April 24, 2026

VOR's Weekly News Update

VOR is a national non-profit organization

run by families of people with I/DD and autism

for families of people with I/DD and autism.

I/DD Advocates Wanted!

Join us on Capitol Hill in June

VOR's 2026 Legislative Initiative

June 8 - 10

Washington D.C.

This is your chance to share with members of Congress about the issues that affect us, as families of individuals with I/DD and autism.

We have a limited number of hotel rooms available, at the ridiculously low price of $170 per night for a single room at the Placemakr Dupont Circle,

located in the heart of DC's historic Dupont Circle neighborhood.

Our room count is filling fast, so

Please register for the Initiative now to reserve your room

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Every year, VOR members go to Washington, D.C. to speak our truth to power.

This year, we are speaking to:

• Support the ICF system as part of a full continuum of care
• Recognize the importance of Direct Support Professionals (DSPs)
• Support Family Caregivers
• Call for accountability in the Protection and Advocacy System, and re-focus their mission to protect all people with I/DD and autism
• Amend or eliminate the Settings Rule
• Recognize the need for efficient and effective services to meet the needs of individuals with co-occurring I/DD and severe mental illnesses (SMI)
• Supporting all employment opportunities for people with I/DD and autism.

This year, we ask our sponsors to participate as they can.

Diamond - $ 5,000

Platinum - $ 2,500

Gold - $1,000

Silver - $ 500

Bronze - $ 250

Advocacy Hero - $ 100

Friends & Families - (Other amounts)

Any and all gifts are welcome.

Donors will be acknowledged at the Annual Meeting and in the VOR Voice

In a nutshell:

A One-Pager on What’s Wrong with U.S. Health Care

By Drew Altman, KFF, April 23, 2026

The other day, I was asked for a one-pager on what’s wrong with the U.S. health system. “Just one page.” To my amazement, with our thousands of fact sheets and policy briefs and even our Health Policy 101, we didn’t have anything short or current, nor could I find one elsewhere to send along.So, while this isn’t my usual column about current issues, and it’s only about problems, not the reasons for them or solutions, it might be useful to some of you.

First, our health system is not affordable, either for people or for the country. About a quarter of the public struggle with their medical bills and the numbers rise sharply for people with chronic illnesses or major diseases who need a lot of care. About 100 million deal with medical debt. We spend almost twice per capita what other wealthy nations spend, putting pressure on other national priorities and for employers on wages.

As is well known, although we spend much more than other wealthy nations, our health outcomes lag behind theirs in most cases. There are a lot of different ingredients in that stew, but our well-heeled health system has not lifted our health outcomes.

Trust in health professionals remains strong, but trust in critical agencies such as the Centers for Disease Control and Prevention and the Food and Drug Administration is at a low point. The agencies take it on the chin for different reasons from both Democrats and Republicans. If we have another COVID-like crisis, we’ll pay a big price for that; national emergencies, like wars, cannot be handled state by state.

Finally, the politics of health care are as broken as the system (and are a reason it is broken). For decades, Democrats and Republicans have not been able to agree on any major solutions to our health care problems and disagree sharply on the role of the federal government in health, forcing us to gravitate to smaller incremental changes where there might be some agreement. They also blow their importance out of proportion. I won’t name names in this short piece.

The result: we have neither a competitive health care system nor a regulated one—we have a fragmented, micromanaged health system that fails to control costs and makes both patients and health professionals more miserable than they should be.

Read Drew's full page here

Robert F. Kennedy, Jr., United States Secretary of Health and Human Services, testified before Congress this week. Disability Advocates of all stripes were outspoken about the Secretary's statements, views, and "facts", and the direction that the administration is undermining efforts to value and protect individuals with I/DD and autism.



WATCH: RFK Jr. testifies on Trump's HHS budget request before Senate committees

By Ali Swenson, Associated Press, via PBS, April 22, 2026

A Republican senator juggling three roles — lawmaker, doctor and political candidate seeking reelection — walked a fine line on Wednesday as he questioned Health Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist who has moved to dramatically roll back the nation's childhood vaccine recommendations.

Kennedy appeared before the Senate Finance Committee on Wednesday at 10 a.m. EDT and before the Senate Health Committee at 2 p.m. EDT. Watch the video in the link below.

Please click here to continue reading, and link to selected clips of the Secretary's testimony

FACT FOCUS: RFK Jr. misleads on Medicaid cuts

By Ali Swenson, AP News, April 23, 2026

In a spate of recent appearances in Congress, Health Secretary Robert F. Kennedy Jr. recoiled almost every time a lawmaker referred to Medicaid cuts enacted in President Donald Trump’s big 2025 tax and spending bill.

Throughout the budget hearings, many Democrats raised concerns about how the cuts could affect rural hospitals and leave vulnerable Americans without health insurance. Kennedy frequently interrupted them to claim no cuts existed.

CLAIM: “There are no cuts to Medicaid,” Kennedy said. “We are increasing Medicaid spending by 47% over the next 10 years. Increasing spending by 47%. How is that a cut? That is only a cut in Washington, D.C.”

THE FACTS: Medicaid analysts say Kennedy’s explanation is inaccurate political spin, and say an inevitable increase in spending due to factors like a changing population and rising health costs doesn’t negate that there was a funding cut.

To help partly offset lost revenue from sweeping tax cuts and new spending, Trump’s law last year enacted significant reforms to Medicaid, including new work requirements and eligibility changes, that are expected to cut the health care safety net program’s spending by nearly $1 trillion over a decade. 

Kennedy’s argument is that Medicaid spending is projected to grow from year to year over the next 10 years — so there can’t be a cut. His staff cited a February Congressional Budget Office report showing 47% growth over a 10-year period to back up his argument.

But experts explain that if the tax cuts and spending law hadn’t passed, Medicaid spending would be growing more.

“This is an old, sort of tired argument that’s been used by conservatives to justify spending cuts by saying, well, if spending is still growing in nominal terms, somehow there wasn’t a cut,” said Edwin Park, a research professor at Georgetown University. “The federal government is spending nearly a trillion dollars less than it otherwise would have in the absence of the legislation.”

Continued

RFK Jr. draws backlash for ripping Medicaid programs that pay people to care for relatives

Advocates for disabled people and those who care for them said they were insulted by Health Secretary Robert F. Kennedy Jr.’s allegations that the programs are "rife with fraud."

By Mike Hixenbaugh, NBC News, April 23, 3036

Health and Human Services Secretary Robert F. Kennedy Jr. sparked outrage among disability rights advocates with recent comments alleging widespread fraud in Medicaid programs that pay people to care for elderly or disabled family members — a system millions of Americans rely on to survive.

During testimony before the U.S. House Ways and Means Committee last week, Kennedy criticized Medicaid-funded programs that pay relatives to serve as caregivers, alleging they compensate people for tasks they “used to do as family members for free.” That includes paying them “for balancing the checkbook, for picking up the groceries, for driving somebody to a doctor’s appointment,” he said.

“And this is rife with fraud,” Kennedy said, because the federal government has no way “to determine if they actually performed that duty or not.”

Video of the remarks quickly spread across social media, drawing a wave of angry responses from caregivers and disability rights advocates who said Kennedy trivialized the reality of caring for medically complex loved ones while conflating legitimate caregiving with illegal activity.

“That’s insulting,” said Kim Musheno, senior director of Medicaid policy at The Arc of the United States, a national disability rights organization. “It’s insulting to the families, and it’s insulting to the work that direct support professionals do for people.”

That work, advocates say, is far more complex than shuttling loved ones to doctor appointments.

For many families, it involves constant, hands-on care for relatives who are unable to live independently — from managing medications and medical equipment to providing continuous supervision for those with significant physical or behavioral needs. The work can be physically and emotionally demanding, advocates say.

Sue Root, a nurse and single mother of three in Colorado who is paid through Medicaid to care for her 25-year-old daughter, said Kennedy’s words bore little resemblance to her daily life. Her daughter, who suffered a catastrophic brain injury as a child, requires around-the-clock care, including a ventilator, feeding tube and seizure monitoring — which Root largely manages at home.

“The suggestion that family caregivers are simply running errands or performing typical normal tasks that should be done for free is not only inaccurate, it is deeply dismissive of the reality of special needs families like mine,” Root said.

More than 11 million Americans are paid through government programs to care for elderly or disabled family members, according to a recent study. Many are reimbursed through a suite of state-administered Medicaid programs known as home- and community-based services, which compensate both family members and professional caregivers to help people live safely at home.

Kennedy’s comments come as Medicaid home-care programs — which have long garnered bipartisan support as a cost-effective alternative to nursing homes and other institutions — face growing scrutiny from conservative policymakers and activists who have framed them as magnets for fraud and waste.

Continued

RFK Jr. Takes Issue With Medicaid Paying Family Caregivers

By Michelle Diament, Disability Scoop, April 23, 2026

Disability advocates are calling out top federal health officials for suggesting that Medicaid’s home and community-based services program pays for assistance that should be provided by families for free.

Recent comments from U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. and Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, have targeted fraud concerns in Medicaid waiver programs allowing family members to be paid to provide care for people with disabilities and aging individuals.

“The waivers allow people, family members who are taking care of an elderly parent to get paid for balancing the checkbook, for picking up the groceries, for driving somebody to a doctor’s appointment,” Kennedy said while testifying before lawmakers on Capitol Hill last week.

“These are family members who are getting paid to do things that they used to do as family members for free,” he said. “This is rife with fraud because we have no way at CMS to determine whether they actually perform that duty or not. We don’t know whether you drove your grandmother to a doctor’s office.”

The comments mirror similar sentiments from Oz who described personal care services as helping “Medicaid patients do something that our families would normally do for us, like carrying groceries,” in a recent social media video.

The statements from federal officials charged with overseeing the Medicaid program have disability advocates alarmed.

Continued

Opinion: What RFK Jr. Doesn’t Get About Paid Family Care

By Calli Ross, as told to Julia Metreaux, Mother Mones, April 23, 2026

Most states allow parents of adult children with disabilities, family members of children with disabilities, and family members of the elderly to be paid for providing attendant care.

Robert F. Kennedy Jr. is now saying all of this should be considered “natural supports” and unpaid labor. And the underlying rhetoric is that this labor should be provided by women.

Tensy is my 11-year-old little boy who was born with a genetic condition that makes him more susceptible to illness. At age one, he developed chronic lung disease. At four, he had his first cardiac arrest, going 33 minutes without oxygen to his brain. He recovered fairly well but with limited mobility. He requires 24/7 ventilator support for his lungs, uses a feeding tube, and is a wheelchair user.

In 2024, he had a second cardiac arrest caused by a seizure. This led to the loss of his smile, facial movement, and any purposeful physical movement. He is still able to communicate using an eye gaze device and experiences a full life because he is supported in his home and community.

In Oregon, like other states, a state assessment determined that to live safely at home, Tensy requires 744 hours of nursing and attendant care each month. These supports go far beyond typical parenting. They include tracheostomy care, manually resuscitating him during seizures, and full support for all activities of daily living.

Because Oregon passed the Children’s Extraordinary Needs waiver in 2023, parents of the highest-needs children are allowed to work up to 20 hours per week providing these supports, care that is clearly above and beyond typical parenting. Similar policies exist for adults with disabilities and the elderly, run by states but supplemented by federal matches. The few states that allow parents of minors to be paid are funded under the same principle.

Our program is incredibly small. Only 155 children can participate [at a time], and the waitlist is thousands long. That bill is named for my son: Tensy’s Law.

These are hours someone else could be paid to work—if the workforce existed. And by someone else, I mean anyone off the street who is 18 or older without a felony. But even that low-qualification workforce doesn’t exist. There is a well-documented national caregiver crisis. Many families are being forced to leave the workforce, rely on state aid, or institutionalize their loved ones at a much higher cost to state and federal systems.

Tensy is one of the 155 in children in Oregon, with a waitlist in the thousands, allowed to choose his dad as his paid caregiver for 20 hours a week. That is the cap, currently, in our state. (Even then, due to administrative delays, my son wasn’t able to benefit from having his dad as his paid caregiver until January.)

It isn’t much, but because of this help, we are able to afford a wheelchair-accessible vehicle. My husband is able to take more time from his job to provide Tensy the care he needs to thrive. As his parents, we are the most knowledgeable and most able to care for our son. But without support, we cannot keep him home. And that’s the reality everywhere.

Read the full editorial here

States Work to Prevent Fraud Against Medicaid, Administration Uses Fraud to Attack Program

By Andy Schneider, Georgetown University McCourt School of Public Policy, April 21, 2026

The first three months of 2026 have witnessed an unprecedented series of fiscal and rhetorical attacks on states by the White House and the political leadership at CMS, ostensibly about fraud against Medicaid. The focal point of these attacks has been Minnesota. On January 6, CMS notified the Governor of Minnesota that his state was out of compliance with federal Medicaid law and that until the state came into compliance CMS would be withholding half a billion dollars in federal Medicaid matching funds every quarter going forward. On February 25, Vice President Vance, at a White House press conference, announced the deferral of $259 million in federal Medicaid matching funds on expenditures for the last quarter of FY 2025. And on March 16, President Trump issued an Executive Order creating a Task Force to Eliminate Fraud chaired by Vice President Vance. The E.O. singled out Minnesota for what it alleged was “staggering fraud and waste,” adding that there was “strong reason to believe that similar problems exist in other States, including California, Illinois, New York, Maine, and Colorado.”

As these actions play out—currently, the compliance action is in a holding pattern, the deferral process is moving forward, and the Task Force has held its first meeting—it’s worth stepping back and asking what exactly is going on here? 

Let’s be clear: fraud against Medicaid (or for that matter, Medicare or commercial insurers) is, regrettably, not a new issue. Over 20 years of DOJ and HHS/OIG reports on controlling fraud against Medicare and Medicaid document that reality. The federal and state agencies responsible for preventing, detecting, investigating, and prosecuting fraud against Medicaid have been in place for at least that many years. And as their annual reports indicate, they are delivering results. Could they be doing a better job? Of course. There’s always room for improvement. 

The question is not whether there is fraud against Medicaid. The question is whether the White House or CMS leadership attacks on Democratic-led states have done anything to reduce it. There’s little evidence that they have. Last month, CMS approved a revised Corrective Action Plan submitted by Minnesota to tighten up its defenses against fraud which the state is in the process of implementing. (A timeline of activity relating to Minnesota is here). Other than that, CMS leadership has made partisan videos; the agency has sent letters to California, Florida, Maine, and New York asking about anti-fraud policies and practices (the letter to New York includes an egregious overstatement of fraud against its Medicaid program); and the agency has published a Request for Information (RFI) for input on how to strengthen its ability to combat fraud, waste, and abuse in Medicare and the Marketplaces as well as Medicaid and CHIP.

Perhaps something substantive will come out of all this fact-gathering. Perhaps not. But there’s no shortage of constructive actions that CMS should be taking. It could start by issuing guidance to states along the lines of last month’s Informational Bulletin on oversight of managed care, explaining what services and provider types it considers to be at high risk of fraud, what the best practices are for mitigating those risks, and what federal funding is available to support state adoption of those best practices. It could also update its program integrity toolkits for state Medicaid agencies; to take one example, its assessment of data analytics to detect fraud against Medicaid is 12 years old and does not include the term “Artificial Intelligence.” 

Finally, it could conduct more focused program integrity reviews, which are efforts to identify weaknesses in individual state programs and the help states fix them, not to punish states financially. (It speaks volumes that CMS’ January 2026 focused review of Personal Care Services in Maine, a detailed 22-page analysis that requests a corrective action plan, receives no mention whatsoever in CMS’ February 6, 2026 letter to Governor Mills requesting “detailed information regarding program integrity…and provider oversight” in the state’s Medicaid program).

As far as one can tell from the public record, the agency is doing none of these things. So what’s going on here? As it happens, a mid-term election is coming up on November 3 that will determine the control of Congress during the last two years of the current administration. It’s hard to avoid the conclusion that the White House is trying to change the subject to avoid a pre-election conversation about the impact of the historic cuts in federal funding for Medicaid enacted last year on access to needed services for millions of Americans. The exclusive focus of the President’s March 16 E.O. on states led by Democratic Governors suggests an exercise that is other than nonpartisan.

But from this vantage point, the administration’s actions, ostensibly to “crush” fraud against Medicaid, are not just about the mid-terms. What’s going on now is also part of a long game, one that started in 1981 under President Reagan, continued during the Speakership of Newt Gingrich in 1995, and most recently resulted in the one-thumb-down defeat of President Trump’s effort to “repeal and replace” the ACA in 2017. The object of the game is to cap federal spending on Medicaid, either by converting the program into a block grant with fixed federal allotments to states, or by imposing a “per capita cap” on federal matching payments. 

What does capping federal matching payments to states have to do with reducing fraud against Medicaid? In a word, nothing. Most fraud is committed by bad actor providers and business people. These bad actors don’t really care whether the Medicaid funds they steal come from the current health insurance program, from a program operating under a per capita cap, or from a block grant. Their focus is the money, not the federal-state financing mechanism. If they aren’t screened out of the program in the first place, or if they find their way into the program and their fraud schemes aren’t detected, they will extract as much as they can get away with. 

What does capping federal matching payments to states have to do with providing health insurance coverage to help low-income Americans access needed medical and long-term care services? In a word, everything. As my colleague Edwin Park has explained, a cap will shift the costs of financing needed health and long-term care services for low-income Americans—including the risks of health care inflation, recessions, and natural disasters–from the federal government to the states. (A cap is a federal budgeteer’s dream: a dial that will enable the government to ratchet down the capped amounts available to states in order to generate offsets to pay for tax cuts, for other spending, or even deficit reduction.) A cap will undercut health care coverage for children (Medicaid covers 40 percent of the nation’s children) and pregnant women (Medicaid covers 40 percent of the nation’s births). It will disrupt the states’ abilities to pay not just for Medicaid services but also for other state priorities, including K-12 education. And that’s not the half of it.

Despite over four decades of efforts to dismantle it, Medicaid remains a health insurance program in which the federal government and the states share the cost. There has certainly been no shortage of proposals to cap the program. But the fact is that Medicaid works, and it is popular. A majority of the public are worried that cuts in federal spending on Medicaid would have a negative impact on their or their family’s access to needed services. 

Consider this recent piece from the Paragon Institute, which argues that there are four types of Medicaid services that are “ripe with improper payments and fraud:” (1) home- and community-based services (HCBS); (2) non-emergency medical transportation (NEMT); (3) applied behavioral analysis for autism spectrum disorder (ABA); and (4) substance abuse disorder services and treatments (SUD). The authors discuss each of these services, referencing examples of improper payments, which are not fraud, and increases in Medicaid spending on these services, which are not necessarily evidence of fraud. They cite examples of actual fraud against Medicaid by NEMT providers and by SUD providers (oddly, not by HCBS or ABA providers), but they do not offer any suggestions for reducing fraud specific these service areas other than curbing payments to family members for caregiving services. 

Here’s their first recommendation:

“The most effective long-term reform, requiring legislative action, would be to cap federal Medicaid funding so that spending above the cap is borne entirely by states. This would force states to internalize the cost of waste and fraud. While Congress has pursued such reforms in other welfare programs, it has failed to do this for Medicaid.”

Rubbish. States have a major fiscal stake in the program. They have already “internalized” the cost of fraud against the program. They have every incentive—financial, programmatic, and reputational–to minimize it and they are doing so. Capping federal payments will do nothing to change that; instead, it will simply shift financial risk from the federal government to states, disrupting their finances, their health care economies, and the health of their low-income citizens. 

Read the full article here

Oz unveils nationwide plan to tackle Medicaid fraud at POLITICO Summit

By Amanda Chu, Politico, April 21, 2026

Centers for Medicare & Medicaid Services Administrator Mehmet Oz is taking his fraudbusting effort to all 50 states.

At POLITICO’s Health Care Summit on Tuesday, Oz unveiled a nationwide plan to crack down on alleged Medicaid fraud, announcing his agency will require all states this week to submit a plan within 30 days on how they will revalidate Medicaid providers.

“We’re asking the states to own that problem… red and blue, all of them,” said Oz, a medical doctor who popularized his moniker, Dr. Oz, when he was a TV show host. As CMS administrator, Oz oversees the nation’s largest health insurance programs.

“If you don’t take it seriously, it indicates to us that we might have to take the audits… more aggressively,” he added.

Oz’s comments arrive as the Trump administration and Congress lean in on anti-fraud messaging in an effort to blunt Democratic attacks on health care affordability ahead of the November midterm elections. Democrats are expected to leverage soaring Obamacare premiums and the more than $1 trillion in Medicaid cuts enacted in Trump’s domestic policy package last year against their GOP counterparts on the campaign trail.

In his State of the Union address, President Donald Trump declared a “war on fraud” and put Vice President JD Vance in charge of the effort. Oz, the high-profile face of the campaign, has released a string of viral videos in recent weeks highlighting his agency’s crackdowns and launched probes mostly in Democratic-led states.

So far, Oz has sent letters to California, Florida, Maine and New York alleging fraud in their Medicaid programs. Last month, CMS approved a plan submitted by Minnesota to combat Medicaid fraud after threatening a $2 billion cut to future Medicaid payments to the state due to noncompliance.

But Oz suffered a major setback earlier this month when his agency admitted that an error in its analysis of fraud in New York’s Medicaid program grossly overstated the number of enrollees with personal care services, according to reports from the Associated Press. Oz had claimed that New York had provided 5 million Medicaid enrollees with personal care services, but the real number was around 450,000.

Continued

Governors and State Medicaid Directors Get a New Assignment from Dr. Oz: Quickly Recertify “High-Risk” Providers

By Andy Schneider, Georgetown University McCourt School of Public Policy, April 24, 2024

On April 23, CMS Administrator Dr. Mehmet Oz sent a letter to all 50 Governors calling upon their Medicaid programs to “undertake a swift revalidation of Medicaid providers of services at high risk of waste, fraud, abuse, and corruption.” In the letter he requests that the Governor notify CMS within 10 business days (May 7) whether the state intends to carry out the “swift revalidation” and if so, on what timetable. “It is urgent,” he writes, “that action be taken immediately to address the rapid increase in fraud, waste, abuse, and corruption in Medicaid and to bar fraudulent actors from further abusing the program.” “Please be advised,” he warns, “that failure to carry out swift revalidation” will be considered as we evaluate the likelihood of fraud in each state moving forward.” 

These letters were sent in tandem with the issuance of a letter to State Medicaid Directors (SMD), also signed by Dr. Oz (not the Director of the Center for Medicaid and CHIP Services as is customary). In addition to requesting a timeline for “swift revalidation” of “high-risk” providers within 10 days, the SMD requests that the Medicaid agency “develop and submit a comprehensive two-year provider revalidation (PR) strategy” within 30 days (June 5 on a business day basis). Among other elements, the strategy must include “a proposed methodology and timeline for conducting off-cycle provider revalidation, with a focus on high-risk providers, including providers without an NPI” (National Provider Identifier).” Pointedly, the SMD requires that the strategy be submitted by the state’s Medicaid Director, not by a designee.

There are three levels of “categorical risk:” limited, moderate, and high. Limited risk screening includes verification of provider licenses and a check of federal databases like the List of Excluded Individuals/Entities maintained by the OIG. Moderate risk screening includes the limited risk screening plus an on-site visit (announced or unannounced) to verify that the information submitted to the Medicaid agency is accurate. High risk screening includes both the limited and moderate risk screening plus the submission of fingerprints and a criminal background check. The state Medicaid agency designates the risk level that applies to each provider, except that some providers must be designated as high risk (for example, when the agency imposes a payment suspension based on a credible allegation of fraud, waste, or abuse).

This brief summary does not begin to do justice to the complexity of provider screening and enrollment. For the details, see the CMS Medicaid Provider Enrollment Compendium (MPEC).

Read the full article here

(EXCEPTS FROM A SUBMISSION FROM PARAGON HEALTH INSTITUTE TO CMS SUGGESTING FURTHER CUTS TO MEDICAID. PARAGON AUTHORED MANY OF THE MEDICAID CUTS THAT WERE ENACTED IN H.R.1, THE ONE BIG BEAUTIFUL BILL ACT)

Re: CMS Request for Information (RFI) Related to Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH)

By Brian Blase, Jackson Hammond, Niklas Kleinworth, and Gabrielle Kalisz, PARAGON Health Institute, March 31, 2026

Dear Administrator Oz,

Paragon Health Institute appreciates the opportunity to respond to the Centers for Medicare & Medicaid Services’ Request for Information (RFI): Comprehensive Regulations to Uncover Suspicious Healthcare (CMS-6098-NC). We commend CMS for prioritizing program integrity and welcome the opportunity to provide recommendations grounded in our research on structural drivers of fraud, waste, and abuse across federal health programs.

Paragon estimates Medicaid improper payment rates have exceeded $1.1 trillion over the last decade, doubling the officially reported number by CMS.⁴ Relative to the trend, hundreds of billions in Medicaid spending could be saved over the next decade by reducing improper payments in the program.

Building on the One Big Beautiful Bill

1. Eligibility redeterminations at least every six months for expansion adults (Sec. 71107, effective January 1, 2027): Ensuring full effectiveness of more frequent redeterminations requires prohibiting self-attestation for key enrollment criteria such as income, household size, and residency. States should be required to cross-check this information against federal databases.
2. Immigration eligibility restrictions (Sec. 71109 and 71110, effective October 1, 2026): CMS should strictly enforce immigration restrictions. This means immediately disenrolling individuals who cannot be verified as eligible by the deadline. CMS should consider rulemaking to reduce the 90-day reasonable opportunity period and clarify that a state may only offer one opportunity period to an applicant.
3. Good-faith waiver limits on 3 percent Payment Error Rate Measurement (PERM) disallowance (Sec. 71106, effective October 1, 2029): CMS should issue guidance now applying a strict interpretation of permissible waivers.

Federal & State Database Cross-Checks

1. CMS should build on OBBB requirements by compelling regular cross-checks against relevant federal and state data sources. These include those covering Social Security, tax, immigration, and criminal databases.
2. CMS should provide clear guidance on the use of reliable third-party data sources to verify eligibility, including income, residency, and eligibility status.
3. CMS should provide states with direct real-time API access to the federal Do Not Pay (DNP) database so pre-payment holds are triggered automatically.

Home- and Community-Based Services (HCBS)

HCBS is among Medicaid’s most fraud-prone categories. Decentralized delivery, family caregiver self-direction, and weak documentation requirements create conditions for false claims, inflated hours, and phantom service delivery.⁶ States lack financial incentives to police this spending under both fee-for-service (FFS) and managed care. CMS should issue appropriate regulations and guidance to accomplish the following:

1. Prohibit paying household members to provide HCBS or personal care.
2. Vigorously enforce the 21st Century Cures Act’s electronic visit verification (EVV) requirement and mandatory Federal Medical Assistance Percentage (FMAP) reduction. Require that EVVs include cross-checks against billing claims. Any billing not reconcilable with EVV data should trigger an automatic pre-payment hold.
3. Require states to share EVV data with the federal government in a uniform machine-readable file.
4. Establish reasonable utilization management guardrails to prevent excessive or unsupported service volumes.
5. Audit HCBS programs to determine whether they unlawfully incorporate room and board costs into HCBS rates and recover payments where this has occurred.
6. Require in-person assessments for all HCBS service determinations and rescind pandemic-era virtual or telephone assessment flexibilities.
7. Require regular and independent reassessment of care plans.

Applied Behavior Analysis (ABA) / Autism Spectrum Disorder

ABA spending has increased 30-fold in some states since CMS’s 2014 Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) guidance. HHS Office of Inspector General (OIG) audits of Indiana and Wisconsin found $56M⁸ and $18.5M⁹ in improper payments, respectively. Neither audit examined managed care claims. Paragon’s research raises concerns about non-clinical incentives driving diagnosis rates. CMS should issue appropriate regulations and guidance to accomplish the following:

1. Require independent diagnostic confirmation before ABA coverage is authorized.
2. Prohibit financial incentives tied to diagnosis volume.
3. Scale services to the severity of the disorder, such as tiered authorization criteria matching service intensity to clinical need, not a blanket entitlement.
4. Require parental or caregiver participation as a condition of Early Intensive Developmental and Behavioral Intervention (EIDBI) and ABA authorization.
5. Require fingerprinting and background checks for all ABA providers regardless of licensing level.
6. Require documentation standards that allow verification of services billed against services delivered.
7. Issue guidance and utilization management parameters for services exceeding 20 hours per week, restrictions on telehealth, and out-of-state providers.

Read the full submission here

Expanding The GUIDE Model To Include Adults With Intellectual Disability And Dementia

By Matthew P. Janicki and Philip McCallion, Health Afairs, April 23, 2026

Adults with intellectual and developmental disabilities (IDD) are living longer, with more reaching older age and qualifying for Medicare. As care has shifted from institutions to community settings (such as family or group homes), responsibility now rests largely with family caregivers and direct-support professionals. When dementia develops, affecting an estimated 10–20 percent of adults with IDD, care demands become more complex, often without adequate training or support. Despite their central role, these caregivers remain underrecognized in dementia care models, contributing to delayed diagnosis, fragmented follow-up, and crisis-driven, and often avoidable, institutional admissions.

The Centers for Medicare and Medicaid Services’s (CMS’s) Guiding an Improved Dementia Experience (GUIDE) Model was designed to improve care coordination, reduce caregiver burden, and delay institutionalization for adults with dementia. Expanding the GUIDE eligibility language to include adults with IDD offers a practical opportunity to address emerging service gaps while advancing health equity.

The Unmet Needs Of Adults With IDD And Dementia

Many adults with IDD experience earlier onset of aging-related conditions, including dementia, and increased levels of sensory decline, polypharmacy, and mental health comorbidities. Caregivers, both family members and paid staff, must coordinate across fragmented service systems while monitoring and responding to subtle yet major functional and behavioral changes.

Standard dementia screening tools often fail to detect meaningful decline in individuals with lifelong cognitive impairment, contributing to delayed recognition and fragmented care. Moreover, current Medicare-based dementia care models rarely incorporate IDD-specific baseline functioning, communication differences, or service contexts.

As a result, despite having significant needs, adults with IDD remain underrepresented in coordinated dementia care programs and face increased risks of caregiver burnout, emergency care use, and avoidable institutionalization.

The Scope Of The Gap

Epidemiological evidence shows that all-cause dementia occurs at higher rates and earlier ages among some adults with intellectual disability. Among individuals without Down syndrome, all-cause prevalence approaches 13 percent after age 60 and nearly 20 percent by age 65. Among individuals with Down syndrome, prevalence (mostly due to Alzheimer’s disease) exceeds 50 percent by age 60. National estimates suggest that 80,000–120,000 adults with intellectual disability are living with all-cause dementia in the United States, with approximately 50,000 residing in community settings. Many are dually eligible for Medicare and Medicaid.

The GUIDE Model is projected to serve about 66,000 beneficiaries annually across roughly 330 programs. However, adults with IDD are only 0.8–1.2 percent of enrollees, that is, fewer than 650 individuals will be reached each year. Increasing participation to 2.5–5.0 percent would expand reach to 1,500–3,200 individuals annually without requiring increased program capacity.

Why Systems Do Not Align

Limited inclusion of adults with IDD reflects a longstanding divide between aging and IDD service systems. Aging services are largely structured around Medicare and the Older Americans Act, while IDD services are rooted in Medicaid home and community-based services and state-administered disability systems. These systems operate under different funding streams, administrative structures, and eligibility criteria. As individuals with IDD age and develop dementia, they fall between these systems, creating gaps in coordination and continuity.

Despite federal initiatives emphasizing integration, practical mechanisms remain limited. The GUIDE Model offers a viable pathway to bridge Medicare dementia services with Medicaid- and state-funded IDD supports.

Continued

Access to Home-and Community-Based Services for People with Disabilities Leaving Incarceration: Barriers and Policy Priorities

By Natalie Kean, Greg Robinson, and Ruby Siegel, Justice in Aging, April 22, 2026

Each year in the United States, more than 600,000 individuals are released from state and federal prisons, and 9 million people cycle through local jails (Incarceration & reentry, n.d.).

Among them are people with disabilities, people of color, and multiply marginalized groups; populations that are overrepresented in carceral institutions (Gann & Kaeble, 2025; Maruschak et al., 2021). The process of reentry—the transition from prison or jail to living in the community—greatly impacts and may even determine the continued health, wellbeing, and access to support networks for individuals with disabilities after incarceration.

Medicaid plays a critical role for most people leaving incarceration by providing access to healthcare coverage. For people with disabilities, Medicaid is even more important because it can cover home and community-based services (HCBS) that provide assistance with daily activities ranging from personal care to transportation to employment supports.

Disabled individuals face considerable barriers to accessing Medicaid and other supports they need at reentry, leaving a setting where their long-term services and supports (LTSS) needs are likely not met and navigating a patchwork of underfunded programs in the community. Moreover, disabled people of color returning to the community experience unique and intersecting discrimination in accessing housing, employment, and community-based support.

This brief examines barriers people with disabilities, including older adults, face when released from incarceration in accessing LTSS. We discuss current policy initiatives to increase Medicaid access, examine gaps in access to HCBS and other supports, and identify promising practices to address those gaps. Based on our research, we propose policy initiatives aimed at supporting disabled people to successfully reenter through improving access to HCBS.

Continued

Why families caring for children with disabilities are suing Washington state

They’re trying to bring a class-action suit, arguing the state has failed to provide services promised under Medicaid to thousands of children.

By Jake Goldstein-Street, Oregon Public Broadcasting, April 22, 2026

When Jamie and Chris Thompson got married, they created a big, blended family. Chris had three children from a previous marriage. Jamie had a son. Together, they had two more kids. The youngest, Colby, had bright blue eyes and chubby cheeks. Jamie Thompson called him the “little ham of the family.”

But in 2010, a babysitter became so frustrated with his crying that she shook and slammed him, Jamie Thompson recalls.

This left Colby, then 8 months, with a traumatic brain injury that nearly killed him.

Now 16, he can’t use his body and can’t communicate. He has severe scoliosis, chronic lung disease, cerebral palsy and is fed via tube, and is dependent on a ventilator to breathe at all times. He requires round-the-clock care.

For years, Jamie Thompson has been his caregiver, to the point that she sleeps in a recliner next to him in the living room.

“I’m employee of the month, Colby would tell you, even though he can’t,” she said. “I show up every day. I never have a sick day, I’m always here.”

When it comes to support from the state, Thompson, like many parents providing care to disabled children, falls into a gap.

Washington compensates parents providing care to disabled children on Medicaid if they are over 18, but not if they’re minors. Other relatives can get paid for taking care of children, just not parents. Professional nursing and personal care are covered, but families say labor shortages make these services often difficult to find.

This has forced some parents to quit their jobs to care for their children full-time without pay. Some fear that such little support will leave them with no other choice than to institutionalize their children.

In response, families have brought a potential class-action lawsuit against the state in federal court for not ensuring that children with developmental disabilities on Medicaid get the nursing and care services they qualify for.

“It’s really frustrating to know that the state of Washington has been taking advantage of us, all of our families, to take care of our kiddos for free, and there’s not a damn thing anybody can do about it,” Thompson said.

Legislation to potentially pay parental caregivers made some progress in the Legislature in 2024 and 2025 but went nowhere this year. The idea has bipartisan support as a way to overcome the caregiving workforce shortage but has faltered amid budget concerns.

“We’re just going through the judiciary to do what they tried to do through the Legislature already,” said Greg Albert, an attorney for the plaintiffs bringing the litigation.

‘You have to find a way’

Outside care for families with disabled children falls into two buckets.

Private duty nursing gives a home-based alternative to institutional care for children with complex needs, like ventilators, tracheostomies or feeding tubes.

Personal care is for outside help to aid in the daily tasks of living, like bathing, dressing, eating and managing medication, among other things.

The children whose families brought the suit qualify for a combination of private duty nursing and personal care, or both. They include a 3-year-old who has spent much of his life in the hospital and skilled care facilities because no private duty nursing services were available to enable him to live at home. Another plaintiff qualifies for 112 hours per week of private duty nursing but has been getting less than 40 hours for over a year.

The state has countered in court filings by arguing that the “alleged harm, if any, arises out of conditions of which the plaintiffs had knowledge and to which they voluntarily subjected themselves.”

The lawsuit claims roughly 100 people in Washington under age 21 who are eligible for private duty nursing services are not receiving them at the level they’re approved for. It counts about 4,700 people in the same boat for personal care aid. A state study in 2023 estimated 1.4 million personal care hours went unused by children in these circumstances.

The plaintiffs are asking a judge to allow them to represent those roughly 4,800 children in the class-action case.

Read the full article here

For many Tenn. families, caring for an adult with disabilities isn’t a choice, it’s their only option

By Hannah McDonald, News Channel 5, Nashville, April 22, 2026

When support systems fall short for adults with intellectual disabilities, families are often left to find solutions for problems that do not always show up clearly in the data.

In Tennessee, roughly one in 11 people who need long-term disability supports receive some type of service through the state. The other 10 rely entirely on family, or go without the support they need. I tried to find how many Tennesseans with intellectual disabilities are served in residential settings statewide, but the state doesn’t track that exact figure.

Tennessee Baptist Adult Homes provides a licensed care option for some families.

The Tennessee Baptist organization serves 35 adults with special needs across multiple state-licensed homes.

Two homes in Lebanon that share a backyard serve 16 men and women with an IQ of 70 or lower.

"It's an honor to care for them," Sherri Russell, one of the house managers, said.

Beth and Jason Goolesby’s 27-year-old daughter, Brittany, moved into the Tennessee Baptist Adult Home for women after public education services came to an end around her 22nd birthday.

"If we did not have somewhere for Brittany to be, one of us would have to pay someone somewhere to keep her, or quit working. And so, it's basically having a small child for the rest of your life, the responsibilities," Beth Goolesby said.

The organization was forced to reduce capacity by eight beds in 2024. But after two critical fundraisers in 2024 and 2025, they have stayed afloat. The organization has set a goal of $575,000 for this year's Father's Day Offering to bridge the funding gap that routine church contributions leave unfilled.

A national association representing disability service providers says direct support professionals face some of the highest turnover rates of any workforce in the country.

"Until you have to make that decision [as a parent], you don't know who to call. It's sad there are people out there living in situations when things could be easier for them," Beth Goolesby said.

Residential care options for adults with disabilities in Tennessee primarily include supported living, group homes, and nursing facilities, largely funded through TennCare CHOICES or 1915(c) waivers. The waivers closed to new enrollment as of July 1, 2016, with limited exceptions. These options can provide 24/7 care or independent living support in community-based settings.

There are an estimated 160,000 adults with developmental disabilities in Tennessee. Only about 15,000 people with developmental disabilities get long-term daily support for their needs, which is only about 9% of the people who need it.

Read the full article here

Police Shootings Expose Failures In Mental Health Crisis Response

By Brendan Nordstrom, The Baltimore Sun, via Disability Scoop, April 22, 2026

When 25-year-old Alex LaMorie called Howard County Police for help during a mental health crisis, his family expected officers trained to de-escalate the encounter. Instead, police fatally shot the Columbia man, who had autism.

Advocates say LaMorie’s March 1 death reflects a broader problem across Maryland and nationwide: Police are often the first responders to mental health crises, and too often, those encounters turn deadly — even in Howard County, widely considered a leader in crisis response, with most officers trained in crisis intervention and behavioral health specialists available 24/7.

“That goes to show you how much more there is to learn and how much more there is to invest in the resources needed for these types of situations,” said Scott Gibson, chief operating officer at Melwood, a family of nonprofits supporting people with disabilities in Washington, D.C., Maryland and Virginia.

Baltimore Police shot a 48-year-old woman undergoing a mental health crisis in January after specially trained officers weren’t available to respond. In June, Baltimore Police also shot and killed a 70-year-old woman experiencing a behavioral health crisis.

A Baltimore County family recently called for an investigation into a 2025 police shooting that paralyzed their 27-year-old son with autism in the midst of a mental health crisis. In September, Cambridge Police shot and killed a suicidal, naked man who wielded a knife.

Advocates warn that an inconsistent, underfunded police response to wellness calls will continue to drive up deaths, unless there’s reform.

“Cities and communities are tired of watching these videos of people in mental health crisis being killed by police and are wondering: Do we have another option here?” asked Tahir Duckett, executive director at Georgetown Law’s Center for Innovations in Community Safety.

Research shows roughly 25% of fatal police encounters nationwide involve someone undergoing a mental health crisis, while more than 10% of police encounters involve a person exhibiting signs of a mental health disorder.

“I think it’s fair to ask ourselves: If we know this about mental health, are we resourcing it enough in our budgets?” Gibson said.

In response to LaMorie’s death, Howard County purchased 200 Tasers for its patrol officers to carry. Every Howard Police officer who directly interacts with the public will now carry a Taser, according to Howard Police spokesperson Sherry Llewelyn, who said officers are already authorized to use pepper or OC spray, beanbag shotguns and rubber projectiles.

Some questioned why the officers weren’t already equipped with all the less-lethal alternatives.

“There’s absolutely no excuse for any agency right now in the police world not to have all the less-lethal devices that are available to them at their fingertips,” Carroll Sheriff James T. “Jim” DeWees said.

Other departments use beanbag shotguns or train officers in the SafeWrap System, a technique to restrain people undergoing mental health crises without injuring them.

Continued

Ohio - Bill mandating emergency alert for kids with developmental disabilities advances toward final vote with unanimous backing 

By Karen Singh, Cleveland . com, April 23, 2026

A bill born out of tragedy and propelled by a grieving mother’s plea for faster action is approaching the finish line at the Statehouse.

Emergency alerts for missing individuals currently operate within a statewide system that already covers seniors and those with mental impairments. However, Ohio law does not require the police to issue an alert within the first 24 hours of receiving information “that meets the activation criteria.”

Under House Bill 359, law enforcement would have to immediately notify the system when a minor with autism or another developmental disability goes missing, closing what advocates describe as a dangerous gap in Ohio’s current emergency response procedure. The bipartisan effort has sparked emotional testimony, urgent calls for reform and broader conversations about how the state protects its most vulnerable children.

Sponsored by Reps. Cecil Thomas of Cincinnati and West Chester’s Jennifer Gross, the legislation reflects a rare alignment of both parties.

Because the proposed alert is an extension of existing infrastructure and technology, it has been framed as both feasible and vital. It would apply when a child under 18 goes missing, has a qualifying diagnosis and faces a credible risk of harm, with sufficient descriptive information available to assist in locating them. 

The notification would be formally designated as the “Joshua Alert” in memory of Joshua Al-Lateef Jr., a neurodivergent boy who disappeared from his home in 2024. Sponsors noted that he was reported missing by his family immediately, but a community-wide cellphone alert was not issued until several hours later. More than a day later, his body was found in a nearby pond after drowning.

At a hearing last month, his mother told legislators that her cries for help fell flat since the authorities were unable to trigger protocol at the most critical stage of Joshua’s absence.

“My oldest son and I each called 911, telling dispatch that Joshua was only 6 years old, nonverbal and autistic,” Jonisa Cook said. “We explained the urgency, pleaded for immediate help and asked if an AMBER Alert could be issued. We were told that Joshua did not meet the criteria.”

AMBER Alerts are reserved for cases involving a confirmed abduction and credible evidence that a child is in immediate danger. Joshua’s disappearance fell outside the scope of the system, despite the urgency of the situation.

Continued

Oregon Acts to Ensure Fundamental Labor Rights for Home Care Workers

By Jake McDonald, PHI, April 14, 2026

Oregon has taken the important step of codifying basic labor protections for home care workers in response to looming federal rollbacks. On March 3, 2026, Governor Tina Kotek signed SB 1518 into law, ensuring that Oregon home care workers will continue to have rights to minimum wage and overtime pay under state law, even as the U.S. Department of Labor (DOL) proposes to strip these same protections under federal law. The lesson from Oregon is simple: when federal protections are under threat, states need to act.

Background: Federal Policy Changes Threaten to Reverse Progress

In 2025, the DOL proposed a rule that would reverse a decade of progress under the Fair Labor Standards Act (FLSA) by reinstating an exemption that once denied home care workers the right to minimum wages and overtime pay. The DOL’s proposed rollback would effectively deem home care work unworthy of the labor rights extended to virtually every other American worker. On top of the proposed rulemaking, the DOL has already instructed its field staff to stop enforcing home care workers’ existing FLSA protections while the rule is pending.

What Oregon’s Law Does

While Oregon’s home care workers already had stronger labor protections than federal law affords, the state’s 2015 Domestic Workers Protection Act referenced federal definitions that the DOL’s proposed rule could undermine. SB 1518 fixes that vulnerability by decoupling Oregon’s minimum wage and overtime protections for home care workers from any new federal definitions. This new state law now ensures that home care workers retain the right to at least Oregon minimum wages and overtime pay, regardless of changes at the federal level. The new law also provides clarity for employers and for the Oregon Bureau of Labor and Industries in enforcing these labor rights—an especially important focus in the highly dispersed home care industry.

Guaranteeing fundamental labor rights for home care workers is critical to the future of care. PHI’s testimony in support of SB 1518 noted that Oregon will need to fill more than 70,000 total openings in home care between 2022 and 2032, while workers in this field continue to face serious economic insecurity and poor job quality. Stripping minimum wage and overtime protections from Oregon’s home care workers would have only deepened that precarity.

Preserving minimum wage and overtime rights will not in itself solve workforce challenges in Oregon, but this law does establish a crucial foundation upon which to build quality home care jobs, and recruit and retain a workforce capable of providing quality home-based care to older adults and people with disabilities across Oregon. The bill also sends a clear message rejecting the DOL’s misguided assertion that home care workers’ essential labor does not deserve the same basic recognition and respect as other work. Oregon correctly recognizes that valuing workers and ensuring access to care are not competing goals; they are interdependent.

A Model for Other States

Oregon’s home care workers are not alone in facing a threat from the DOL’s proposed rollbacks. Several states do not have their own minimum wage and overtime protections at all, or they exclude home care workers from these protections. Other states share the same vulnerability that Oregon addressed with this law: cross-references to federal definitions that could be weakened by federal rulemaking. Oregon’s approach of affirmatively extending state minimum wage and overtime protections to home care workers offers a straightforward and replicable model.

Continued

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VOR SUPPORTS:

H.R.6137 / S.3211 - Rep. Brian Fitzpatrick (R-NJ) and Sen. Maggie Hassan (D-NH) - A bill to require the Office of Management and Budget to consider revising the Standard Occupational Classification system to establish a separate code for direct support professionals

H.R.6766 / S.3492 - Rep. Claudia Tenney (R-NY) and Sen. Richard Blumenthal (D-CT) - Essential Caregivers Act - To amend titles XVIII and XIX of the Social Security Act to require skilled nursing facilities, nursing facilities, intermediate care facilities for the intellectually disabled, and inpatient rehabilitation facilities to permit essential caregivers access during any period in which regular visitation is restricted.

H.R.4796 - Rep. Laura Friedman (D-CA) - Restoring Essential Healthcare Act -To amend Public Law 119-21 (The One Big Beautiful Bill Act) to repeal the prohibition on making payments under the Medicaid program to certain entities.

H.R.4807 - Rep Greg Landsman (D-OH) - Protect Our Hospitals Act - To amend Public Law 119-21 to repeal certain changes to provider taxes under the Medicaid program. 

H.R.1262 & S.932 - Rep. Michael McCaul (R-TX) and Sen. Markwayne Mullin (R-OK) "Give Kids A Chance Act" - To amend the Federal Food, Drug, and Cosmetic Act with respect to molecularly targeted pediatric cancer investigations. This bill would renew research into pediatric cancers and includes increasing funding for rare diseases, some of which cause Intellual and developmental disabilities and autism.  

H.R.1509 & S.752 - Rep. Lori Trahan (D-MA) & Sen. Chuck Grassley (R-IA)

Accelerating Kids' Access to Care Act -

This bill would amend titles XIX and XXI of the Social Security Act to streamline the enrollment process for eligible out-of-state providers under Medicaid and CHIP, and streamline enrollment under the Medicaid program of certain providers across State lines.

H.R.2598 & S.1277 - Rep Jared Huffman (D-CA) and Sen Chris Van Hollen (D-MD) The IDEA Full Funding Act

To amend part B of the Individuals with Disabilities Education Act to provide full Federal funding of such part.

S.2279 - Sen. Josh Hawley (R-MO)

A bill to repeal the changes to Medicaid State provider tax authority and State directed payments made by the One Big Beautiful Bill Act and provide increased funding for the rural health transformation program.

H.R.1950 - Rep. Mark Pocan (D-WI) - Protect Social Security and Medicare Act

To protect benefits provided under Social Security, Medicare, and any other program of benefits administered by the Social Security Administration or the Centers for Medicare and Medicaid Services. 

S.779 & H.R.1735 - Sen. Alex Padilla (D-CA) & Rep. August Pfluger (R-TX)

To amend title XIX of the Public Health Service Act to provide for prevention and early intervention services under the Block Grants for Community Mental Health Services program

H.R.2491 & S.1227 - Rep Kat Cammack (R-FL) & Sen. Edward Markey (D-MA) - The ABC Act

To require the Administrator of the Centers for Medicare & Medicaid Services and the Commissioner of Social Security to review and simplify the processes, procedures, forms, and communications for family caregivers to assist individuals in establishing eligibility for, enrolling in, and maintaining and utilizing coverage and benefits under the Medicare, Medicaid, CHIP, and Social Security programs



VOR OPPOSES:

H.R.2743 & S.1332 - Rep. Bobby Scott (D-VA) & Sen. Bernie Sanders (I-VT) Raise the Wage Act - A bill to provide increases to the Federal minimum wage and for other purposes. VOR opposes the provision in this bill that would phase out section 14(c) and sheltered workshops for indiviiduals with I/DD and autism.

S.2438 - Transformation to Competitive Employment Act (Sen. Chris Van Hollen (D-MD) - A bill 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 people with disabilities through competitive integrated employment, to phase out the use of such special certificates, and for other purposes. 

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