GCDD's Deputy Director Visits the White House
This is a two-part blog written by Pat Nobbie, GCDD Deputy Director, on a community leaders briefing at the White House on Friday, February 10, 2012. In this blog, Nobbie shares an overview of her White House visit and the various issues that were addressed, as well features pictures below.
Part 1:
One hundred fifty members of Arcs in the United States were invited to meet with senior policy officials in the Obama Administration. It was a very exciting and productive day, and I felt so fortunate to be included. Thank you to the Arc of Georgia for making this opportunity available to myself, Sandy Edge from Albany Arc and Jessica Howell, Arc of Georgia Board Member.
The day began in the Dwight Eisenhower Executive Office Building at 8 AM. The Office of Public Engagement, the “open front door to the White House” was our host, and Kareem Dale, Special Assistant to the President for Disability Policy, was the moderator for the morning.
The first speaker we heard from was Carol Galante, Acting Assistant Secretary- Federal Housing Administration Commissioner, HUD.
Galante affirmed that housing is the platform for a quality of life—that a home of one’s own is the cornerstone of independence and that HUD was committed to removing the barriers preventing people from acquiring the security of their ‘own home.’ She reviewed changes to the Section 811 Housing and described some of the innovative housing arrangements being developed in different parts of the country, including the Mercy Arc housing development in San Francisco. This innovative work involved 14 accessible apartments being integrated into a larger apartment complex within easy access of the services of the Arc of San Francisco. Additionally, she spoke about the HUD / HHS Community Living Initiative and the challenges both departments are working on such as trying to integrate funding streams and regulatory requirements that are delivered through different federal agencies and different appropriations committees.
She also referenced a new initiative, PRAD, (told us to remember that name) which stands for “Project Renovation Assistance Development” program. With this initiative, HUD will provide funding directly to housing authorities when they agree to partner with Human Service and Medicaid agencies. This will be a formula grant in which states must apply to participate in, and they will be looking for states whose housing entities have been working collaboratively with Human Service and Medicaid agencies already and can build on those initiatives. She closed by saying that HUD does appreciate the challenge of moving from the older model section 8 and 202 housing, which were more congregate in nature to individually leased homes. This is the margin where changes can be made because 75% of HUD is section 811 and 202 housing and 25% of that is for new construction.
The Next speaker was Cecilia Munoz, Director of the Domestic Policy Council.
Munoz began by saying the administration’s goal is for people with disabilities to have a fair share and a fair shot at opportunities available to all. Regarding education, that means students with disabilities leave high school ready to work or continue on to higher education; In employment, that means they have opportunities to be supported to work in competitive environments with competitive wages, and they have the opportunity to attain self-advocacy skills. She also referenced several grants that the Administration on Developmental Disabilities had led for employment, as well as the 4 Self-Advocacy Summits that will be held to enhance self-advocacy efforts.
Later, Kareem Dale came back and reviewed the tools available for citizens to communicate with the White House. The White House distribution list is . Through this email address, you can send suggestions, comment on policy and sign up for Dale’s monthly phone calls. He also reviewed the Federal government’s commitment to employing people with disabilities, talked about the section 503 Rehab Act rule to mandate 7% inclusion of people with disabilities in federal contracts and mentioned Project SEARCH participation in the Departments of Labor, HHS and Education.
He also talked about the Administration’s efforts at Olmstead Enforcement, referencing Georgia’s settlement agreement, the recent agreement issued in Virginia and the Delaware settlement. The White House is tentatively considering engaging with people with disabilities in seven cities in the US. There is no schedule or structure yet. They are just in the beginning planning stages, and the main purpose would be to listen and provide an opportunity for people with disabilities to ask questions and share their experiences.
Cindy Mann, Deputy Administrator, Centers for Medicaid and Medicare.
Mann confirmed the Administration’s strong commitment to maintaining Medicaid, strengthening the program and fixing the structural problems. She talked about some of the opportunities under the Affordable Care Act: Health Home Program, which provides a 90/10 match rate for up to eight quarters for programs which design fully integrated behavioral, physical, acute and developmental services and care for people with chronic conditions. There is no clock on this initiative. They want states to take their time planning how they could deliver services under this model. Another program opportunity under the act is the Community First Choice program, which would provide attendant care in a community setting, including self-direction. The regulations are being finalized for this program, which offers an additional 6% federal match. Also there is a Balancing Incentive Payment Program, which offers an additional 2% federal match to states who are still below the 50% mark for funding in home and community-based supports vs institutional care. States have to apply, and there are several requirements. There is only $3 billion for the entire country for five years. Georgia is going to apply for this program.
Another critical piece of the discussion in CMS is the definition of “home and community-based setting.” During the comment period in the summer, CMS received 1,500 comments with a great deal of variability. Common perspectives were that people need more choice and states need more resources. The focus should be less on the “bricks and mortar” aspect of HCBS and more focused on the person’s experience; but opportunities should be integrated in community to the greatest extent possible, and OCR, DOJ, HHS and HUD are all seeking to collaborate on this issue.
In terms of managed care, CMS will be seeking guidance from states, families and people with disabilities on their concerns about managed care systems and how they adhere to the ADA and Olmstead. In the states’ waiver applications and quality reviews, they are looking for specific ideas to put in waiver application documents that would specify what we want to affirm for people in managed care settings and how CMS can check and monitor that those things are being done.
In the end, Mann said we have to make sure the system works for “this person.”
*To be continued on Thursday, February 23, 2012.
These are several pictures featuring the community leader briefing at the White House:
