A Communication from the Policy Information Exchange
Volume 11, Number 2 - Spring, 2010

A Slice of Pie is an ongoing publication keeping our readers informed about important public policy issues.
It is the mission of the Policy Information Exchange to educate and inform Pennsylvanians with disabilities, their families and advocates, and the general public, regarding public policy issues and to further the exchange of policy information between the Pennsylvania Developmental Disabilities Council and federal, state and local policy makers.
The Policy Information Exchange is funded by the
Pennsylvania Developmental Disabilities Council

 Spring 2010 Slice of Pie (PDF)

STATE NEWS
NATIONAL NEWS
RESOURCES
CONFERENCES

State Budget 2009-10
On March 5, Representative Dwight Evans (D-Philadelphia), Chair of the House Appropriations Committee, introduced HB 2279, a bill for the state budget for July 2010 through June 2011. The bill is almost identical to the Governor’s proposed budget for 2010-11; in fact, disability related line items are the same as the Governor’s proposed amounts. (For more information on the Governor’s proposed budget, see the last issue of the Slice of PIE or contact the PIE Office.) The bill moved quickly through the House and was passed on March 23, 2010 by a mostly party line vote of 107-89.

HB 2279 is currently in the Senate Appropriations Committee where it is likely to remain as Senate leaders wait for additional information on revenues coming into the state. Senator Jake Corman (R-Centre), Chair of the Senate Appropriations Committee, has indicated that the growing deficit makes the House passed budget out of balance and will require deeper cuts. In February, the Governor projected a $525 million funding shortfall. Senator Corman predicted a year-end $1 billion shortfall for the current 2009-10 year. The situation was made worse by a PA Commonwealth Court ruling in mid-April which held that the state must return over $800 million to the MCARE Fund, a fund that provides excess medical malpractice coverage to doctors. If this decision is upheld on appeal, it could push the deficit to almost $2 billion. According to the National Conference of State Legislatures, PA is among the majority of states having to deal with budget deficits. Revenues are not expected to return to previous highs until 2012.

The Department of Public Welfare has budget briefing and update information on its website at www.dpw.state.pa.us/About/Secretary/003683356.htm

Bills of Interest
Below we summarize some bills of interest to the disability community. For more information about these or any other state bills, go to: www.legis.state.pa.us/cfdocs/legis/home/session.cfm . At the top of the page is a box labeled, “Find Legislation By”, choose “Bill #”, then enter the bill number and click on “Go”.

HB 60. Introduced by Representative Peter Daley (D-Washington). This bill would create a Housing Trust Fund providing funding for, among other things, increasing the “availability or quality of accessible housing for persons with disabilities.” It was voted out of the House on April 26, 2010 by a vote of 179 to 8 with 13 members not voting. See also SB 599 introduced by Senator Gene Yaw (R-Bradford) which is currently in the Senate Appropriations Committee.

HR 647. Introduced by Representative RoseMarie Swanger (R-Lebanon). The resolution designated March 3, 2010, as “Spread the Word to End the Word Day” in Pennsylvania. It was adopted by the House by unanimous vote on March 23.

SB 642. Introduced by Senator Robert Tomlinson (R-Bucks). The bill would amend the Sign Language Interpreter and Transliterator State Registration Act to provide for provisional registration and for exemptions from registration. It was voted out of the Senate on March 17, 2010 by a vote of 50-0. It has been sent to the House Professional Licensure Committee. See also HB 916 introduced by Representative Matthew Bradford (D-Montgomery) which passed the House on May 12, 2009 and was referred to the Senate Consumer Protection and Professional Licensure Committee.

SB 699. Introduced by Senator Vance (R-Cumberland). This is the bill supported by a coalition of advocates which would create an Adult Protective Services System for adults between the ages of 18 and 59. The bill was voted out of the Senate Aging and Youth Committee on April 21, 2010 with amendments approved by the advocates. It was given first consideration by the full Senate. See also HB 1319 introduced by Rep. Baker (R-Bradford) and HB 1185 introduced by Representative Josephs (D-Philadelphia). Both bills are currently in the House Aging and Older Adult Services Committee.

Primary Election
In the primary election on May 18, Pennsylvanians will choose candidates for November’s general election for U.S. Senator and Representatives and Governor. We’ll also select for all 203 state house seats and 25—half of the 50—state senate seats. There are 488 candidates for these 228 races in the PA General Assembly. That’s 57 more candidates than two years ago. More incumbent legislators who are seeking re-election face challenges than in the last election. In 23 legislative districts, there is no incumbent running. These facts will likely result in many new faces in the General Assembly joining the new Governor in January 2011.

Voter Registration
April 19, 2010 was the last day to register for the May 18 primary election and October 4, 2010 is the last day to register for the November 2nd general election. Those who aren’t sure if they are registered to vote can find out by searching Pennsylvania’s voter registration database https://www.pavoterservices.state.pa.us/Pages/VoterRegistrationStatus.aspx . You also can confirm your registration by contacting your County Board of Elections or by calling 1-877-VOTESPA. You can find the contact information for your county at the County Contacts and Web Sites page. Once registered to vote, you are not required to register again unless you change your residence, name, or political party affiliation.

Michael Dallas Waiver
The Office of Long Term Living has announced that the Michael Dallas waiver (MDW) will not be renewed and the approximately 84 individuals affected will be served in the Independence Waiver. The MDW serves adults who are ventilator-dependent living in the community. The Independence Waiver will be amended to accommodate the eligibility and services of the MDW. The OLTL has assured participants and their families that their services will not be changed or interrupted in the transition. For more information, contact David Gingerich at 717-772-4646 or dgingerich@state.pa.us .

ODP Bulletins
The Office of Developmental Programs (ODP) has issued a new Bulletin which can be viewed at: www.dpw.state.pa.us/PubsFormsReports/NewslettersBulletins/003673169.aspx

• Correction to Medical Assistance Program Fee Schedule for Select Services (00-10-01) was issued on March 22, 2010 and was effective July 1, 2009. The Bulletin corrects 00-09-06 published on June 27, 2009 for the waivers and base services.
• Quality Management Strategy (00-10-02) was issued on March 22, 2010 and becomes effective on July 1, 2010. The Bulletin distributes the Office of Developmental Programs Quality Management Strategy that includes quality assurance and quality improvement components.
• See also OMHSAS-10-01 below that affects certain ODP programs.

OHMSAS Bulletins
The Office of Mental Health and Substance Abuse Services (OMHSAS) has issued two new Bulletins which can be viewed at www.dpw.state.pa.us/PubsFormsReports/NewslettersBulletins/003673169.aspx

• Peer Support Services - Revised (OMHSAS-09-07) was issued on January 1, 2010 and was effective on that date. The Bulletin announces the addition of Peer Support Services telephone contact as a reimbursable service on the Medical Assistance Program Fee Schedule and issues provider handbook pages for the service.
• Medication Prescribing Practices of CRNPs in Mental Health and Mental Retardation Programs (OMHSAS-10-01) was issued on March 27, 2010 and was effective on that date. The Bulletin communicates that, in certain circumstances, medications may be prescribed by a Certified Registered Nurse Practitioner (CRNP) in these programs.

Personal Care Homes
On March 13, 2010, the Department of Public Welfare published a Statement of Policy on the responsibility of Personal Care Homes in conducting fire drills for residents who are actively dying while receiving hospice care and services. In limited circumstances, including the requirement of consent by the resident or their representative and certification by a doctor independent of the facility that they would be hurt or die sooner, a facility may choose to simulate the evacuation process to be used in an actual fire, but not disturb the actively dying resident in a fire drill. The policy became effective on April 12, 2010. To view the full text, go to www.pabulletin.com/secure/data/vol40/40-11/444.html .

Pennhurst
The Pennhurst State School and Hospital that was built in 1908 to house people with physical and mental disabilities was closed in 1987 after a court ruling that the institution violated the residents’ constitutional rights. The Pennhurst Memorial and Preservation Alliance wants to use the vacant Pennhurst campus to ensure that those human and civil rights achievements won at Pennhurst are not forgotten. Ideas include a museum. Also, in April, a PA Historic Marker was dedicated at Pennhurst. For more information go to www.preservepennhurst.com .

CHIP Program Extended
Gov. Rendell signed legislation in March which reauthorizes Pennsylvania’s Children’s Health Insurance Program (CHIP). The bill, sponsored by Senator Jake Corman (R-Centre), will extend CHIP through Dec. 31, 2013. More than 196,000 Pennsylvania children get health coverage through CHIP.

Admin Changes
Pennsylvania Secretary of Education Gerald Zahorchak has resigned effective May 7 to become the new superintendent of the Allentown School District. Thomas Gluck, Executive Deputy Secretary for Department of Education, has been nominated to be the next Education Secretary.

Joan Erney, Deputy Secretary for the Office of Mental Health and Substance Abuse Services (OMHSAS) has resigned effective mid-May. Sherry Snyder has been appointed to serve as acting Deputy Secretary.

Health Care Reform
The goal of passing health care reform legislation was accomplished on March 23, 2010 when the Patient Protection and Affordable Care Act became Public Law No. 111-148. A few days later President Obama signed the Health Care and Education Affordability Reconciliation Act (P.L. 111-152) into law. These bills will result in major changes in our health care system over the next decade. Many of the provisions affect people with disabilities and low income individuals. Below is a summary provided by Disability Policy Collaboration of UCP and The Arc of the US:

Coverage

• Prohibiting private health insurance exclusions for pre-existing conditions.
• Eliminating annual and lifetime caps in private insurance policies. 
• Restricting the consideration of health status in setting premiums. 
• Expanding Medicaid to cover individuals with incomes up to 133 percent of the federal poverty line (approximately $29,000 per year for a family of four).

Benefits

• Ensuring that minimum covered benefits include products and services that enable people with disabilities to maintain and improve function, such as rehabilitation and habilitation services and devices.

Access to Quality Care

• Improving training of physicians, dentists, and allied health professionals on how to treat people with disabilities.
• Requiring the Centers for Medicare and Medicaid Services to collect data on beneficiaries’ with disabilities access to primary care services and the level to which primary care service providers have been trained on disability issues.
• Ensuring prevention programs include a focus on individuals with disabilities.

Long Term Services and Supports

Strengthening long-term services and supports through a two pronged approach:

1. Taking pressure off of the Medicaid program:
• The Community Living Assistance Services and Supports (CLASS) Act would create a national long term services insurance program which assists eligible individuals and their families to meet long term needs with a cash benefit and without forcing them into poverty to receive Medicaid benefits.
2. Improving the Medicaid program:
   
• The Community First Choice Option would help to eliminate the institutional bias by encouraging states to cover personal attendant services under the state’s optional service plan instead of through the waiver system by offering a 6% increase in the federal share of Medicaid for these services.
• Increasing the federal share of Medicaid, known as the Federal Medical Assistance Percentage (or FMAP), for home and community based services (HCBS) and during periods of economic downturn.
• Allowing states to offer additional services under the 1915(i) Medicaid HCBS Waivers State Plan Option.
• Providing spousal impoverishment protections for HCBS Beneficiaries.

Detail on the long term services and supports provisions are found at the Collaboration’s public page at www.ucp.org/ucp_general.cfm/1/8 . Additional information on the new law is available at Families USA at www.familiesusa.org/health-reform-central or the Kaiser Foundation at http://healthreform.kff.org .

FY 2011 Budget
Congress has not yet adopted a Budget Resolution for the FY2011 federal spending plan proposed by President Obama in February. The Resolution would serve as a blueprint for the work of the Appropriations Committees prior to the new fiscal year which begins on Oct. 1, 2010. The proposed spending for many disability programs compared to the enacted FY2010 budget is shown at www.ucp.org/uploads/FY_2011_Presidents_Budget_Request.pdf .

FMAP Extension
Congress has not yet passed legislation to extend financial help to states. A bipartisan group of 47 governors sent a letter on February 22 urging House and Senate leaders to extend for at least six months the American Recovery and Reinvestment Act’s (ARRA) temporary increase in the federal share of Medicaid spending (Federal Medical Assistance Percentage -FMAP). Governor Rendell’s proposed budget anticipates that Pennsylvania will receive additional enhanced FMAP for the full fiscal year, and without it, there would be a large funding gap in his proposed budget. A fact sheet on what the funding means to each state is available at www.familiesusa.org/assets/pdfs/fmap-extension-talking-points-2-10.pdf .

Housing Vouchers

CMS
Harvard University professor Donald M. Berwick, MD has been nominated as Administrator of the Centers for Medicare and Medicaid Services (CMS). Berwick is considered an expert in quality improvement and fostering best practices in medicine. As Administrator of CMS, Berwick would be responsible for changes to Medicare and Medicaid required by the new health reform law.

Ed Funds
The U.S. Department of Education announced the winners among state applicants for the $4 billion Race to the Top competition. Of the 40 states and the District of Columbia which submitted applications, only two states were awarded funding: Delaware ($100 million) and Tennessee ($500 million). Pennsylvania, where there was $400 million at stake, placed seventh. Applications are due June 1 for a second round of winners, which will be announced in September. For more information, go to www2.ed.gov/programs/racetothetop/index.html

Access Draft
The United States Access Board released a draft update of the Standards for Section 508 of the Rehabilitation Act for electronic and information technology in the Federal sector, Guidelines for Section 255 of the Telecommunications Act for telecommunications products, and the ADA Accessibility Guidelines to include automatic teller machines, fare machines and self-service kiosks. The purpose of the standards and guidelines is to ensure access for people with disabilities to telephones, cell phones, computer hardware and software, websites, media players, electronic documents, PDAs, and e-ticketing machines at airports. Comments on the draft standards and guidelines can be submitted until June 21, 2010. After reviewing the comments received in response to this advance notice and draft, the Access Board will issue a proposed rule followed by a final rule. For more information, including the draft, go to www.access-board.gov/news/ict-draft-rule.htm .

Transportation Funding
In March, Congress passed the Hiring Incentives to Restore Employment Act (HIRE) and the President signed it into law (P.L. 111-147). This law will give employers (including nonprofit employers) a tax exemption on paying certain payroll taxes when they hire previously unemployed people. The bill also extends the highway and transit bill until December 31, 2010. The extensions are needed because the Safe, Accountable, Flexible, Efficient Transportation Equity Act-A Legacy for Users (known as SAFETEA-LU) has not been reauthorized. SAFETEA-LU provides for highway and transit programs including Section 5310 and the New Freedom Program which fund transportation for people with disabilities. Information about the HIRE act is on the IRS website at www.irs.gov/businesses/small/article/0,,id=220745,00.html?portlet=7 .

Restraints in School
In March, the House passed HR 4247, The Keeping All Students Safe Act (formerly the Preventing Harmful Restraint and Seclusion in Schools Act), by a vote of 262-153. The bill, which would set the first federal safety standards on restraint and seclusion in schools, has been referred to the Senate Health, Education, Labor and Pensions (HELP) Committee.

Auto Safety
Current environmental concerns have led to an increased number of vehicles on the road which utilize alternative fuels and run much more quietly than older automobiles. This has placed pedestrians, including those who are blind or have reduced vision, who use noise to navigate safely, at serious risk. A recent report from the National Highway Traffic Safety Administration concluded that, at low speeds, hybrid and electric vehicles are twice as likely to be involved in accidents with pedestrians as vehicles with internal combustion engines. To address this problem, bills have been introduced in both houses of Congress. HR 734, the Pedestrian Safety Enhancement Act, was introduced on January 28, 2009 by Rep. Edolphus Towns (D-NY) with 203 co-sponsors and sent to the House Committee on Energy and Commerce. A companion bill, S841, the Pedestrian Safety Enhancement Act, was introduced on April 21, 2009 by Sen. John Kerry (D-MA) and 28 co-sponsors and referred to the Senate Committee on Commerce, Science, and Transportation. The bills would direct the Secretary of Transportation to study the problem and establish standards for new vehicles which would enable people who are blind and other pedestrians to travel safely.

Fiscal Commission
In mid-February, President Obama issued an executive order to establish a bipartisan National Commission on Fiscal Responsibility to develop recommendations to deal with the national debt. The Commission has the authority to review all entitlement (i.e. Medicaid, Social Security) and discretionary spending and revenue issues. House Speaker Pelosi and Senate Majority Leader Reid have pledged to have Congress vote up-or-down on the Commission’s recommendations before the end of the year. The first meeting is scheduled for late April. For information, go to the White House website at www.whitehouse.gov/the-press-office/president-obama-establishes-bipartisan-national-commission-fiscal-responsibility-an .

Compassionate Allowance
The Social Security Administration (SSA) has announced the addition of 38 new conditions to its list for the Compassionate Allowance (CA) initiative, including early onset Alzheimer’s and several rare disorders. The CA initiative allows SSA to find people to be eligible for disability benefits based on a documented diagnosis of listed conditions. The initiative helps applicants to get a decision more quickly and also frees up staff time to process those applications that need more time. For a copy of the press release and a list of the 38 new conditions go to www.ssa.gov/pressoffice/pr/cal021110-pr.html .

Sub-minimum Wage
The Office of Disability Employment Policy at the Department of Labor (DOL) is opening discussion on the use of the sub-minimum wage and creating a federal interagency task force to make policy recommendations on how to phase out the program without doing harm to the 424,000 individuals currently affected. Under this rule, certain employees receive wages below the federal minimum wage. Currently, 70% of these workers are people with intellectual and developmental disabilities. A report on the rule and oversight of its use is at www.napas.org/issues/emp/wage/Basic-Overview-of-14(c)(2009).doc and information about integrated and supported employment is at www.apse.org/publications/positions.cfm .

DD Council
The Pennsylvania Developmental Disabilities Council has published a new brochure describing the Council and its mission and grants. The Council has also funded a brochure produced by the Lehigh Valley Center for Independent Living, “Doing Business with the Deaf and Hard of Hearing.” Both publications are available by contacting the Council through their website www.paddc.org or by phone 877-685-4452 or tty 717-705-0819.

Congressional Directory
The GPO Congressional Directory - 111th Congress (2009-10) is the official directory of the U.S. Congress. The Directory includes short biographies of each member of the Senate and House, listed by state or district, as well as committee memberships, terms of service, administrative assistants and/or secretaries, and room and telephone numbers. It also lists officials of the courts, military establishments, and other Federal departments and agencies, including D.C. government officials, governors of states and territories, foreign diplomats, and members of the media. To view the directory, go to www.gpoaccess.gov/cdirectory/browse-cd-09.html .

Census
The US Census Bureau encourages all individuals to complete and return their census form so that the count is accurate. Many program and service funding allocations are based on population. Information about how a community is doing is available in a response map showing the return rate of census forms, by location, including zip, code at http://2010.census.gov/2010census/take10map .

Transportation
Act 44 of 2007 directed PennDOT, in association with the Department of Public Welfare, the Department of Aging and the Office of the Budget to study human service transportation (HST) in Pennsylvania. The report recommends: a coordinated approach to HST management; piloting a regional approach to HST management and service delivery; getting input on coordination and the pilot from consumers; and the establishment of performance standards to measure the efficiency, productivity and effectiveness of HST. It’s available at ftp://ftp.dot.state.pa.us/public/bureaus/PublicTransportation/HST%20Coordination%20Study%207-16-09.pdf .

Disability Statistics
The Rehabilitation Research and Training Center on Disability Statistics and Demographics, funded by the U.S. Department of Education, recently released a compendium of disability statistics for 2009 from various federal agencies. Read report at www.DisabilityCompendium.org .

Housing
The National Council on Disability (NCD) has released a report entitled “The State of Housing in America in the 21st Century: A Disability Perspective”. The report provides recommendations to improve housing opportunities for people with disabilities. To view the report, go to www.ncd.gov/newsroom/publications/2010/NCD_Housing_Report508.pdf .

Employment
The Equal Employment Opportunity Commission (EEOC) has released its enforcement and litigation statistics for Fiscal Year 2009. The EEOC reported that complaints of disability discrimination rose by about 10 percent to 21,451 claims, the largest increase of any category. The increase coincided with changes to the Americans with Disabilities Act last year that made it easier for people with epilepsy, diabetes and other conditions to argue that they are disabled. For more information, go to www.eeoc.gov/eeoc/statistics/enforcement/index.cfm .

In late March, Telework Exchange announced the results of their “Unnecessary Barriers” study, which explored federal agencies’ performance in hiring, retaining, and effectively managing employees with disabilities. The study finds federal agencies ill-equipped to manage employees with disabilities and discusses ways to improve. To download the study, go to www.teleworkexchange.com/unnecessarybarriers .

Long-Term Services
The January 2010 issue of Health Affairs (Volume 29, Number 1) focuses on long-term care in the U.S., the challenges of delivering long-term services and support, legislation, and issues related to private and public payment. In addition, several articles focus on patient transition into and out of skilled nursing facilities, improving quality of care, end-of-life care, and the long-term care workforce. One article focuses on issues family caregivers face. Read the issue at http://content.healthaffairs.org/content/vol29/issue1 .

Assisted Living Payment
The National Center for Assisted Living and the American Health Care Association have released a report, State Medicaid Reimbursement Policies and Practices in Assisted Living. The 170 page report is available at www.ahcancal.org/ncal/resources/Documents/MedicaidAssistedLivingReport.pdf .

Voter Registration
The PEW Center on the states has published a study on On-Line Voter Registration at www.pewcenteronthestates.org/report_detail.aspx?id=58215 .

Uninsured
The PA Health Law Project has released “Uninsured Pennsylvanians” a collection of personal stories illustrating the importance of health care coverage. To view the report, go to www.phlp.org and click on “PHLP Releases: Uninsured Pennsylvanians: Meet your friends, neighbors, co-workers.”

Access to HCBS
Families USA has released, Helping People with Long-Term Health Care Needs: Improving Access to Home- and Community-Based Services in Medicaid. To view the document, go to www.familiesusa.org/assets/pdfs/health-reform/help-with-long-term-health-needs.pdf .

ADA Podcasts
The Disability Law Lowdown Project is a set of podcasts that provide information on the Americans with Disabilities Act and related disability laws. You can listen to the podcasts available in English, Spanish, and American Sign Language, or read the transcripts. Subscription is free. The Disability Law Lowdown is a project of the national network of ten ADA Centers across the country. Contact the Center that serves you by calling 1-800-949-4232 v/tty. To subscribe or listen to archived podcasts, go to www.DisabilityLawLowdown.com .

Autism
The Bureau of Autism Services of the PA Department of Public Welfare will host the third annual Pennsylvania Autism Training Conference (PATC), “A New Vision for Autism Services: Practical Strategies & Solutions,” on June 2-4, 2010 at the Eden Resort Inn & Suites in Lancaster. For more information or to register, go to www.solutionwhere.com/bastraining/cw/main.asp .

Transitions
On August 5 and 6, 2010, Edinboro University will host its first disabilities conference, Transition, Independence and Empowerment, which will focus on ensuring the educational achievement of students with disabilities. For more information on program content, contact Jacqueline Conforti Barnett at (717) 720-4010 or Jacqui.Barnett@edinboro.edu . For more on conference logistics, contact Cyndi Peterson, 814-732-2711 or peterson@edinboro.edu .

Contact PIE

Contact the PIE Team with any questions, comments, suggestions, or information to share at PIE, c/o The Arc of Pennsylvania, 101 South Second Street, Suite 8, Harrisburg, PA 17101, by email at pie@thearcpa.org or by phone at 800-692-7258.

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The PIE Team

CONSULTANTS:
Theotis Braddy
Joan W. Martin
Vini Portzline
Terry Roth

THE ARC OF PENNSYLVANIA PIE STAFF:
Gwen Adams
Todd Dickinson
Maureen Jordan
Stephen H. Suroviec

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