October 4, 2024

VOR's Weekly News Update

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run by families of people with I/DD and autism

for families of people with I/DD and autism.

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Please Contact Your Legislators!


Senators Tom Cotton and John Boozman send a letter to Shalanda Young, Director of the The Office of Management and Budget and Julie Su, the Acting Secretary of Labor in defense of 14(c) programs. The letter stated that all people deserved to have the opportunity for dignified work, which these programs provide. They also declared that only Congress has the authority to amend or overturn a law passed by congress.


We urge our members to share the Senators' letter with their elected officials, and give voice to protecting all employment opportunities for people with I/DD.


Link to Senator Cotton's statement


Download a copy of the letter here

This Week's News:

Note:Many of VOR's family members with I/DD are aging. This article may be helpful to their parents, siblings, and DSPs


Use of Biomarkers in the Diagnosis of Alzheimer’s Disease in Adults with Intellectual Disability

By Aoife McFeely, MB, Antoinette O’Connor, MB PhD, Prof Sean P Kennelly, MB PhD. The Lancet, October 3, 2024


Summary

People with intellectual disability are a vulnerable cohort who face challenges accessing health care. Compared with the general population, people with intellectual disability have an elevated risk of developing dementia, which often presents at a younger age and with atypical symptoms. The lifelong cognitive and functional difficulties faced by people with intellectual disability further complicate the diagnostic process. Specialised intellectual disability memory services and evaluation using reliable biomarkers of neurodegeneration are needed to improve diagnostic and prognostic certainty in this group.


Conclusions:

Adults with intellectual disability are disproportionately affected by dementia. Diagnosis of neurodegeneration in this population is challenging and requires careful evaluation. Although substantial progress has been made in the development and validation of ATN biomarkers in the general population, adults with non-Down syndrome intellectual disability have been under-represented in research on biomarkers. Little access to specialist services and poor understanding of ATN biomarker dynamics in this population reduce the chance of receiving an accurate, timely diagnosis. Biomarkers, especially blood-based biomarkers, have the potential to revolutionise the diagnosis of Alzheimer’s disease in this population, but these need to be first clinically validated in future studies.


With intellectual disability, small changes in functional ability or independence can substantially affect the quality of life and influence care structure or location. Ensuring that this group has equity of access to diagnostic and therapeutic opportunities is a moral obligation. Those at the forefront of research into neurodegenerative biomarkers need to take on the responsibility of including adults with intellectual disability in their studies, to help to overcome the discrimination of exclusion.


Read the full article, or download the pdf, here

Note: Reports of "Institutional Bias" are greatly exaggerated....


‘Far more people’ Receive HCBS than Institutional Services, CMS Says   

By Lois A. Bowers, McKnights , September 30, 2024


“Far more people” received home- and community-based services such as those provided in some assisted living communities and other settings than institutional services such as those provided in nursing homes and elsewhere in 2021, according to recently published data about long-term services and supports from the Centers for Medicare & Medicaid Services.


HCBS expenditures also accounted for a higher proportion of LTSS spending than institutional services in 2021, the most recent year covered several publications on Medicaid LTSS users and expenditures that CMS released this summer with assistance from research and data analytics consultancy Mathematica.

States used a combination of programs and state plan options to deliver LTSS, the report authors noted, with state plan home health services being the most common among HCBS users, Section 1915(c) waiver program services being the largest HCBS expense category, and nursing facilities accounting for most institutional users and expenses. 


Fewer users received LTSS through fee-for-service programs than managed care in 2021 (4 million and 5.2 million, respectively), but the majority of LTSS expenses were for services delivered through FFS ($112.7 billion, or 62%), CMS said. “These trends suggest that although the use of managed care to deliver LTSS has increased considerably over time, FFS is still a substantial delivery model for LTSS,” according to one of the reports.


The number of Medicaid program beneficiaries receiving LTSS decreased slightly from 2019 to 2021, but spending increased each year during that time, according to the agency.


Nationally, the number of Medicaid LTSS users (including those receiving HCBS, including assisted living residents) dropped from 8,919,776 in 2019 to 8,836,143 in 2020 to 8,652,049 users in 2021, CMS said. 


Continued

King, Casey Introduce Homecare Workforce Legislative Package

Press release from Senator Angus King, September 30, 2024


.Senators Angus King (I-Maine) and Bob Casey (D-Penn), Chair of the Senate Committee on Aging, have introduced three bills to better support Direct Support Professionals (DSPs), the workforce responsible for providing homecare and assistance to seniors and people with disabilities who frequently rely on long-term service and support. The three bills would strengthen and support this workforce by creating new programs and modifying current federal funding to support home and community-based services (HCBS).

“Over the years, Maine has seen an increased shortage of long-term home health care professionals,” said Senator King. “This has had serious impacts on older Maine people aging gracefully at home and those with disabilities who rely on this critical support. Unfortunately, low wages and difficult working conditions have led to high turnover. This DSP legislative package with Senator Casey would make significant investments into the long-term home care industry to bolster wages and provide more opportunities for workers to pursue additional education and trainings to help them advance in their careers. This is commonsense legislation that will make a tangible difference for both those relying on care and those providing it.”


“Our Nation is in the midst of a caregiving crisis, and it’s a crisis that stems from a lack of investment in the caregiving workforce,” said Senator Casey. “I’m proud to introduce these bills with Senator King that would respond to this crisis by improving our national capacity to recruit, train, and retain the care workers that provide essential care to older adults and people with disabilities.”


Caregiving is in a crisis across the United States. Caregivers that include DSPs are widely underpaid, earning a median wage of $15.43 an hour and often living in poverty. The result is caregivers are in short supply — a recent survey revealed 92% of nursing home respondents and nearly 70% of assisted living facilities reported significant or severe workforce shortages. Another recent survey of HCBS providers showed all 50 states experiencing home care worker shortages, and 43 states reported that some HCBS providers have closed due to worker shortages.


According to the Bureau of Labor Statistics (BLS), DSPs are projected to be one of the fattest growing labor markets. Theoretically this should be a boon for the industry, but labor shortages due to low wages and difficult work conditions have made it difficult for the industry to recruit and retain staff.


The Direct Support Worker Training Reimbursement Act would:

  1. Provide enhanced federal matching payments for direct support worker training programs at a 75 percent rate.

The Mollie Baldwin Upskilling of Personal and Home Case Aides Act would

  1. Create funding through the Health Resources and Services Administration (HRSA) for demonstration projects to provide individuals already working in the home care workforce with opportunities for education, training and career advancement.

The Career Advancement for Direct Support Aid Workers (CADSAW) Act would:

  1. Create funding through HRSA to help individuals already working within the home health care field with opportunities to pursue increased education and training to facilitate career advancement.


Read the full article here

Children With Disabilities in Foster Care Have Poor Outcomes

By Sara E. Teller, Legal Reader, September 27, 2024   


Children with disabilities who enter the foster care system are significantly more at risk than their peers without disabilities. Recent research shed light specifically on high rates of maltreatment, difficulties in finding permanent homes, and increased mortality rates while in care. Given that many children in foster care placements have already experienced trauma prior to placement, and are thus more likely to be disabled, undergoing more difficulties while in care only compounds already existing issues and leads to poor outcomes.


The research analyzed data from the federal Adoption and Foster Care Reporting System covering approximately 3.24 million children aged 16 and younger from 2005 to 2019. The findings indicate that children with certain disabilities, such as intellectual disabilities, emotional disturbances, and physical disabilities, more like to have poor outcomes rather than positive ones like adoption or reunification with their biological families.


The study uncovered that children in foster care with disabilities are not only less likely to secure a stable home environment but also face a significantly higher risk of running away, being transferred to other agencies, or aging out without a permanent solution.


Dr. Jill D. McLeigh, the senior author of the study, expressed surprise at the severity of these disparities, stating, “We expected to find differential outcomes for children with disabilities, but the extent to which these risks were magnified across various disability types was striking. Children with physical disabilities and emotional disturbances faced notably higher mortality rates while in care.”


As the data shows, the intersection of disability and foster care complicates the pathways to permanency. Given that children in foster care have higher rates of disability, it is imperative for both child welfare and healthcare systems to work collaboratively to address the specific needs of these children and support their caregivers effectively.


Continued

NJ Wants New Penalties to Fight Abuse in Group Homes for People with Disabilities

By Gene Myers, NorthJersey . com, October 2, 2024


After years of complaints about poor care and mismanagement, group homes for New Jerseyans with developmental disabilities could face a bevy of new regulations under legislation introduced in Trenton this week.


A suite of seven bills proposed Tuesday would allow New Jersey to fine and even take over underperforming homes, put new restrictions on spending and executive salaries at the facilities and give the state new oversight powers.


State Sen. Joseph Vitale, a veteran Middlesex County Democrat, drafted the legislation in collaboration with Gov. Phil Murphy's administration, which has been criticized by disability advocates for weak enforcement of violations by the industry, which cares for an estimated 8,000 of the state's most vulnerable residents.


The package of bills, first reported by NJ.com and the Newark Star-Ledger, includes provisions for enhanced enforcement and stiffer penalties for providers who fail to meet safety standards.


“By enhancing protections and boosting accountability for providers, we underscore our dedication to enabling every person to achieve their full potential and live with the dignity and respect they deserve,” state Human Services Commissioner Sarah Adelman said in a statement.


What the group home legislation calls for

If approved by the full Legislature and signed by the governor, the bills would allow the Human Services Department to punish infractions such as inadequate employee background checks or poor internal investigations into instances of neglect or injury, poor living conditions and incorrect dosing of medications for residents.


The Division of Developmental Disabilities, the state agency that licenses group homes, would be empowered to terminate government contracts with providers who fail to meet standards.


In an industry known for low pay and high turnover, the legislation would also cap executive salaries so more funds can be directed toward care. Home providers would be required to post audited financial statements online, a move aimed at increasing financial transparency.


A Disablilty watchdog wants 'more accountability'

Paul Aronsohn, the state's disability ombudsman, has been calling for many of these changes for years. His annual reports to Gov. Murphy, align closely with the package of bills, emphasizing the need for improved safety and accountability among group home operators.


Aronsohn's report last year called for more rigorous abuse and neglect investigations and better staff training at group homes. Providers should direct more money toward frontline staff, he said, mirroring the legislation's focus on capping executive salaries to improve resources for direct care.


"The more accountability and transparency we have, the less abuse and neglect there will be," Aronsohn said in an interview Wednesday. "Many residents are vulnerable; some can't effectively communicate and are highly dependent on staff. We're not just talking about physical abuse—emotional abuse, deprivation of food, restricting outdoor access, and preventing family visits are all forms of abuse that happen too often,” he said.


Read the full article here

New Jersey - Severe Autism, Frantic Families

By Susan K. Livio, NJ Advance Media, October 4, 2024


Gianna Joachim is a hurricane, a twister of giggles and screeches, a steel blue-eyed, ivory-skinned 7-year-old whose internal motor is always revving at top speed.


Gianna hurls herself on the floor and cries when her mother lingers for more than a minute on the telephone. She has slammed her own face into floors and walls, loosening her teeth and causing nosebleeds. A bookstore and a department store had to be locked down and searched after she stealthily hid from her parents.


Gianna is among the nearly 17,000 children with “profound” or “severe” autism in New Jersey, representing slightly more than one-quarter of the children on the autism spectrum. Medical experts say they need steady, intensive behavioral therapy and medication to lead anything approaching a peaceful, fulfilling life.


But the Joachim family of Howell in Monmouth County, like so many others raising children with severe autism, spend most of their waking hours bargaining and battling for the services a physician has prescribed for their daughter.


Gianna is supposed to be getting 15 hours a week of behavioral therapy after school to learn basic life and social skills, like dressing herself, riding in a car and playing with other children. But since November, those hours have been cut to three hours, then to 90 minutes, said her mother Chelsea Cella. In the last few weeks, Gianna is not getting any behavioral therapy as the mother and company disagree over the type and terms of treatment the child should receive.


When she pressed the state-licensed therapeutic company for an explanation, Cella said she was told the problem was “staffing issues.” Instead of treatment, Gianna gets a growing number of medications to control her behavior. It’s an awful tradeoff and no way for a child to live, Cella said.


The struggles of Gianna’s family are all too familiar in New Jersey, home to the third-highest child autism rate in the nation. Many families say it is difficult if not impossible to get the help they need for their children, forcing them to spend hours each week cobbling together networks of public and private services. This is especially true for kids with severe autism.


Part of the problem is that there is a shortage of skilled therapists able to meet the demands of working with a child with severe autism and willing to accept the meager wages compared to jobs in schools. Many times, parents also have to fight with insurance companies who may question the necessity of frequent, long-term treatment.


Read the full article here


For more about Gianna and her family, watch these 3 YouTube Videos:

The reality of raising a child with severe autism in N.J.


The clock is ticking and N.J. families are facing an autism services crisis


N.J. children with severe autism need more help NOW. Where is the sense of urgency from the state?

Indiana - Commission Makes Nearly 20 Legislative Recommendations to Address Indiana's Behavioral Health Needs   

By Abigail Ruhman, WBOI News (NPR), September 1, 2024


A new report from the Indiana Behavioral Health Commission said the state needs to invest more funding and attention to improve behavioral health infrastructure. The commission recommends expanding on previous investment, building Indiana's workforce and addressing care for vulnerable populations.


Jay Chaudhary, chair of the Indiana Behavioral Health Commission, said the only way to meaningfully improve Indiana’s behavioral health care system is through “intense collaboration.”

“We think ultimately, though, it'll be up to my legislative colleagues to go in there and make the case and fight for it,” Chaudhary said.


The commission made nearly 20 recommendations to the General Assembly for the 2025 legislative session. The recommendations cover a wide range of concerns, including workforce shortages and care for children, older adults, and individuals with intellectual and developmental disabilities.


988 crisis response and Certified Community Behavioral Health Clinics

The commission’s 2022 report advocated to create a new comprehensive crisis response system and expand the Certified Community Behavioral Health Clinics model. This led to a two-year, $100 million investment from the General Assembly during the 2023 legislative session.


The commission recommended the General Assembly continue contributing $50 million to the Community Mental Health Fund, which funds the initiatives. It also said lawmakers could increase that funding to make up for the additional costs to expand the programs or consider some of the funding sources the commission proposed.


Workforce development

As of 2024, every county in Indiana is designated as a behavioral health workforce shortage area. The commission's final report included a number of recommendations on how to build and expand that workforce.


These include leveraging other areas of health care to make care more accessible, sustainably funding psychiatry residency positions, securing funding for first responder mental health and resiliency training, and addressing barriers to workforce development.


Specifically, the commission wants lawmakers to make it easier for doctors to transfer their licenses to Indiana. It also wants to eliminate collaborative practice agreements for advanced practice registered nurses.


Behavioral health services for children

The commission made recommendations including, among other things, promote the Comprehensive School Mental Health Framework, support for children with high acuity needs and expand care for adolescents with severe mental health needs to reduce risk of incarceration and residential treatment.

Sen. Andrea Hunley (D-Indianapolis) said schools often the first place where mental health needs are recognized — but Indiana has the worst counselor to student ratio in the entire nation. There’s also only one school psychologist per almost 2,700 students.


“How can we expect our counselors and our psychologists and our social workers to reach every child in need when we don't have enough of them?” Hunley said.


Read the full article here

Montana Commission Releases Behavioral Health System Recommendations

By Jacob Owens, NBC News Montana, September 30, 2024


Gov. Greg Gianforte received a final report Monday about how the state can improve behavioral health and developmental disability services in Montana.


The report by the Behavioral Health System for Future Generations Commission identified gaps in workforce, case management and continuum capacity.


The commission provided Gianforte with 22 recommendations and 11 short-term initiatives. The estimated cost of the recommendations is $105 million.


Recommendations include expanding access to waiver services for those with developmental disabilities. Another recommendation would create an electronic bed registry for behavioral health.


Continued

New York - Calls grow for N.Y. to Bid Medicaid Program Contract with Care

By Kate Lisa Spectrum News, NY, September 26, 2024


Everyone agrees: A $9 billion state home care program under Medicaid needs reform. But some officials have kicked up a last-ditch effort to delay planned cuts as sources say the state is leaning toward contracting with a company that's known for wage theft and mismanagement in other states.


Multiple people, including state Senate Health Committee chair Gustavo Rivera, said Thursday they have heard company Public Partnerships LLC is a frontrunner to win the state Health Department's multi-billion-dollar contract to manage the state's Consumer Directed Personal Assistance Program.


PPL has lost or had contracts terminated managing similar home care programs in New Jersey, Washington, West Virginia, Virginia and Tennessee.


"I would be incredibly concerned if that is the way the state wants to go forward," Rivera, a Bronx Democrat, told Spectrum News 1 on Thursday.


The five-year contract, to start Oct. 1, will be awarded to a single company to manage CDPAP, which allows family members to care for disabled or elderly relatives and help them stay in their homes.


PPL, one of a handful of companies to submit a bid, has a history of delaying home care worker pay for months, which resulted in a class action suit involving 20,000 workers. And the company has faced allegations it fraudulently obtained its former contract in Pennsylvania.


Public Partnerships LLC has had at least seven changes in CEO in the last four years. The company did not respond to a request for comment.


The state received more than 100 bids for the contract, according to Gov. Kathy Hochul's office. The state Health Department will make a decision by Tuesday's planned start date. The state Budget Division has yet to receive, or review, the new contract.


New York's $9 billion program that serves more than 250,000 New Yorkers has reports of widespread fraud, made worse by more than 600 fiscal intermediaries, effectively middlemen, taking advantage of the program's current structure. FIs lack oversight and are not required to have a state license.


The company to win the bid will have six months to transition New York's program to one system — a timeline all stakeholders involved have said will be impossible to meet without issues.


Continued

Direct Support Professionals

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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


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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.

VOR Bill Watch:

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


VOR SUPPORTS:



S.4120 / H.R.,7994 - The Long-term Care Workforce Support Act - This bill would increase FMAP and offer grants to all DSPs and caregivers for the elderly and for people with I/DD and autism. VOR worked with members of the Senate Aging and Diability Policy Committee and other peer organizations to improve this bill from its original form. It is not perfect, and it contains one major flaw to which we continue to object (the permanent reauthorization of the Money Follows the Person Rebalancing Demonstration Program) but we will continue to work to improve this bill and remove its flaws.


S.1332 / H.R.2941 - Recognizing the Role of Direct Support Professionals Act

Sen Maggie Hassan (D-NH) / Rep. Brian Fitzpatrick (R-PA) This bill requires the Office of Management and Budget to establish a separate category within the Standard Occupational Classification system for direct support professionals (i.e., individuals who provide services to promote independence in individuals with an intellectual or developmental disability) for data reporting purposes.


H.R.7267 - Disability Community Act of 2023 To amend title XIX of the Social Security Act to provide a temporary higher Federal medical assistance percentage for Federal expenditures under the Medicaid program that are associated with the cost of compliance with certain Federal regulations with respect to services furnished in certain intermediate care facilities or home and community-based services furnished to individuals with intellectual and developmental disabilities.


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

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


S.7302 - The Credit for Caregiving Act of 2024 Sen. Michael Bennett (D-CO) This bill would amend the Internal Revenue Code of 1986 to provide a nonrefundable credit for working family caregivers. In the case of an eligible caregiver, there shall be allowed as a credit against the tax imposed by this chapter for the taxable year an amount equal to 30 percent of the qualified expenses paid by the taxpayer during the taxable year to the extent that such expenses exceed $2,000. The tax credit is not to exceed $5,000 per year.


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

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


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


H.R.670 - Think Differently Database Act

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


S.1298 - Supporting Our Direct Care Workforce and Family Caregivers Act

Sen. Time Kaine (D-VA) A bill to award grants for the creation, recruitment, training and education, retention, and advancement of the direct care workforce and to award grants to support family caregivers.


H.R.2965 / S.1333 - Autism Family Caregivers Act of 2023

Rep. Grace Meng (D-NY) / Sen. Robert Menendez (D_NJ) To award grants for providing evidence-based caregiver skills training to family caregivers of children with autism spectrum disorder or other developmental disabilities 


H.R.3380 - HEADs UP Act of 2023

Rep. Seth Moulton (D-MA) This bill authorizes the Department of Health and Human Services (HHS) to award grants to support health centers that provide services for individuals with developmental disabilities, including dental care. Grant recipients must provide specialized treatment to individuals with developmental disabilities as necessary.


VOR OPPOSES:


H.R.8109 - To Make Permanent the Money Follows the Person Rebalancing Demonstration Program. MFP has been used to erode the ICF system. We call for congressional hearings, studies by the GAO, and audits by the Congressional Budget Office before any action should be taken to reauthorize this program.


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

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


S. 1148 - The Guardianship Bill of Rights

Sen. Bob Casey (D-PA) - A bill to establish rights for people being considered for and in protective arrangements, including guardianships and conservatorships, or other arrangements, to provide decision supports. This bill would give ACL power to create a Guardianship Council and appropriate more money to P&As so they may encourage people to leave guardianships and move to Supported Decision Making. Dangerous over-reach in response to media hype on Britney Spears, et al.


S.1193 / H.R.2708 - The Latonya Reeves Freedom Act of 2023

Sen. Michael Bennett (D-CO) / Rep. Steve Cohen (D-TN) Allegedly written and strongly supported by ADAPt and other self-advocacy groups, this is a watered-down version of the Disability Integration Act. It is strongly biased against care in larger congregate facilities, and falls just short of seeking the elimination of ICFs.



VOR HAS SIGNIFICANT CONCERNS WITH:


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

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

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


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

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


S.3118 - The HCBS Relief Act of 2023

Sen. Boby Casey (D-PA) A bill to provide for an emergency increase in Federal funding to State Medicaid programs for expenditures on home and community-based service. This bill, like others above, only provides funding for people receiving Long-Term Services and Supports through HCBS, denying any support for people in nursing homes or ICFs.



VOR supports increasing funding for people with I/DD, but we have concerns that the above bills, in their 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.



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