April 15, 2022
VOR 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.
VOR promises to empower you to make and protect quality of life choices for individuals with developmental disabilities
VOR & YOU:

Sunday, May 15, 2022
2 - 5 pm EDT / 1 - 4 pm CDT / Noon - 3 pm MDT / 11 am - 2 pm PDT
On Zoom

Followed by calls to congressional offices throughout the week. We will help our participants to arrange meetings with Congressional Staffers via Zoom, help our members to understand how to use Zoom if they need it, and give you the advance materials and tools to make a strong presentation.

Debriefing sessions on May 16 & 17,
6:30 - 8 pm EDT

This year's initiative will focus on the diversity of individuals within the I/DD population, the need for a full continuum of care, and need to ensure parity for all services - ICF, group home, family home, or intentional community - to meet the needs of all people with I/DD and to allow families to choose from a full range of options.

As always, our Legislative Initiative is geared to helping you become a better advocate for your loved ones with I/DD.
The Sunday Initiative will help prepare you for your meetings with Congressional Staffers. It will be followed by individual and group Zoom meetings with Congressional Offices
May 16 - 19,
with follow-up meetings during May and June while Congress is in session. We will help you to arrange your meetings, and if you wish, one of our Board members will sit in and help steer you though your first meetings with congressional aides.

We are here to help you!


Registration is free. Donations are welcome.
You must be a current member of VOR to participate in the Initiative
VOR's
2022 Legislative Initiative Fundraising Drive

VOR advocates for human rights and high quality care for all people with intellectual and developmental disabilities. What sets us apart from many other advocacy groups is our recognition of those individuals with the most severe and profound I/DD, and the need to preserve a wide range of options to enable them to live their best lives.

Our Annual Meeting & Legislative Initiate are designed to help our families to participate in our organizations, to reach out to their Members of Congress, and to become better advocates for their family members with I/DD.

To continue our work, we are asking members to contribute, yet again, to keep
VOR viable.

Those who have attended our June meetings in years past will recall what they spent on transportation to and from D.C.. what hotel rooms cost, and what other expenses they incurred while in Washington. We ask that you consider giving a share of that expense, say 1/4 or 1/3 if you can,
to help us cover the ongoing costs of our advocacy and of maintaining our organization.

VOR has helped so many families over the years. Times change, politicians come and go, policies change, but the need to help families of people with I/DD continues.

Please help us to help you.
Please help us to help families like yours.
CMS Open Door Forum Arrives Tuesday
By James M. Berklan, McKnight's Long-Term Care News, April 15, 2022
The Centers for Medicare & Medicaid Services will hold its next Open Door Forum stakeholder conference call for Long-Term Services and Supports at 2 p.m. ET Tuesday.

The agency will give general announcements and updates, including the latest on the Money Follows the Person (MFP) program. Of particular note will be the previously sent press release “HHS to Provide $110 Million to Strengthen Safety Net for Seniors and People with Disabilities” through the MFP program.

A question-and-answer segment will conclude the program. The conference call leaders will be Jodie Sumeracki, CMCS, and Jill Darling, of CMS’ Office of Communications.
To attend the Open Door Forum, call (888) 455-1397 and use the passcode 5109694. Attendees are encouraged to call in at least 10 minutes before the start time to ensure they are admitted early enough to hear the start. An operator will briefly ask for a caller’s identity and affiliation.

Anyone unable to take part Tuesday can visit the CMS Podcasts and Transcript webpage where the most recent Long-Term Services and Supports Open Door Forum call will be available for reading or listening. Both the audio file and transcript will be posted.

State News
Update on Iowa

Last week, the Iowa Department of Human Services announced that they will be closing the Glenwood Resource Center, one of the state's two remaining state-operated ICFs, in the course of the next two years. VOR has been working with the families of the residents of Glenwood, and will continue to share our experience to help facilitate the best possible outcomes for everyone involved.
------------------------------------
Capital Corner: Health and Human Services Budget
By State Representative Sandy Salmon, Waverly Newspapers, April 11, 2022

The Health and Human Services budget passed last week in the House and appropriates $2 billion state money for a total of $6 billion state and federal monies to Medicaid, child care assistance, family assistance, child and family services, Cherokee and Independence MHI’s, Glenwood & Woodward Resource Centers, Dept. of Human Services (DHS), Dept. of Public Health (IDPH), Dept. on Aging, Dept. of Veteran Affairs, and the Iowa Veterans Home.
It also provides for the merger of DHS and IDPH into a new agency Health and Human Services (HHS).
The Health and Human Services budget prioritizes community-based services for Iowans with intellectual disabilities as well as mental health services.

Disability Care

• Provides a $14.6 million investment (including federal match it is $38 million) in home and community-based services rates. This allows for a $2 raise to all direct support professionals, and this bill requires this increase to go towards our front-line workers wages.

• Provides a $7.4 million state investment to reduce the waitlist on the intellectual disability services waiver. This appropriation should add an additional 250 ID waiver slots.

• Intermediate Care Facilities for those with intellectual disabilities receive a total increase of $8.2 million, and also require these funds to go directly to direct support professional wage increases.

• Provides a $4 million appropriation to create a new home health rate structure that provides an incentive for providing care to rural Medicaid members.

Opinion: Transforming Iowa’s Direct Care Workforce
By Maribel Slinde, Corridor Business Journal, April 11, 2022

The demand for direct care workers (DCWs) will increase substantially in the coming years as the population of older adults and people with disabilities in Iowa increases. DCWs go by different names, often determined by their work and the populations they support or serve.

Regardless of their title, they provide most hands-on care in settings that range from in-home care, assisted living, nursing homes, and hospitals to residential care facilities, supported living, adult day services and hospices.

Our state has struggled to maintain an adequate direct care workforce. This is a challenge that we share with every state in the country, but an especially vexing problem in Iowa due to our slow population growth. More than 59% of Iowa’s nursing homes report they are short-staffed, according to a February AARP Nursing Home COVID-19 Dashboard. Attracting and retaining DCWs to meet Iowa’s present and future needs is impossible with the wages currently paid. DCWs’ median hourly wage is below $15 an hour, with 15% living below the poverty guidelines according to PHI National. Twenty-eight percent work more than one job to make ends meet. Caring for and supporting other human beings is a beautiful calling, but should not require people to take a vow of poverty to do so.

Kentucky - Closure of Residential Service Results in Move of 60-70 Residents
By Christie Netherton, Messenger-Inquirer, April 6, 2022

D&S Residential Services, a residential care provider for individuals with disabilities, will close its doors April 9, resulting in between 60-70 clients having to move.
The residential facility, at 1102 Triplett St. in Owensboro, was forced by the Department for Medicaid Services to close. The facility and its owner, Sevita Health, declined to comment on the reasons for the closure.

With limited options for residential services available, not only in Owensboro, but statewide, individuals in need of the services already face the possibility of having to move outside Owensboro and possibly away from family and loved ones, according to Amanda Owen, executive director for Puzzle Pieces, a possibility that becomes more looming as residential services experience closures, staffing shortages and other issues that have been brought on by the COVID-19 pandemic.

Puzzle Pieces is a nonprofit serving individuals with intellectual disabilities and a provider of residential services.

“Kentucky is really in a state of crisis,” Owen said. “COVID caused agencies across Kentucky — a lot of long-term housing — to close.”

There are several providers outside of D&S locally, including Puzzle Pieces, Wendell Foster, Strategic Partners and Bridges of Kentucky. However, Owen said, despite the presence of other residential services, it is unlikely that any one facility would be able to take on 60-70 new clients at once due to the closure of D&S.

Tennessee - Families Frustrated with State's Katie Beckett Program Ask for Accountability
By Katelyn Keenehan, WBIR-10 News, April 9, 2022
Some families are running into problems with a program meant to help children with disabilities.Tennessee’s Katie Beckett program is for children under 18 years old with disabilities or complicated medical needs. This program is for children who are not Medicaid eligible because of their parent’s income or assets.

Some families say the program is so complicated that navigating it feels like a part-time job.

"It's the caregivers and the parents who wind up working 15 extra hours a week to get their kids the services that they need," said Shannon Efteland, a mother who is navigating the program.

Over 1,000 people are using the program in Tennessee, and the program is steadily growing as more people come to learn of the benefits. Tennessee enacted this waiver around a year and a half ago, and it was the last state to do so. 

"There were a lot of families that were vocal at trying to get the Katie Beckett program started," Efteland said. "So, we were all waiting for it like we were already on board."

Shannon Efteland's son's name is Liam. He is an active, bubbly 11-year-old boy. 
"Liam has more energy than we kind of know what to do with. So we always try to find other activities for him," Efteland said.

Liam is a good candidate for the Katie Beckett program because he was diagnosed with Down Syndrome. He requires additional medical attention, specialized therapies and individualized classrooms and activities.

Individually, those things can be costly, but together, they all stack up expensive bills for the Efteland family. Katie Beckett Part B, a part of the state's program to help people who don't qualify for TennCare, can help families with up to $10,000 a year in services for their child with a disability.
When the Katie Beckett waiver was rolled out in Tennessee, the Efteland family was one of the first ones to sign up. However, it took months to get their son into the program.

"The application is involved. It's a long application, and I didn't have all of the information for it. So there were times when I just had to wait weeks till I collected all the information," Efteland said.

Kansas - Medicaid Inspector General issues Report on HCBS Waiver Program
By Tim Carpenter, Kansas Reflector, via Hays Posts,
April 14, 2022
An audit by the Medicaid inspector general in Kansas identified oversight shortcomings in the state’s home and community based service programs that raised questions of potential overpayment to managed-care companies and control weaknesses at an agency in the administration of Gov. Laura Kelly.

Medicaid inspector general Steven Anderson, who is assigned to the office of the state attorney general, concluded Wednesday the Kansas Department of Health and Environment lacked “an effective system for tracking” beneficiaries in the program.

The assessment covered services delivered to Medicaid enrollees in the home or community from January 2018 through April 2021. The report was submitted to Attorney General Derek Schmidt, Cabinet secretaries at KDHE and the Kansas Department for Aging and Disability Services, and the Legislature’s joint oversight committee for Medicaid.

The state’s Medicaid system, known as KanCare, serves more than 440,000 people. KanCare is a privatized system in which the state contracts with three companies to deliver $3.9 billion in services annually.


---------------------------------------------

Press Release from the Kansas Attorney General:, April 13, 2022

Kansas Medicaid Inspector General Steven D. Anderson today released a report examining the Kansas Medicaid program, concluding that the agency responsible for administering the home and community based services (HCBS) program lacks an effective system for tracking the redetermination of beneficiaries in the HCBS program.The audit looked at the HCBS program administered by the Kansas Department of Health and Environment (KDHE) and Kansas Department for Aging and Disability Services (KDADS) for a period of 40 months from January 1, 2018 through April 30, 2021.The number and types of findings identified during the audit indicate control weaknesses, which could place Kansas waivers at risk.

In addition, the audit found that 2,854 individuals identified as being enrolled in an HCBS waiver, but who did not have any HCBS claims filed on their behalf for a total of 12 months or more during the audit period. The amount of payments made to managed care organizations contracted to provide services to these beneficiaries totaled more than $193 million.

The Office of Medicaid Inspector General (OMIG) is required by K.S.A. 75-7427(k)(1) to make provision to solicit and receive reports of fraud, waste, abuse and illegal acts in such programs from any person or persons who shall possess such information.

The report was submitted to Kansas Attorney General Derek Schmidt, Secretary of Health and Environment Janet Stanek, KDHE Medicaid Director Sarah Fertig, Secretary of Kansas Department for Aging and Disability Services Laura Howard and the members of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight.

The report is available at https://ag.ks.gov/medicaid-ig.

VOR's Annual Membership Meeting

Celebrate VOR's 39th Year of Family Advocacy

Sunday, June 12, 2022
On Zoom

Featuring:
  • Guest Speakers (to be announced next week!)
  • Reports from the States & Networking Meeting
  • Our Cakeless Bake Sale!

As in previous years, the Annual Meeting will feature an open meeting of the VOR Board of Directors and we will reveal the results of the current Board elections.

Details coming soon. Registration will open in May.
Massachusetts - Viewpoint: Disability Services Network in 'System Failure' due to Workforce Drought
Opinion by By Christopher White – CEO, Road to Responsibility, Boston Business Journal
April 10, 2022

After decades of “getting by” (sometimes just barely) due to a large population of young people seeking to enter the job market complemented by a vast pool of legal immigrants, the day has arrived where the human service system has effectively reached the point of failure because we can’t hire enough workers.
This may sound hyperbolic, but how would you describe a situation where there are thousands of people with various disabilities needing services, there is money to pay for those services, yet those people cannot access them? That’s precisely what’s happening across the state.

The state Department of Developmental Services (DDS) has over 7,000 people waiting to return to the services they were receiving pre-pandemic. This doesn’t include the many young adults who are now aging out of school-based services and looking forward to moving on to adult services. Unfortunately, most of them learn there are no services to be had due to the workforce shortage. There is no foreseeable solution in sight for this problem unless something significant changes.

Why is this happening now? The pandemic has accelerated the pace of baby boomers retiring. Subsequent generations, being much smaller, aren’t sufficient to replace those retirees in normal times, and these aren’t normal times. It also forced millions of women out of the workforce to care for young children or other family members. I

n the past, this problem was masked by a relatively abundant flow of legal immigrants. Unfortunately, legal immigration was largely curtailed under the Trump administration, and the Biden administration hasn’t meaningfully addressed it. This dynamic has led to a massive shift in the labor market.

Businesses like Target ($24 per hour), Bank of America ($20 per hour), Amazon ($18.50 per hour) and Hobby Lobby ($18.50 per hour) are all offering a higher starting wage to perform jobs of less societal importance and impact than the essential work performed every day, pandemic or not, by our human services workforce. If Target is short-staffed, we are inconvenienced. When human services are short-staffed, the lives of our members and their families are jeopardized. 

The primary issue is money. Companies like Road To Responsibility can’t compete in this market without significant increases to the rates the state uses to purchase services. Using one-time funds (primarily a PPP loan) we have increased our starting pay to $17 per hour and have added recruitment and retention bonuses of $2,500. However, our state contracts will only support an entry-level wage of $15 to $16.79 per hour. While our efforts have helped to stabilize us, they haven’t significantly decreased our vacancies (we still have more than 27% of our positions vacant). This is happening across the field — children, mental health, developmental disabilities and elder services.

Colorado - Fort Collins Police Services Utilize App To Help Identify, Interact With Those Living With Intellectual Disabilities
By Dillon Thomas, CBS-4 News Denver, April 14, 2022
Fort Collins Police Services will be the first agency in Colorado to partner with “Vitals Ap,” a technology that will help first responders identify and properly interact with community members who live with intellectual disabilities. In partnership with UCHealth, the health provider that has covered the associated costs for the police department in order to launch the app in Fort Collins, Fort Collins police and mental health responders will be able to better serve those who have profiles through the app.

The app, which was developed by former law enforcement officers and experts in mental health response, is subscription-based. For as little as $2.99 a month families can create a profile on the app for their loved ones. A profile includes a photo of the individual, their name and information about their disabilities that the family feels comfortable sharing.

The app also includes information on what types of actions an officer can expect from the user that is experiencing distress, contact information for loved ones and even best practices for that individual’s preferred form of de-escalation.
Users are given a keychain that it tied to their account. An officer only has to come within 80 feet of the individual for the officer’s phone to link the profile.

Police are unable to track the whereabouts of a user, as the app on the officer’s phone only works if they are within 80 feet of the user.

“We are the first co-response in the nation that is using this,” FCPS Chief Jeff Swoboda told CBS4’s Dillon Thomas. “Vitals is going to allow our officers to interact with people in a different way.”

In its opening phase in Fort Collins, Vitals will be used predominantly by the mental health response team from UCHealth. Once officers are further trained on the usage of the application they will also adopt the process.

“It is that type of interaction that is going to be a game-changer for police officers on the street,” Swoboda said.

APRIL IS AUTISM AWARENESS MONTH
Long-Term Care News
Note: Several articles appeared in McKnight's Long-term Care News this week concerning policies that affect the long-term care industry. While mostly related to the Nursing Home industry, it is worth noting the changes in the Center for Medicare and Medicaid Services' policies and funding.
CMS Cuts SNF Pay Rates by Net $320 Million
By Kimberly Marselas, McKnight's Long-Term Care News, April 11, 2022

The Centers for Medicare & Medicaid Services will adjust nursing home payment rates downward by 4.6% to account for unintentional overpayments in the transition to the Patient Driven Payment Model, the agency announced late Monday. That $1.7 billion decrease will result in a new, $320 million annual decrease after accounting for a market basket increase and other factors, officials explained.

“To do this during a pandemic is actually heartless. We were comfortable with them spreading it out and thought that would be the case,” Rick Matros, president and CEO of Sabra Health Care REIT, told McKnight’s Long-Term Care News.

In issuing its 2023 Skilled Nursing Facilities Prospective Payment System, CMS also said it was proposing a 3.9%, or $1.4 billion, payment boost for the sector. That includes a 2.8% market basket update and a 1.5 percentage point forecast error adjustment, as well as a 0.4% lower productivity adjustment. The 3.9% Part A adjustment is significantly more than CMS proposed for providers in recent years.

Combined, the two adjustments will result in an estimated aggregate decrease of about $320 million in Medicare Part A payments to SNFs in fiscal 2023.

In the same announcement, CMS also addressed two separate workforce issues.

CMS ‘Heartless’ for its Big Nursing Home Pay Cut Proposal
By Danielle Brown, McKnight's Long-Term Care News, April 12, 2022

Providers are struggling with the federal government’s “heartless” decision to decrease pay for skilled nursing facilities by $320 million in fiscal 2023. 

Officials said Monday’s announced nursing home pay rule is an attempt to compensate for overpayments that started with the introduction of the Patient Driven Payment Model in late 2019 and lingered throughout the pandemic. 

The proposed net payment reduction has industry stakeholders worried how SNFs would be able to provide adequate care if nothing is changed after what is expected to be a very active comment period. 
“Many nursing homes already face imminent closure, and this Medicare cut could force more seniors across the country to relocate and find alternative care farther away from family and loved ones,” Mark Parkinson, president and CEO of the American Health Care Association, said in a statement to McKnight’s Long-Term Care News on Monday. 

“It is critical that Medicare remain a reliable funding source and reflect the increasing costs providers are facing,” he added. 

Nursing Home Pay Rule Reveals CMS Strategy on Minimum Staffing
By Kimberly Marselas, McKnight's Long-Term Care News, April 13, 2022

The release of a proposed 2023 pay rule Monday afternoon reiterated the Centers for Medicare & Medicaid Services’ commitment to implementing a minimum staffing rule after more than 20 years of debate on the issue. Staffing-related provisions include a new value-based incentive element for total nurse staffing and an official request for comment on the coming direct care staffing requirements. 
CMS, however, has much to consider in a yearlong study leading up to an officials staffing rule set to be proposed early next spring.

The agency Monday asked stakeholders to weigh in on at least 17 related issues. They range from how to calculate the measure to who to include and how to account for labor challenges to how much the requirement will cost — and if better outcomes, such as lower hospitalization rates, might provide an offset.

“It’s obviously very important that we have standards of care and that facilities should be meeting those standards,” Ashvin Gandhi, Ph.D., a UCLA health economist who studies staffing and turnover, told McKnight’s Long-Term Care News. “CMS does have to think really carefully about whether and to what degree facilities are going to be able to financially meet staffing requirements. You could have unintentional consequences.”

Congress ‘Must Prohibit’ REITs from Operating Nursing Homes, Lawmaker Says in Scathing Letter
By Danielle Brown, McKnight's Long-Term Care News, April 12, 2022
A U.S. Congressman is seeking to put additional scrutiny on nursing homes with certain investors. 
Rep. Bobby Rush (D-IL) has called on the House Subcommittee on Oversight and Investigations to schedule a hearing on the “failures” of nursing homes during the pandemic, operating practices of Real Estate Investment Trusts and the impact both have had on residents, USA Today reported over the weekend. The subcommittee falls under the Committee on Energy and Commerce. 

Rush went as far as saying Congress should “prohibit REITs from operating nursing homes” in the letter he sent earlier this month. He argued REITs shouldn’t have the authority to operate nursing homes or receive public funding. 

Some of the biggest REITs in the long-term care sector own hundreds of facilities each. Rush did not specifically mention any REITs in the letter. 
“I believe that the profiteering, cold-hearted nature of these corporations must be exposed, and it is up to Congress — and specifically, the Energy and Commerce Committee — to shine a bright light on the current practices, to rein them in, and to set and strictly enforce high standards for performance,” Rush wrote. “It is Congress’s job to stand in-between greedy corporations and those who are the most defenseless.” 

Rush’s letter came in response to the USA Today’s highly critical nursing home investigation that highlighted a five-month surge from October 2020 through February 2021, when about 71,000 nursing home residents died from COVID-19.

Florida - Governor Signs Bill Walking Back Nursing Home Staffing Requirements
By Danielle Brown, McKnight's Long-Term Care News, April 8, 2022

Florida nursing homes now have more staffing flexibility after Gov. Ron DeSantis (R) signed a measure Wednesday that “modernizes [the state’s] outdated staffing requirements.” 

“This legislation will bring more individualized, comprehensive care to residents while easing the burdens posed by significant staffing challenges,” Emmett Reed, CEO of the Florida Health Care Association, said in a statement. 

His comments came after DeSantis signed HB 1239 into law, following weeks of uncertainty. The measure, which was supported heavily by provider advocates in the state, reduces the minimum number of hours of direct care per resident day provided by CNAs to 2. It also accounts for time other workers, including therapists, spend with residents.

Florida currently requires certified nursing assistants in the Sunshine State to provide a minimum of 2.5 hours of direct care per resident/patient day. CNAs and licensed nurses also are required to provide a weekly average of 3.6 hours of direct care per resident/patient per day.

Families of individuals with severe/profound intellectual and developmental disabilities and autism need a voice in Washington, D.C.

For 39 Years, VOR Has Been That Voice

Please help us to continue to speak truth to power about the need for a diverse range of services, increased funding, and a full continuum of care to meet the needs of all people with I/DD and Autism.

This year, we engaged in over sixty meetings with Congressional Staff. Together, we have advised on bills to protect Intermediate Care Facilities, to preserve 14(c) opportunities for individuals with I/DD, and to increase pay, training, and benefits for direct support professionals to alleviate the DSP crisis.

We have contacted attorneys from the Department of Justice’ Civil Rights Division concerning increased mortality rates among people with I/DD in wake of the closing of state operated intermediate care facilities in Virginia. We have met by Zoom with the same DOJ attorneys concerning their current action in to move people out of ICFs in Iowa. Just today, we met with leadership of the Administration for Community Living to discuss our mutual concerns and to offer paths forward to help serve all people with I/DD,

In order to have such a presence in D.C., we have had to change with the times. Covid made in-person meetings next to impossible. We have had to adapt to holding virtual meetings on Zoom or WebEx. In order to compete with larger, better-funded organizations, we have had to hire the lobbying firm of Health Policy Source to advise us on how best to approach the powers that be and to facilitate our access to congressional staff. This has cost us, but we feel this has been money well spent. Now, we are asking you to help support us in this effort.

VOR Bill Watch:
[Please click on blue link to view information about the bill]

VOR SUPPORTS:

Modifying the Build Back Better Act to include language to provide funding for Intermediate Care Facilities in parity with increased funding for HCBS services, and to remove any provisions that would phase out or eliminate 14(c) wage certificate programs.

H.R. 4779 & S. 1437 - Recognizing the Role of Direct Support Professionals Act - To require the Office of Management and Budget to revise the Standard Occupational Classification system to establish a separate code for direct support professionals, and for other purposes.
H.R.6075 - The HEADs UP Act - To amend the Public Health Service Act to expand and improve health care services by health centers and the National Health Service Corps for individuals with a developmental disability as a Medically Underserved Population (MUP).

H.R.4761 - A bill to amend the Rehabilitation Act of 1973 to ensure workplace choice and opportunity for young adults with disabilities.

H.R.4762 - A Bill to amend the Rehabilitation Act of 1973 to clarify the definition of competitive integrated employment.


VOR OPPOSES:

S. 3417 - The Latonya Reeves Freedom Act of 2021 - This bill may be seen as the offspring of the Disability Integration Act from the 116th Congress. It misrepresents Olmstead, and contains provisions that would be harmful to the existence of ICFs, including a section that would promote lawsuits against larger congregate care facilities.

H.R. 603 & S. 53 - The Raise the Wage Act - These bills are aimed at raising the minimum wage, but they also have provisions to phase out and ultimately eliminate vocational centers and 14 (c) wage certificates over the next six years and to immediately stop the issuing of any new certificates. VOR believes the issue of employment options for individuals with intellectual disabilities should not be buried in a bill for raising the federal minimum wage. Both issues deserve clean, stand-alone bills.

H.R.1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration.

H.R. 2383 & S. 3238 - The Transformation to Competitive Integrated Employment Act - this bill purports to assist employers providing employment under special certificates issued under section 14(c) of the Fair Labor Standards Act of 1938 in transforming their business and program models to models that support individuals with disabilities through competitive integrated employment, to phase out the use of these special certificates. We feel that, if enacted, tens of thousands of people with I/DD and autism will still be forced out of opportunities they currently, needlessly, and left without viable alternatives to occupy their time or address their needs and their abilities.

H.R.4131 & S.2210 - The Better Care Better Jobs Act - To be clear, we don't oppose this bill. We object to the fact that it excludes the most vulnerable members of the I/DD population.

While the Better Care Better Jobs Act would greatly increase the amount of federal funding for people with I/DD, it only supports those in waiver programs receiving Home and Community Based Services. It unjustly discriminates against those who have chosen Intermediate Care Facilities as the necessary and proper form of residential treatment. By giving a 10% increase n federal matching funds only to HCBS clients, and providing training and increased pay only to direct support professionals working in HCBS facilities, the act deliberately favors one form of treatment over another, one ideology over another, and one set of people with I/DD over another.
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 join.

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


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.

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 info@vor.net
droppable-1631310642232
836 South Arlington Heights Road #351 Elk Grove Village, IL 60007
Toll Free: 877-399-4867 Fax: 877-866-8377