (PA) and Sen. Menendez (NJ) Minimum services includes “mental health and substance use disorder services, including behavioral health treatment.” 10
  11. 11. Autism training grants Authorizes grants to UCEDDs or other interdisciplinary education, research, and service entities To provide training, continuing education, TA, and information to improve services and address unmet needs of ASD and related DD Authorizes establishment of up to 4 new UCEDDs to improve services to individuals with ASD with priority to minority serving institutions
  12. 12. Long term services in health reform Community Living Assistance Services and Supports (CLASS) Act Community First Choice Option (Sec. 101 of the Community Choice Act) 12
  13. 13. CLASS Act National LTSS Insurance program For working individuals (18 and up) Auto-enrollment through employer with opt-out Self-funded and reduces deficit and Medicaid spending 13
  14. 14. CLASS Act Participants vested after 5 years Estimated monthly premium $125/mo. Eligibility for cash payments (average $75/day) based on needing assistance to perform at least 2 activities of daily living ADL = eating, toileting, transferring, bathing, dressing, continence To purchase non-medical services and supports to maintain independence 14
  15. 15. Community First Choice (CFC) Core elements of the Community Choice Act (Section 101 of S. 683/HR 1670) Medicaid State Plan option (not mandate) To provide community-based attendant services and supports Individuals eligible for nursing homes and other institutional settings 6% enhanced FMAP for states that select the CFC option 15
  16. 16. Autism Treatment Acceleration Act S. 819 introduced by Sen. Durbin, Casey (D-PA), and Menendez (D-NJ) on April 2 H.R. 2413 introduced by Mike Doyle (D-PA) and Chris Smith (R-NJ) on May 14 Comprehensive services bill that focuses on services across lifespan, not just children Combines elements of Sens. Clinton and Obama/Durbin bills from last Congress
  17. 17. Acceleration Act Main elements Demonstration project to develop comprehensive, coordinated autism services Demonstration grants to develop adult services Voluntary population-based registry Provision to strengthen existing national, regional, and local networks National training initiatives to provide interdisciplinary training, continuing education initiatives, and technical assistance Requires that health insurers cover the diagnosis and treatment of ASD, including ABA, assistive communication and assistive technology devices 17
  18. 18. Seclusion and Restraints Jan. 2009 NDRN Report outlines the problem GAO Report requested by Chairman Miller Less than half of states have laws or regulations concerning restraint or seclusion use in schools; almost (90%) still allow prone restraints, and only 45% require or recommend that schools notify parents Most cases identified involved kids with disabilities and majority diagnosed with autism Federal law (Children’s Health Act) only pertains to public facilities, not schools 18
  19. 19. AUCD Recommendations Federal legislation to ban use of seclusion and prone restraints and other types of restraints except in case of immediate physical safety of students or staff Mandate development comprehensive continuum of positive behavior supports and interventions in every school Authorize funding for UCEDDs to provide training and TA 19
  20. 20. Next Steps Chairman Miller (D-CA) and Rep. McMorris Rodgers (R-WA) of House Education and Labor Committee will introduce bill this Wednesday Sen. Dodd (D-CT) working with House to draft bipartisan, bicameral legislation Need Republican co-sponsor in Senate 20
  21. 21. Other Legislation Coming Up After health care reform…. WIA Reauthorization DD Act Reauthorization NCLB Reauthorization 21
  22. 22. Resources AUCD: Public policy/Autism Legislative News In Brief Action Center: Consortium for Citizens with Disabilities (CCD) Autism Task Force: 22