This week’s Capitol Insider focuses on private meetings of the “Super Committee” and a Medicaid lawsuit on cuts to provider rates going to the Supreme Court. See details below.


Capitol Insider
for the Week of October 3, 2011
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Major Events Last Week
Autism – Combating Autism Reauthorization Act signed into law
On Friday, September 30, President Obama signed the Combating Autism Reauthorization Act into law.   This law will continue to support the programs established by the Combating Autism Act of 2006, which include screening and surveillance of autism spectrum disorder (ASD) and educating professionals about proper screening, diagnosis, and intervention for children with ASD as well as many other developmental disabilities. The act authorizes $231 million a year from Fiscal Year (FY) 2012 through 2014 for these efforts. The Arc celebrates the reauthorization of this important legislation
State and Local Government – Americans with Disabilities Act

The Department of Justice reached its 195th agreement under Project Civic Access with the city of Warrenton, Virginia. The city agreed to take steps to make all of its facilities and programs accessible to people with disabilities.  
Major Events This Week
Budget – Joint Select Committee meeting privately
The Joint Select Committee on Deficit Reduction is entering the crucial stage in its efforts to identify at least $1.2 trillion in deficit reduction before the Nov. 23 deadline. While the Committee has held only two public hearings to date, it has been meeting in private. The Committee has not released any details on the private meetings, nor have they scheduled a public meeting for this week. With nearly eight weeks until the deadline for producing a plan, the pressure is on the Members of the Committee to work through the multitude of potential policies such as tax reforms, entitlement changes, and other policies that could be considered. Created as part of legislation to increase the debt limit in August, the Committee is charged with proposing deficit reduction strategies through spending cuts, revenue increases, or a combination of both. Learn more about the Budget Control Actand how it may affect funding for entitlement programs and discretionary disability-related programs.
Medicaid – U.S. Supreme Court to hear case regarding Medicaid rate cuts
The Supreme Court will hear oral arguments in a case on Monday, October 3, that The Arc and the disability community are watching very closely.  The case, Douglas v. Independent Living Center of Southern California, concerns whether individuals and providers can sue states to block cuts to Medicaid rates.  California maintains that only the federal government can enforce the portion of the law concerning payment rates.  The case began in California when the state planned to cut provider rates, some as much as 10%.  The Justice Department and National Governors Association filed briefs taking the side of the state in the case, while House Minority Leader Nancy Pelosi (D-CA) and Representative Henry Waxman (D-CA), both from California, have sided with the respondents.
Medicaid law requires states to keep their payment rates high enough to attract an adequate supply of providers.  The argument in the case before the Supreme Court involves whether individual beneficiaries and providers have the right to enforce that mandate while overriding the state law reducing provider rates.  The respondents argue that under the Constitution’s Supremacy Clause, individuals have the right to sue a state to ensure that provider rates are adequate.  The 9th Circuit Court of Appeals ruled in their favor in 2008, blocking the cuts.
If the Court finds that individuals do not have the right to sue a state to enforce the payment provision of Medicaid law, The Arc and other disability organizations fear that the federal government alone would not have the capacity to monitor over 51 different Medicaid programs to make sure that provider rates are adequate to ensure an adequate supply of providers.  A decision could come at any time during the Court’s term, which runs until June 2012.
FY 2012 Appropriations – More battles may lie ahead
A stopgap spending bill expected to clear Congress tomorrow will give lawmakers more time to wrap up FY 2012 spending issues. The continuing resolution (CR) scheduled for a vote Tuesday will expire Nov. 18. This will leave less than 7 weeks to finish FY 2012 appropriations, likely through an omnibus bill that includes all 12 annual spending bills.   The short bridge CR that was passed last week expires Tuesday, adding pressure for House lawmakers to clear the longer-term bill and avoid the threat of a government shutdown. However, House conservatives could push for deeper spending cuts. Republican leaders, on the other hand, have repeatedly said that they will stick with the agreed upon $1.043 trillion cap for FY 2012 established by the Budget Control Act. According to press reports, appropriators already have begun broad discussions about how to divide up the available discretionary spending among federal programs.
Employment – House hearing to examine modernizing the Workforce Investment Act
On October 4 at 10:00 a.m. (EDT) the House Committee on Education and the Workforce, Subcommittee on Higher Education and Workforce Training, will hold a hearingon “Modernizing the Workforce Investment Act: Developing an Effective Job Training System for Workers and Employers.” The hearing may be viewed livefrom the Committee’s web site. 
Employment – Department of Labor awards nearly $25 million to improve employment for people with disabilities
The Department of Labor (DOL) has awarded nearly $25 million in grants and other funding to improve the employment picture of the nation’s workers with disabilities. Seven states – California, Hawaii, Ohio, South Dakota, Tennessee, Washington, and Wisconsin – were provided a total of $21,166,560 under the Disability Employment Initiative to improve education, training, and employment opportunities and outcomes for youth and adults who are unemployed, underemployed, and/or receiving Social Security disability benefits. Additionally, DOL’s Office of Disability Employment Policy provided $3,787,000 in continued funding to five organizations managing consortia that develop models, provide technical assistance and share best practices to improve employment opportunities for people with disabilities.
Housing and Medicaid – CMS announces grants to develop partnerships with State Housing Agencies
The Centers for Medicare & Medicaid Services (CMS) has awarded $1,980,000 in grants to six states to develop sustainable partnerships with State Housing Agencies. These Real Choice Systems Change Grants seek to create long-term strategies to provide permanent and affordable rental housing for people with disabilities who receive Medicaid services. The grants are intended to support recent legislative changes to the Department of Housing and Urban Development’s Section 811 Supportive Housing for Persons with Disabilities program that focus on maximizing integration of supportive housing units as well as cost efficiency.
Federal Medical Assistance Percentage (FMAP) – States can apply for an increased payment
The Centers for Medicare and Medicaid Services (CMS) sent guidance to states about the State Balancing Incentive Payments Program effective October 1. States can apply for an increased Federal Medical Assistance Percentage (FMAP) payment for diverting people from institutional care by increasing access to community based services and supports. States that rely heavily on institutional services get more FMAP as an incentive to move their systems away from facilities and toward community-based service provision.
States in which only 25% of spending is for community-based services (75% or more of spending goes toward institutional services) will receive a 5% increase in FMAP and states that spend 50% on community-based services (and 50% on institutional services) will receive 2% increase in their FMAP. States must create a single point of entry, conflict-free case management services, and a standardized assessment instrument in order to be eligible for grants.


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)