April 14, 2023

VOR's Weekly News Update

VOR is a national non-profit organization that advocates for

high quality care and human rights for all people with

intellectual and developmental disabilities.

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VOR promises to empower you to make and protect quality of life choices for individuals with developmental disabilities

VOR & YOU:

VOR Mourns the Loss of Polly Spare


We are sad to announce the passing of one of VOR's brightest beacons, Polly Spare, who passed away on April 1, 2023.


Polly Spare served as President of VOR from 1992 to 1999. She followed our founder, Marty Pratt as president, and brought new depth to the organization expanding the range of our advocacy in the media, the courts, and on Capitol Hill.


Polly was a mother to four children, Sandra, Christopher, Jonathon, and Kathryn. The eldest two, Sandra, born in 1952 and Christopher in 1955, were both born with severe intellectual disabilities.


In the 70's and 80's, Polly became involved in the Pennhurst case. She originally organized families to improve the facility, bringing it up to a much higher standard of care. But the lawsuit she and others had initiated to improve Pennhurst became a class action suit, aimed at closing it. Polly dropped out of the suit and fought against the closure, unsuccessfully. Pennhurst was closed in 1987, despite the improvements that the families had made, despite it having been transformed into the best run facility in the state.


Polly's tenure with VOR came as The ARC now the Arc) was changing from an organization that advocated for choice between institutional care and the developing system of smaller private group homes, into a large national organization that sought the closure of larger congregate care facilities.

Polly fought for choice. She understood the diversity of the I/DD (then MR) population and she understood the need for a diverse range of options to cover the varying needs and aspirations of people with intellectual disabilities.


Polly remained a force even into her mid 90's, I remember her hiring a car service so that she could testify against Governor Wolf's decision to close the Hamburg State Center in 2017.


Polly, we miss you. We are honored to carry your torch.

VOR's Calendar of Upcoming Events:

VOR's Annual Legislative Initiative


Briefing Session - Sunday, May 7, 2023


3 - 5 pm Eastern / 2 - 4 pm Central / 1 - 3 pm Mountain / Noon - 2 pm Pacific


On ZOOM


Registration is open!


Our focus this year will be on improving safety standards for people with I/DD and autism,

preventing abuse and neglect,

and

supporting our Direct Support Professionals


The meeting for our 2023 Legislative Initiative will take place on Sunday afternoon, on Zoom.

We ask that you register prior to the initiative, and that your membership is up to date.


We will supply the legislative materials in advance of the Sunday meeting, and we will supply you with contact information so that you may set up with your elected officials for the week(s) that follow.

Please Click Here to Register

You must be a current member or VOR to participate in this event.

We encourage members to pre-arrange meetings with your

Congressional Staffers

during the weeks of

May 8 - 12 & May 15 - 19


(We sill provide you with contact information for the offices of your Members of Congress after you register for the Initiative)

\VOR's 40th Anniversary Annual Meeting


June 11, 2023 - 11:30 am - 5:30 pm (Eastern)


Our Annual Members Meeting (again, on Zoom) will take place on the afternoon or Sunday, June 11th. The schedule is yet to be determined, but the program will include a "State of the Union" speeches from our President, Joanne St. Amand, our Treasurer, Larry Innis, and our Executive Director, Hugo Dwyer, as well as reports from our various committee chairs on their work through the past year.


This Year's Speakers:


Congressman Glenn Grothman - (R-WI)


Representative Charlie Meier (Illinois General Assembly)


Amy S. F. Lutz, PhD.


And, as we do every year, we will have a special networking meeting for our members to submit reports on what is going in their states, so that we can share our problems, solutions, strengths, and hope.


This event is open to all. Registration will open in May.

ONE MORE ANNOUNCEMENT!


There will be a meeting of the


President's Committee for 

People with Intellectual Disabilities

(PCPID)

on

May 1, 2023

Noon - 5:00 pm ET

on Zoom


We encourage our members to attend, and to identify their names as being members of VOR, both in the Zoom window and in the chat.


We need to make our presence known.


The PCPID, though ostensibly an independent entity, has been overseen & facilitated by the Administration for Community Living.

If we do not show up, our loved ones will not have a seat at the table. 


For more information, 

Click Here


To register for the meeting,

Click Here


And Now, The News:

Ohio - Joint Commission Recommends Redesignating State's Protection and Advocacy Agency


On April 11, 2023, Ohio's Joint Commission to Examine the State Protection and Advocacy System and Client Assistance Program recommended to the Governor that the state "redesignate" its P&A, having found Disability Rights Ohio for "intentionally not protecting and advocating for all individfuals with disabilities."

The report came in response to hearings on Nov. 1 and Nov. 15, 2023 in which families testified about their dissatifaction with the DRO's actions and biases against people in ICFs and sheltered workshops.


Excerpted from the report:


"[T]estimony given by parents, guardians, and family members expressed concerns over DRO’s administration of its service system. Specifically, the testimony described DRO’s excessive litigation against the State to which families objected. It also described DRO’s efforts to promote transfers of residents out of ICFs, sheltered workshops, and facility-based day programs into community settings without regard to individual choice and parental rights. 4 Those efforts included DRO staff meeting privately with ICF residents without their guardians or parents present to encourage them to leave their ICF placement.


Furthermore, the testimony indicated unilateral actions taken by DRO to target ICF settings, day programs, and workshops, without seeking cooperation from families and ignoring families’ advocacy to preserve these settings. Witnesses stated DRO’s actions run counter to health and safety needs and disregard the informed decision-making of families. Moreover, witnesses emphasized the importance of the specialized services and expertise offered in ICFs to support individuals with complex physical, medical and/or behavioral needs.


The witnesses also touched on the issue of aging caregivers, and the importance that families have access to intermediate care facilities to appropriately address the needs of their loved ones when they are no longer able to provide that care. In addition, witnesses stated that it is vital for policymakers to underscore and promote a multi-dimensional strategy, which includes access to ICFs, sheltered workshops, facility-based day programs, and community-based residential and work settings. However, witnesses stressed that DRO takes a one-size-fits-all approach preferring community settings to the detriment of other options. In its adherence to this approach, families are concerned that DRO acts adversely to their disabled family members’ interests who require higher levels of specialized care."


Download the report here


The hearings may be viewed here:


November 1 Hearing: https://ohiochannel.org/video/ohio-joint-committee-to-examine-the-protection-and-advocacy-system-11-1-2022


November 15th Hearing: https://www.ohiochannel.org/video/ohio-joint-committee-to-examine-the-protection-and-advocacy-system-11-15-2022


Ohio has a provision in its state code that calls for hearings before the state legislature every two years allowing families to testify about the state's Protection and Advocacy agency.

This section of the State Code may be found at https://codes.ohio.gov/ohio-revised-code/section-5123.603


We hope that other states will follow Ohio's lead and add such provisions to their own state codes.

New Mexico Gov to Abusive Caregivers: 'We're Coming For You'

By Susan Montoya Bryan, Associated Press, March 20, 2023


Any caregivers who mistreat and abuse developmentally disabled or otherwise vulnerable people will be held accountable, New Mexico’s governor and top health officials warned Monday.

Gov. Michelle Lujan Grisham, members of her cabinet and law enforcement officials gathered at the state Capitol to provide an update on ongoing investigations into an alleged abuse and neglect case involving a developmentally disabled person that was brought to the state's attention March 1.


The case resulted in the state terminating contracts with four providers in the Albuquerque area. It also prompted what the governor described as a forensic review of the entire developmentally disabled waiver system, which is meant to offer an alternative to institutional care.


Five more cases — including three in which individuals being cared for died — are under investigation. Officials said that they haven't determined if those deaths are tied to abuse or neglect.


Over the weekend, state health workers visited more than 1,000 people who are part of the federally funded waiver program. As a result, another eight potential cases warrant future review, officials said.


“If you’re not providing the care that you were supposed to provide, we will find you and you will be held accountable. That’s it — zero tolerance in the state of New Mexico. We are coming,” Lujan Grisham said during a news conference.


Lujan Grisham, whose sister is developmentally disabled, called the recent cases in New Mexico alarming, and vowed that the state will not tolerate abuse, neglect and exploitation of any vulnerable populations.


Officials with the New Mexico Department of Health have been tight-lipped about the allegations that prompted the initial investigation and the cancellation of the providers' contracts.


Health Secretary Patrick Allen said Monday that the client involved in the March 1 case suffered life-threatening injuries but didn't provide further details.

He said that the other instances identified in recent weeks involve neglect such as malnutrition.


Continued

New Mexico - Abuse Scandal Triggers More Supervision of Disability Care in New Mexico

By Daniel J. Chacón, Santa Fe New Mexican, April 10, 2023


As the state of New Mexico continues to conduct in-person wellness checks on thousands of developmentally disabled people in the care of private providers — a review prompted by what the governor has called a horrific case of abuse that left a client severely injured — a troubling trend is emerging.


The state, it seems, has allowed providers to go largely unsupervised.


“I’m certain that the overwhelming majority of providers are doing a marvelous job, that they care deeply about the clients they serve, and they’re doing good work,” Department of Health Secretary Patrick Allen said in an interview with The New Mexican.


“I think we need to make sure we’re doing the things that we need to do to find out about the small minority who aren’t because there [are] a number of providers — small — but there [are] a number of providers who aren’t doing the things that they need to do, and I think I’m increasingly concerned that we’ve not been doing the job we need to do to make sure that all our clients have fabulous providers and are getting the services and care that they need,” he said.


At issue are 6,815 intellectually and developmentally disabled New Mexicans who receive services from one of the state’s Developmental Disabilities Waiver programs, which provide Medicaid funding for home and community-based services for children and adults with developmental disabilities or related conditions. (Approved programs are allowed to waive certain Medicaid requirements to provide services.)

As of noon Friday, state employees from various agencies had visited 4,654 of the 6,815 clients and identified 68 sites with possible concerns, the department wrote in a news release.


At 26 of those sites, the concerns dealt mostly with home repairs, damages or other environmental issues.


But at the remaining 42, the site visits resulted in reported allegations of potential abuse, neglect and exploitation of some of the most vulnerable — and sometimes voiceless — people in New Mexico.

Each of the 68 incidents of concern identified so far is being fully investigated, according to the department.


“Our staff have reported to me visits they’ve been involved in where, like, a parent or guardian or someone has said, ‘This is the first time anybody from the agency has ever visited,’ ” said Allen, who was appointed health secretary in January and inherited the problem.


“That’s a concern,” he added. “We need to do better than that.”


The apparent lack of oversight involves not just people but hundreds of millions of dollars in taxpayer money.


For fiscal year 2023, Medicaid has paid $639 million in claims for developmental disability waivers, including $136 million from the state’s general fund and $503 million in federal matching dollars, Marina Piña, a spokeswoman for the Human Services Department, wrote in an email.


The projected expense for fiscal year 2024 is expected to be $776 million, including $207 million from the general fund and $568 million in federal matching dollars, she wrote.


Continued


Read a related article from March here

New Mexico - State Provides Update on In-Person Wellness Checks for Disabled Clients

Press Release from the New Mexico Department of Health, April 8,2023


The New Mexico Department of Health (DOH) reports progress in completing health and safety wellness checks for clients receiving services from the states’ Developmental Disabilities (DD) Waiver programs.  

As of 12 p.m. on Friday, April 7, 4,654 in-person wellness visits have been completed statewide for the 6,815 individuals receiving services from Developmental Disabilities Waiver programs. These visits identified 68 sites with possible concerns. Every one of these incidents is being fully investigated.  

Of those 68 sites: 

  • 42 sites resulted in reported allegations of potential abuse, neglect and exploitation. 
  • 26 sites had concerns that primarily revolved around home repairs, damages or other environmental concerns. 

In addition, both the Aging and Long-Term Services Department (ALTSD) and DOH have employees from their agencies outside of the Developmental Disabilities Supports Division staff in the field to complete the home visits, including DOH’s Office of General Counsel and Division of Health Improvement. Representatives from the state Children, Youth and Families Department, Human Services Department, Office of Peer Recovery and Engagement, and the Corrections Department are assisting with field visits.  


Anyone found to be in an abusive situation or who is in danger of immediate harm will be removed. Individuals associated with cases where abuse has been substantiated will be referred to the Employee Abuse Registry. Licensed professionals will be referred to their respective boards, and referrals to law enforcement will also be made as appropriate. 


Read the press release here

And where was New Mexico's P&A during all of this?


Click here to go to Disability Rights New Mexico's website

BREAKING NEWS: CMS Failed to Publicly Post Deficiencies for Two-Thirds of Nursing Homes, OIG Finds

By Kimberly Marselas, McKnight's Long-Term Care News, April 12, 2023


Medicare’s Care Compare site did not accurately reflect nursing home deficiencies in two-thirds of listings reviewed by a federal watchdog agency, a finding that implies more than 10,000 health, life safety or emergency preparedness violations may have been left out of view of consumers.


The report, issued early Wednesday by the Department of Health and Human Services Office of Inspector General, also found that the Centers for Medicare & Medicaid Services sometimes reported deficiencies to Care Compare that were not found in survey documentation. Scope and severity levels were also inaccurate for one out of every three nursing homes reviewed in a small sample, the OIG said.


While the OIG’s attention was trained on CMS, the findings also stand to malign nursing homes by reinforcing the idea that deficiencies are widespread in the sector. It could also lead to renewed CMS attention to public reporting accuracy, which in some cases could benefit consumers and nursing homes.


“Consumers rely on the information they find on Care Compare to make informed healthcare decisions and expect it to be accurate; the information can set the expectation for a consumer’s experience with a particular nursing home,” the OIG said in a report reviewed exclusively by McKnight’s Long-Term Care News Tuesday. 


“The findings in this report demonstrate the need for CMS to take additional measures to ensure that the information it reports on Care Compare for nursing homes is accurate.”


Continued

Minnesota - Opinion: Why the Governor's Proclamation on Autism Made Me Wince

By Dawn Kovakovich, The Star Tribune, April 9, 2023


We recently received a newsletter from the Autism Society of Minnesota (AUSM) explaining its rationale for switching terminology from the previously used "Autism Awareness Month" to "Autism Acceptance Month." I was dismayed to read the statement made by the governor:

"Minnesota acknowledges the limits of asking for awareness and promotes and celebrates the acceptance and appreciation of people with autism as the next step beyond awareness," said Gov. Tim Walz in his proclamation. "Minnesota acknowledges that although this celebration of autistic culture and community provides a starting point, that there remains significant room for progress towards equitable access and inclusion for all Minnesotans with autism."


His statement reflects a clear lack of understanding and dismissiveness toward the approximately 50% of individuals (and their families) who suffer with what can be an extremely debilitating developmental disorder. Many longtime AUSM members do not share their current position and philosophy regarding autism "acceptance."


By stating that "you shouldn't try to fix people who aren't broken," AUSM is not acknowledging that for 40-50% of autistic people, autism is a very serious, devastating condition. These individuals are left out of the conversation because they cannot typically speak for themselves and their family members are discounted if they speak on behalf of them. The flawed logic is like saying we should "accept" blindness or deafness or any other disability because there is no cure and many of these people live very fulfilling lives if they are simply accepted.


The fact remains that blindness, deafness and autism are still disabilities. Thousands of autistic people are born with serious cognitive, sensory and/or neurological dysfunction. Whether these traits are referred to as "comorbidities" or recognized as part of the autism diagnosis for many people is irrelevant. They are still living with a disability.


We adore our autistic daughter exactly as she is. But that doesn't mean we would wish on anyone the heartache, frustrations and limitations she lives with on a daily basis as a result of her condition. She often says she "wishes there were a cure for OCD and autism." Could there be a cure for the neurological dysfunction that causes her brain to cycle in circles and short-circuit into violent tantrums? Maybe there could be. We might never know if funding for autism research is stymied because a certain subset of autistic individuals do not wish to acknowledge it as a disability.


The staggering increase of autism should be great cause for alarm. Research, prevention and programming are seriously affecting by the dismissive tone that AUSM has adopted toward the seriousness of this condition. I am, quite frankly, disgusted by this attitude. AUSM is no longer advocating for half of the very people it claims to serve. While we accept our daughter, we will never "accept" autism — or any other developmental disability.


The National Council on Severe Autism (NCSA) recognizes this. It is long past time to separate the diagnosis of mildly autistic people, whose brain structures more closely resemble ADHD, with those who have been born with profound autism. It is time to recognize that one size does not fit all.


Link to Dawn's Letter to the Editor here


Dawn Kovakovich is a member of VOR, the National Council on Severe Autism, the Coalition for the Preservation of Employment Choice, and the A-Team.

Working Strategies: In Defense of the Subminimum Wage  

By Amy LIndgren, Twin Cities Pioneer Press, April 8, 2023


If you don’t have a loved one with moderate to severe cognitive disabilities, you may not be aware of sheltered workshops and their role in the continuum of work opportunities for this population. In essence, these facilities are organized around a principle of gathering socially to conduct relatively simple work, such as shredding paper or stuffing envelopes.


The individuals in these jobs tend to stay for long periods, drawn by the familiarity of the task, the camaraderie, and the pride of earning their own income.


The thing is, the income is low — shockingly so. In many cases, the workers can spend all day at their tasks and gross only a few dollars for their trouble. This happens under a little-understood exception to minimum wage laws, allowing for subminimum rates of $3 or $4 an hour, or even less. Essentially, employers granted a federal 14(c) certificate are allowed to pay less than the federal minimum of $7.25 or the higher minimum wage found in some cities and states.


Over the years, disability rights advocates have raised this issue as being unfair to the worker; this year proposed legislation has advanced in several states, including Minnesota, to change the laws that allow the workshops or other employers to pay so little. (To track the progress of these bills, go to apse.org/state-legislation/)


Deep breath: I’m not on board with this legislation.


There’s a cartoon I’ve seen that illustrates the difference between equality and equity: Three fans without tickets are trying to watch a ballgame through holes in a wooden fence. In the first panel, all three have equality — they each have the same size box to stand on. Unfortunately, they are different heights and only one of them can actually see the game. In the second panel, the three have equity — they can all see the game because their boxes are sized appropriately for them.


Equity is the goal for fair employment — but this will not be the result of giving everyone in a sheltered workshop the same wage as non-disabled workers. It will more likely result in the disabled workers having an “equal” chance to compete for their jobs on the basis of productivity, which in turn would result in only the non-disabled workers being kept on. At that point, the disabled workers will have the opportunity to compete “equally” on the job market for positions in the mainstream, where they may or may not enjoy the job even if they prevail and receive an offer.


I understand the argument that workers gain dignity from being paid appropriately. But I also value what these workers receive besides a wage.


In some cases, the individuals involved are only moderately productive for their workshop employers. And yet they are kept on, provided ongoing coaching, and given a place to belong with a consistent circle of friends and acquaintances. Their families receive value as well, in terms of respite care. Given the cost of in-home care, it can be argued that the $5-$8 an hour these workers aren’t receiving in wages is more than covered.


It’s one thing for a worker and their family to give the bigger market a try, to test the worker’s wings, so to speak. That opportunity exists now and always will. If the worker is ready for a more mainstream job, then that will be a good outcome — for that individual.


But to push everyone out of the boat with the hope they can all learn to swim? That’s essentially what it would mean for all the cognitively disabled individuals if the sheltered workshops were to close.


Continued

Pennsylvania - Staff Members Express Frustration as Polk State Center Closure Drags On

By Gavin Fish, Explore Clarion, April 12, 2023


Staff members at Polk State Center are expressing their frustration after yet another delay in the center’s closure and transition to employment with Verland Community Living Arrangements.


According to an April 11th memo sent to staff by Kevin Dressler, Director of the Bureau of State Operated Facilities, the date is now April 30. The most recent delay has been attributed to the state changing from a lease agreement to a management agreement with Verland.


“The state was working on a lease agreement for Verland,” Verland’s CEO Bill Harriger told exploreClarion.com. “They had to shift gears just two-and-a-half, three weeks ago to more of a management agreement in order to meet some of the Department of Health regulations.”


In November of last year, Verland Community Living Arrangements received a $2MM grant from the Redevelopment Assistance Capital Program to help construct new homes for residents being displaced by the closure of Polk State Center and provide jobs for those that will be lost.


Verland plans to construct four group homes within a 15- to 20-mile radius of Polk and has already hired 124 of the current Polk staff members to continue providing care for residents.


Verland will care for the patients at Polk Center under the new management agreement until the group homes are constructed. At that time, the patients will be transferred to their new homes.


The uncertainty surrounding the transition from state employee to Verland employee has caused stress and concern among staff members. In light of the Dressler memo, Harriger felt the need to send out a memo of his own.


“I felt I had to get a memo out basically saying, ‘Look, people have been living with this change coming for three and a half years. Verland has been negotiating with the state in earnest. Those agreements don’t just happen overnight,” Harriger said.


“When the state says that April 14th is going to be the transition date, and it doesn’t end up being the transition date, everybody freaks out,” he added. “It’s going to happen. There’s nothing magic about the 14th. There’s nothing magic about the 21st. There’s nothing magic about the 28th. There’s nothing magic about April 30th.”


The closure of Polk State Center and other state centers has raised concerns about the availability of trained staff to fill what Verland calls Direct Support Professional—the state refers to the position as Resident Services Aid—jobs throughout the Commonwealth. With 55,000 jobs available in the state and 20% remaining unfilled, the closure of these centers may exacerbate this issue.


Continued

VOR Bill Watch:

[Please click on blue link to view information about the bill]


VOR SUPPORTS:


H.R. 553 - Workplace Choice and Flexibility for Individuals with Disabilities Act

Rep. Glenn Grothman (R-WI-6) - This bill would amend the Rehabilitation Act of 1973 to clarify the definition of competitive integrated employment.


H.R.1296 - Restoration of Employment Choice for Adults with Disabilities Act Rep. Glenn Grothman (R-WI-6) - TTo amend the Rehabilitation Act of 1973 to ensure workplace choice and opportunity for young adults with disabilities.


H.R.485 - Protecting Health Care for All Patients Act of 2023

Rep. Cathy McMorris Rodgers (R-WA-5) - This bill prohibits all federal health care programs, including the Federal Employees Health Benefits Program, and federally funded state health care programs (e.g., Medicaid) from using prices that are based on quality-adjusted life years (i.e., measures that discount the value of a life based on disability) to determine relevant thresholds for coverage, reimbursements, or incentive programs.


H.R.670 - Think Differently Database Act

Rep. Marcus Molinaro (R-NY-19) - This bill would amend title IV of the Public Health Service Act to direct the Secretary of Health and Human Services to establish a clearinghouse on intellectual disabilities, and for other purposes. Such clearinghouse shall include information on individual community-based services and long-term support services available to individuals eligible for medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act.


VOR OPPOSES:


S.533 / H.R.1263 Transformation to Competitive Employment Act

Sen. Bob Casey (D-PA) / Rep. Bobby Scott (D-VA 3) - This bill would support employers who wish to transform their facilities to provide only competitive integrated employment while forcing the elimination of programs that offer employment opportunities under Section 14(c) of the Fair Labor Standards Act. This bill would be unlikely to create a significant increase in employment for people with I/DD and autism, but would deprive over 120,000 individuals of the opportunity to work, develop skills, and be part of their community.



VOR HAS SIGNIFICANT CONCERNS WITH:


S.100 / H.R.547- Better Care Better Jobs Act

Sen. Bob Casey (D-PA) Rep. Debbie Dingell (D MI) This bill establishes programs and provides funds for state Medicaid programs to improve home- and community-based services (HCBS), such as home health care, personal care, case management, and rehabilitative services.

The bill also makes permanent (1) the Money Follows the Person Rebalancing Demonstration Program (a grant program to help states increase the use of HCBS for long-term care and decrease the use of institutional care), and (2) certain provisions regarding Medicaid eligibility that protect against spousal impoverishment for recipients of HCBS.


S.762 / H.R.1493 - The HCBS Access Act

Sen. Bob Casey (D-PA) Rep. Debbie Dingell (D MI) While this bill purports to eliminate waiting lists and provide more Home and Community-Based Services for people with I/DD and autism, it favors the aspirations of those individuals who are most independent and neglects the very real needs of those most dependent on Medicaid Long-Term Services and Supports. It would not distribute funds appropriate to the varying needs of individuals, but to providers of HCBS programs. It fails to recognize the severity of the DSP and Nursing Crises, and paints an unrealistic picture of a simplistic solution. This is a purely political bill that would ultimately fail to make the extensive changes that the DD/A system needs.



VOR supports increasing funding for people with I/DD, but we have concerns that this bill, in its current form, would discriminate against people with the most severe I/DD and autism and jeopardize the higher-care facilities that are most appropriate to their needs.



[Please click on blue link to view information about the bill]


VOR SUPPORTS:


H.R. 553 - Workplace Choice and Flexibility for Individuals with Disabilities Act

Rep. Glenn Grothman (R-WI-6) - This bill would amend the Rehabilitation Act of 1973 to clarify the definition of competitive integrated employment.


H.R.485 - Protecting Health Care for All Patients Act of 2023

Rep. Cathy McMorris Rodgers (R-WA-5) - This bill prohibits all federal health care programs, including the Federal Employees Health Benefits Program, and federally funded state health care programs (e.g., Medicaid) from using prices that are based on quality-adjusted life years (i.e., measures that discount the value of a life based on disability) to determine relevant thresholds for coverage, reimbursements, or incentive programs.


H.R.670 - Think Differently Database Act

Rep. Marcus Molinaro (R-NY-19) - This bill would amend title IV of the Public Health Service Act to direct the Secretary of Health and Human Services to establish a clearinghouse on intellectual disabilities, and for other purposes. Such clearinghouse shall include information on individual community-based services and long-term support services available to individuals eligible for medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act.


VOR OPPOSES:


S.533 / H.R.1263 Transformation to Competitive Employment Act

Sen. Bob Casey (D-PA) / Rep. Bobby Scott (D-VA 3) - This bill would support employers who wish to transform their facilities to provide only competitive integrated employment while forcing the elimination of programs that offer employment opportunities under Section 14(c) of the Fair Labor Standards Act. This bill would be unlikely to create a significant increase in employment for people with I/DD and autism, but would deprive over 120,000 individuals of the opportunity to work, develop skills, and be part of their community.



VOR HAS SIGNIFICANT CONCERNS WITH:


S.100 / H.R.547- Better Care Better Jobs Act

Sen. Bob Casey (D-PA) Rep. Debbie Dingell (D MI) This bill establishes programs and provides funds for state Medicaid programs to improve home- and community-based services (HCBS), such as home health care, personal care, case management, and rehabilitative services.

The bill also makes permanent (1) the Money Follows the Person Rebalancing Demonstration Program (a grant program to help states increase the use of HCBS for long-term care and decrease the use of institutional care), and (2) certain provisions regarding Medicaid eligibility that protect against spousal impoverishment for recipients of HCBS.


S.762 / H.R.1493 - The HCBS Access Act

Sen. Bob Casey (D-PA) Rep. Debbie Dingell (D MI) While this bill purports to eliminate waiting lists and provide more Home and Community-Based Services for people with I/DD and autism, it favors the aspirations of those individuals who are most independent and neglects the very real needs of those most dependent on Medicaid Long-Term Services and Supports. It would not distribute funds appropriate to the varying needs of individuals, but to providers of HCBS programs. It fails to recognize the severity of the DSP and Nursing Crises, and paints an unrealistic picture of a simplistic solution. This is a purely political bill that would ultimately fail to make the extensive changes that the DD/A system needs.



VOR supports increasing funding for people with I/DD, but we have concerns that this bill, in its current form, would discriminate against people with the most severe I/DD and autism and jeopardize the higher-care facilities that are most appropriate to their needs.



Please share this offer with your loved one's

Direct Support Professionals!


VOR ❤️s OUR

DIRECT SUPPORT PROFESSIONALS!


Our loved ones' caregivers are essential to their health, safety, and happiness.

In appreciation of their good work and kind hearts, VOR offers free digital memberships to any DSP who would like to receive our newsletter.


We encourage our members to speak with their loved ones' caregivers to extend this offer of our gratitude.


If you are a Direct Support Professional interested in receiving our newsletter and e-content, please write us at


[email protected]


with your name, email address, and the name of the facility at which you work. Please include the name of the VOR member who told you of this offer.

Planned Giving


As we approach the mid-April tax season, we ask that our members consider making a donation to VOR as a way to ease your tax burden while supporting our mission to advocate for individuals with I/DD and autism.




As always, we suggest you consult with your policy administrators and tax professionals to determine how best to contribute.


What's Happening In Your Community?

Is there an issue in your loved one's home that you need help with?
Do you have information or a news story you would like to share?
Is there legislation in your state house that needs attention?

Contact us at [email protected]
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