Today in the Capitol, Phil and I are meeting with House Republican Leader on rebalancing, Medicaid expansion and prompt payments for providers. 


Capitol Insider
for the Week of May 6, 2013 
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 Major Events Last Week

Medicaid – Blueprint Calls for Per Person Caps

Last week, the House Energy and Commerce Committee Chairman Fred Upton (R-MI) and Senate Finance Committee Ranking Member Orrin Hatch (R-UT) released the “Making Medicaid Work” blueprint to modernize the Medicaid program. A key provision included in the plan is per capita caps which would limit the amount of federal dollars spent on each beneficiary.

The plan states that health care needs of the aged, people who are blind and people with disabilities “should be customized and targeted appropriately to improve care and reduce costs.” The plan calls for placing four separate capped spending amounts on each of four major groups: the aged, people who are blind and people with disabilities, children, and adults. The number of individuals in a group would be multiplied by the cap amount for that group resulting in the amount of federal dollars the state would receive for each person in that group. The cap for each group would be based on what a state currently spends on that group. Annual increases to the per capita caps would be based on “a realistic exogenous and appropriate growth factor for each state.” States that currently spend more on each person would be less than increases to states that currently spend less on each person until spending were “normalized” across states. If state spending exceeded the caps, there would be no additional federal dollars.

The plan proposes creating shared-savings and risk corridor models to encourage states to provide healthcare services at lower cost. States that achieved savings could use them “to determine how to protect vulnerable populations such as the disabled from unpredictable spending above the state’s cap.” States that exceeded their spending caps could deny Medicaid to “high income recipients.”

The 20-page blueprint includes two broad goals and 11 sub goals. There is little detail about how the proposal would actually work. The plan’s authors state that Congress and the governors “will enact comprehensive and sustainable Medicaid reform.” The Arc will monitor details of the blueprint as they become available.
Employment – Historic Verdict on Behalf of Workers with Intellectual Disabilities

Thirty-two men with intellectual and developmental disabilities each were awarded $2 million in punitive damages and $5.5 million in compensatory damages by an Iowa jury for discrimination and harassment they endured while working at Henry’s Turkey Farm. The Equal Employment Opportunity Commission filed the case against Henry’s Turkey Farm alleging discrimination and harassment for the treatment they received while working at a turkey processing plant in West Liberty, Iowa. For decades, Henry’s sent hundreds of men with I/DD from Texas to Iowa to work for 41 cents an hour. The men lived in a 100-year old Atalissa school building that had been converted to a bunkhouse. The Atalissa operation was closed down in 2009. The Equal Employment Opportunity Commission (EEOC), which filed the case, was restricted to the final two years of operation limiting the number of workers who could seek compensation. The settlement is groundbreaking in that the jury put a value on the lives of men with I/DD comparable to that of men without disabilities.
ADA/Olmstead – Statement of Interest Filed in Case That Argues the Olmstead Decision Created a Right to Institutionalization

The US Department of Justice (DOJ) filed a statement of interest in a case in Illinois in which the plaintiffs argue that the Olmstead decision created a right to institutionalization. The case was filed by guardians of individuals who reside in one of the state’s Developmental Centers. Illinois plans to close two of its centers and redirect the dollars to community-based services. In its brief, DOJ stated that the Americans with Disabilities Act does not confer a right to remain in any given institution and that courts have found that it does not violate federal law for states to close an institution.


Housing – New Guidance on Design & Construction, Service Animals

The Department of Housing and Urban Development (HUD) and the Department of Justice (DOJ) have jointly released new guidance on design and construction requirements under the Fair Housing Act. The Fair Housing Act prohibits discrimination in housing based on disability, race, color, national origin, religion, sex and familial status; it requires that multifamily housing built for first occupancy after March 1991 contain accessible features for persons with disabilities. According to HUD, “The new guidance is designed to assist design professionals, developers and builders in understanding and meeting their obligations and to assist persons with disabilities in understanding their rights regarding the ‘design and construction’ requirements of the federal Fair Housing Act.”

HUD has also issued a notice on assistance animals and reasonable accommodations for persons with disabilities. The notice discusses the intersection of the Fair Housing Act and the Americans with Disabilities Act with regard to assistance animals, describing housing owner’s obligations under the Fair Housing Act and when multiple nondiscrimination laws apply.

Registration Now Open for The Arc’s National Convention

Make your plans now to join old friends and make new ones at The Arc’s annual gathering of more than 700 individuals with intellectual and developmental disabilities, families, professionals, experts in the field and special guests. This year we’re headed to the East Side of Seattle August 3-5 for three full days dedicated to Achieving Momentum in the I/DD movement and you’re invited! Registration is now open, so take advantage of early bird discounts along with the best availability of rooms at the Hyatt Regency Bellevue.

Taking a cue from our tech-savvy host city, the home of Microsoft’s flagship store, this year’s event is all about innovation! You’ll be treated to technology demonstrations from some of the top names in the communications and technology fields who are constantly coming up with new ways to help people live better, more connected lives. Plus, we have sessions planned on supporting self-advocacy, building our grassroots network, updates from Washington, ACA implementation and Medicaid managed care. Get more details at and register today.

Tony Paulauski
Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
815-464-1832 (CELL)