Federal Legislative UpdateCAAI Meeting

Combating Autism ActAuthorizes $210 million in FY2010:

143.5 for NIH research into causes, diagnosis, early detection, intervention, and treatment $19.5 million for the CDC’s Disabilities Surveillance and Research Program $47 million to HRSA to increase awareness, reduce barriers to screening and diagnosis, promote evidence-based interventions for individuals with autism, and train professionals to utilize valid and reliable screening tools to diagnose autism and provide evidence-based interventions

For LENDS - $28.2 or +$2 million expected

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FY 2010 AppropriationsHouse passed 12 bills; Senate passed 3Continuing resolution at FY 09 levelsLabor, HHS, Education Appropriations bill passed by House but not full SenateLikely to be included in omnibus – split difference between H&S billsHope to have bill by end December!

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Combating Autism Act (PL 109-416) Signed De. 16, 2006

The law authorized expansion of interdisciplinary training to increase number of sites able to diagnose or rule out ASD or other DD; andTo expand existing or develop new maternal and child health interdisciplinary leadership in neurodevelopmental and related disability programs in States that do not have such a program

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Now 39 LENDs in 33 statesFY 2008 four new LENDs in Arkansas, Colorado, Connecticut, and Illinois and awarding 18 supplemental grants to existing LENDs FY 2009 increase of $2 million provided partial expansion to 17 LENDs that had not received the previous year’s expansion dollars and to establish one more LEND in the state of Minnesota. FY2010 appropriations will provide $2 million to establish up to two new LENDs and to complete the award of supplemental grants for existing programs. 5

CAA Reauthorization

CAA expires in 2011 and must be reauthorizedEach section contains sunset provisionDiscussions likely to begin next year…. After health care reformStart educating your members on the Senate HELP and House Energy and Commerce Committees

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Health Care Reform

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What’s Happening?House passed HR 3962 Nov. 7 on vote of 220 – 215 with one GOPSenate in second week of debateMajor outstanding issues are public option, abortion, and cost of the billHope to have Senate bill by ChristmasMust then conference the bill and pass final bill by both chambers

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Health reform critical provisionsExchange or market place for people without insurance to shop for plansExpansion of Medicaid to households earning less than 133-150% FPLCannot deny coverage based on pre-existing conditionsElimination of annual and lifetime capsEmployer mandatesIndividual mandate and subsidies

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Critical provisions

Rep. Doyle (PA) and Sen. Menendez (NJ)Minimum services includes “mental health and substance use disorder services, including behavioral health treatment.”

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Autism training grantsAuthorizes grants to UCEDDs or other interdisciplinary education, research, and service entitiesTo provide training, continuing education, TA, and information to improve services and address unmet needs of ASD and related DDAuthorizes establishment of up to 4 new UCEDDs to improve services to individuals with ASD with priority to minority serving institutions

Long term services in health reform

Community Living Assistance Services and Supports (CLASS) ActCommunity First Choice Option (Sec. 101 of the Community Choice Act)

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CLASS Act

National LTSS Insurance programFor working individuals (18 and up)Auto-enrollment through employer with opt-outSelf-funded and reduces deficit and Medicaid spending

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CLASS ActParticipants vested after 5 yearsEstimated monthly premium $125/mo.Eligibility for cash payments (average $75/day) based on needing assistance to perform at least 2 activities of daily livingADL = eating, toileting, transferring, bathing, dressing, continenceTo purchase non-medical services and supports to maintain independence

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Community First Choice (CFC)Core elements of the Community Choice Act (Section 101 of S. 683/HR 1670)Medicaid State Plan option (not mandate)To provide community-based attendant services and supportsIndividuals eligible for nursing homes and other institutional settings6% enhanced FMAP for states that select the CFC option

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Autism Treatment Acceleration Act S. 819 introduced by Sen. Durbin, Casey (D-PA), and Menendez (D-NJ) on April 2H.R. 2413 introduced by Mike Doyle (D-PA) and Chris Smith (R-NJ) on May 14Comprehensive services bill that focuses on services across lifespan, not just childrenCombines elements of Sens. Clinton and Obama/Durbin bills from last Congress

Acceleration Act Main elements

Demonstration project to develop comprehensive, coordinated autism services Demonstration grants to develop adult servicesVoluntary population-based registryProvision to strengthen existing national, regional, and local networksNational training initiatives to provide interdisciplinary training, continuing education initiatives, and technical assistanceRequires that health insurers cover the diagnosis and treatment of ASD, including ABA, assistive communication and assistive technology devices

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Seclusion and RestraintsJan. 2009 NDRN Report outlines the problemGAO Report requested by Chairman Miller Less than half of states have laws or regulations concerning restraint or seclusion use in schools; almost (90%) still allow prone restraints, and only 45% require or recommend that schools notify parentsMost cases identified involved kids with disabilities and majority diagnosed with autismFederal law (Children’s Health Act) only pertains to public facilities, not schools 18

AUCD Recommendations

Federal legislation to ban use of seclusion and prone restraints and other types of restraints except in case of immediate physical safety of students or staffMandate development comprehensive continuum of positive behavior supports and interventions in every schoolAuthorize funding for UCEDDs to provide training and TA 19

Next Steps

Chairman Miller (D-CA) and Rep. McMorris Rodgers (R-WA) of House Education and Labor Committee will introduce bill this WednesdaySen. Dodd (D-CT) working with House to draft bipartisan, bicameral legislationNeed Republican co-sponsor in Senate

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Other Legislation Coming Up

After health care reform….

WIA ReauthorizationDD Act ReauthorizationNCLB Reauthorization

Resources

AUCD: http://www.aucd.orgPublic policy/AutismLegislative News In BriefAction Center: http://www.aucd.org/template/capwiz.cfm

Consortium for Citizens with Disabilities (CCD) Autism Task Force: http://www.c-c-d.org

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