Friday, April 7, 2017

Disability Integration Act Introduced

Disability Integration Act (S. 910) Introduced, Kick-off event coming up soon

Senate Minority leader Sen. Chuck Schumer of New York has introduced the Disability Integration Act, Senate Bill 910 in this legislative session. Sen. Casey and Warren are original cosponsors of the bill that will have a more public kick-off sometime later this spring.
ADAPT marches for equal rights

Twenty-five years after the signing of the Americans with Disabilities Act (ADA) of 1990, unwanted institutionalization remains a serious problem for people with disabilities and seniors. This issue was documented in the HELP Committee report: “Separate and Unequal: States Fail to Fulfill the Community Living Promise of the Americans with Disabilities Act”.

That report recommended that Congress amend the ADA to clarify and strengthen the law’s integration mandate in a manner that accelerates Olmstead implementation and clarifies that every individual who is eligible for LTSS under Medicaid has a federally protected right to a real choice in how they receive services and supports. The report and this recommendation were well received by the Disability Community.

Although the Disability Integration Act (S.2427) does NOT amend the ADA, the legislation, modeled on the ADA and the ADA Amendments Act, strengthens Olmstead’s integration mandate and creates federal civil rights law which addresses the civil rights issue that people with disabilities who are stuck in institutions cannot benefit from many of the rights established under the ADA.

Legislative Background
The Disability Integration Act builds on the 25 year campaign that ADAPT has done to end the institutional bias and provide seniors and people with disabilities an alternative to unwanted institutionalization. There have been a number of different incarnations of legislation intended to address Medicaid’s institutional bias, starting with the Medicaid Community Attendant Services Act.

Previous versions of legislation were required to do two things: create a Medicaid infrastructure that would meet the assistance needs of all individuals at the institutional level of care and mandate that states implement such a program. Consequently, previous versions of legislation were focused on Medicaid.

However, the Affordable Care Act included language that created the Community First Choice (CFC) Option. This language established a simple Medicaid State Plan option that pre-invests the savings associated with transition to home and community-based services into an incentive of an enhanced FMAP.

Current Environment

Although CFC was optional, it was believed that the six percent additional FMAP would result in states selecting the option and providing a real alternative to institutionalization. Unfortunately, only six states (California, Oregon, Maryland, Montana, New York and Texas) have implemented Community First Choice. Other states have indicated that they intend to implement CFC or have submitted a State Plan Amendment to CMS, but uptake of this option has been extremely limited. Some states – like Illinois – determined the state would actually generate excess long term revenue by implementing CFC, but still haven’t selected the option. It is possible for states to implement CFC, secure the extra federal funds, and continue to maintain policies that limit access to services or fail to provide a real alternative to institutionalization.