Legislative Update

November 29, 2009

State Programs Face Continued Budget Cuts

Shortfalls in state revenue collections have forced state agencies to live with less since August.   State Treasurer Scott Meacham reports that revenue collections in October once again failed to meet the estimate for a tenth consecutive month, requiring a continued reduction of five percent from monthly allocations to state agencies.  However, Meacham has expressed cautious optimism since October’s shortfall of 18.2% is an improvement over the 26% shortfall of previous months.

State revenue collections are significantly in several categories.  The biggest shortfalls are occurring in gross production taxes which are down over 54% from the estimate and 69% over last year’s level.  Revenue is also down substantially in personal and corporate income tax and state sales tax.

Projected State Legislation for 2010

                Workers Comp:  Rep. Mark McCullough, R- , has again announced he plans to file Workers Compensation reform legislation for introduction in 2010.  McCullough wants to lower costs for employers while getting benefits to injured workers more quickly.  His proposal is a total overhaul of the current workers comp system.  The existing Workers Compensation Court would be downscaled and phased out as current cases are decided.  The bill would create a Workers Compensation Commission to handle claims filed after the legislation is enacted.    The Commission would be made up of an attorney, doctor and business representative, all appointed by the Governor with Senate confirmation.  It would oversee a system of administrative law judges who would decide on claims.  A medical officer under the Commission would evaluate worker injuries.  If a claimant refuses a settlement offer and chooses to go to court, the attorney’s fees could only be taken out of the award amount in excess of the earlier settlement offer.  The attorney fee limitation is intended to discourage unnecessary litigation.

Rep. Morrissette expects to once again introduce a bill to advance availability of self-directed in-home care in Oklahoma.  The plan is called Cash and Counseling.  The concept is to use Medicaid funds for the program, which would give monthly cash to elderly or disabled recipients who need in-home supports, and allow them to hire their own assistance.  In a meeting before the House Appropriations Subcommittee on Human Services, Morrissette explained the program would give recipients the flexibility to use in-home assistance funds for other emergency needs such as rent.

An interim study is examining the possible need for legislation to curb use of cell phones, texting and other practices which distract drivers and cause injuries, disability and death.  Rep. Danny Morgan, D-Prague, and Rep. Sue Tibbs, R-Tulsa, expect to introduce legislation to restrict use of these devices while driving.

Rep. Anastasia Pittman has renewed meetings with individuals concerned about education of children with visual disabilities.  In a meeting in early November, parents, teachers, students and others identified several areas they would like addressed, including funding for Braille textbooks and accessible school materials,    

Bills Becoming Effective November 1, 2009

House Bill 2026 affects Insure Oklahoma and creates a core benefits package for young, healthy Oklahomans to purchase health insurance that costs less because it is exempt from state laws requiring health insurance to cover things like hearing aids for children. The law also creates an insurance hub to help match Oklahomans to private insurance plans that fit their needs. 

House Bill 1603 caps noneconomic damages in physician malpractice and other personal injury lawsuits, except when gross negligence is involved.  Proponents claim this will reduce the cost of health care for consumers – available data shows that the cost of malpractice insurance could be reduced, but there is no indication that consumer health care costs will drop.

Senate Bill 135 enacts a plan to increase the number of therapists serving children with autism.  The law creates a licensing process for behavioral analysts and a means to train more doctors in how to diagnose autism conditions.  The law does not required health insurance coverage of autism.

Oklahoma City Transportation

Oklahoma City residents will be able to vote on December 8 on a MAPS-3 proposal that will raise $777 million for several projects, including a downtown area electric streetcar system.  MAPS initiatives have been used by City residents to impose a temporary sales tax to fund specific one-time projects such as school construction and major renovation, and development of the Oklahoma River.  The MAPS-3 levy would extend the current 1-cent MAPS sales tax for seven years and 10 months.  Projects are:

• A new, approximately 70-acre central park linking the core of downtown with the Oklahoma River
• A new rail-based streetcar system, plus potential funding for other rail transit initiatives, such as commuter lines and a transit hub
• A new downtown convention center
• Sidewalks to be placed on major streets and near facilities used by the public throughout the City
• 57 miles of new public bicycling and walking trails throughout the City
• Improvements to the Oklahoma River, including a public whitewater kayaking facility and upgrades intended to achieve the finest rowing racecourse in the world
• State of the art health and wellness aquatic centers for senior citizens throughout the City
• Improvements to the Oklahoma State Fairgrounds

More Oklahoma City Transportation News

Stimulus funds may give Oklahoma City Metro Transit the chance to acquire voice enunciation technology that has been on the list of needed system improvements but lacked a possible funding source.  The technology uses a global positioning system to announce bus stops to passengers, let riders use a website to check on bus arrival times before heading down to the bus stop, and improve bus route coordination.  If no obstacles get in the way, the system could be operational in two years or less.

Metro Transit and its passengers have also benefited from funding approved by voters in 2008 (General Obligation Bond Issue) that has allowed the transit system to replace worn out vehicles.  Nine new paratransit vehicles were purchased in 2008 and 2009 each, and the system has been able to replace 15 older lift equipped buses with new ramped vehicles.

State Long Range Transportation Plan

The State Department of Transportation (ODOT) seeks public comments for the development of the state’s long range transportation plan 0 a 25-year plan that is periodically updated.  Input is also sought for the Statewide Transportation Improvement Program (STIP), another shorter range transportation plan that specifies projects and funding available for the near future.

The long range plan will state ODOT’s guiding transportation policies for the next 25 years. It contains information and policies for highways, airports, rural transit, waterways, rail, pedestrians and bicyclists   The Plan will address goals related to safety and security, accessibility and mobility, transportation system maintenance, freight/shipping options, and transportation and the economy. Residents are encouraged to provide comments and propose future ideas for ODOT.

The Statewide Transportation Improvement Program (STIP) is prepared biennially and presents transportation projects scheduled by ODOT for the next four federal fiscal years.  The public can comment on these and suggest any other projects they would like ODOT to consider.           

Comments can be submitted via the LRP Web site at www.oklongrangeplan.com or can be mailed to ODOT Planning & Research Division, 200 N.E. 21^st Street, Oklahoma City, Oklahoma, 73105.  The website also has a survey that people can complete online as a way of indicating their transportation priorities.

For more about ODOT’s Long Range Transportation Plan, go to www.oklongrangeplan.com.

National News

Health Care Reform

The two health care reform bills now in play are H.R. 3962(Dingell, D-MI) which passed the House on November 7, and H.R. 3590, which merges Senate Finance and HELP committee versions and will be debated on the Senate floor beginning the week of November 30.

A 60-39 Senate vote last Saturday evening cleared the way for debate to begin on the Senate bill and amendments to be considered after Senators return from the Thanksgiving holiday. 

The Congressional Budget Office (CBO) estimates the Senate package will cost $849 billion over 10 years, but cut the deficit by $127 billion in 10 years and $650 billion in 20 years. CBO says the bill is fully paid for, and will extend health coverage to 31 million more Americans.  The bill also comes in below the $900 billion cost figure that the President has suggested as a top limit. 

Both bills contain many provisions affecting Americans with disabilities.  Some features of the Senate proposal include:

• Tax credits to help families below 400 percent of poverty buy health coverage through an approved health insurance Exchange.
•  Prohibits insurers from denying or limiting coverage based on pre-existing conditions and charging higher premiums based on gender or health status.
• Makes states look more closely at how insurance premiums are set, to look especially at how much of the health care dollar is spent on non-health costs like marketing, administration and insurance company profits.
• Reduces the size of the Medicare drug benefit “doughnut hole.”
• Offers tax credits to small businesses to make employee coverage more affordable.
• Allows children to stay on family policies until they reach the age of 26.
• Requires coverage of prevention and wellness benefits and exempts these benefits from deductibles and other cost-sharing in public and private insurance coverage.

Some other provisions affecting group and individual health plans are:

• No lifetime or annual limits on coverage.
• Immediate access to health insurance for uninsured persons with pre-existing conditions.
• Simplified health insurance information.
• Guaranteed  renewability of insurance.
• Prohibition on excessive waiting periods.
• Creates health benefit exchanges that allow consumer choice.
• Hospitals can presume eligibility for Medicaid.

Subtitle E of the Senate bill provides new options for states to provide long-term services and supports.  This section would enact some features long sought by disability advocates including:

• Community First Choice Option – provides that beginning October 1, 2010, a state may provide through a state plan amendment for the provision of attendant services and supports for Medicaid recipients with incomes at or below 150% of poverty or, if higher, the income level that applies to persons who are determined nursing home eligible.  States must assure that attendant services and supports are person-centered and controlled by the individual or appropriate representative.  States using this option would receive a 6% increase in federal match for services under the option.  States are also given permission to target services under this option to specific populations and to tailor their services to such populations.
• A protection against spousal impoverishment for recipients of home and community services and supports.
• Appropriating $10 million for each year from 2010 to 2014 to expand state Aging and Disability Resource Centers.  (These programs, where they exist, are currently supported by grant funds and provide information on long-term care options and supports.)
• There is a “Sense of the Senate” provision that notes that currently 69% of Medicaid spending for long term care of elderly or disabled persons goes to institutions.  The provision states that Congress should address long-term services this session and make long-term care available in the community in addition to institutions.

To pay for its reforms, the bill increases the threshold for the so-called Cadillac tax, raises the payroll tax by 0.5% on individuals who earn more than $200,000 and families earning more than $250,000 a year, and makes Medicare cuts aimed at reducing waste. The payroll tax increase would only apply to employees (not employers).

Information on health reform bills:The Kaiser Family Foundation health reform web page includes information on the legislative process for health reform, an updated side-by-side comparison of versions and much more.http://healthreform.kff.org/

2010 Federal Funding for Disability Programs

H.R. 3293 is the FFY-2010 appropriations bill for the federal departments of Labor, Health and Human Services, and Education.  Combined, these departments administer the majority of disability programs, including vocational rehabilitation.  This bill passed the House on July 24^th.     On August 4^th the Senate Appropriations Committee reported a substitute bill, which was placed on the Senate calendar.  No Senate vote has yet occurred.  Since we are already into Federal Fiscal Year 2010, funding for Labor-HHS-Ed programs is being maintained via a Continuing Resolution.

Highlights of the Senate and House Labor-HHS-Ed appropriations bills

Office of Disability Employment Policy, US Dept. of Labor

Appropriations, 2009, $26,679,000

Budget estimate, 2010, $37,031,000

House allowance, $37,031,000

Senate Committee recommendation, $39,031,000

The increased funding includes $12 million to be devoted to joint efforts by ODEP and Labor’s Employment and Training Administration (ETA) to make the workforce system more accessible and effective for job seekers with disabilities.

Rehabilitation and Disability Research

Appropriations, 2009, $4,067,762,000 (includes $680 million in stimulus funds)

Budget estimate, 2010, $3,500,735,000

House allowance, $3,504,305,000

Senate Committee recommendation, $3,507,322,000

Vocational Rehabilitation State Grants

The Committee recommends the full amount authorized by the Rehabilitation Act of 1973 for this mandatory funding stream. Current year funding is higher due to ARRA funds.

Client Assistance State Grants

The Committee recommends $13,000,000 for the client assistance State grants program, slightly over fiscal year 2009 funding level and the budget request - both are $11,576,000. The Committee is particularly interested in the increase being utilized to assure that services provided under the Rehabilitation Act comply with all requirements related to integrated settings and competitive wages.

Training- The Committee recommends $37,766,000 to train rehabilitation personnel (level funding).   

Demonstration and Training Programs

The Committee bill includes $9,031,000 for demonstration and training programs for persons with disabilities. This is slightly under the 2009 level ($9,594,000) and the budget request of $6,506,000.  The Committee recommends continued support for parent training and information centers.  It also specifies some programs to be funded and the amounts.

Migrant and Seasonal Farmworkers – Level funding.

Recreational Programs – Level funding at $2,474,000.

Protection and Advocacy of Individual Rights - The Committee recommends $18,101,000, slightly higher than the year 2009 funding level and the budget request - both are $17,101,000.

Projects with Industry – Level at $19,197,000.

Supported Employment State Grants – Level at $29,181,000.

Independent Living State Grants - The Committee recommends $23,450,000 for independent Living State Grants, the same amount as the budget request. The fiscal year 2009 funding level is $41,650,000, which includes $18,200,000 available from the American Recovery and Reinvestment Act.

Independent Living Centers - The Committee recommends $80,266,000 for independent living centers, the same amount as the budget request. The fiscal year 2009 funding level is $164,766,000, which includes $87,500,000 in stimulus funds.

Independent Living Services for Older Blind Individuals - The Committee provides $34,151,000 for independent living services to older blind individuals, the same amount as the budget request. The fiscal year 2009 funding level is $68,451,000, which includes $34,300,000 available in stimulus funds.

Evaluation – Slightly down at $1,217,000 , the same amount as the budget request. The fiscal year 2009 funding level is $1,447,000.  These funds support evaluations of the impact and effectiveness of programs under the Rehab Act.

Helen Keller National Center – The Senate committee recommends a slight increase to $10,000,000. The 2009 funding level and the budget request were $8,362,000.

National Institute on Disability and Rehabilitation Research – A slight increase.  The Committee recommends $110,741,000 for NIDRR, the same amount as the budget request. The 2009 funding level was $107,741,000.

The budget proposes $3,000,000 to support demonstration of promising models to serve students with intellectual disabilities. Instead, the Committee has provided $14,000,000 for model comprehensive transition and postsecondary education programs for students with intellectual disabilities, as authorized in the Higher Education Opportunity Act, within the Higher Education account.

The Committee notes that the Americans with Disabilities Act Amendments Act of 2008 and related regulations will require sustained training and technical resources from the disability and business technical assistance center program and requests that NIDRR consider ways to ensure that training and technical assistance services continue to be available during this period of change.

The Committee encourages NIDRR to use a portion of the increase proposed in the budget to enhance support for the disability and business technical assistance center program. The Committee also strongly urges NIDRR to reconsider the current requirement for centers to dedicate limited direct service resources for research, which, given the modest 15 percent requirement, may not add significantly to the research base, but does divert critical direct service resources away from needed training and technical assistance that will more effectively meet the goal of the Americans with Disabilities Act [ADA]. If NIDRR believes that supporting research on the ADA is a priority, the Committee encourages NIDRR to use a portion of its requested increase for research in this area.

Assistive Technology - The Committee recommends $30,960,000 for assistive technology, the same as in fiscal year 2009 and the budget request.  The Committee recommendation includes $25,660,000 for State grant activities authorized under section 4, $4,300,000 for protection and advocacy systems authorized by section 5, and $1,000,000 for technical assistance activities authorized under section 6.

Rehabilitation Act Reauthorization

Some are predicting that Rehabilitation Act renewal, now almost six years overdue, could be taken up soon after the new year starts.  The Act is part of the larger Workforce Investment Act (WIA), which governs job services provided to the general public through One-Stop workforce centers. 

WIA-VR legislation is expected to begin in the Senate Committee on Health, Education, Labor and Pensions (HELP).  In the past this Committee has shown an interest in prioritizing VR services to transition-aged youth, increasing transition funding, and eliminating the 18-month limit on VR provision of supported employment services for an individual.  More recently, the VR community has learned that a move may be made to transfer Vocational Rehabilitation, and presumably all other Rehab Act programs, out of the U.S. Department of Education and into the U.S. Department of Labor.

Although reactions to this possible transfer are just beginning to surface, some concerns have been expressed by rehabilitation and disability groups.  Issues raised so far include:

• The track record of each agency in providing rehabilitation and disability services should be closely examined before making such a major change.
• Would specialized disability services be maintained and improved in such a transfer?
• Could the emphasis on highly qualified rehabilitation staff and masters’ level training be maintained under Labor where generic service models are common?
• Could VR funding be maintained in the event of such a transfer, or would VR funding become vulnerable to pressure of funding needs of the employment program for the general public?
• Could site and program accessibility of the One-Stop workforce centers be assured if such a transfer occurred?
• Is it important to keep VR services for transition-aged youth closely connected with high school and higher education as well as special education policy?
• Under such a transfer, could VR, independent living, Indian VR, assistive technology, disability rights and other Rehab Act programs remain close partners or would the current integration of disability programs and knowledge be adversely impacted?

Disability organizations are monitoring this issue and will hopefully have something definite to report in the coming weeks.

The new Chairman of the Senate HELP Committee is Senator Tom Harkin (D-IA) who took the lead role following the death of Senator Edward Kennedy.  Other members of the HELP Committee are (by rank):

Democrats:

Tom Harkin (IA)

Christopher Dodd (CT)

Barbara A. Mikulski (MD)

Jeff Bingaman (NM)

Patty Murray (WA)

Jack Reed (RI)

Bernard Sanders (I) (VT)

Sherrod Brown (OH)

Robert P. Casey, Jr. (PA)

Kay Hagan (NC)

Jeff Merkley (OR)

Al Franken (MN)

Michael Bennet (CO)

 

Republicans:

Michael B. Enzi (WY)

Judd Gregg (NH)

Lamar Alexander (TN)

Richard Burr (NC)

Johnny Isakson (GA)

John McCain (AZ)

Orrin G. Hatch (UT)

Lisa Murkowski (AK)

Tom Coburn, M.D. (OK)

Pat Roberts (KS)

Quiet Cars

H.R. 734 and S. 841.  These bills require development of a standard for minimum sound information necessary to be conveyed by quiet cars to blind pedestrians.  The National Highway Transportation Safety Board has already convened a group of experts and advocates to study ways to address this issue.  So there is a chance this issue could also be addressed by DOT regulation.

H.R. 3101

The 21^st Century Communications and Video Accessibility Act.  The bill would restore the FCC’s previous requirement that some prime time television programming have audio description.  It would require non-visual access to on-screen emergency warnings.  The measure also requires a number of other accessibility measures to give persons with hearing and visual disabilities better access to video programming of all types.

Medicaid

On November 23rd the Centers for Medicare and Medicaid Services (CMS) is expected to publish a notice in the Federal Register formally withdrawing the Medicaid Rehabilitation Services Option proposed rule which was initially put forth by the Bush Administration. The proposed rule would have generated $2.3 billion in cuts over 5 years by restricting the scope of eligible rehabilitation services and eliminating coverage for day habilitation services for individuals with developmental disabilities.