September 17, 2021
VOR Weekly News Update
VOR is a national non-profit organization that advocates for
high quality care and human rights for all people with
intellectual and developmental disabilities.

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

VOR & YOU: Direct Support Professionals
National Recognition Week For
Direct Support Professionals
September 12 - 18, 2021
Opinion: Health Care Pandemic Heroes Deserve a Fair Paycheck
By Roberta Lynch, Executive Director of AFSCME Council 31, Chicago Sun-Times, September 16, 2021
Everyone who works hard deserves a living wage, paid time off, affordable health care, parental leave and more. But we owe a special debt to those who work in the care economy.

The COVID-19 pandemic has redefined what it means to be a hero. Ordinary people have risked their lives doing essential work — and not just in health care. People who care for children, the elderly and those with disabilities have supported the most vulnerable members of our communities when we needed them most.

It’s long past time that caregivers get the support — and the pay — they deserve. To that end, Congress’ recently passed budget reconciliation instructions provide an opportunity for a historic investment in the care-giving economy.

For those who care for the elderly, people with disabilities and more, President Joe Biden has proposed $400 billion for home and community-based services. These funds would strongly encourage states to expand Medicaid HCBS, putting resources and additional staff where it’s most needed.

We must also ensure individuals and families have the choice to use intermediate care facilities for more comprehensive services, as appropriate for the individual. And we must ensure these settings are staffed adequately as well.

These care workers, many of them AFSCME members, allow seniors and individuals with disabilities to enjoy greater dignity and independence. They help with everything from basic tasks like bathing and feeding to building social skills and job training. Their work makes it possible for these individuals to have a wider array of choices in how they live.

But too often, these dedicated caregivers are an afterthought, rarely getting the respect they deserve or a family-supporting wage.

Child care providers are also among the lowest-paid workers in the country. President Biden’s Build Back Better agenda would build the seamless child care system working families deserve. He has proposed $250 billion to make care affordable, and to raise standards and better support the workers who care for our kids.

Our union is proud to represent thousands of Illinois public service workers who enrich the lives of children, the elderly and people with disabilities. We strongly support President Biden’s plans to invest in these workers and reform the systems that have failed to recognize their worth. Congress must act with haste to pass the President’s plans in full.

National News:
Note: In the following article, spokespersons from two disability advocacy organizations speak out on the need for funding in the amount of $400 Billion for people with I/DD and the workforce that sees to their care and well-being, but only for Home and Community Based Services (HCBS).

VOR has been working tirelessly with our peers and Members of Congress to add funding for individuals with I/DD who reside in ICFs, both public and private, and to ensure that the DSP workforce in all facilities are supported with better wages and training.

We ask Congress not to pick favorites in this bill, but to cover everyone with I/DD and every direct support professional who devote themselves to providing compassion and care for our most vulnerable citizens.
Congress May Halve Biden’s $400 Billion Plan To Boost Disability Services
By Michelle Diament, Disability Scoop, September 17, 2021

President Joe Biden proposed a massive $400 billion investment in Medicaid home and community-based services earlier this year, but now Congress is considering less than half that amount.

Biden proposed the funding this spring as part of his American Jobs Plan in an effort to help many people with disabilities who are on waiting lists access services and address long-held problems like low pay and poor retention of direct support professionals.

“These investments will help hundreds of thousands of Americans finally obtain the long-term services and support they need, while creating new jobs and offering caregiving workers a long-overdue raise, stronger benefits, and an opportunity to organize or join a union and collectively bargain,” the White House said when the proposal was announced.

Now, Congress is working to make that plan a reality through a reconciliation bill that lawmakers are pushing through. But, legislation unveiled earlier this month from the U.S. House of Representatives’ Energy and Commerce Committee would allot just $190 billion for home and community-based services.
That’s simply not enough, disability advocates say.

“Given that funding for home and community-based services has been underfunded for decades, we need this provision to be fully funded,” said Kim Musheno, vice president of public policy at the Autism Society of America. “We have almost a million people waiting for services such as respite care,
residential supports, supported employment, behavioral supports and other services paid for by Medicaid waiver services. These families are suffering. We fear that if this provision isn’t fully funded some states will not take it up, people will be left on these waiting lists, and the shortages in quality direct support professionals will deepen.”

Nicole Jorwic, senior director of public policy at The Arc, said, “The funding level needs to stay close to the proposed $400 billion because you need substantial funding, more than $190 billion, to sufficiently address both the access to Medicaid home and community-based services and also raise wages and increase support for the direct care workforce.”

State News:
West Virginia - Systemic Abuse and Neglect in WV Group Homes Continues, with Additional Death Reported
By Ian Karbal, Mountain State Spotlight, September 16, 2021
West Virginia’s deputy secretary of Health and Human Resources stood before state lawmakers earlier this week and described the latest death at one of the state’s group homes for intellectually and developmentally disabled people.

“It was a situation where, basically, the individual [was] emaciated, and was not properly cared for, and died as a result of that lack of care,” Jeremiah Samples said.

He didn’t give any additional details about the person, or the health care provider responsible for their death at Tuesday night’s meeting of the Legislative Oversight Commission on Health and Human Resources Accountability. But the tragedy was not an anomaly.

“We’ve had some heinous deaths, and I don’t use those words lightly,” Samples said.
It’s been four months after an initial report on abuse and neglect at group homes was delivered to the same group of lawmakers. That report outlined grave conditions: a teenager who died in a car wreck after getting the keys to a facility vehicle, residents who weren’t provided with hundreds of necessary doses of medication, excessive uses of restraint, a resident who drank antifreeze but wasn’t taken to a hospital for hours even after complaining. There have also been reports of sexual and physical abuse in group homes.

But the dire conditions have continued, and the state continues to do business with behavioral health centers that have had severe violations.
Now, another person has died. While state officials have instituted small changes to address the problem — the Office of Health Facility Licensure and Certification is in the process of closing or transferring management of 10 problematic facilities and is working on new training materials with the Department of Health and Human Resources — the behavioral health facilities’ issues are numerous, and will require more drastic action to correct.

“Regulators have reported some improvements, but they continue to report situations with deplorable living conditions, even after all of the attention, which is very concerning,” Samples said.

There are nearly 2,000 people living in these group homes around West Virginia.

But despite the urgency of the situation, legislators aren’t likely to act soon. Tuesday’s meeting focused on recommendations from stakeholders,
who include care providers and disability advocates, arrived at in meetings with DHHR and OHFLAC. They’re suggesting lawmakers take steps to increase staffing at behavioral health facilities, create new training programs, increase funding, and increase direct oversight by OHFLAC and the ability of the state to penalize bad actors.

While DHHR and OHFLAC have identified the problem providers, they say they’re limited in the steps they can take: Shutting down the homes they run would mean permanently eliminating the beds, which could mean that residents have nowhere else to go.

Samples said his primary concern was staffing issues. With non-competitive pay and few training requirements in some cases, maintaining qualified employees has been a challenge for group homes of all types. According to DHHR, in 2020, West Virginia was able to employ only an estimated 17% of the necessary mental health care professionals to take care of people in need in the state. The national average is 27%, and West Virginia ranks 48th among the states.

To fix this issue and attract more qualified workers for these group homes, DHHR wants lawmakers to use American Rescue Plan funds, some of which are already earmarked by Medicaid to hire and keep staff. But more money from the state’s coffers will likely be necessary. DHHR would also like group homes to introduce a tiered pay model, which would allow for upward mobility for staffers.
As it stands, low pay is endemic in the industry, which makes finding and retaining qualified caretakers difficult. Without a large budget increase, even beyond the American Rescue Plan funds, there is little hope of fixing the staffing issues.

According to committee member Delegate Mike Pushkin, D-Kanawha, it will ultimately require the Legislature to put up the necessary money, at cost to the state.

“The government has to step in when there are things that just aren’t profitable for the private sector to do,” Pushkin said in an interview.

“Especially when you’re talking about taking care of a vulnerable population that can’t take care of itself. This is one of the most important roles of government.”

New York - Senate Hearing Explores 'Critical' Staffing Cuts at Agency that Cares for Disabled
By Brendan J. Lyons, Times-Union, September 14, 2021

Thousands of bed, staffers have been eliminated at agency that cares for individuals with disabilities

The vice president at one of New York's largest labor unions told a state Senate committee on Tuesday that years of staffing and budget cuts at the state Office for People With Developmental Disabilities have created critical shortfalls in the ability to provide quality and accessible services for at-risk New Yorkers.Randi DiAntonio, vice president of the Public Employees Federation (PEF), said the situation has been exacerbated by declining staffing levels during the coronavirus pandemic — and also by years of handing over services for individuals with intellectual and developmental disabilities to private providers in an effort to cut costs.

"The state of New York has embarked on a long-term effort to reduce funding and staffing at all of its agencies. OPWDD has seen some of the most dramatic reductions in staffing overtime," DiAntonio said in a written statement provided to the panel, noting that the agency had its workforce cut by 16 percent — nearly 3,800 employees — between 2011, when Gov. Andrew M. Cuomo began his first term, and 2020.
"This reduction in staff is directly attributable to the imposition of 'bare bones' budgeting at all of the state agencies that has been in place for years so the state can remain under the arbitrary 2 percent annual state spending cap," she added. "This budgeting approach left the state ill-prepared to address the (COVID-19) pandemic and has hampered the ability of the state to meet its ethical obligations to maintain the continuity of quality and accessible services for many at-risk New Yorkers, including individuals with developmental disabilities."

DiAntonio, under questioning from the panel, said nurses and other health care professionals "are leaving in droves," and morale and burnout in the industry are at an all-time low.

"You have a workforce issue that was created, but that means it also can be solved," she told the panel, noting that health care workers are spread so thin they are bouncing from assignment to assignment at a time when the numbers of group homes and available beds for disabled individuals are plummeting.
"The number of people with disabilities is not shrinking ... and the needs for people with children with autism are exponentially larger," she said. "The waiting list for services has not gone down. ... We've closed almost 5,000 beds."

Tom McCalvanah, executive director of New York Disability Advocates, told the Senate committee that there is a roughly 25 percent vacancy rate for direct care workers, which is about 75 percent higher than before the pandemic.

"Historically, (direct support professionals') wages were significantly higher than minimum wage, but due to years of lack of investment and cuts to the system, wages are now at minimum wage or just above in all regions across the state," he told the Senate.

In a separate statement issued late Monday, PEF also responded to a Times Union story published Sunday in which parents and other caretakers for adults with conditions such as autism said they are being forced by OPWDD to choose between sending their high-needs children to a fenced-in institutional facility in the far reaches of the Adirondacks, or face the prospect of losing funding for their long-term care. OPWDD is targeting individuals in out-of-state schools and treatment centers.

New York - State Seeks to Move High-Needs Autistic Clients to Secure Facility
By Brendan J. Lyons, Times-Union, September 12, 2021

The parents of adults with conditions such as autism say they are being forced by a state agency to choose between sending their child to a fenced-in institutional facility in the far reaches of the Adirondacks, or face the prospect of losing funding for their long-term care.The situation has rankled a group of state lawmakers who say the practice, put in place under former Gov. Andrew M. Cuomo, is an apparent cost-saving measure that exploits a loophole in a 2014 law designed to give parents due-process rights in decisions about long-term care for their children when they reach age 21.

Some parents say they've been left with no alternative to sending their disabled children to what they feel is a remote and prison-like facility that apparently houses individuals convicted of crimes such as child sexual abuse or those who have been deemed incompetent to stand trial.

Joseph and Michele Atkinson of Long Island, whose son Joseph recently graduated from an adolescent program at the Judge Rotenberg Education Center in Canton, Mass., wrote a letter to Cuomo on July 13 detailing the history of their son's conditions, which include autism, obsessive compulsive disorder, anxiety and ADHD.

They explained that their son, upon reaching puberty, became so aggressive that he would later cry, apologize and lock himself in his bedroom "so he could escape all triggers."

After rotating through a dozen New York schools, and after it was determined that no other schools would take him, the state looked for programs in other states that would be appropriate. Michele Atkinson said their son was placed in the Massachusetts facility three years ago under a program paid for by his New York school district.

The Atkinsons said their son thrived at the school in the suburbs of Boston, had his medications sharply reduced and lost 60 pounds as his lifestyle became more healthy. He learned to work through his daily aggressions and handle tasks such as chores, putting simple meals together, forming relationships and going on outings. He has lived in a single-family residence and his aggressive meltdowns have been reduced to episodes that last only a few minutes, and usually only one or two times per day.

After Joseph turned 21 in April — and by July was no longer considered a student — his parents said they understood that he had "aged out" and would need to be placed in an appropriate residential program in New York. But he was rejected by all residential state schools that reviewed his background, and the state informed the Atkinsons this summer that he would be placed in the most secure area of the Sunmount facility in Franklin County.

In that setting, they told Cuomo in their letter, they feared their son would be "denied an opportunity for appropriate socializing with peers" and that all of his activities would take place inside the fenced-in compound.

In contrast, at the Massachusetts school, they said had had made such progress that this year he was able to sit through an hour-long graduation ceremony and also attend his prom without incident.

After receiving notification this summer from the state Office for People with Developmental Disabilities that his school funding would end and the state would not pay for him to reside in the Massachusetts school, they received a letter informing them their child could go to the Sunmount facility or "OPWDD may not provide funding" for his continued treatment out of state.
Michele Atkinson, in a recent interview, said the family took part in a virtual tour of the Tupper Lake facility and "pretty much what we found was a compound — a prison-like facility that apparently houses disabled individuals who have been convicted of crimes like rape, arson, murder."
"They're mixed in the general population," she continued. "These people could be housed with my son. ... This is definitely happening to others."

New Mexico - Department of Health Seeking Additional $53.9 Million for Fiscal Year 2023
By David Morgan, NMHealth Org, September 16, 2021

Funding requested to address lost decade of investment in public health 

On Thursday, the New Mexico Department of Health (NMDOH) announced that it is seeking an additional $53.9 million for its Fiscal Year 2023 budget as part of an effort to strengthen health services and address the health needs of communities across the state.

“For many years prior to 2019, the state of New Mexico cut back funding in public health, and did not substantially fund services for the elderly and for people with developmental disabilities. Under Governor Lujan Grisham, we’re changing that,” said DOH Acting Secretary David R. Scrase, M.D. “In addition, the maintenance and operations of state healthcare facilities has been chronically underfunded as well, and addressing this challenge is a key priority for DOH.”

The department’s request aligns with Governor Lujan Grisham’s vision to reduce substance use across the state, improve quality and oversight in New Mexico’s boarding homes, hospitals, crisis triage centers, and other facilities, and address the 13.5-year waiting list for people with developmental disabilities to receive Medicaid waiver services,

Oklahoma - Five Year Residency Requirement for Developmental Disabilities Services Unconstitutional, Federal Agency Says
The Frontier, September 16, 2021
The Oklahoma Department of Human Services said it plans to drop a five-year residency requirement for people seeking to sign up for intellectual or developmental disability waiver services after a letter from the U.S. Department of Health and Human Services stated the requirement was unconstitutional.

Services stated the requirement was unconstitutional.House Bill 2899, was passed by the Oklahoma Legislature and signed by Gov. Kevin Stitt in May. The law sought to address the state’s waiting list for developmental and intellectual disabilities services, a list that has
nearly 6,000 people on a mostly first-come-first-served basis and has a wait time of more than a decade.

The waiting list is for services funded through a federal Medicaid waiver program administered through the Oklahoma Department of Human Services that provides community-based and in-home support services for adults and children with intellectual and developmental disabilities.

Managed Care:
Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care?
By Rebecca Grapevine, Georgia Health News and Andy Miller, Kaiser Health News, September 13, 2021
Just before Frank Berry left his job as head of Georgia’s Medicaid agency this summer, he said the state “will be looking for the best bang for the buck” in its upcoming contract with private insurers to cover the state’s most vulnerable.

But whether the state — and Medicaid patients — are getting an optimal deal on Medicaid is up for debate.

Georgia pays three insurance companies — CareSource, Peach State Health Plan and Amerigroup — over $4 billion in total each year to run the federal-state health insurance program for low-income residents and people with disabilities. As a group, the state’s insurers averaged $189 million per year in combined profits in 2019 and 2020, according to insurer filings recorded by the National Association of Insurance Commissioners. Yet Georgia lacks some of the financial guardrails used by other states.

“Relative to other states, Georgia’s Medicaid market is an attractive business proposition for managed-care companies,” said Andy Schneider, a professor at Georgetown University’s Center for Children and Families.

Georgia is among more than 40 states that have turned to managed-care companies to control Medicaid costs. These contracts are typically among the biggest in these states, with billions of government dollars going to insurance companies. Insurers assume the financial risk and administrative burden of providing services to members in exchange for a set monthly fee paid for each member.

The health plans, though, have at times drawn questions both on spending and quality of care delivered to Medicaid members.

“The transition to managed care was supposed to save states money, but it’s not clear that it did,” said Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation. (KHN receives funding support from the foundation.)
States can require Medicaid insurers to pay back money if they don’t hit a specified patient-spending threshold. That threshold is typically 85% of the amount paid to the insurance companies, with the rest going to administration and profit.

But Georgia does not require its Medicaid insurers to hit a specific target for spending on patient care, a federal inspector general report noted. Though Georgia is trying to “claw back” $500 million paid to its Medicaid insurers, it could have lost out on recoupment dollars, the report indicated.

And state documents show that the Peach State company, which now has the largest Medicaid enrollment of the three insurers, failed to reach the 85% mark from 2018 to 2020.
Overall, Georgia’s Medicaid “medical loss ratio,” which assesses how much was spent on patients’ claims and expenses, was fifth from the bottom nationwide last year, behind only Mississippi; Washington, D.C.; Wisconsin; and Arkansas, according to data from the insurance commissioners association. Spending rates on patient care in the state fell from 82.9% to 80.8% in 2020. (The NAIC uses a different method for calculating the ratio than the state and federal governments do.)

The insurers also make money off their management services firms. In 2020, the insurer Peach State paid a subsidiary of its parent company, Centene Management Company, $114.7 million for administrative services. The nonprofit CareSource paid its management services firm $86.5 million in 2020.

“Fees paid to subsidiary companies represent another source of revenues for the parent companies,” said Baumgarten. “And it’s done in a way that does not allow the state to hold the HMOs accountable.”

Compared with other states, Georgia has a stunningly low rate of referring poor children to specialty services under Medicaid, according to a recently released National Health Law Program report. DCH said recently it’s investigating why the rate is so low.

And, currently, the state is reporting low covid vaccination rates for those 12 and older covered by the Medicaid managed-care companies. A state posting shows the rates for the three companies are each below 10%, far lower than Georgia’s overall rate.

Centene has also faced questions about overbilling. Ohio settled an $88 million pharmacy fraud lawsuit it filed against Centene months before awarding it a contract, while Mississippi settled with it for nearly $56 million. Now Georgia is expected to get money back under the $1 billion that Centene set aside to settle with other states affected by the pharmacy overbilling.

A bill that aimed to bring more transparency and accountability to the state’s health care plans was vetoed last year by Republican Gov. Brian Kemp. The legislation would have allowed a committee to examine records of health care contractors and compel the state to respond to questions about them. Kemp said the bill would have violated the separation of powers doctrine between the executive and legislative branches of government.

Oklahoma - Health Care Facility Says Medicaid is Working, No Need for a Change
by James King, KTUL-8 News, September 15, 2021

"Oklahoma has a history with Medicaid managed care. It was tried in the 1990s and early 2000s and it didn’t work particularly well. The decision was made by the Medicaid agency with full support of the legislature and the governor at the time to do away with managed care companies,”
- Dr, David Blatt, OU-Tulsa professor of Public Administration

At Morton Comprehensive Health Center they’ve enrolled over 1,200 people in the state’s Medicaid program, with the recent expansion making it more accessible to those who need it.

“Yesterday, I went into our enrollment center that we have here and there was a patient that had never had insurance her whole life,” said Morton CEO Susan Savage.

But the recent talks of moving SoonerCare into the hands of private companies have Savage worried about the impact it could have on patients.

“The concern with the privatization to for-profit entities is that somewhere a profit has to be made,” said Savage. “So where does that occur? Historically, provider rates, reimbursement rates were cut.”

Those cuts mean patients see their doctors for shorter times to meet quotas and some providers could decide not to accept Medicaid any longer, jeopardizing the quality of care the over one million Oklahomans enrolled in the program will get.

“We become pushed by the profit motive of the managed care companies. The goal here is for everyone to have quality health outcomes all across the system. Whether they’re Medicaid or commercially insured we all want that.”

In Other News:
California - This Jurupa Valley Nonprofit uses Horses to Help Those with Disabilities
By Rebecca K. O'Connor, Press-Enterprise, September 11, 2021
Queen of Hearts Therapeutic Riding Center aims to improve the lives of individuals with mental, physical and emotional disabilities through the power of the horse. Riding and working with horses can have a beneficial effect on a variety of diagnoses, including cerebral palsy, autism, post-traumatic stress disorder, intellectual disabilities, sight impairment and hearing impairment according to Robin Kilcoyne, the organization’s founder and executive director.

“Through counselling and learning to care for the horses, clients learn to find their value,” Kilcoyne said. “They find their purpose, self-worth and compassion for themselves as well as for others.”

The three-dimensional movement a horse makes when it walks moves the rider’s pelvis into a walking position. This helps activate centers in the brain to help riders develop balance and strength, Kilcoyne said. An individual who is not able to walk finds a lot of power being able to sit on the horse and steering. Through therapeutic riding, clients learn to process information faster and develop a faster response system.

Queen of Hearts was briefly shut down at the onset of the COVID-19 pandemic and when the
organization reopened in June 2020, had to scale back the number of clients it served, working with nine rather than 30 each week. Some clients whose health is more fragile have not yet been able to return.

During this time, Queen of Hearts has been able to work with volunteers through its Helping the Equine and Rider Team, or HART, program. People who were out of work were able to volunteer and get out of the house and assist at the ranch to groom horses, work on repairs, and help teach.

“People in the community came forward to help with animals,” Kilcoyne said. “We had some money set aside to help with the horses, but not enough for everything.”

Albert Einstein College of Medicine Awarded $5 Million for Research on Intellectual and Developmental Disabilities
By Albert Einstein College of Medicine, NewsWire, September 15, 2021
Albert Einstein College of Medicine has received a five-year, $5 million grant from the National Institutes of Health (NIH) to support the Rose F. Kennedy Intellectual and Developmental Disabilities Research Center (RFK IDDRC), which has been at the forefront of research on normal and abnormal brain development for more than 50 years. The funding will sustain and deepen collaborations between Einstein scientists and clinicians at Montefiore Health System aimed at improving the care and treatment of children with intellectual and developmental disabilities (IDD), including those stemming from rare diseases.

“Our center is home to dozens of basic science and translational researchers who investigate the biological pathways and neurological mechanisms that underlie a range of intellectual and developmental disabilities,” said Sophie Molholm, Ph.D., co-primary investigator on the grant and co-director of the RFK IDDRC. “But ultimately, our sights are set on helping the children with IDDs in the Bronx and empowering their families and caregivers, a goal this new grant will help us achieve,” added Dr. Molholm, who is professor of pediatrics, in the Dominick P. Purpura Department of Neuroscience, and of psychiatry and behavioral sciences at Einstein.

Investigating Gene Mutations

Previous NIH support helped establish a research program on 22q11.2 Deletion Syndrome (22q11.2DS), an incurable genetic disorder associated with delayed intellectual development and psychiatric conditions.
This new grant’s research focus involves the X chromosome's KDM5C gene, which plays a central role in brain development and behavior. Mutations in the KDM5C gene lead to intellectual disabilities and other conditions, particularly in males although females can also be affected.

In 2020, the IDDRC’s annual Rare Disease Day event featured a special program in which 12 families with children who have a KDM5C variant came together from around the country and from England to meet for the first time. They learned about recent findings and the RFK IDDRC partnerships at Montefiore and Einstein that are addressing research and care. Hayden Hatch, an M.D./Ph.D. student at Einstein, spearheaded the effort.

Einstein is one of 15 IDDRCs funded by the NIH and was among the first such centers established in the 1960s. More than 100 researchers study neurodevelopmental conditions including autism spectrum disorders, attention-deficit hyperactivity disorder, Rett and Williams syndromes, Niemann-Pick and other lysosomal storage diseases, neurocutaneous disorders, and infantile and childhood seizures. The RFK IDDRC also has more than 20 clinical partners in neurology and pediatrics.

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


Congressman Glenn Grothman (R-WI) has introduced two bills in the House to support
Vocational Centers and 14(c) Wage Certificates:

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

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


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

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

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

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

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