Federal Legislative Issues Update - Feb 2005
February 2005
Bare-Bones Budget Dominates Congressional Agenda
President Bush sent his $2.57 trillion FY2006 budget to Capitol Hill on Monday, February 7. Budget debates will consume most congressional energy for the next two months. The President's budget is used as a blueprint for the House and Senate Budget Committees to develop their own respective budget resolutions-the broad outline for spending and revenue. Congress is supposed to approve a budget by April 15, after which decisions on how to appropriate the money among all federal programs are made. This appropriations process usually continues until the fall or beyond, as agreement on cuts and choices is particularly difficult to achieve.
President Bush vowed in his State of the Union address on February 2 to reduce the deficit by half by 2009. As a result, his bare-bones budget includes increases in defense, homeland security, and international programs while freezing or cutting discretionary funds for many domestic programs. Contributing to the budget constraints are the request by the President to make his 2001 and 2003 tax cuts permanent and the need to continue funding for the war in Iraq.
Some of the critical areas of the President's budget for AOTA and occupational therapy include cuts of $60 billion to Medicaid, more than a half a billion dollars cut from the Centers for Disease, Control, and prevention (CDC), and cuts to training and research programs. For instance, the Health Resources and Services Administration (HRSA) was cut by $843 million from FY2005. HRSA is the agency in the Department of Health and Human Services (HHS) responsible for administering many of the specialized programs in promoting training, access, and research in health care. Programs under HRSA include the Allied Health Professions Training and Nursing Programs (Title VII and VIII).
The budget proposes to spend $15 billion of the redirected Medicaid funds to increase outreach and recruitment to children eligible for Medicaid and the State Children's Health Insurance Programs and to help seniors and the disabled get long-term care at home rather than in institutions. Families USA details how proposed Medicaid cuts could affect states.
AOTA and the Health Professionals and Nursing Education Coalition will continue to work for increased funding for Title VII and VIII programs. Title VII of the Public Health Service Act authorizes a variety of grants for students, programs, and institutions to improve the racial and ethnic diversity, geographic distribution, and quality of the health care workforce. Just like the previous four year's proposed cuts, the President has asked for a 96% decrease in funds to Title VII, from $300 million in FY2005 to $11 million in FY2006. However, in past years, Congress has rebuffed the President's proposed cuts and provided level funding for these programs.
(See related story in the February 14 One-Minute Update for a story on AOTA President Carolyn's Baum's presentation to the Health Resources and Services Administration which administers the Title VII programs.)
AOTA is working in another, larger coalition of over 400 organizations to urge the administration, HHS, and Congress to increase discretionary funding for public health by $3.5 billion in the final budget due April 15. AOTA will also participate in a Congressional briefing on March 4 on public health funding to educate Representatives and their staff on the importance of adequate funding for public health.
The Consortium for Citizens with Disabilities, of which AOTA is a leading member, has issued a press release detailing important programs that can not afford any cuts. Visit www.c-c-d.org to read the release.
The Education Department's overall budget will see a 3.7% decrease in funds (or, $2.7 billion less than FY2005) for the first time since President Bush has been in office. In addition, the budget would eliminate more than 40 programs, many aimed at helping low-income children attend college. In their place, the President proposes to expand the No Child Left Behind Act provisions to include high schools, saying this would provide a more comprehensive approach to ensure at-risk children are ready for college. Funding for Pell Grants would also increase under the President's budget. Read more about special education funding below.
It is extremely important as professionals to work to keep your lines of communication open with your Representatives and Senators, especially during times of budget cuts to programs that affect occupational therapy. Use the Legislative Action Center to find your elected officials and their contact information.
Medicare
AOTA is working once again with other the Trialliance (the American Physical Therapy Association and the American Speech-Language-Hearing Association, and AOTA) on a final policy answer to the "$1500" cap on Medicare Part B Outpatient Therapy. While the ability to get one or two year moratoria in even the toughest budget years has provided a reprieve from full implementation of the cap, this year's budget situation is grave. AOTA and the Trialliance have hired a special budget consultant to help us analyze how much a repeal of the cap might cost. In the budget, any changes to Medicare must be paid for with money obtained through other changes. It is important to have accurate -and low-cost estimates for repealing the cap or implementing any other interim solutions.
AOTA is working with the Centers for Medicare and Medicaid Services and the Government Accountability Office on efforts to identify ways to assure appropriate therapy while still preventing overspending.
A bill to repeal the caps is expected to be reintroduced in the near future by longtime champions Sen. John Ensign (R-NV) and Rep. Phil English (R-PA). Watch the website for a call to action!
Health Care Community Holds Freshmen Representative Meet and Greet
The American Academy of Nurse Practitioners, American Association of Nurse Anesthetists, American Chiropractic Association, American Hospital Association, American Occupational Therapy Association, American Optometric Association, American Psychological Association Practice Organization, American Physical Therapy Association, and the American Podiatric Medical Association joined with one another to host a freshman Republican meet and greet on February 1. Republican Representatives Thelma Drake (VA), Mike Conaway (TX), Lynn Westmoreland (GA), Mike Fitzgerald (PA), along with Chief Majority Whip Eric Cantor (VA) and four-term Representative Paul Ryan (WI), as well as several staff members from other offices came to talk with the health care community. This group of health care associations also will host another freshman meet and greet for Democrats later this month. Get a full list of all freshman Congress members in the Senate and House of Representatives. This would also be a good time to write a welcome letter if you have a new Member of Congress in your area. Go to AOTA's Legislative Action Center to send a letter to welcome all Members to the 109th Congress.
Occupational Therapist on Congressional Staff
Congressman Brad Miller (D-NC) has hired an occupational therapist, Heather Parsons, to handle his education, health care, and social security issues. AOTA's Federal Affairs staff has met with Heather to talk with her about her new responsibilities as a congressional aide. Heather attended Wake Forest University and the University of North Carolina before moving to northern Virginia to work in the school systems. She started her job with Representative Miller in early fall of 2004. AOTA's Federal Affairs Department is preparing materials for presentation at AOTA's Conference in Long Beach on working on Capitol Hill. Watch the website for updates on the Federal Affairs page.
Home Health
AOTA continues to work on the issue of occupational therapy in home health, including expanding occupational therapy's role as a qualifying service under Medicare. AOTA is working with key sponsors of the home health bill in the 108th Congress to introduce legislation this year. Watch the Legislative Action Center for updates and calls to action in regard to home health legislation.
Meanwhile, other activities with the home health community continue. AOTA is a founding member of the newly reorganized Home Care Coalition representing a broad spectrum of home care, therapy, equipment, and consumer groups and hosted the groups first meeting in January at the national office. The Coalition will work to highlight the value of home care to our health care systems, with the goal of gaining broad congressional and public support for home care services. AOTA plans to work with the Home Care Coalition to get further support for the Medicare occupational therapy coverage eligibility act.
Education
New Education Secretary Sworn In
Margaret Spellings became the 8th Secretary of Education when she was sworn in by President Bush on January 31st. Mrs. Spellings had previously served as Assistant to the President for Domestic Policy, during the President's first term, where she helped craft education policies, including the No Child Left Behind Act. She also was responsible for the development and implementation of White House policy on health, labor, transportation, justice, housing, and other elements of President Bush's domestic agenda.
IDEA Regulations Under Development; OT's representing the profession across the country
On December 29, 2004, the Department of Education issued a request for comments and recommendations on the development of proposed regulations for the recently amended Individuals with Disabilities Education Act (IDEA). In addition, the department began hosting informal public meetings around the country to solicit input from parents, teachers, related services providers, and other interested parties. AOTA was able to identify local occupational therapists to attend several of these meetings and provide comments. Thanks to Brenda Brodbeck, Deborah Slater, June Bunch, Jessica Keller, Debra Young, and others for providing verbal and written comments and for advocating for occupational therapy.
There is still time for AOTA members to provide feedback to the Department. Get more information about how to submit comments and to read the talking points and messages AOTA developed for members. Contact federal affairs at fad@aota.org if you would like assistance in developing your comments.
FOA Re-introduced in the Senate
On January 26th, Senators Chuck Grassley (R-IA) and Edward Kennedy (D-MA) reintroduced the Family Opportunity Act (S. 183) in the Senate. The bill had been approved by the Senate last year, but was not voted on by the House. This is the third time FOA has been introduced in Congress.
Budget
After years of significant annual funding increases, the IDEA state grant program (Part B) would only receive an additional $508 million under President Bush's FY2006 budget request. The preschool (Section 619) and Infants and Toddlers (Part C) programs are level funded, as is the Personnel Preparation program under Part D. A new Special Education Transition Initiative, which would help states improve high school graduation rates and post-school outcomes for students with disabilities, is funded at $10 million. Special education research and studies and evaluation activities are now housed under the Department's Institute for Educational Sciences, and are funded at $82.6 million.
AOTPAC
Paul Fontana, AOTPAC chair, and his wife, along with Linda Savino of New Jersey and AOTA staff Christina Metzler and Dan Jones, represented occupational therapy during inaugural week activities in Washington, DC in January. The activities surrounding the inauguration of President Bush and Vice President Cheney provided a great number of opportunities to promote occupational therapy and gain valuable political visibility for the profession.
The AOTPAC Board of Directors will meet on May 11 in conjunction with the AOTA Annual Conference in Long Beach, California. Begin to make your plans now to support AOTPAC during the AOTA Conference. Schedule time to visit the AOTPAC Booth in the registration area where you can speak to board and staff members, receive educational information, and make a contribution. Plan to attend the annual AOTPAC Night event on Saturday, May 14-a fun and relaxing time to meet with friends and colleagues.
AOTPAC is also beginning its annual fundraising efforts with a new "Dollar-a-Day" program targeted to raise enough funds to enable occupational therapy to compete with other health professions in the political arena.
AOTA Conference - Public Policy and Advocacy sessions
A number of sessions will be held during the AOTA Annual Conference in May in Long Beach, California, that relate to public policy and advocacy. Make your plans now to attend these important sessions.
Thursday, May 12:
- 12:00-1:30 p.m. Legislative Developments in Emerging Practice Areas, short course (SC 04)
- 3:30-5:00 p.m. Understanding and Asserting the Occupational Therapy Scope of Practice, short course (SC 15)
Friday, May 13:
- 9 a.m.-12 p.m., AOTA's Reimbursement and Regulatory Department Medicare Update, workshop (WS 18)
- 1:30-3:00 p.m. California Workers Compensation Update, short course (SC 45)
- 3:30-5:00 p.m. Medicare on the Hill: How Legislation Will Affect Practice, short course (SC 50)
- 3:30-5:00 p.m. Occupational Therapy Services Under IDEA: A Parent's Perspective, short course (SC 57)
Saturday, May 14:
- 8:00-9:30 a.m. Reauthorization of IDEA Status Report, short course (SC 79)
- 1:30-3:00 p.m. Survival Tools for the Business of OT, short course (SC 80)
- 3:30-5:00 p.m. State Legislative and Regulatory Forum, short course (SC 90)
Do you have a grassroots advocacy story to tell? Do you know or have a connection to your Senators or Representatives? Contact AOTA's Federal Affairs Department and share your experience! E-mail: fad@aota.org, Mail: PO Box 31220, Bethesda, MD20824-1220 , Telephone: 800-729-2682, or Fax: 301-652-7711.
02/24/05