With just 11 days to go before the expiration of a budget procedure prohibiting a filibuster on health care reform legislation, the Senate is making one last attempt to repeal and replace most of the Affordable Care Act (ACA). NDSS opposes this new effort and urges all Senators to reject this proposal and, instead, work toward bipartisan solutions that ensure that all adults and children with disabilities have access to the health care they need.
The current effort comes in the form of a proposal by Senators Lindsey Graham (R-GA) and Bill Cassidy (R-LA). It maintains a number of provisions of the ACA that are important to people with Down syndrome, including allowing young adults under the age of 26 to stay on their parents’ insurance plans, preventing insurance companies from discriminating against individuals with pre-existing conditions, and barring insurance providers from imposing annual and lifetime limits.
However, like previous measures considered, but rejected, by the Senate in July, the Graham-Cassidy proposal would establish Medicaid per capita spending caps. This will lead to potentially significant cuts in cost-effective health insurance and supportive services for people with disabilities as states will face even larger funding deficits in their Medicaid programs.
In addition to capping medical assistance expenditures made on behalf of adults with disabilities, the Graham-Cassidy proposal will lead to steep cuts in programs critically important to people with Down syndrome, such as employment supports through Long-Term Services and Supports (LTSS), and Section 1915(c) Home and Community-Based Services (HCBS). These are optional services that states are not mandated to provide, and would likely be the first services to be cut by reimbursement caps.
To support community integration and economic independence, people with Down syndrome need more cost-effective health insurance options and supportive services, not less. The Medicaid funding cuts in the Graham-Cassidy proposal will take a sharp turn in the wrong direction, and NDSS urges every Senator to oppose it.
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Do You Know?
PA CONNECTING COMMUNITIES provides the following services through the Office of Developmental ProgramTransitional Services W1424 1:1 Services directed towards supporting individuals in transition to integrate, completive employment through work. PA Connecting Communities Transition services can be thought of bridging the gap between school programs and the opportunities of adult life, including higher education or training, employment, independent living and community participation.Supportive Employment Services W7235 1:1 There are 2 components:1) Job Support: Some functions of job support include training of individuals in job assignments, periodic follow-up or ongoing support. Other activities include support to relearn a job, training to assist individuals to use transportation for work, maintenance of appropriate work behavior on the job.2) Job Finding: Development of skills, outreach to potential employers, training of job tasks and other such tasks to assist individual in acquiring a job Some functions of job finding include interview assistance, employer outreach and orientation, resume preparation, job skill development.Home and Community Habilitation Services W7059 1:3 W7060 1:1 Services to help people gain, maintain, and improve skills that allow them to live and participate in their local community This service may be made available to individuals in their own home or in other residential or community settings not subject to licensing regulations.Behavioral Services: W7095 1:1 Services that specialize in behavioral support for individuals who have challenging behaviors. Support individuals based upon assessment, those with behavioral that prevent an individual from living or working without crisis. The provision includes the training of individuals, staff, relatives and caregivers.Do You Know? PA CONNECTING COMMUNITIES provides the following services through the Office of Vocational Rehabilitation (OVR) at our new vocational center located at 564 Washington Ave., Carnegie, Pa 15106. We have a contract with OVR to provide:Evaluations& Assessments to assess the individuals’ skills and interests.Job Coaching/Supportive Employment persons are provided 1:1 staff to assist with job development of obtaining and retaining employment.CBWA (Community Based Work Assessment) allows the individuals to work under supervision with a group of individuals at a community site before being placed on a job.PWAT (Personal Work Adjustment Training) 1:1 staff to client; short term work experience designed to help an individual develop skills needed to obtain competitive employment including work behavior and social skills.Extended Services beyond the 90 day typical training period.Soon to come a Job Readiness Training Center! All waivers, contracts and school district funding sources will be considered.Do You Know? PA CONNECTING COMMUNITIES provides the following services through the Bureau of Autism Services. Behavioral Specialists 96150 & 96151 1:1 Provides specialized behavioral support for individuals who demonstrate behavioral challenges because of limited communication skills, social skills, limited or impaired sensory systems. The behaviorist will develop the initial plan from the FBA, a crisis intervention plan and on-going support which includes training.Community Inclusion W7201 1:1 Assist participants in acquiring and obtaining communication, socialization, self-help and adaptive skills necessary to reside in the community. This service includes activities to improve the participants’ capacity to perform activities of daily living. Services may be furnished in a participants’ home or other community locations.Job Assessment & Finding W7071 1:1 Provides support necessary to obtain paid or volunteer work in the community including job assessment and job development. Provide on-going support to the participants once work is obtained.Supportive Employment W7200 1:1 Provides on-going assistants in developing the communication, socialization, self-direction, self-help and adaptive skills necessary to maintain employment in a community setting.Transitional Work Services W0011 1:1 – 1:3 Provides community employment opportunities in which the participant is working along- side other people with disabilities. The intent of this service is to support individuals in transition to integrated, competitive employment.Do You Know? PA CONNECTING COMMUNITIES provides the following services through the Office of Long-Term Living (OLTL) Support Services WaiversSupport Services Waiver is a shortened term for the Medicaid Home and Community Based Waiver Program. This program provides funding for supports and services to help you to live in your home and community. Waivers offer an array of services and benefits such as choice of qualified providers, due process and health and safety assurances.The name waiver comes from the fact that the federal government “waives” Medical Assistance/Medicaid rules for institutional care in order for Pennsylvania to use the same funds to provide supports and services for people closer to home in their own communities. Each waiver has its own unique set of eligibility requirements and services.Pa Connecting Communities offers the following waivers from OLTL:Attendant Care/Act 150 If you have a physical disability, the Attendant Care Waiver and state funded Act 150 program may be available to you to continue to live in your home and community with support and services.COMMCARE Waiver A Home and Community-Based Services Waiver for Individuals with Traumatic Brain Injury (TBI). If you have a medically determined diagnosis of traumatic brain injury (TBI), the COMMCARE Waiver can help you remain as independent as possible.Independence WaiverIf you are an adult with a severe physical disability, the Independence Waiver may be able to help you live or remain in the community and remain as independent as possible.OBRA WaiverOBRA Waiver is a Home and Community Based Waiver program that may help you if you have a developmental physical disability to allow you to live in the community and remain as independent as possible.