February 24, 2023

U.S. Government Accountability Office (GAO) Releases Report and Recommendations Regarding 14(c) Programs

From the GAO Website, February 24, 2023

Employers that hold a special certificate from the Department of Labor can pay people with disabilities wages below the federal minimum wage. We found that about 120,000 workers were employed under these certificates, with half earning less than $3.50 an hour.

DOL oversees the certificate program, in part, by reviewing employers' applications and ensuring that they pay workers the correct wages. However, DOL has no timeliness goals for processing applications and has taken over a year to process some of them.

We recommended that DOL set and track timeliness goals for processing these applications to improve oversight of this program.

Highlights of the Report:

Through the 14(c) program, the Department of Labor (DOL) certifies employers to pay individuals with disabilities wages below the federal minimum—also known as subminimum wage. Employer participation in this program decreased by about half from 2010 to 2019, according to GAO's analysis of DOL data. During this period, the number of 14(c) workers also fell from about 296,000 to 122,000. Officials GAO interviewed from DOL and four stakeholder organizations attributed this decline, in part, to federal and state policies restricting the payment of wages below the federal minimum. Since August 2019, most 14(c) workers earned less than $3.50 per hour, while about 14 percent earned at or above the federal minimum of $7.25. Representatives from two of the four stakeholder organizations said these earnings patterns may reflect differences in workers' skills and abilities, employment opportunities, and state minimum wage laws.

Community rehabilitation programs provide vocational rehabilitation and other services to individuals with disabilities and represent the vast majority of 14(c) employers. According to GAO's survey of these employers, almost all 14(c) workers had an intellectual or developmental disability, and most were White and of prime working age (25 to 54 years old). In addition, these employers reported few 14(c) workers engaged in competitive employment—which includes earning at least minimum wage in a work setting with individuals without disabilities.

DOL oversees the 14(c) program in part through its certification process, such as by ensuring employers calculate wages accurately. However, this oversight has been hampered by long processing times for some applications, including renewals. DOL's processing times varied from 2 days to over 2 years, with about 40 percent completed within 4 months, based on GAO's analysis of data from 2019 through 2021. DOL's application processing manual states that staff are to ensure timely processing, but the agency has not set or communicated timeliness goals. Employers with an existing certificate are allowed to continue paying workers subminimum wages while waiting for their certificates to be renewed. However, if the employer incorrectly calculated wages during this period, the employer may owe workers significant back pay to make up the difference between the correct wage and the wage paid.

Recommendations for Executive Action:

1. The Administrator of DOL's Wage and Hour Division should set and track timeliness goals for intermediate steps and overall duration for processing 14(c) applications.
2. The Administrator of DOL's Wage and Hour Division should externally communicate its goals for processing 14(c) applications to employers and other program stakeholders, and its progress toward meeting these goals.
3. The Administrator of DOL's Wage and Hour Division should solicit feedback from 14(c) employers regarding the online application and take appropriate action to address any limitations to help improve the overall timeliness of certificate application processing. 

To read more, and to download the full GAO Report, Recommendations, or Highlights, click here

Senators Say Health Worker Shortages Ripe for Bipartisan Compromise

By Michael McAuliff, Kaiser Health News, February 17, 2023

The shortage that’s only worsened since the pandemic is a prescription for skyrocketing costs, suffering, and unnecessary death, Sen. Bernie Sanders (I-Vt.), the new chairman of the Senate’s top health committee, warned in his committee’s first hearing Thursday.

“We are going to produce legislation, and I think people will be surprised about the level of bipartisan supporters,” Sanders said in a brief interview during a break from the hearing. He called for the committee to “produce something meaningful.”

The shortage of health care workers of all sorts is a widespread problem, but is especially acute in rural areas and minority communities. Sanders pointed to the startling numbers of Americans living in medical care deserts to illustrate the point. There are nearly 100 million people who don’t have easy access to a primary care physician, almost 70 million with no dentist at hand, and some 158 million people who have few local mental health providers, Sanders said.

The covid-19 pandemic contributed to the nation’s existing worker shortage as many left the workforce as the crisis worsened. Some contracted the virus themselves, and large numbers of health care providers died. An investigation by KHN and The Guardian revealed more than 3,600 health workers in the United States died during the pandemic’s first year alone. Some got burned out or sought higher-paying jobs elsewhere.

“Despite all of our health care spending, we don’t have enough doctors, nurses, nurse practitioners, dentists, dental hygienists, pharmacists, mental health providers, and other medical professionals,” Sanders said, pointing to data that suggest the nation faces a shortfall of about 450,000 nurses and 120,000 doctors in the coming years, and 100,000 dentists now.

Continued

VOR Submits Comments to the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization

VOR's past president Sam Friedman submitted comments on behalf of VOR's families on the importance of protecting vulnerable populations against COVID-19 infections.

Download VOR's submission (and review submissions from others, as well) here

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.

• For information on various forms of planned giving, including making a charitable contribution using the Required Minimum Distribution from your IRA, making gifts of securities, or making legacy contributions through your life insurance policy, please click here.

• For information on the lasting impact of a will bequest, please click here.

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

Maine - Children are 'Languishing' in Hospitals While Waiting for Mental Health Services

By Emily Bader, Sun Journal, February 18, 2023

Children with mental and behavioral health needs end up "languishing" in hospitals for months on end thanks to long waiting lists and administrative barriers to treatment, proponents of a bill that would repeal the MaineCare "fail first" rule said.

Under the MaineCare rule, to be approved for treatment at a children's residential care facility a provider must give clinical documentation that a child or adolescent's situation has not improved with home or community-based services over the prior two to six months.

This often leaves children — defined as anyone under the age of 21 under state and federal laws — stuck waiting at the most restrictive level of care while their families and providers "jump through administrative hoops" to get them the proper level of care, the bill's sponsor, Rep. Ed Crockett, D-Portland, said.

This bill, LD 387, comes on a personal note, he told lawmakers on the Joint Standing Committee on Health and Human Services on Thursday. He said his nephew, who has severe autism, has "cycled in and out of hospital emergency departments and Spring Harbor Hospital when he didn't get the supports he needed in the community."

Continued

North Carolina - “Nobody Cares If We’re Shuttled Off Somewhere”

By Clarissa Donnelly-DeRoven, NC Health News, February 21, 2023

Jessica Aguilar has twin 10-year-old boys with autism. The family lives in Union County, just southeast of Charlotte. The boys require support workers to help them live with more ease — people who will take them to activities in the community, or who will help them practice new skills, like saying hi to strangers. 

But finding reliable people to do this work hasn’t been easy. 

“I have one [worker] that left my kids alone,” she said. Aguilar described how she went to take a shower once the support staff arrived, but then one of her boys got angry and started throwing things. In the middle of his episode, Aguilar said, the worker just left, without saying a word to her. 

“She got scared, and she went away,” said Aguilar, whose path to getting proper services for her children has led her to get involved in disability advocacy organizations. 

The challenges faced by direct support professionals and the people with disabilities who rely on them for care have been building for decades. 

“Without intervention, the current system of supports and services is at risk,” wrote three researchers from the University of Minnesota in a chapter of a 2002 book on the future of services for people with disabilities. 

“In the next 25 years, the focus of research and practice must shift from simply reiterating earlier findings to describing, testing, and implementing interventions to overcome workforce challenges,” they said. “Improving pay, paid leave time policies, benefits, and opportunities for advancement must become priorities among policymakers if community support services are to continue.”

More than 20 years later, you’d be hard-pressed to find a policymaker at the state or federal level who would argue that the shortage of these support workers isn’t a problem. What’s harder to locate, though, is the political will to solve the shortages, which are building to unsustainable levels. 

Right now, in North Carolina, about 20 percent of services the state authorizes for people currently on the waiver don’t get delivered, according to an analysis by NC Health News. That’s largely because of a worker shortage, advocates say. 

A national and local problem

In 2017, the President’s Committee for People with Intellectual Disabilities produced a 60-page report for then-president Donald Trump about the workforce crisis.

For 30 years, they wrote, persistent low pay, limited benefits and few opportunities for career advancement created a situation where the number of support providers is not keeping up with the number of people with disabilities who need their services. 

“There is no issue more pressing in regard to sustainability of service provision for people with [intellectual disabilities] than responding to the serious crisis it now faces,” the authors wrote. The shortage puts “people with [intellectual disabilities] who need assistance at great risk of harm, contribute[s] to unreasonably long waiting lists for services and [leads] many people to reconsider more expensive institutional models of segregated care outside their home.

Continued

Follow up on a previous article

Nevada -Young Man with Autism Stuck in Renown Moves into New Home

By Mark Robison, Reno Gazette Journal, February 22, 2023

CJ Stout – a young man with severe autism who’d been lingering for almost 10 months in a sparse hospital room because he had nowhere else to go – moved into a North Valleys group home Monday.

“He was confused because he’d been in the hospital for so long,” said Austyn Mahon, CJ’s legal guardian.

“He went to bed because he was used to being in bed all the time. I told him, ‘No, buddy, this is your house, you can get out of bed and run around the house a bit.'"

CJ has severe autism, is nonverbal, suffers seizures and has the mental age of a 3-year-old. At age 19, he was taken by Reno police to Renown Medical Center after attacking his family.

Renown is an acute-care hospital and trauma center. It is not equipped or staffed to handle patients with severe behavioral issues like CJ, but it had nowhere to send him despite months of seeking possible placements around the country.

The state of Nevada said unprecedented staffing vacancies and Reno’s affordable housing shortage have created hurdles for setting up intensive supported-living group homes.

Two days after the RGJ’s story about CJ published, Mahon was told a group home had been found.

“The story was wonderful, and we think it was helpful in getting him out of the hospital,” he said.

Continued

Connecticut - Medicaid Rates Leave CT Kids Without Autism Services

By Ginny Monk, CT Mirror, February 20, 2023

On a bad day in Antoinette Snow’s quest to get medication management services for her 15-year-old grandson, who has an autism diagnosis, the call goes something like this:

“We no longer participate in HUSKY.” Click.

On a good day, it’s more like:

“I would be glad to take you in, but I don’t participate in Medicaid or HUSKY. I’ll give you a number to this doctor that does.”

But another call reveals that the new doctor isn’t taking new patients.

It’s been the same way for the past few weeks. Snow’s grandson, Jaylen Poole, was discharged from a group home in December. His psychiatrist through the home gave him three months’ worth of prescriptions to carry him through until he found someone new.

But his grandmother isn’t sure she’s going to find someone by March. And through the waiting, her grandson’s behaviors are getting worse.

“He starts throwing stuff,” Snow said. “He does get aggressive sometimes. The doctors said most of that is communication issues. … He gets angry, and he lashes out.”

Kids across Connecticut, like Jaylen, are in a holding pattern. They’re wait-listed for autism services such as therapy and medication management, and while they wait, behavioral issues that need quick and consistent intervention are solidifying, parents and providers said.

If they don’t get the help they need, they are often at heightened risk of needing to be institutionalized or hospitalized because of their mental health issues.

Federal law requires that kids with autism diagnoses receive “timely and adequate medically necessary services,” a Dec. 15 letter from disability and child advocates to state officials said.

Reimbursement rates for Medicaid in Connecticut, where the program is known as HUSKY, are too low for autism behavioral services, providers and advocates say. They’re the lowest in New England.

It means providers are losing money when they offer services to kids with HUSKY insurance. Many have either added more patients with private insurance to their workload or aren’t accepting the public option, providers and advocates said.

“Kids with autism and other developmental and intellectual disabilities are really underserved,” said Sarah Eagan, Connecticut’s child advocate. “No one has ever pushed back on that — everyone acknowledges that.”

Continued

California Bill Would Reform ‘Failing’ System Serving Adults and Kids with Disabilities

By Maggie Angst, The Sacramento Bee, February 22, 2023

A state lawmaker has joined with parents and advocates in an ambitious effort to reform the system that serves adults and children with disabilities, a vast network of nonprofits that is “failing in significant ways,” according to a new bill.

Assemblywoman Dawn Addis, D-Morro Bay, last week introduced a bill designed to provide greater transparency, accountability and increased confidence in California’s $13 billion developmental disability service system. The measure follows a series of recent reports, a state audit and public hearings that revealed racial disparities, inadequate oversight and limited accountability at California’s regional centers — a network of 21 nonprofits that coordinate services for about 400,000 children and adults with developmental and intellectual disabilities.

“We all know somebody or have a family member that’s connected to the system and it’s important that we’re speaking out and paying attention,” Addis, a longtime special education teacher, said in an interview. “This level of accountability is incredibly important so that we know they’re getting the services they need.”

The Lanterman Developmental Disabilities Services Act, enacted in 1977, requires California to provide services and support to individuals with intellectual and developmental disabilities. The Department of Developmental Services funds those services through contracts with the regional centers, which maintain an operating budget of more than $13 billion.

AB 1147 states that the regional centers are “failing in significant ways to deliver critical, adequate, and timely services to individuals and families” — and especially to Californians of color. As a result,

individuals and their families are denied timely access to services and support, the bill says, barring them from living independently and integrating their lives with the surrounding community.

The legislation, called the Disability Equity and Accountability Act, would establish statewide performance standards for regional centers across a range of categories, including equity in access, civil rights and health and safety. It also would set strict response times for regional centers when they receive phone calls and requests for evaluations.

A state audit released last summer reviewed practices at three of the state’s regional centers — Alta California in Sacramento, North Bay in Napa and North Los Angeles — and found a slew of deficiencies at each.

Among the findings was that none of the agencies employed enough service coordinators to meet legally required coordinator-to-consumer ratios. They also failed to properly monitor vendors who provide direct services and had no mechanism to track crucial customer service metrics, such as wait times, timeliness of referrals and the distance that individuals must travel to get services. And according to two recent reports, communities of color have, and continue to be, plagued the most by those issues.

Read the full article here

(Reminder: California closed all of its State Operated Intermediate Care Facilities in recent years to support a one-size-fits-all community model)

Illinois - GOP Lawmakers Make Proposals for Choate while Decrying Pritzker’s Handling of Troubled Downstate Mental Health Center

By Jeremy Gormer, Chicago Tribune, February 23, 2023

Decrying Democratic Gov. J.B. Pritzker’s administration’s response to the systemic mistreatment of residents of a downstate mental health center, GOP lawmakers on Thursday laid out a plan to address the long-standing issues.

The proposal from House and Senate Republicans for the Choate Mental Health and Developmental Center in Anna offers fixes that range from additional surveillance cameras to additional employees who are better trained to work with the mentally and developmentally disabled residents of the facility.

“These are the families’ loved ones. We need to fix it. This is a plan. Is it the perfect plan? No. But it’s a plan and it’s a start. And it’s more than we’ve had from this administration,” state Rep. Charles Meier, of Okawville, said during a news conference at the Illinois State Capitol.

The lawmakers also wrote a letter to their cohorts in the Democratic supermajority calling for legislative committee hearings to discuss the problems.

The letter notes that Choate has been the subject of “more than 1,500 complaints to the Illinois Department of Human Services spanning the last decade” and acknowledges the problems “have spanned multiple DHS directors and multiple gubernatorial administrations.”

“Our concern in this matter is for the dignity, safety, and well-being of the 270 residents of Choate that suffer from the most profound developmental and mental disabilities in the state,” the legislators wrote. “Our concern is far from political.”

Pritzker’s office on Thursday said the administration has taken steps to address the issues at Choate that include more training for staff, as well as an ongoing effort to install indoor and outdoor cameras, an increase of about a half dozen security workers and “increased management presence in living areas and professional staff presence after hours.”

“The governor is closely monitoring the situation and will move forward on additional reforms in the coming weeks,” said Pritzker spokesman Alex Gough. “We take the long-standing problems at Choate very seriously and remain committed to providing good, quality care for residents and patients at the facility.”

Pritzker last week said that finding the right workers for rural facilities like Choate can be a challenge. At the GOP news conference, Meier said there needs to be a “mass hiring” at Choate to bring in workers who “won’t feel threatened maybe from a few bad apples of the past, workers that threatened to try to cover up abuse.

“Let’s train them. Let’s get them in there,” Meier said. “Let’s not hire two or four or 10 at a time. Let’s bring in a group of 50 workers or more immediately to help take care (of this).”

Gough said the Pritzker administration has arranged for an independent, third-party review of conditions at the facility, and that other reviews, including from the Illinois State Police for “security” and “physical structure” needs, have been conducted.

Republican state Sen. Jil Tracy of Quincy acknowledged she’s seen “improvements” in the facility, but suggested that there are “doable solutions” to Choate that can avert a potential for shutting it down, which Pritzker has suggested as recently as last week could be an option.

Tracy grew up in Anna and said she has a developmentally disabled brother who has lived in Choate for about two decades. “They (Choate) have the type of care that is needed by the population that resides there.”

Meier said Choate’s staff needs to keep better track of problems between workers and residents, while also making simple changes such as decorating hallways and rooms.

“This is a small thing but the more the homes (that) are clean, well-decorated, the more the staff and residents take pride in their home,” he said.

Continued

My Intellectually Disabled Child is Growing Up to be an Intellectually Disabled Adult. I Won’t Let It be a Tragedy

By Erin Prater, Fortune, February 18, 2023

Moms are fixers.

We fix all the things. From bloody noses and skinned knees, to broken hearts and shattered self images, we have the uncanny ability to make everything right—even when we’re not quite sure ourselves how we manage to.

Apparently, however, there are limits to this magic called a mother’s love—a reality I’ve been wrestling with as of late. 

My son was diagnosed with intellectual disability later in childhood—at age 10, delayed a bit by pandemic upheaval. Since age 6, Cyrus had carried a clinical diagnosis of Opitz Kaveggia Syndrome—a rare, X chromosome-linked “mental retardation” disorder. Also known as FG Syndrome, the condition often involves “midline defects” like tethered spinal cord, brain abnormalities, and laryngeal cleft, in addition to low muscle tone, absolutely wicked constipation, immune deficiencies, and, well, intellectual disability. 

No one symptom, however, is obligatory—not even intellectual disability, Dr. John Opitz, a legend in the world of genetics who discovered this and many other syndromes, and who so generously met with and diagnosed Cyrus in retirement, once told me.

The actual diagnosis of intellectual disability eluded Cyrus for years. Neuropsychological testing repeatedly returned IQ scores in the normal range from ages 4 through 6—though he began to amass an entire collection of other cognitive diagnoses like ADHD, Auditory Processing Disorder, Visual Processing Disorder, Sensory Processing Disorder, executive dysfunction, slow processing speed, and nearly every learning disability known to man.

All the while, most medical and educational professionals dismissed Cyrus’ warning signs of intellectual disability, from delayed developmental milestones to woeful academic performance despite every intervention I could afford. Six-year-old Cyrus attended occupational, physical, and/or speech therapy five or six nights a week for years. He would catch up if he just worked harder, they insisted.

How wrong they were. After years of gaslighting, Cyrus’ IQ tanked an astonishing 30 points in two years, for reasons we still can’t fully explain.

Now, my adorable, sweet intellectually disabled child is turning into an intellectually disabled adult whom society simply doesn’t value. While he’s only 11, he’s in the final stage of puberty, his endocrinologist says—a process hastened by the growth hormone shots he takes nightly because his brain doesn’t produce enough. Middle school looms. And nothing I’ve done—not the countless nights I’ve lost sleep to research his myriad conditions, not the tens of thousands I’ve thrown on extra resources insurance won’t cover—has changed this reality.

When and where it matters the most, I feel like I’ve failed. I didn’t fix it. I didn’t fix him. And the whole thing is gutting me.

Continued

Nowhere To Go: The Lack of Provision for Young People with Complex Needs

By Renata Blower, Special Needs Jungle, February 22, 2023

We are all painfully aware of the lack of special school places and the impact that this has on young people, their families and the schools that are having to try and bridge the gap without adequate funding or resources. However, we hear far less about how these gaps in provision affect our young people with the most complex needs which require highly specialised residential support.

Today Sarah London shares her family's fight to prevent her son becoming homeless after his residential home closed without consultation, giving the families only three weeks' notice:

"As a mother of a 17-year-old severely autistic young man, I feel pretty accomplished in navigating the complex systems and processes that comes with special needs. I’ve been a voice for a child who cannot speak or comprehend his place in the world. I’ve immersed myself in a world of EHCPs, communication systems, sensory diets and behaviour support plans. All of which, at times, have broken me. Forced me to bury my head in the sand and suffer the overwhelm and horrendous guilt of parental failure. But then there have been the times where the utter injustice of it all has enraged and empowered me to fight, to TRY and change the utterly broken system that underpins my child’s entire life.

At the age of seven, my child’s needs became unmanageable at home and his special school was on the brink of excluding him. Caring for a severely autistic child, who is also profoundly deaf, non-verbal, and has significant learning and behavioural difficulties is a challenge, to say the least. I didn’t want my child to go into a residential school at this young age but I had no choice. Neither did I have a choice over where this placement would be; he was sent out-of-county. No provision existed for him close to home. At just seven, I packed up my son’s belongings and moved him 75 miles away from all he’d ever known. 

The reality of being an absent parent, a role I never wanted, was forced upon me. I became a mother who detached herself from her child in order to function, to live. Letting go of not putting my child to bed, knowing that if he wakes frightened in the night and wants me I can’t be there. Accepting that strangers will spend more time with my child than me. 

The only positive I can take from this is that it has made me fiercely protective, if I cannot perform these motherly duties then the people who can better do a damn good job! 

However, the truth is, as a parent you feel that no one can care for your child better than you. No one can even come close. This situation was always destined to fail.

And it has failed, epically.

My biggest battle began on 22nd November 2022, when my son’s school gave him notice to leave in three weeks’ time. This was a residential placement that has become my child’s home 52 weeks a year, a place of education, a therapy centre - a multidisciplinary security blanket. 

After nearly 10 years, my boy was expected to leave, no transition and no preparation. All because this private company were trying to avoid the implications of a forced closure by Ofsted. The fourth consecutive ‘inadequate’ rating finally came with some consequences. I hadn’t been happy with the care my son received for many years but as a parent, you have little control. We are dealing with a private company profiting from vulnerable individuals who require care above and beyond you and me. Every child is a business transaction.

My boy’s world was about to fall apart. I fought so hard; raised awareness through the media, created campaigns on social media, recorded a podcast and worked alongside our local authority and MP, even funding legal representation.

The day before his eviction the notice period was suspended and my child was given the chance to spend Christmas in his home. I like to think that we live in a society that was as outraged as me that a vulnerable child could be made homeless just before Christmas by a company that claims ‘to actively enable each and every one of the people in our care to achieve their personal best’.

Continued

Another Way to Say Thank You

Have you thought about maybe making a recurring donation to VOR?

Many folks have found that recurring donations are an easier, more budget-friendly way to contribute.

May we suggest $19 per month?



We don't know why, but that seems to be the popular amount that many charitable organizations suggest. No matter; we are grateful for any gifts we may receive, be they recurring, annual, spur-of-the-moment, or in gratitude for past benefits or paying it forward for the future.

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.

[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) - To 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) To 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 HAS CONCERNS WITH:

S.100 - Better Care Better Jobs Act

Sen. Bob Casey (D-PA) 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.

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.

VOR OPPOSES:

At this time, there are no bills which we outrightly oppose. Stay tuned.



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