UCEDD Directors Meeting December 2, 2012 3:15 6:15 pm A U C D 1 - PowerPoint PPT Presentation

UCEDD Directors Meeting December 2, 2012 3:15 ‐ 6:15 pm A U C D 1 Association of University Centers on Disabilities

Welcome A U C D 2 Association of University Centers on Disabilities

Recognition  Timm Vogelsberg, PhD (MT)  Judy Struck, MD (SD) A U C D 3 Association of University Centers on Disabilities

UCEDD TA Updates  Native American DD Needs Assessment  PCPID 2012 Report to the President  Involving People w/ Most Significant Disabilities  Capacity Building Tool ‐ kit  Minority Partnerships report  UCEDD Annual Report A U C D 4 Association of University Centers on Disabilities

UCEDD TA Updates  Allies in Self ‐ Advocacy  Final Summit Report  Promotional video  State team progress  Listserv  Organizational Development Mini ‐ grants  Updated website www.AlliesInSelfAdvocacy.org A U C D 5 Association of University Centers on Disabilities

Upcoming Requests  UCEDD National Salary Survey ‐ elements  Director & associate director $, degree, longevity  UCEDD admin. home, budget, FTE  University Carnegie classification  Salary source  University support for UCEDD  UCEDD Evaluation Plans A U C D 6 Association of University Centers on Disabilities

Self ‐ Advocacy Online  Amy Hewitt, PhD  www.SelfAdvocacyOnline.org A U C D 7 Association of University Centers on Disabilities

Leadership Development  3 major efforts  AIDD/AUCD Fellowship  AUCD Policy Fellowship  UCEDD Leadership Institute  Wonderful opportunities for early ‐ mid career network members and trainees  Strongly encouraging applicants with cultural, ethnic, linguistic diversity A U C D 8 Association of University Centers on Disabilities

UCEDD Leadership Institute  Sue Fox, Associate UCEDD Director, IOD, NH A U C D 9 Association of University Centers on Disabilities

AIDD/AUCD Fellowship  Mette Pedersen, PhD, 2012 ‐ 2013 Fellow  Applications due December 15 for 2013 ‐ 2014! A U C D 10 Association of University Centers on Disabilities

AUCD Disability Policy Fellow  Kristina Majewski, JD, 2012 Fellow  Applications for 2013 due now! A U C D 11 Association of University Centers on Disabilities

Partnership  Martha Roherty, Executive Director, NASUAD  www.nasuad.org A U C D 12 Association of University Centers on Disabilities

BREAK 10 minutes Don’t miss a minute of the ACA! A U C D 13 Association of University Centers on Disabilities

Health Care Reform Update 2012 AUCD Annual Meeting UCEDD Directors Kim Musheno AUCD Director of Legislative Affairs Rachel Patterson AUCD Policy Analyst

Impact of election Affordable Care Act will not be repealed ACA will continue to be implemented by HHS Secretary Kathleen Sebelius Medicaid will not be block granted Medicare will not be fundamentally altered House bills to consolidate and cut education and employment programs will not pass Bills to weaken the ADA will not pass Cuts to discretionary programs will not be as severe Still need bipartisan support to pass any bill

Public Law 111-14 Historic Legislation Patient Protection and Affordable Health Care Act and the Health Care and Education Reconciliation Act Signed into LAW on March 23, 2010 16

Purpose • Expands coverage and access • Transforms focus from treating sickness to preventing illness and promoting wellness • Strengthens protections for people with disabilities who have been discriminated based on pre-existing conditions or health status • Goal to achieve health equity and reducing health disparities • Bending the Cost Curve over time 17

Insurance Market Reforms “Guaranteed issue and renewability” – Insurance companies must not deny anyone “Medical loss ratio” means 80 ‐ 85% of premiums must be spent on medical care, not on advertising or CEO paychecks ‐‐ Or you get money back! Regulations require insurers to justify any unreasonable rate increases 18

“Individual Mandate” Everyone must share responsibility for lowering costs and covering more people 19

Expanding Coverage Temporary high ‐ risk pools Small business tax credits to cover employees Premium subsidies (133 ‐ 400% FPL) Employer & individual responsibility Medicaid expansion – 133% of FPL covered Insurance Exchanges – more coverage, increased competition, lower costs

Expand Coverage: Medicaid Cost ‐ effective Efficient Humane Expands Medicaid Estimated to cover eligibility for everyone Federal share of 17 million more up to 133 % of Federal costs to states: in 2014 Poverty Level (2014) • Administration lower than • Up to $14,600/ private insurance individual • States will receive100% for • $29,400 /family of four newly eligible first 3 years (2014 – 2016) • Phases down to 90% for 2020 and subsequent years more info: www.kff.org

Health Insurance Exchanges Exchange = = Market You can shop in the If you can’t get Medicaid marketplace for insurance with government subsidies 22

Making Coverage Affordable Paid by Subsidies for Government directly to marketplace comes in Insurer form of Tax Credits provided for HOW? individuals/families Limits out of between 133% ‐ 400% pocket costs: Federal Poverty Deductibles, Coinsurance, Copayments Approximately Up to $43,000 individual Up to $88,000 family of 4

Essential Benefits Package for Exchanges and Medicaid Services Everyone Expects to be Covered by their Insurance Hospitalization, emergency services, ambulance Prescription drugs and Maternity and laboratory services newborn care Rehabilitative and Pediatric services habilitative services including dental and devices and vision care Mental health and substance use disorder services Preventative and including behavioral health wellness services and treatment chronic disease management 24

HUGE Focus on Prevention and Wellness Requires new plans to cover certain preventive and immunization services without deductible or co ‐ insurance (applies to Medicaid and Medicare) One percent federal Medicaid share increase for States if it covers clinical preventive services Grants to provide state incentives to Medicaid beneficiaries who successfully participate in a wellness program $11 billion increase FY 2011 for Community Health Centers 25

Prevention and Wellness • Coordination and goals National Prevention Council Prevention and public • $7 billion (FY 2010 ‐ 2015); $2 billion/yr (FY2015+) Health Fund for transformational sustained • Sen. Coburn “ prevention and investments public health slush fund ” • Community Transformation Grants • Comprehensive workplace wellness programs Numerous Prevention and • Education and Outreach Campaign wellness programs such as: • Oral health prevention 26

Increasing and Improving the Workforce Oral Health: Grants National Health for dental and Care Workforce dental hygiene Commission schools, residency established programs, public health programs Primary Care Increases Medicaid Training Grants for reimbursement for Medical Schools primary care physicians and •training on treating pediatricians to individuals with disabilities priority Medicare rates population (2013 and 2014)

Accessibility Access Board (under the Rehab Includes Act) establish • examination tables standards for and chairs accessibility of • mammography medical equipment diagnostic • x ‐ ray machines equipment

Understanding Health Disparities: Data Collection Requires government to collect health survey data from people with disabilities to enable better understanding of the health of people with disabilities compared to other minority groups. Requires HHS to survey health providers to asses access to care and treatment for people with disabilities. Requires development of recommendations for quality measures to improve the quality of health care for individuals with disabilities. 29

New State Incentives for Community Living Community First Choice State Option • new Medicaid state plan option (beginning Oct. 2011) to provide comprehensive home and community ‐ based attendant services and supports for individuals who are eligible for an institutional level of care Reforms 1915(i) State Option • Allows states to provide HCBS services without a waiver Grants to assist states to balance their Medicaid systems in favor of community Extends Money Follows the Person grants CLASS Act – Community Living Assistance, Services and Supports Act 30

Challenges to Health Reform Legal Challenge Congressional Challenges continue Won (mostly) 31

Supreme Court Decision Medicaid expansion is unconstitutionally coercive of states Court upheld the Bottom line – individual mandate as • Power of Secretary Medicaid expansion constitutional exercise to withhold all in ACA is now of Congress’ power existing funds for an option to levy taxes state non ‐ compliance

Medicaid expansion No deadline for 4 Republican states to decide governors do not on joining the plan to join in the expansion and expansion they can drop out 16 yes at any time Partial expansion? • E.g. limit Will Congress enrollment to slash Medicaid people with budget? income up to 100 percent of the FPL rather than 133 %

Cutting Medicaid Block grants off the table, but Per Capita Caps still under discussion Limitations on Medicaid provider taxes Blended match rate Limit federal reimbursement for certain expenses