February 14, 2020
VOR Weekly News Update 
VOR is a national organization that advocates for high quality care and human rights for 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's 2020 Annual Meeting & Legislative Initiative

 Hyatt Regency Capitol Hill
Washington, D.C.
June 6 - 10
VOR's Annual Meeting and Legislative Initiative will be held on June 6 - 10th this year.
Details will be forthcoming.

If you are planning on creating a crowdfunding campaign, now is the time to begin!

Our room reservation block at the Hyatt won't open for several weeks, but it's not too early to start planning your stay and making reservations for air or train travel.
VOR and YOU:
While this week's National News may appear to dominate this week's Newsletter, please read through to the State News as well. In addition to the Pennsylvania governor vetoing the bill that would save the White Haven and Polk Developmental Centers, there are two articles about Arizona and North Carolina that are of great importance to the survival of Intermediate Care Facilities
VOR ❤️ 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.
Another Way To Donate
Over the years, VOR members have suggested that donations be made in memory of loved ones with I/DD or their family members, or to honor a member of their community who have helped in the struggle to support services for people with I/DD.

If you are interested in setting up a memorial or a tribute, please use the form on our website. This will ensure that both the donor and person setting up the donations will be notified accordingly.
National News :
As Caregivers Age, People With Disabilities See Few Housing Options
By Michelle Diament, Disability Scoop February 10, 2020
A national study finds housing choices are limited for people with developmental disabilities who often get little say about where they might live when they leave home.

Currently, about 75 percent of adults with disabilities live with an aging parent or caregiver and most are not utilizing public supports or services, according to a new report from The Arc. More than half of families have no plan for the future.

The report is based on a survey of 615 people across the country, split about evenly between those with intellectual and developmental disabilities and their family members. Researchers also conducted a series of group brainstorming sessions with 111 individuals with disabilities and their families in Illinois, a state that’s notorious for having limited community-based options for adults.

Families reported significant barriers to finding
housing. More than half of those surveyed said that the current living situation was the only one available to them. When asked about their dream home for themselves or their loved one with developmental disabilities, over 60 percent said it would be their own home or apartment, while just 14 percent cited a group home and fewer than 12 percent said the home of a family member or friend.

There is no centralized place to find information about housing for this population, the report found. Instead, families said they have turned to government agencies, local centers for independent living, social media and informal networks of family and friends for ideas.

Poliitics:
Trying to Be Apolitical in a Politically Charged World

The future well-being of our loved ones is VOR's most important concern. We try to remain neutral in political matters, but that's practically impossible as policy is determined by those we elect to office and those they appoint to head agencies like HHS, DOJ, and CMS.

We understand that many of our members are not one-issue voters, but that I/DD issues hold a higher priority in their support of one candidate or another. Therefore, we do try to keep our members informed of the issues and the candidates' positions.

In reading any news articles, please remember to evaluate the source. All news outlets these days have their biases and most of their readers have their own biases as well. We can't tell anyone who to trust (Where's Walter Cronkite when we need him?) but we try to provide information to help you to better understand and evaluate the decisions that will face you in the political season that lies ahead.

That being said, remember that there is no candidate that meets our needs as far as helping people with I/DD and autism. Some believe the ARC's view of Olmstead as an inclusion mandate, and that one size will fit all. Others don't swallow that Kool-Aid, but want to make drastic cuts to the funding that holds up the safety net that is vital to our loved ones' well-being.

Needless to say, if there was a candidate that supported a full continuum of residential care and employment opportunities, while increasing funding to levels that would eliminate waiting lists and provide appropriate services to meet the needs of all people with I/DD and autism, we would abandon our apolitical stance and quickly endorse them. Until then, we continue to hope, to educate, and to advocate.
Trump Budget Calls For Cuts To Disability Programs
By Michelle Diament, Disability Scoop, February 13, 2020
President Donald Trump is proposing cuts to countless programs benefiting people with disabilities, advocates say, touching everything from Medicaid to employment and autism treatment.

Trump unveiled his $4.8 trillion budget proposal this week for the 2021 fiscal year that starts in October. The president’s budget is unlikely to be rubber-stamped by Congress, but essentially serves as a wish list outlining his priorities.

Trump is seeking reductions to Medicaid, food assistance, state councils on developmental disabilities, university centers on developmental disabilities and protection and advocacy programs, said David Card at the National Disability Rights Network.

“These programs don’t need cuts, they need increases to continue to meet the need of people with disabilities to be able to live and work in their communities,” Card said.

Trump would do away with a supported employment program and eliminate funding for an Autism CARES Act initiative to train health professionals to screen, diagnose and treat those with autism, officials at the Autism Society of America noted.

The budget plan would chop respite care funding in half and includes a $48.56 million cut to the Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities, which tracks the prevalence of autism and other disabilities.
“This budget requires tremendous sacrifices from those with the least ability to sacrifice,” said Christopher Banks, president and CEO of the Autism Society of America. “The president’s budget dramatically reduces the funding for vital supports that assist those with autism, negatively impacting the quality of life and opportunity for our community.”




Related Articles:




Bernie Sanders’s Regressive Disability Plan
By John Hirschauer, National Review, February 11, 2020
Whatever the intentions of its drafters, Bernie Sanders’s new “Disability Rights” platform would deprive thousands of people with the most severe disabilities of both their freedom of choice and their ability to access intensive support services. Sanders’s platform, concocted in tandem with a coterie of disability activists and self-advocates, details the candidate’s plans to pass the “Disability Integration Act” and to instruct the Department of Justice to “aggressively” enforce the Supreme Court’s Olmstead decision.

These policies will, if enacted, affect some of the most vulnerable members of our society, who cannot voice their objections to the dogmatic pronouncements of those claiming to speak on their behalf.

The Disability Integration Act, for instance, threatens the home of Stacie Choslovsky, a resident at the Misericordia campus in Chicago. Her brother, Bill, is Stacie’s guardian, and an Illinois attorney who has argued and consulted on numerous disability-related cases. Bill told National Review that Stacie was “born with an ageneis of the corpus collossum,” which is a rare congenital brain condition characterized by the lack of transverse fibers between the two brain hemispheres. She “functions at a one-year-old level and needs help with every aspect of life,” Bill said, and requires assistance “walking, eating, bathing, and toileting.”

To Choslovsky’s dismay, Sanders promised that he, as president, would “pass the Disability Integration Act,” citing the supposed endorsement of “a broad cross-section of the disability community.” Whether a group of federally funded advocacy non-profits and associated polemicists
who call themselves the “disability community” is, in fact, representative of all persons and families with disabilities is unclear.Sanders nevertheless brandishes this “broad” endorsement in defense of the DIA.The bill, as written, would treat Stacie’s residential placement at Misericordia — a campus setting with on-site medical, nursing, and psychiatric services — as a prima facie injustice to be “eliminated” rather than, as Bill calls it, “a family to us, and a beautiful lifeline” for his sister. The DIA, which has been introduced in the Senate, instructs states to “eliminate institutionalization” and transition individuals with “all types of disabilities at all ages out of institutions and into the most integrated setting.” It also invokes the “holdings of the Supreme Court in Olmstead v. L.C” as a mandate for its proposed course of action.

Despite its drafters’ claim to the contrary, the DIA betrays the Court’s holding in Olmstead. This case weighed the legality of institutional placements under the Americans with Disabilities Act. The Court’s majority held that states were obligated to provide placement in the “most integrated setting appropriate to the needs of qualified individuals with disabilities (emphasis mine),” deferring that judgment to the state’s medical professionals, and — critically — rejecting the suggestion that there was a “federal requirement that community-based treatment be imposed on patients who do not desire it.”

Verma Strikes Back on MFAR: Worries Over Billions in Medicaid Cuts ‘Alarmist’ and ‘Overblown’
By Alex Spanko, Skilled Nursing News, February 12, 2020

The head of the Centers for Medicare & Medicaid Services (CMS) on Wednesday issued a strong defense of a proposed rule that nursing home advocates claim would place up to $50 billion in Medicaid reimbursements in immediate jeopardy, framing the move as a necessary step toward reducing fraud and waste.

The Medicaid Fiscal Accountability Regulation (MFAR), which would bring stricter oversight to various Medicaid supplemental payment programs developed at the state level, was not designed to cut funding for health care facilities, CMS administrator Seema Verma wrote in a blog post.
“This proposed rule is not intended to reduce Medicaid payments, and alarmist estimates that this rule, if finalized, will suddenly remove billions of dollars from the program and threaten beneficiary access are overblown and without credibility,” Verma wrote. “If states have arrangements that need to evolve, we will work with them to achieve a successful transition.”

Though Verma did not mention a specific price tag in her piece, the American Health Care Association and the American Hospital Association estimated the potential loss to health care providers at $50 billion each year.

“The bleak reality is that Medicaid funding is already inadequate,” AHCA CEO Mark Parkinson and AHA CEO Rick Pollack said in a joint statement released late last month. “Enacting this proposed rule would cut up to $50 billion nationally from the Medicaid program annually, further crippling Medicaid financing in many states and jeopardizing access to care for the 75 million Americans who rely on the program as their primary source of health coverage.”

State News:
Pennsylvania - Gov. Wolf Vetoes Bill to Put Moratorium on Closing State Centers
By FOX56 Newsroom, February 12th 2020
Governor Tom Wolf vetoed Senate Bill 906, which would have put a moratorium on the closing of any state center and was introduced after the Department of Human Services (DHS) announced the closing of two of the remaining four state centers – Polk, in Venango County, and White Haven, in Luzerne County.

The bill would have blocked the closure of any state center for at least five years and put the decision to close any state center in the hands of the task force created by the bill.

According to a press release issued today, Gov. Tom Wolf gave a statement on his decision-

“All people deserve the opportunity to live among their family and peers in integrated, supportive homes. Quality home and community-based care should be the priority for the individuals we serve. Community care results in better outcomes for individuals with disabilities. Individuals with disabilities should be offered an everyday life as fully integrated members of our communities. My goal is to serve more individuals in the community, reduce reliance on institutional care, and improve access to home and community-based services.

State Senators John Yudichak, Lisa Baker, Scott Hutchinson and Michele Brooks released the following statement regarding Governor Wolf’s veto of Senate Bill 906:

“We are profoundly disappointed with Governor Wolf’s decision to veto Senate Bill 906 – a bipartisan bill that would have empowered families with what we believe is their right to choose the best level of care for their loved ones with intellectual
disabilities. The Administration’s decision to close White Haven and Polk State Centers ignores the voices of families and mounting data that underscores the shortcomings of limiting choices on how best to serve individuals with intellectual disabilities.
Furthermore, the Governor’s veto of Senate Bill 906 is devastating for the family members, the dedicated employees and the individuals with intellectual disabilities who call White Haven and Polk State Centers home.”

State Rep. Gerald Mullery issued the following statement after Gov. Tom Wolf’s veto today of S.B. 906, which would put a moratorium on the closing of the White Haven and Polk state centers:
“Governor Wolf’s decision to close the White Haven and Polk centers was wrong and his decision to veto legislation designed to protect our most vulnerable neighbors is equally wrong,” Mullery said.

“Governor Wolf’s cavalier dismissal of these residents’ desires, their family’s concerns, and their caregiver’s commitment is disheartening. To issue this callous veto in the face of the recent Office of Inspector General report is nothing more than repulsive. Not only are our community-based care providers failing their residents, our Department of Human Services is complicit in their failings and unprepared or unwilling to protect our intellectual and developmentally disabled citizens. Anyone who read the OIG report would agree the need for a moratorium is correct and necessary. Governor Wolf appears more interested in saving face with interest groups like The Arc than ensuring the safety and well-being of these centers’ residents.

Pennsylvania - Opinion: Don’t close Polk Center Without Plan for What Comes Next
By Lisa Thompson, GoErie, February 9, 2020
Red “Polk Center Strong” placards light up dead lawns and key crossroads in my native Venango County. They are more common now than the only other sign of political activism – art trumpeting fealty to the president.The two are not unrelated.

Donald Trump got traction here in part because he promised a return of something that anymore feels like snatches of a dream you can barely recall upon waking. A community flush, not desiccated and left to feed on itself. After decades of loss – the exodus of Quaker State and major retailers; the Pennzoil refinery shutdown; Joy Manufacturing’s downsizing – decline itself has become a prominent industry. Courts and human services agencies treat dysfunction sown by poverty and despair.

Polk Center, a historic institution that cares for people with developmental disabilities, stands in contrast. Home to 800 government jobs, it now anchors the economy as the county’s largest employer.

That’s why when Gov. Tom Wolf’s administration in August abruptly marked Polk for closure, residents and lawmakers, some not inclined to activism or even necessarily likely political allies, rushed to the barricades.
The campaign to save Polk Center rightly focuses first on the facility’s residents.

Numbering nearly 200, they are people like Vicie Jewell, who, as my colleague Jim Martin memorably detailed in September, communicates with a bird-like coo. Polk, her home of 72 years, is all she has ever known, her sister said.

Wolf’s administration seeks the closure of Polk and another center in Luzerne County in the name of savings and inclusion. Individuals like Jewell, however, are not the sort who will move into group homes, forge new relationships and exercise freedoms as so many others did when the push to empty institutions began decades ago.

And there are legitimate questions about whether community-based options can deliver the same quality of care to them.

But people here also raise the alarm because we know our own vulnerability. If the governor closes Polk Center, he might as well bring a pillow with him when he does it, put it over our collective faces and get it over with. We are done.

Arizona - Hacienda HealthCare Case Prompts Federal Legislation
By Stephanie Innes, The Republic, February 13, 2020
The rape of a patient at Hacienda HealthCare in Phoenix was the catalyst for a proposed federal law that is set to be introduced Thursday in Congress.

The bill aims to improve transparency by giving the public easily accessible information about quality problems and substantiated complaints at facilities such as Hacienda.

The bill will be introduced in the Democrat-controlled House by Rep. Ruben Gallego, an Arizona Democrat whose 7th Congressional District includes the 60-bed intermediate-care facility on East South Mountain Avenue in Phoenix where the patient was raped and on Dec. 29, 2018, gave birth to a boy.

A 911 call during the birth indicated that none of the staff had known the woman was pregnant. Phoenix police later arrested one of the patient's caregivers on sexual assault charges, citing DNA evidence. 

"This is a problem that's in my backyard and it's our responsibility to fix it and to prevent it in the future," Gallego told The Arizona Republic on Wednesday.

Rep. Tom O'Halleran, a Democrat representing Arizona's 1st Congressional District, is a co-sponsor of the bill, which zeroes in on facilities that like Hacienda are designated as "intermediate-care facilities for people with intellectual disabilities." 

Among the bill's measures is a mandate that information about intermediate-care facilities be publicly posted, including inspection reports and the number, type, severity and outcomes of substantiated complaints. The public needs to be able to easily find information about facilities' shortcomings, Gallego said.

Companion legislation is expected to be introduced in the Republican-controlled Senate by Sen. Martha McSally, R-Ariz., and Sen. Kyrsten Sinema, D-Ariz. 

“Despicable abuse in residential care facilities, particularly those that care for vulnerable patients, should never take place again anywhere," McSally said in an emailed statement. "Following the appalling instances at Hacienda HealthCare in Phoenix, members of the Arizona delegation are partnering together to introduce bicameral, bipartisan legislation to increase transparency and accountability at these facilities and I am glad to lead the effort in the Senate.”

North Carolina - Court Ruling Says NC is Illegally Segregating People with Disabilities
By Trent Brown and Lynn Bonner, The News & Observer, February 07, 2020
North Carolina has been illegally segregating people with intellectual and developmental disabilities in institutions or putting them at risk of institutionalization, a court ruled Thursday.

The lawsuit was filed by Disability Rights North Carolina in 2017 against the state, the N.C. Department of Health and Human Services and Secretary Mandy Cohen.

It argued that insufficient state funding and inattention to disabled people’s needs are causing many to be placed in an institution or live without the services they require.

“This order is the first step, and we will be actively working toward a remedy that helps more people with I/DD get the support they need in the home they choose, said Virginia Knowlton Marcus, CEO of Disability Rights NC, in a press release. “We hope that the State and DHHS will commit to do the same.”

The decision came from Judge Allen Baddour in the N.C. Superior Court.

The nonprofit group filed the lawsuit on behalf of five people, including a woman who the lawsuit said had been forced to live in a state developmental center because her parents could not find community care providers for her. Two others lived outside institutions but had services being cut.
The fourth person lived in a Morganton group home despite his wish to live in Raleigh near his family, and the fifth person was getting inadequate treatment in an adult care home, according to the lawsuit.

Innovations Waiver Waitlist

Disability Rights NC said the judicial order declares the state and DHHS have violated a legal mandate that people with disabilities may not be forced to live in institutional settings in order to get the services they need.

In most states, people with disabilities apply for a Home and Community Based Services waiver, created to meet the long-term needs of people who don’t want to live in a state institution. The waivers are funded through both federal and state money. In North Carolina, the waiver is called the Innovations Waiver, which around 13,000 people use.

However, there are also more than 12,000 people waiting for the waiver, and that number is continuously growing, The News & Observer recently reported. State budgets proposed by the legislature or the governor would add 150 to 1,000 new waiver spots.

Oregon - DHS Got $30 Million For Developmentally Disabled Program; Now It Needs $12 Million To Fix Errors
By Ben Botkin, The Lund Report, February 12, 2020
A year ago, state legislators approved $30 million to improve a program run by the Oregon Department of Human Services for the developmentally disabled.

But on Wednesday, DHS officials were back before the Legislature, asking for more money.
They need $12.2 million of taxpayer money to fix errors that shouldn’t have happened in the first place.

The errors were made by a vendor hired by DHS to design a higher rate system for caregivers, aides and other staff who care for some of society’s most vulnerable. The $30 million that the Legislature approved last session was supposed to be used to increase their hourly wages to $15 starting this July. They currently earn an average of $13.86.

To do that, DHS needs a new rate system, which is used to pay providers such as The Arc that hire the front-line staff.
The program cares for 29,500 people with intellectual and developmental disabilities. DHS pays private companies taxpayer money to serve this population.

The problem with the program came up Wednesday during a meeting by a Ways and Means subcommittee.

Advocates said a denial of the funding would be devastating for Oregon’s efforts to appropriately fund a program that serves people with special needs. Services can range from around-the-clock care to less intensive care for people.

The errors have created uncertainty for providers who rely on DHS to pay their caregivers.

New Jersey - Sweeney Bill Would Fund Pay Hike for Direct Care Workers
Insider NJ, February 13, 2020
A senate committee today approved legislation sponsored by Senate President Steve Sweeney that would provide $16.5 million to fund pay increases for the direct care workers who provide care for the disabled. The additional funds would increase the existing appropriation of $40 million this year to a total of $56.5 million. 

“The service providers who are on the frontline providing care for the disabled should be fully appreciated and valued for their service,” said Senator Sweeney (D-Gloucester/Salem/Cumberland). “I have a lot of respect for these dedicated workers because I understand and appreciate the type of work they do. This is additional funding that will help provide them with a living wage.”

Providing these services requires a trained support professional workforce, Senator Sweeney said. They provide support necessary for individuals with intellectual and developmental disabilities to live with a level of independence in their home communities.
These DSP workers, called direct support professionals, hold jobs that require background checks, training and working with people who have medical and behavioral challenges, as well as limited communication skills. Their duties include meeting medical and behavioral health needs, and teaching workplace, and social skills.
 
At an average starting salary of $12 per hour, DSP wages are not competitive. Due to the low salaries, there is a high turnover and some of the workers are forced to seek public assistance or work multiple jobs. The increased state funding will support the service organizations in paying their employees the increased minimum wage, which will climb to $15 per hour in the coming years.

Tennessee - Opinion: My Sister Wouldn't Have The Help She Needed if not for Direct Support Professionals
By Frances James Metheny, The Tennessean, February 13, 2020

When my youngest sibling Carol was diagnosed with autism at age two, it was the beginning of my family’s journey to find education and support for her special needs. Carol is now 56 and our journey continues, helped immeasurably by dedicated Direct Support Professionals (DSPs) whose assistance is crucial to her quality of life.

Carol requires 24/7 supervision and cannot function on her own. SRVS, a Memphis disability services nonprofit on whose board I serve, provided an environment where Carol found a home in one of its residential settings, in a community that understands her needs and provides peace of mind to the family.
Caregivers' work goes unappreciated    

Disability services providers rely on DSPs to assist individuals with activities of daily life. Everyday tasks can seem daunting to people with Carol’s challenges and she requires close supervision. The DSPs are surrogate family in every sense of the word. They learn the likes and dislikes of the people they support as well as their strengths and weaknesses.

Support includes monitoring health, administering medications, providing supervision for meal preparation, housekeeping, laundry and personal hygiene. Many accompany the people they support to medical appointments and interact with the health care professionals.

As a family member and a SRVS Board member since the 1990’s I have personally witnessed the compassion, patience and ingenuity of DSPs. The state legislature in recent years approved a raise in base pay for DSPs across the state to $10 an hour. That commitment was a much-appreciated step in the right direction. 

However, it’s not enough for DSPs to get by today as higher paying jobs, outside the field of their passion, lure them away. DSPs need the $15 an hour sought by disability services provider trade association Tennessee Community Organizations (TNCO) to help retain employees rather than see them leave for that wage somewhere else. 

Losing a longtime DSP can be as devastating as losing a family member .

California - Chiu Bill Would Expand Access to Dental Care for Special Needs Patients
Bay City News via San Francisco Examiner, February 13, 2020
State Assemblyman David Chiu, D-San Francisco, announced Wednesday he’s introducing a bill to expand access to dental care for special needs patients throughout California.

Assembly Bill 2146 would allow dental clinics at public universities to have access to federal matching dollars in order to increase access to dental care for people with developmental disabilities and other special health care needs, according to Chiu’s office.

The federal matching dollars would come from an agreement between the schools and the California Department of Health Care Services and the U.S. Centers for Medicare and Medicaid Services.
“Dental care is such a vital part of maintaining good health, and yet it is so often overlooked in broader health care conversations,” Chiu said in a statement. “The special needs dental clinics at our public universities are a lifeline for many, but they need more resources to increase access and care for our most vulnerable,” he said.
Research shows people with developmental and intellectual disabilities have a disproportionately high rate of dental disease and tooth decay. Also, because they often have special health care needs, many dentists aren’t equipped to provide them with care, leaving people with disabilities few treatment options.

The bill would also help provide dental students with training and aims to increase the number of providers who are able to treat special needs patients.


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]
VOR Bill Watch:
Click on blue link to view information about the bill

VOR OPPOSES:

H.R. 555 & S. 117 - The Disability Integration Act - This bill has written into it the goal of eliminating "institutional care". In addition to the inherent bias against ICF's and people with severe and profound I/DD, the bill is prohibitively costly and there are not enough Direct Support Professionals to meet the provisions of this act.

H.R. 582 & S. 150 - The Raise the Wage Act - This bill is aimed at raising the minimum wage, but it also has provisions to eliminate 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. 873 & S. 260 - The Transformation To Competitive Employment Act - This bill has declared the goal of eliminating Sheltered Workshops and 14(c) Wage Certificates, under the mantle of everyone with a disability is capable of competitive integrated employment.
Sponsors of the bill recently added a new summary that significantly downplays the effect the bill would have on eliminating work centers and 14(c) that benefit those who are unable to compete in the employment opportunities the bill promotes.

Money Follows the Person Renewal (Authorization and Appropriations) - Money Follows the Person (MFP) has been a popular program that has helped many people to move from congregate care into smaller, settings. Unfortunately, it has been used by some states to force the closure of ICFs and move people into "integrated" settings without their consent. We ask that MFP not be renewed until this and other shortcomings have been remedied. MFP has passed through Congress by voice votes, without discussion of these problems.

VOR SUPPORTS:

H.R. 2417 - 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. 5443 & S. 3220 - Ensuring Access to Direct Support Professionals Act -
To amend title XIX of the Social Security Act to clarify that the provision of home and community-based services is not prohibited in an acute care hospital, and for other purposes.

H.R. 1379 & S. 560 - Ensuring Lasting Smiles Act - To require that group and individual health insurance coverage and group health plans provide coverage for treatment of a congenital anomaly or birth defect. (i.e. Cleft palate, ectodermal dysplasia, etc.)
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