What's Happening in Washington?: Federal Disability Policy Updates
by Alison Barkoff, Director of Advocacy, Center for Public Representation
It’s been another busy few months on disability policy in DC. One highlight was going to Capitol Hill with members of the Georgia Council on Developmental Disabilities in April. We advocated on disability employment, community integration and Medicaid. It was a great reminder that sharing our personal stories with members of Congress can make a difference!
Below are some of the most significant federal policy developments over the last quarter:
Disability employment continues to be a hot topic, both in Congress and federal agencies. In April, the House Committee on Education and Labor held a hearing on barriers to employment, including for people with disabilities. The hearing included a focus on the Transformation to Competitive Employment Act, a bipartisan bill that would provide funding to states and providers to expand opportunities for competitive integrated employment (CIE) while phasing out over six years the use of subminimum wages to people with disabilities under Section 14(c) of the Fair Labor Standards Act. We expect that the Committee will continue to move the bill forward by doing a “mark-up” later this year. Read the testimony from the hearing and watch it here.
We continue to monitor the possibility of the Department of Education (DoE) opening for public comment the Workforce Innovation and Opportunity Act (WIOA) regulations that define CIE. Last fall, the Department gave notice it plans to revisit these regulations, and estimates a public comment process in late 2019. Disability groups continue to advocate that the DoE not open the regulations. If opened for comment, it will be critical for stakeholders to share their employment stories and why CIE is important to them.
Disability groups continue to advocate for funding for the Money Follows the Person (MFP) program, which has helped more than 90,000 people with disabilities and older adults move out of institutions and into the community. In April, Congress passed a second short-term funding bill to fund MFP through September. On June 19, the House passed H.R. 3253 – Empowering Beneficiaries, Ensuring Access and Strengthening Accountability Act – to fund MFP through 2023 as part of a broader funding package in the House. We hope that the Senate will also act. Disability advocates will continue to push Congress to pass the bipartisan EMPOWER Care Act. Continue to educate your members of Congress (especially Senators) about the importance of MFP to Georgians with disabilities and the need for long-term funding.
Disability advocates also continue to push for the passage of the Disability Integration Act (DIA), a bipartisan bill to ensure the full community integration of people with disabilities. The focus has been on gaining support in the House, with a majority of representatives signed on as co-sponsors. Advocates are pushing for a hearing on the bill in the House, an important step before the bill can be brought to a vote. If the DIA passes in the House, it will need to pass the Senate and be signed by the President before becoming law.
HCBS Settings Rule
States are continuing to implement the Home and Community Based Services (HCBS) Settings Rule, a federal rule to ensure that everyone receiving Medicaid-funded HCBS has the full benefits of community living. In March, the Centers for Medicare and Medicaid Services (CMS) issued long-awaited guidance about the “heightened scrutiny” process for evaluating settings presumed to have institutional characteristics, including those that isolate individuals from the broader community.
Georgia, like many other states, is in the process of developing its final statewide transition plan (STP) to fully implement the rule by March 2022. We expect Georgia’s STP to be out for public comment in a few months, and it will be critical for stakeholders to provide input during public comment.
Healthcare also continues to be a hot topic. Much of the activity of this Congress has centered around expanding access to healthcare, unlike the prior Congress where we fought against bills to repeal the Affordable Care Act (ACA) and cut Medicaid. In the last several months, three “universal healthcare” bills have been introduced: Medicare for All in the House, Medicare for All in the Senate, and Medicare for America in the House.
Disability groups spent months advocating that any universal healthcare bill must include the services important to people with disabilities, including HCBS.
As a testament to the disability community’s strong advocacy, each of these bills includes mandatory HCBS (which would mean no more waitlists) and a community-first presumption, unlike the current structure in Medicaid.
While we do not expect any of these bills to pass this Congress, their inclusion of services for people with disabilities sets an important precedent as the conversation about healthcare moves forward in Congress and the upcoming presidential race.
In contrast, the attacks on healthcare continue through litigation and regulation by the Administration. Texas v. U.S., the lawsuit challenging the constitutionality of the ACA, continues in the US Court of Appeals. In April, a number of disability organizations, including the Center for Public Representation, filed a brief describing the importance of the ACA to people with disabilities. In May, the Department of Justice filed a brief on behalf of the Administration that for the first time argued that the entire ACA should be struck down, including the protections for people with pre-existing conditions, rather than just the “individual mandate” to have insurance. Oral argument is scheduled for July. We expect a decision late this summer, and then it will likely head to the Supreme Court in the fall. The ACA remains in effect during the lawsuit.
We continue to see regulations from the Administration that would weaken the ACA. Currently, the Administration is seeking comment on the non-discrimination protections of the ACA, known as Section 1557. The proposed rule would roll back healthcare protections for a number of groups, including LGBTQ individuals and people with limited English proficiency. Additional changes could also impact people with disabilities.
INTEGRATED EMPLOYMENT NOW!
Over 25 national organizations, including the National Association of Councils on Developmental Disabilities and the Center for Public Representation, recently formed the Coalition to Advance Competitive Integrated Employment. The Coalition’s focus is to make sure that every person with a disability has the chance to work together alongside people without disabilities at fair wages. At the end of May, we launched our new website featuring articles, videos and information all related to CIE. Check it out and spread the word!
Resources for What’s Happening in Washington?
- Money Follows the Person and advocacy around the EMPOWER Care Act
- Status of the proposed Disability Integration Act (DIA)
- Status of implementation in Georgia of the Home and Community Based Services (HCBS) Settings Rule
- Texas v. U.S. and other attacks on the Affordable Care Act (ACA)
- Proposed Rollback of Nondiscrimination Protections under the ACA’s Section 1557
Alison Barkoff is the Director of Advocacy at the Washington, DC office of the Center for Public Representation. She works on policy and litigation related to community integration and inclusion of people with disabilities, including Olmstead enforcement, Medicaid policy, employment, housing and education.
To read more in Making a Difference magazine, see below: