April 4, 2025

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 must express my regrets that the newsletter has been so long lately, and so full of articles warning of the same issues, like the possibility of cuts to Medicaid, Snap, Special Education, and other programs aimed at helping our loved ones with I/DD and autism.

I, too, tire of the redundancy of these articles, and of the redundancies of articles about states worrying about how they can possibly deal with such cuts.

But I feel it's important to our members to stay on top of these issues, to see how different states will be affected, to understand the ripple effects of losing hundreds of billions of dollars, and to hear the voices of those individuals and families who are already underserved and fear the consequences of these cuts.

I regret all of this, but I didn't make the news. I just make it available to you to read.

Thank you all, for all you do.

Please join us on Capitol Hill

May 12-14, 2025

VOR's Annual Legislative Initiative

Washington, D.C.

We will meet in D.C. on May 12th - 14th

for meetings with

Congressional Staff and Federal Agencies

to discuss issues of critical importance to

individuals with severe or profound I/DD and autism

and their families.

This year's topics are expected to include:

Preventing Cuts to Medicaid

and

Rebuilding and Supporting our DSP Workforce

This event is open to all members of VOR

Please register early, to reserve your spot.

Our hotel room bloc will only be available until April 11,

so please register now to ensure you can stay with the rest of our participants.

To register for the Legislative Initiative,

Please Click Here

Unable to join us in D.C. this year?

You can still help by becoming a sponsor!

We are still far short of our goal for sponsorships

This is a critical time for our families.

The actions taken by Congress and the Administration

in the next few months could impact the lives of

hundreds of thousands of people with I/DD and autism in the years to come.

Please help us help.

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

Congress has begun the process of drafting a Reconciliation Bill. Cuts to Medicaid programs may or may not be written into this bill, depending on whether Republicans feel they have enough votes to pass it in order to pass President Trump's new tax cuts, or if the Senate would prefer to hold off at this point or pass a smaller package that would allow the existing tax package (the baseline taxes) to be extended without newer cuts added. Our families', our loved ones', lives all hang in the balance.

If Congress passes these cuts, which primarily benefit the wealthiest Americans, they will come at the expense of Medicaid benefits for the elderly and people with intellectual disabilities and autism. Add that to the anticipated rise in inflation and the cost of living that is expected to result from the newly announced tariffs, and, well - you can do the math yourself.

To quote Bette Davis, "Fasten your seatbelts. This is going to be a bumpy ride."

Thune faces GOP divisions on critical budget resolution 

By Alexander Bolton, The Hill, April 4, 2025

Senate Majority Leader John Thune (R-S.D.) faces a number of divisions among Senate Republicans that could derail the Senate budget resolution, a measure that will be critical to passing President Trump’s legislative agenda later this year. 

Key points of contention include how to calculate the cost of extending Trump’s tax cuts, Medicaid cuts, defense spending and increasing the debt ceiling.

Republican Senate leaders intend to adopt a controversial current-policy baseline that would enable them to claim that extending the 2017 tax cuts won’t add to the deficit and open the door to making a signature Trump first-term accomplishment permanent.

Sen. Bill Cassidy (R-La.) says he’ll go along with the current-policy baseline, but if it’s used he wants the cost of extending the 2017 Tax Cuts and Jobs Act, which expires at the end of this year, “paid for” with either spending cuts or other revenue-generating measures.

But paying for an extension of the tax cuts with big spending cuts or other deficit-reducing strategies would appear to defeat the purpose of using the current-policy baseline in the first place, which is to make it easier for Republicans to permanently extend the expiring tax cuts without needing to include offsets within the bill.

The budget resolution, which Senate Republicans unveiled Wednesday, includes language giving Senate Budget Committee Chair Lindsey Graham (R-S.C.) the authority to set the budgetary baseline for a future reconciliation bill. Graham has said he plans to use a current-policy baseline.

But Democrats are accusing Republicans of planning to break Senate rules and precedents. They argue that a “current-law” baseline has always been used to score the cost of legislation passed under budget reconciliation.

Under current law, much of the 2017 Tax Cuts and Jobs Act is due to expire at the end of this year. Extending those tax cuts for nearly another decade would add an estimated $4.6 trillion to the federal deficit, according to a score based on a current-law baseline.

Thune met with several Republican senators who had concerns about proceeding with the budget resolution Thursday. Those with qualms about elements of the budget resolution still voted to proceed to the bill, which will be subject to dozens of amendment votes before it’s expected to receive a final vote this weekend.

The size of potential cuts to Medicaid is another major point of friction within the Senate GOP conference.

Several Republican senators have stated clearly that they won’t support big cuts to Medicaid, which provide health care and nursing to hundreds of thousands of their constituents.

While they are open to rooting out fraud in the system and adding new work requirements to the program, they are ruling out any cuts that would affect benefits.

“I’m concerned about the instruction to the House Committee for $880 billion, it’s the Energy and Commerce Committee in the House, which has jurisdiction over Medicaid, because I don’t see how you can get to that amount without cutting Medicaid benefits,” Sen. Susan Collins (R-Maine) told reporters.

The Senate budget resolution includes language drafted by House Republicans instructing the House Energy and Commerce Committee to reduce the deficit by $880 billion, a target that policy experts say can’t be met without cutting deeply into Medicaid.

“In my state, there are more than 400,000 Mainers that rely on that health care program. Our rural hospitals depend upon it as well, and they are really struggling because of actions and inactions by the state Legislature. So the last thing I want to do is cut Medicaid for vulnerable people who are disabled or seniors who cannot work,” she said.

Sen. Jerry Moran (R-Kan.) warned that cuts to Medicaid would threaten the financial viability of rural hospitals in Kansas.

“I want to make certain that my colleagues know my view the value of making certain we do no harm to those in desperate need of health care in Kansas and across the country,” Moran said on the Senate floor.

While he acknowledged that Congress should reform flaws in the system, he argued that the benefits from the program are critical to the survival of rural hospitals.

“Our ability to maintain those hospitals and keep their doors open is a major priority for me,” he said, noting that rural hospitals in Kansas receive 9 percent of their revenue from Medicaid.

Read the full article here

Congress Moves to Cut Medicaid

By Lindsey Copeland, April 3, 2025

Yesterday, Senate Republicans released a budget resolution that sets the stage for significant program cuts. The House and Senate are still negotiating policy specifics, but Medicaid, Medicare, the Affordable Care Act, and SNAP remain under threat.

Under pressure from the White House to pass a budget bill by Memorial Day, but at an impasse on the legislation’s scope, Republicans are sidestepping aspects of the typical reconciliation process.

The new budget plan is an attempted compromise between the House and Senate. Though both chambers previously advanced their own budget resolutions, they must pass identical versions to unlock the reconciliation process. But they remain far apart on what that eventual bill should look like and how much it should cost. Instead of resolving those differences now and crafting a budget resolution that reflects a unified, bicameral approach, they are moving ahead anyway—an unorthodox strategy to give themselves more time and the White House a “win.”

The concurrent budget resolution reveals the House-Senate divide over the bill’s price tag, assigning different savings targets to each. The Senate committees would only have to find $5 billion, while House committees could keep their larger $1.5 trillion minimum. Typically, these numbers align. In allowing the deviation, lawmakers are theorizing that since reconciliation rules only apply in the Senate, only that chamber needs to meet its targets.

Major Cuts Likely

Notably, the Senate’s levels are floors, not ceilings, meaning lawmakers can cut more than the blueprint requires. They are widely expected to do so, likely yielding a reconciliation bill that is closer in size to the House’s vision. For now, the plan’s lack of detail gives them room to negotiate internally and cover to say they are not gearing up to slash Medicaid, even though the cuts being contemplated are impossible otherwise.

For now, the plan’s lack of detail gives them room to negotiate internally and cover to say they are not gearing up to slash Medicaid, even though the cuts being contemplated are impossible otherwise.

The budget resolution would also make the 2017 Trump tax cuts permanent, using a controversial and untested budget gimmick—the “current policy baseline”—that would not require any offsets. If successful, this would let Republicans swell the federal debt they claim to be trying to reduce. It also includes other spending, authorizing up to $1.5 trillion in additional tax cuts.

According to the nonpartisan Committee for a Responsible Federal Budget, the budget resolution “would allow lawmakers to add up to $5.8 trillion to deficits through 2034” and cause the debt to grow “twice as fast as under current law.”

Take Action Now

The Senate plans to vote on the budget resolution in the coming days, sending it to the House before Congress adjourns for a two-week recess on April 11. If it passes, we expect both chambers to quickly begin drafting reconciliation legislation that could fundamentally undermine access to affordable health care for older adults and people with disabilities.

As lawmakers prepare to vote on the budget resolution, they need to hear from you. Tell them to vote NO and explain how cuts to Medicaid will harm people in your community. Learn more and take action today.

Read the full article here

5 things to know about Republicans’ new blueprint to pass Trump’s agenda

By Aris Folley, The Hill, April 2, 2025

Senate Republicans on Wednesday rolled out a 70-page blueprint to advance President Trump’s tax agenda, along with directions that could pave the way for more than a trillion dollars in cuts to government spending.

The resolution comes after weeks of negotiations between House and Senate Republicans to reach a compromise on how to enact the president’s priorities. Republicans are pushing to quickly adopt the resolution to kick-start a complex process that will allow them to eventually move major spending and tax cut legislation through Congress without Democratic support.

However, some instructions in the measure underline a few of the differences both chambers will need to hammer out in the coming weeks as they look to assemble the planned package.

Here are five things to know about the framework.

Trump tax cuts 

Senate Budget Committee Chair Lindsey Graham (R-S.C.) said in a statement accompanying the release of the resolution that Republicans intend to permanently extend Trump’s signature 2017 tax cuts.

“This will allow the tax cuts to be permanent — which will tremendously boost the economy,” he argued, as Republicans have sought to make the case that their tax cuts are “pro-growth.”

(Continued)

Spending cuts 

The resolution includes different instructions for the House and Senate for spending cuts over roughly the next decade.

(Continued)

Debt limit 

The House instructions call for raising the debt limit by $4 trillion, while the Senate instructions detail a $5 trillion increase to the debt ceiling.

The debt limit caps how much money the Treasury Department can owe to pay the country’s bills.

(Continued)

Medicaid 

The resolution still contains instructions from the House’s earlier budget resolution that calls for its Committee on Energy and Commerce, which has jurisdiction over Medicaid, to submit recommendations to reduce the nation’s deficits by at least $880 billion.

The Congressional Budget Office said in a report last month that House Republicans would have to make cuts to Medicaid in order to cut $2 trillion in spending over the next decade. 

However, Republicans in both chambers have raised concerns over potential cuts to the program, posing a possible hurdle for leadership as they look to move quickly to craft and pass the major legislation this year. 

(Continued)

Senate confirms Dr. Oz as CMS administrator in 53-45 party-line vote

By Dave Muoio, Fierce Healthcare, April 3, 2025

Mehmet Oz, M.D., more commonly known by his television moniker Dr. Oz, has been approved by the Senate to serve as administrator of the Centers for Medicare & Medicaid Services (CMS).

Senators voted 53-45 along party lines in favor of the nomination, which would place the thoracic surgeon at the head of more than 160 million Americans' health coverage. A procedural vote earlier in the day to advance his nomination was passed 50-45 along party lines.

He enters the role at a time of major upheaval. Congressional Republicans and the administration have outlined major reductions to federal health through, respectively, major spending cut targets within the ongoing budget reconciliation process and a slew of layoffs at the Department of Health and Human Services (HHS).

Within CMS—which was relatively unscathed with about 300 job cuts—those cuts reportedly included the Office for Equal Opportunity and Civil Rights, the Office of Minority Health and the Office of Program Operations and Local Engagement.

Ahead of, during and after Oz’s March 14 Senate Finance Committee confirmation hearing—which proved much less confrontational than those of his new boss, HHS Secretary Robert F. Kennedy Jr.—Senate Democrats criticized Oz’s history as a spokesperson of private Medicare Advantage plans and broad support of the privatized program, which drives higher spending than traditional Medicare.

They also pointed to financial conflicts of interest—from which the nominee has pledged to divest—stated support for Medicaid work requirements and the expectation that he would fall in line with the more controversial portions of RFK Jr.’s agenda. The latter of these has become particularly pertinent to the lawmakers as the secretary undercuts long-established public health practices around vaccination and his overhauls of the health department come into clearer light.

Senate Finance Committee ranking member Ron Wyden, D-Oregon, in comments made on the floor ahead of the final vote, voiced his opposition by underscoring Oz’s alleged “record of dodging Medicare and Social Security Taxes. If confirmed, the person running the Medicare program thinks it’s acceptable to not pay the taxes he owes into the programs he’s running,” he said.

Continued

Senate Confirms Dr. Oz to Oversee Medicare and Medicaid

By Reed Abelson and Susanne Craig, The New York Times, April 3, 2025

The Senate on Thursday confirmed Dr. Mehmet Oz, the celebrity TV doctor, 53-45 and along party lines to lead Medicare and Medicaid, which insure nearly half of all Americans.

The future of both programs is the subject of fierce debate: Republicans are contemplating significant cuts to Medicaid, which provides health care to low-income Americans. The Trump administration and G.O.P. lawmakers have proposed sizable reductions in Medicaid spending in part to find savings to pay for President Trump’s tax-cut package.

At his confirmation hearing before the Senate Finance Committee last month, Democrats grilled him at length about the potential steep cuts to Medicaid, which could result in a substantial number of people becoming ineligible for health coverage.

In recent days, Health Secretary Robert F. Kennedy Jr. has overseen deep cuts to the Health and Human Services Department, including laying off roughly 10,000 employees on top of another 10,000 buyouts, retirements and departures early on in the new Trump administration.

The cutbacks also affect Dr. Oz’s agency, the Centers for Medicare and Medicaid Services, which has a budget of about $1.5 trillion in annual spending. Still, Dr. Oz has given few clues as to what if any changes he has planned.

Senators largely sidestepped criticism of Dr. Oz’s extensive and often murky financial ties to companies he will oversee in his new position.

He and his wife are wealthy. All told, his business and family ventures are valued in the neighborhood of roughly $90 million to $335 million. He has made tens of millions of dollars over the years pitching dietary supplements and promoting health-related companies on his television show.

In an attempt to avoid conflicts, he announced in February he would sell his interest in more than 70 companies and investment funds.

The investments he said he planned to sell included stakes in UnitedHealth Group, the giant conglomerate that is the nation’s largest provider of private Medicare plans; Inception Fertility Holdings, a privately held company that operates a chain of clinics; and Amazon, which has a vast reach that now includes an online pharmacy and sells myriad medical devices and equipment.

In addition, he pledged to resign from various paid advisory jobs.

Read the full article here

Thousands laid off as Kennedy and Musk take aim at health agencies               

By Sophie Gardner, Ruth Reader, Lauren Gardner, and David Lim, Politico, April 1, 2025

Robert F. Kennedy Jr. is making good on his promise to lay off thousands of employees across the government’s health care agencies.

Overnight, employees of the Department of Health and Human Services lost their jobs as part of a reduction in force that aims to cut 10,000 of the department’s workers. The cuts hit staff across the panoply of HHS agencies, including the Food and Drug Administration, the Centers for Disease Control and Prevention and the National Institutes of Health.

Combined with another 10,000 voluntary resignations, they leave HHS with about 62,000 workers — a 25 percent reduction since President Donald Trump took office.

Those let go included senior civil service leaders, as well as workers handling everything from communications to worker safety to HIV prevention.

“This RIF action does not reflect directly on your service, performance, or conduct,” emails to the affected employees said.

The early-morning move comes after days of worry for the workers, many of whom were told to expect notices on Friday or over the weekend. The move was delayed in part due to tensions between the Elon Musk-led push to downsize the federal government and leadership at HHS that has felt left out of the decision-making.

The cuts are part of a much broader push, led by Musk, to make the government more efficient. Kennedy has embraced the push, promising in the run-up to his February confirmation as HHS secretary to make “corrupt” FDA workers he sees as too cozy with the pharmaceutical industry “pack your bags.” The agency regulates drugs, food and medical devices.

He also pledged hundreds of job cuts at the NIH, the largest funder of medical research in the world, with a budget of $48 billion.

Driving the cuts is Kennedy’s desire to reorient HHS to combat chronic diseases, rather than infectious ones, and root out conflicts of interest he claims have led it to approve dangerous drugs. A longtime critic of vaccination, Kennedy has accused HHS of downplaying vaccine side effects — in defiance of public health consensus that vaccines are safe.

More broadly, Trump has targeted government programs favored by his predecessor, Joe Biden, aimed at promoting “diversity, equity and inclusion,” calling them wasteful and discriminatory.

Read the full article here

A Second Trump Shock To Programs For Seniors And People With Disabilities

By Howard Gleckman, Forbes, April 2, 2025

The Trump administration has cut by more than 40% the staff that oversees critical federal programs for older adults and younger people with disabilities who live at home. Health and Human Services Secretary Robert F. Kennedy Jr. fired the staffers who manage and review federal grants to state and local governments and community-based organizations for programs such as Meals on Wheels. It also eliminated regional office positions, along with those who evaluate the benefits of those programs and communicate the office’s work to grantees and the public at-large.

Those staff reductions came just four days after Kennedy abolished the office that managed those programs, called the Administration for Community Living. ACL, which had a staff of about 200 at the beginning of the year, manages critical programs such as Meals on Wheels, senior center nutrition, falls and elder abuse prevention, transportation, area agencies on aging, and family caregiver supports.

The result: While Kennedy says he wants to refocus health policy on chronic disease, his cuts are likely to make life worse for those with chronic conditions and end up costing the medical system more money. Addressing chronic diseases not only means prevention or treatment, it also requires supporting those living with these conditions.

Kennedy said in late March he would split ACL’s responsibilities among three entities in the Department of Health and Human Services: the Administration for Families and Children, the Office of the Assistant Secretary for Policy and Evaluation, and the Centers for Medicare and Medicaid Services. However, Kennedy also made deep staff cuts at ACF and abolished ASPE, leaving staffers uncertain about how these programs will operate.

The Trump Administration has not stopped funding the programs administered by ACL, many of which are included in the Older Americans Act. ACL also manages the RAISE Act, which helps coordinate a broad range of federal programs for older adults and people with disabilities.

However, funding for those programs is in jeopardy as the Trump administration and congressional Republicans look to cut domestic spending to help fund planned tax cuts.

While Kennedy did not formally cut spending for the programs managed by ACL, it is hard to see how they will continue to operate without staff to manage grants and other agreements with those who run OAA programs day to day. For example, how will a contract get renewed if there is no staff to measure its success and review the application?

Read the full article here

Admin For Community Living Has Money From Congress, But No One To Send It Out

By Luke Zarzecki, Inside Health Policy, April 3, 2023

The Trump administration has fired the entire budget office at the Administration for Community Living (ACL), leaving no employees able to send the agency’s appropriated money where it needs to go. ACL funding supports the needs of the aging and disability populations, including improved access to health care and long-term services.

Continued

(Note: I was unable to access any more of this article without a subscription)

Trump Administration and DOGE Eliminate Staff Who Help Older Adults and People With Disabilities

By Julie Carter, Medicare Rights Center, April 3, 2025

Elon Musk’s Department of Government Efficiency (DOGE) and Robert F. Kennedy, Jr.—the newly installed head of the U.S. Department of Health and Human Services (HHS)—have fired thousands of people across many agencies and announced plans for sweeping organizational changes. This week, the terminations continue, targeting agencies and programs that support older adults and people with disabilities, especially those with limited resources.

Some of the latest firings target the Medicare-Medicaid Coordination Office (MMCO) within the Centers for Medicare & Medicaid Services (CMS), which works to help these two complex programs coordinate and function more seamlessly for enrollees by identifying opportunities for improved care and savings. This work is vital because of the challenges dually eligible people face when they try to navigate both sets of coverage, including delays or denials of care, convoluted appeals processes, duplicated and wasteful services, and administrative burdens.

At least one-third of the MMCO staff have been fired, leaving the agency—and people who are dually eligible for Medicare and Medicaid—in an untenable position.

Additional details have come out about firings at and the dismantling of the Administration for Community Living (ACL). This includes the termination of the entire Center for Policy and Evaluation, which analyzes services and programs dedicated to supporting long-term services and supports, employment for people with disabilities, family caregiver supports, and consumer rights and protections. The reassignment of ACL’s programs is likely to cause significant disruption and raises major questions about the impacts on access to care and community-based providers.

All of these layoffs come on top of previous assaults on the Social Security Administration—some fueled only by personal animus without regard to impact or outcome— that have increased wait times, decreased data security, and stretched the capacity of the already understaffed agency.

Together, these cuts do not reflect a thoughtful strategy to improve program performance or eliminate fraud, waste, and abuse. Indeed, some of the very people and groups targeted for elimination empower, train, and support volunteer watchdogs against fraud, while other changes are likely to worsen efficiency, the customer experience, and taxpayer costs.

Read the full article here

HHS Layoffs Likely To Have Ripple Effect On Disability Programs Nationwide

By Michelle Diament, Disability Scoop, April 3, 2025

Mass firings at a federal agency supporting community living efforts for people with disabilities are fueling concerns that funding will be disrupted and programs could be forced to close.

Nearly 50% of the staff at the U.S. Department of Health and Human Services’ Administration for Community Living was terminated this week, including the organization’s budget, policy, evaluation and communications offices.

The firings were part of a broad reorganization of HHS, which announced last week that it would let 10,000 workers go. Overall, the agency indicated that it would shrink from 82,000 to 62,000 full-time employees when factoring the layoffs, buyouts and early retirements since the Trump administration took over.

Many programs funded through the Administration for Community Living, including developmental disabilities councils, are supposed to be receiving their notice of awards around this time of year, indicating what their funding will look like, said Jill Jacobs, who served as commissioner of the Administration for Community Living’s Administration on Disabilities between 2021 and 2024 and is now executive director of the National Association of Councils on Developmental Disabilities.

“All of the people who manage these awards were let go, so how will we get those funds?” she said. “I recognize that having a leaner government and having leaner programs is a priority for this administration and I understand that, but to make these changes without putting out any kind of plan or any kind of participation of anyone who knows how these programs work, I can’t imagine that this can happen without programs closing.”

Programs supported through the Administration for Community Living focus on everything from accessible transportation to alternatives to guardianship, respite care, improving home and community-based services and enhancing the direct care workforce.

“If those all go away we’re looking at real problems. Even if there’s just a momentary glitch, we’re going to have real problems,” Jacobs said.

Read the full article here

‘If they cut too much, people will die’: Health coalition pushes GOP on Medicaid funding

From KFF Heatlh News, via News-Medical, April 3, 2025

Tina Ewing-Wilson remembers the last time major Medicaid cuts slashed her budget.

In the late 2000s, during the Great Recession, the pot of money she and other Medi-Cal recipients depend on to keep them out of costly residential care homes shrank.

The only way she could afford help was to offer room and board to a series of live-in caregivers who she said abused alcohol and drugs and eventually subjected her to financial abuse. She vowed to never rely on live-in care again.

Now the 58-year-old Republican from the Inland Empire is worried Medicaid cuts being mulled by her party in Washington could force her into another vulnerable spot.

"If they reduce my budget, that doesn't change the fact that I need 24-hour care," said Ewing-Wilson, who has struggled with seizures and developmental disabilities her entire life. "If they cut it too much, people will die or they'll lose their freedoms."

Similar stories have already surfaced in GOP-held swing districts nationwide where activists have been applying political pressure to sway vulnerable House members from supporting $880 billion in cuts that health experts say would almost certainly hit safety net programs. But in California, which sends more Republicans to Congress than any state west of Texas, consumer groups and health industry giants are joining forces in a quieter campaign to lobby lawmakers in solidly red districts, some of which they say would be disproportionately affected if those cuts materialize.

Organizers are trying to highlight a thorny fact that faces many conservative members as they navigate a complex decision: The scale of spending cuts top GOP leaders are demanding is nearly impossible to achieve without slashing Medicaid funds to states, which are a lifeline for their largely poor, rural districts. In Rep. Doug LaMalfa's northern Sierra district stretching to the Oregon border, for example, some 43% of residents are enrolled in Medi-Cal, while 48% of residents in Rep. Jay Obernolte's district, centered on San Bernardino County, rely on Medi-Cal.

"The hospitals, the health plans — we don't always get along with those folks," said Dustin Corcoran, CEO of the powerful California Medical Association, which represents more than 55,000 doctors and encouraged its members to call their representatives. "On this, there's not a lot of daylight. It will take strange bedfellows, for sure."

The California Hospital Association has sent letters to Republican lawmakers and encouraged executives of its more than 400 member hospitals to reach out or provide tours to them. Consumer advocates and patient groups have protested outside members' district offices and community health center CEOs have requested private meetings.

Continued

Senators call for federal investigation of assisted living

By Lois A. Bowers, McKnight's Senior Living, April 1, 2025

Three senators have asked the Government Accountability Office to investigate whether additional federal oversight of assisted living is needed as part of an update they’ve requested to the watchdog organization’s 2018 report on state and federal oversight of assisted living.

“Given the threats to residents’ health and safety revealed by GAO’s 2018 report, a new review is necessary to evaluate the extent to which the Centers for Medicare & Medicaid Services (CMS) and state Medicaid agencies have improved their capacity to protect the hundreds of thousands of seniors and individuals with disabilities who reside in these facilities,” Sens. Kirsten Gillibrand (D-NY), the ranking member of the Senate Special Committee on Aging; Ron Wyden (D-OR), the ranking members of the Senate Finance Committee; and Elizabeth Warren (D-MA), a member of both the Aging and Finance committees and the ranking member of the Senate Banking Committee, wrote in a letter dated yesterday to GAO Comptroller General Eugene L. Dodaro.

Warren was one of four senators in a bipartisan group that in 2015 had requested the report that ultimately was issued in 2018. That report produced a to-do list for CMS related to state reporting of deficiencies in care and services provided to Medicaid beneficiaries living in assisted living communities. Some federal lawmakers and consumer advocates, however, said they would push for changes in assisted living because of the report’s findings.

The 2018 report found that state Medicaid agencies had spent more than $10 billion in federal and state funds on assisted living services in 2014. Those programs served more than 330,000 beneficiaries.

The GAO, for instance, found that for various reasons, 26 of the 48 state Medicaid agencies studied could not report the number of “critical incidents” — such as abuse, neglect or exploitation — that occurred in the assisted living communities located in their states. Additionally, states had varying definitions of what they considered to be critical incidents; all states included physical, emotional and sexual abuse, but seven did not include medication errors, and three did not include unexplained death. Also, although 34 state Medicaid agencies made information on critical incidents available to the public in some way, 14 did not.

Yesterday, the three senators asked the legislative branch’s independent, nonpartisan agency to investigate four questions:

1. How do state Medicaid programs currently oversee and monitor the health and welfare of beneficiaries that receive services in assisted living communities, and how has this oversight changed since GAO’s 2018 report was written?
2. What types of deficiencies and critical incidents have state Medicaid programs or other state or local regulatory agencies identified at assisted living communities in recent years?
3. How is CMS implementing the requirements for state Medicaid programs to meet new standards for monitoring and reporting on critical incidents in home- and community-based settings such as assisted living communities, and what other steps has the agency taken to improve federal oversight of beneficiary health and welfare in assisted living facilities?
4. Is there a need for additional federal oversight of assisted living?

Read the full article here

These articles are personal to me. My brother Tom lived at Southbury Training School (STS) for over 40 years. I believe they offered him a level of care and a sense of community he could never have experienced in a smaller setting. I believe he would not have survived to the age of 64 in a group home.

Two weeks ago, the Governor of Connecticut announced he would honor the legal settlement and allow the remaining residents at STS to remain in place, as long as they needed.

A few days later, the usual voices came forth demanding the state renege on its commitment to these individuals....

Connecticut's Southbury Training School will remain open, Lamont says

By Paul Hughes, CT Insider, March 24, 2025

Gov. Ned Lamont on Monday reaffirmed that all remaining clients of the state Department of Developmental Disabilities residing at the Southbury Training School are free to continue to live there or voluntarily relocate to community-based settings.

Lamont was asked about the status of Southbury Training School following a news conference at the Legislative Office Building concerning President Donald Trump’s order calling for the dismantling of the U.S. Education Department.

The governor told reporters that senior adviser Jonathan Dach is reviewing the delivery of services to developmentally disabled individuals of all ages in the DDS West Region, including meeting the continued needs of the remaining residents of the Southbury Training School. He had no timetable for how long the review will take.

There were 100 clients residing at Southbury Training School in December, according to the most recent monthly census. This was down 15 from the total for December 2023.

Lamont said the campus of the training school could be freed up for other purposes if the remaining residents were relocated to community-based settings.

"But right now they have a right to be there and we honor that right,” he said.

Lamont acknowledged many of the remaining residents have lived at Southbury Training School for most of their lives and relocation for these older clients would be distressing for them.

“It’s tough to move people who are that fragile at this stage," he said.

Continued

CT looks toward closure, other options for facility that costs more than $500,000 per resident

By Christopher King, Hartford Courant,

In the 1930s, Connecticut established a safe haven for people with developmental disabilities to live out their lives. The 1,600-acre campus, with 125 buildings, met all the residents’ needs, from laundry to ambulance service, even power and public safety.

Today, with fewer than 100 residents remaining at the Southbury Training School, costs total more than $500,000 per resident per year. It is the most expensive program in state government, exceeding the costs for prison inmates and nursing home residents. The expenses are high because 436 state employees currently care for the fragile elderly in a setting where the caregiver-to-resident ratio is more than 4 to 1.

State officials are looking ahead to future uses of the sprawling campus as it heads toward eventual closure. Its residents, many of whom arrived as children, are now an average age of 74 years old.

Southbury represents a throwback to the days of institutionalization for the intellectually disabled, and most other similar facilities have been closed across New England. As part of that trend, no new residents have been accepted at Southbury since 1986, meaning that those still remaining have been there for decades.

Gov. Ned Lamont is not making any quick moves to close the campus because the medically fragile residents are difficult to move and many have never lived anywhere else in their lives. A federal court ruling allows them to live there for the rest of their lives, officials said.

“Those people have a right to be there,” Lamont told The Courant in an interview. “That said, if we could find community-based shelters for them elsewhere, I think we could free up that location for other purposes. But right now, they have a right to be there, and we honor that right.”

Currently, 97 patients are on the campus after two died in January, and three are in the process of moving to community living arrangements.

But those still remaining at Southbury — along with their families and guardians — have wanted to remain in their longtime homes on the campus.

The residents range in age from 60 to 91 years old with the average age at 74. The resident who has lived there the longest has been there for 82 years since 1943, according to the Department of Developmental Services that oversees the campus. The newest resident has been there 41 years since 1984.

As similar facilities have closed nationwide in favor of the decades-old newer model for group homes, Southbury has become a rare entity of continuous operation. Under a federal court order and later a state law, Southbury has not been permitted to accept any new residents since 1986.

For decades, advocates for the disabled have called for closing the training school. Gov. Lowell P. Weicker Jr. pushed for the shutdown at the same time that he shuttered the Mansfield Training School in 1993. Weicker declared at the time that he would not stop until Southbury “is closed and has a plaque on it.”

At the closing ceremony for Mansfield, Weicker said, “Nothing that has happened during the course of my being governor is more important than this day. Nothing.”

But Weicker did not seek reelection in 1994, and the next governor, Republican John G. Rowland, went in the opposite direction and poured millions into the Southbury campus to keep it open. As a volunteer at the campus in his high school days, Rowland strongly favored keeping the facility running and later allocated millions in state money that was matched even further by additional millions in federal money.

New England states such as Maine, Vermont, New Hampshire and Rhode Island long ago closed their institutions but many of the Southbury residents’ family members have pushed through the years to keep the school open.

State Sen. Rob Sampson, a Wolcott Republican, said legislators have grappled for years over the best course of action for the training school as family members and guardians want the best for the patients.

“It’s the most difficult of difficult situations,” Sampson said in an interview. “Southbury Training School is kind of the last stop for those folks that they just cannot find a way to treat or cover in some other mechanism. To be honest with you, I think we need more facilities like that, not less. They went way overboard as far as getting rid of those type of institutions, and there should have been more of a blend of ways to take care of people.”

While most of the developmentally disabled have been living in group homes for decades, Sampson questions the state’s decisions for closures of institutionalized settings.

“There was this overwhelming push to close down all those facilities and treat people in other, less-expensive ways,” Sampson said. “I think it has worked out well in a lot of cases. … It’s going to be a drain on taxpayers in some way or another. You’ve got to find a way to assess the needs of these folks on an individual basis and have a mechanism that is the most cost effective. We haven’t done that. We closed too many of those facilities.”

Read the full article here

Florida - Ann Storck Center to Host Open House for Northwood Home, an Intermediate Care Facilities Behavior Focus Home, on April 16

March 31, 2025

Ann Storck Center – a Fort Lauderdale-based private nonprofit organization dedicated to enriching the lives of children and adults with intellectual and developmental disabilities – offers residential placement, an inclusive and caring solution for families who can no longer meet the support needs of a loved one with a developmental disability. For guardians seeking care for Individuals with Intellectual Disabilities (ICF/IID), Ann Storck Center will host an open house for its Northwood Home, an Intermediate Care Facilities Behavior Focus Home, on Wednesday, April 16, from 3 to 6 p.m.

The Open House is an opportunity for families and community members to see how Ann Storck Center combines comfort, care and innovation to create a nurturing environment. Caregivers will have the opportunity to tour the home, meet the staff and learn more about the programming. Light refreshments will be served.

Located in Pembroke Pines, the Northwood Home has a unique home-like setting where bedrooms are individualized to likes and preferences. No two rooms are alike. The Northwood Home provides 24-hour behavioral, nursing and residential services, alongside innovative therapy, recreation and community inclusion.

The Northwood Home boasts eight beds and has three family-style homes supported by an around-the-clock team of residential staff, nurses and therapists who collectively provide intensive specialized services to individuals with developmental disabilities, behavioral challenges and/or significant functional skill impairments. It is based on a behavioral model which provides all services (multidiscipline).

Individuals must have the ability to benefit from rehabilitative services, known as Active Treatment Each individual is provided with an individual plan that is tailored to their specific needs and their parent/guardian is a valued member of their Circle of Support.

Eligibility for placement includes: 

• An individual must have a developmental disability which occurs prior to age 18 and constitutes a substantial handicap that can reasonably be expected to continue indefinitely.
• Disabilities served include Intellectual disabilities (full-scale IQ of 70 or below), severe forms of autism, spina bifida, cerebral palsy, Prader Willi syndrome, down syndrome.
• All individuals must have the ability to benefit from rehabilitative services called Active Treatment.
• All potential admits must follow the APD application process.
• Only Floridians are eligible for services.

Continued

Illinois - Intellectual and developmental disability services brace for potential Medicaid cuts

By Erin Drumm. Capitol News Illinois, March28, 2025

Intellectual and developmental disability service organizations are bracing for potential cuts to Medicaid and Medicare from the federal government under congressional Republicans and President Donald Trump.

About 3.9 million Illinoisans are enrolled in Medicaid. Of that total, 44% of Medicaid recipients are children, 9% are seniors and 7% are adults with disabilities, according to the Illinois Department of Healthcare and Family Services.

“We’re very concerned. We don’t see what the path is right now,” Illinois Association of Rehabilitation Facilities CEO Josh Evans CEO said. “And so our mission is to continue to educate our members of Congress that this is not just a program that is ripe with payments, it’s serving people.”

IARF is an association of community-based providers that serve children and adults with intellectual and developmental disabilities and serious mental illnesses in Illinois. Community providers focus on inclusion in a smaller community that offers more independence when providing care and some community providers help their residents find employment.

“I’m going to do whatever it is that I can do, but I can’t come up with $8 billion to keep a federal program going in my state,” Gov. JB Pritzker said in an interview with The Contrarian last week. “I can spend hundreds of millions of dollars to try to provide free healthcare for people who are most acute, but people are going to die because of what they’re doing.”

Prtizker proposed increased funding in the developmental disabilities division at the Department of Human Services, DHS, in his proposed 2026 fiscal year budget. This would include funding to continue placements of individuals who qualify and want to live in community-based settings and for new placements under a 2011 federal court order the state has struggled to comply with.

The Ligas Consent Decree requires states to provide care options in integrated community settings for Illinoisans with intellectual and developmental disabilities who request community-based services.

Despite Trump’s claim that he would not make cuts to Medicaid, congressional Republicans’ budget resolution would almost certainly result in shrinking funding for the program.

Continued

Medicaid cuts in Michigan potentially ‘catastrophic’

By Capital News Service, Midland Daily News, March 29, 2025

A proposal in Washington would slash trillions of dollars from the Medicaid program that is jointly funded by the federal government and the states to provide health care coverage to low-income and disabled people. 

If passed by Congress, that would be potentially catastrophic for beneficiaries and health care providers, according to experts at the Michigan State Medical Society, Marquette County Health Department and Michigan State University. 

In Michigan, more than 3 million people are enrolled in Medicaid and associated programs like the Children’s Health Insurance Program, according to the U.S. Center for Medicare and Medicaid Services.

That’s almost 30% of all state residents.

Tom George is the CEO of the Michigan State Medical Society and a retired physician. 

“This will have a disproportionate effect on rural Michigan because so many recipients live in rural counties,” he said. 

According to the American Council on Aging, Medicaid in Michigan covers most services if a single person earns less than $2,901 per month, or $5,802 for married couples.

“There is no good path for the state to follow if they pull the funding out of Medicaid,” George said. “If the federal government cuts back the funding, then it will be up to the state to decide how to make up the shortfall.” 

According to George, the state has few options: It can cover fewer people, leaving more uninsured, or it can cover fewer forms of care, or it can reduce the amount it pays for covered care. 

Any of those would have negative consequences for both recipients and caregivers, he said.

Continued

Wisconsin - Medicaid cuts could decimate health programs

By Jazmin Orozco Rodriguez, Wisconsin Examiner via ICT News, March 30, 2025

As Congress mulls potentially massive cuts to federal Medicaid funding, health centers that serve Native American communities, such as the Oneida Community Health Center near Green Bay, Wisconsin, are bracing for catastrophe.

That’s because more than 40% of the about 15,000 patients the center serves are enrolled in Medicaid. Cuts to the program would be detrimental to those patients and the facility, said Debra Danforth, the director of the Oneida Comprehensive Health Division and a citizen of the Oneida Nation.

“It would be a tremendous hit,” she said.

The facility provides a range of services to most of the Oneida Nation’s 17,000 people, including ambulatory care, internal medicine, family practice, and obstetrics. The tribe is one of two in Wisconsin that have an “open-door policy,” Danforth said, which means that the facility is open to members of any federally recognized tribe.

But Danforth and many other tribal health officials say Medicaid cuts would cause service reductions at health facilities that serve Native Americans.

Indian Country has a unique relationship to Medicaid, because the program helps tribes cover chronic funding shortfalls from the Indian Health Service, the federal agency responsible for providing health care to Native Americans.

Medicaid has accounted for about two-thirds of third-party revenue for tribal health providers, creating financial stability and helping facilities pay operational costs. More than a million Native Americans enrolled in Medicaid or the closely related Children’s Health Insurance Program also rely on the insurance to pay for care outside of tribal health facilities without going into significant medical debt. Tribal leaders are calling on Congress to exempt tribes from cuts and are preparing to fight to preserve their access.

“Medicaid is one of the ways in which the federal government meets its trust and treaty obligations to provide health care to us,” said Liz Malerba, director of policy and legislative affairs for the United South and Eastern Tribes Sovereignty Protection Fund, a nonprofit policy advocacy organization for 33 tribes spanning from Texas to Maine. Malerba is a citizen of the Mohegan Tribe.

“So we view any disruption or cut to Medicaid as an abrogation of that responsibility,” she said.

Continued

With Medicaid in Washington’s crosshairs, North Carolinians rally against federal cuts  

By Jamie Baxley, North Carolina Health News, March 31, 2025

Addressing a crowded ballroom at a Raleigh hotel last Wednesday, Gov. Josh Stein said he is “gravely concerned” about congressional Republicans’ plans to slash federal funding for Medicaid. 

“These proposals would take away people’s access to health care, destabilize rural hospitals and challenge the bipartisan progress we have made here in North Carolina,” said Stein, who noted that more than 3 million North Carolina residents — about a third of the state’s population — depend on the government-funded health insurance program.

The cuts being contemplated in Washington are meant to offset the cost of President Donald Trump’s promise to extend trillions of dollars worth of expiring tax breaks. A resolution passed by House Republicans in February directs the Committee on Energy and Commerce, which oversees Medicaid, to reduce spending by $880 billion — something experts say cannot be achieved without making significant cuts to the program. 

Stein said those cuts could have expensive consequences.

“Here’s the thing: If you cut Medicaid, that does nothing to stop people from getting sick,” he said. “Instead of going to a primary care doctor that treats symptoms on the front end, folks will end up in the emergency room, where it costs a heck of a lot more money. The cost of taking care of people will simply go up.”

The governor’s comments came near the end of the 2025 Rural Summit, a two-day conference focused on issues that affect rural communities. Stein said rural areas, which are home to a disproportionately large share of the state’s Medicaid enrollees, are likely to bear the brunt of the proposed cuts.

“I am pushing our federal delegation not to vote for any budget that includes cuts to Medicaid,” he said to applause. 

Stein isn’t alone. Advocacy groups, health care professionals and Medicaid beneficiaries from across the state have made similar appeals to members of Congress in recent weeks.

The question now: Will that advocacy make any difference?

Continued

Virginia - Federal cuts could inhibit progress on developmental disability care

By Adrienne Hoar McGibbon, VPM, March 31, 2025

Virginia has expanded care for the community, but Medicaid cuts could lead to setbacks.

The clock is ticking for Catherine and Mike Rey, of Bon Air. Their sons — J.P., 12, and Louie, 10 — were both born with alpha thalassemia X-linked intellectual disability, a genetic syndrome that affects their motor skills and ability to communicate. They require assistance walking and feeding themselves.

Federal law mandates that students like J.P. and Louie receive occupational, physical and speech therapies at school — all paid for through Medicaid. But once the boys leave school, the Reys will need to provide care for them day and night.

While they’re still in the classroom, Catherine has time during the day to run errands, do work around the house and sometimes work as a substitute teacher. In the afternoons, she relies on a handful of part-time helpers, often graduate students who are paid $13.34 an hour through Medicaid, to watch one son while she takes the other to doctors’ appointments, physical therapy or the store.

Without the extra hands, Catherine said it’s difficult to leave the house with both of her sons.

“Right now, we have a typical double stroller that they can squeeze into, but it’s awkward,” she said. “We do it if we have to.”

But once they’ve left the school system — and outgrown their double stroller — Catherine worries about finding care, and how she and her husband will cover the cost.

Continued

Beyond Health: What Cutting Medicaid Means for Disabled People, Including in Maine

By Kings Floyd, The Century Foundation, April 2, 2025

Congress, in alliance with the Trump administration, is once again trying to create a post-apocalyptic Groundhog Day scenario when it comes to health care. Recently, the House-passed budget resolution has targeted funding that will likely come from Medicaid, in a situation eerily reminiscent of the attempt to repeal the Affordable Care Act (ACA) in 2017.

Fast forward to 2025, when House Republicans, with support from the Trump administration, have teed up $880 billion in cuts to the Medicaid program over ten years. Cuts of this magnitude cannot be achieved simply by promoting “efficiencies,” but rather would entail cutting support for a broad array of services that Medicaid provides—services reductions that could be life-threatening for people with disabilities.

By proposing deep cuts to Medicaid, Congress, aided and abetted by the Trump administration, has once again levied a great and terrible threat on the American people. For example, the House may seek to achieve cuts by capping funds to states or reducing their options to pay for their share of costs, forcing them to ration care to people with disabilities, who by virtue of their need require more funds per person. That means once again lives are on the line. That means my life, and the lives of others in my community, are on the line. For people with disabilities on Medicaid, losing that coverage means risking life itself.

The services provided through Medicaid are what allow me to have basic medical equipment covered, such as my power chair. My power chair allows me to get out of bed in the morning. I use it as an indispensable tool for every task in my day, including for my job, my personal care needs, and socializing with friends. Medicaid coverage allows me to use local physical, occupational, and massage therapy resources to ensure that I can keep working. Through HCBS, I am able to hire my own personal care assistants and live in the community, rather than being institutionalized.

Emblematic of other highly rural parts of the nation, Maine—where I live—understands Medicaid’s critical importance. Maine has a higher percentage of people with disabilities than the national average, the largest percentage of elderly residents in the country, and a population that is particularly dependent on public health insurance. Altogether, more than 400,000 Mainers are currently covered under MaineCare, Maine’s name for its Medicaid program. Cuts to HCBS would likely mean a drastic reduction in the number of hours of services that people with disabilities would be able to receive, as well as a continued worsening of the care workforce shortage, for both paid and unpaid caregivers.

Why Health Coverage Matters to Mainers Like Me

There are no words that can stabilize the deja-vu effect this moment is having on mental health, the idea that we have been here before and fought this battle but are trapped in a Sisyphean effect, once again rolling a large rock uphill. I really don’t want to have to get arrested again in a post-insurrection society where the right to protest is called into question and presents a direct threat to self, and when Capitol police specifically are even more wary of demonstrations.

In the eight years since 2017, my personal health has diminished, making the coverage I receive under both private insurance and Medicaid more important than ever, but also making my body frailer and more susceptible to injury if needing to take or resist physical action. But whether or not I personally put myself in the breach, more Maine residents and people with disabilities across the country than ever are reliant on a program that is critical to their lives. For many, the stakes could not be higher, it’s literally life or death.

Read the full opinion piece here

California must fulfill its commitments to people with developmental disabilities  

By Jeff Gonzalez and Amy Westling, The Press-Telegram, April 3, 2025

As we mark the 40th anniversary of one of the most consequential court decisions impacting people with developmental disabilities in the state, we also celebrate The Lanterman Developmental Disabilities Services Act which the decision protected. This year through Assembly Concurrent Resolution (ACR) 55, it’s important to remember how far we have come and the vital milestones that have sustained commitment to Californians with developmental disabilities. 

As the only developmental disabilities entitlement in the country, the Lanterman Act is a California law that was established in 1967 to ensure that Californians with developmental disabilities and their families have access to services and supports needed that are guaranteed by the law.

While the 1967 law was a groundbreaking commitment to this community it was challenged in 1982 after its first decade of existence. The state stripped away needed services during a budget crisis leaving people with developmental disabilities and their families with a bare minimum of support that didn’t take into account their individual needs. This action would have destroyed the person-centered system, but for the California Supreme Court decision in 1985 asserting people were indeed entitled to the services they needed as identified in their individualized plans.    

The Lanterman Act has provided decades of critical continuation of giving California responsibility and obligation to its residents who have developmental disabilities; this remains a key pillar to providing for the 450,000 Californians who have developmental disabilities. This is achieved through California’s developmental services system and once a person is determined to be eligible for regional center services, they are in the system right away and they are entitled to be supported for the rest of their lives through one of California’s 21 regional centers. 

As the author of ACR 55, Assemblymember Jeff Gonzalez, is a parent of a child who is in the regional center system, the entitlement provided through California state law. Considering in all other states a person with a developmental disability and their family would have to wait, in many cases, well over a decade, to receive the support and services they need to live an integrated full life in their community, this remains a remarkable milestone for this community. The continued commitment by the state and all stakeholders and families across California to better the lives of these individuals keeps the progress moving in the right direction towards continued improvement.

Continued

My child has autism. Trump and RFK Jr linking it to vaccines scares parents like me

By Robert Tait, The Guardian, March 29, 2025

Read the editorial here

Then They Came for People With Disabilities

By Sara Jones, NY Magazine, April 3, 2025

Read the editorial here

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VOR SUPPORTS:

H.R.1950 - Rep. Mark Pocan (D-WI)

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. 

H.R.869 - Rep. Susie Lee (D-NV)

To require full funding of part A of title I of the Elementary and Secondary Education Act of 1965 and the Individuals with Disabilities Education Act.

H.R.1509 - Rep. Lori Trahan (D-MA)

To 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.

S.752 - Sen. Chuck Grassley (R-IA)

Accelerating Kids' Access to Care Act - A bill to amend title XIX of the Social Security Act to streamline enrollment under the Medicaid program of certain providers across State lines.

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) and Sen. Edward Markey (D-MA)

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



H.R.2598 - Rep Jared Huffman

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

VOR OPPOSES:

To date, no bills have been entered that VOR outwardly opposes, though we understand that the budget process is about to begin, and we expressly oppose any attempt to cut $880 billion from Medicaid should that be proposed.