Federal Legislative Issues Update - Jan 2005
January 2005
The 109th Congress Begins
Tuesday, January 4 marked the beginning of the 109th Congress (2005-2006) with the swearing in of freshmen Members of Congress. AOTA's Federal Affairs staff attended a day of meetings and ceremonies honoring new and returning members of the House and Senate. Neither chamber will be in session again until January 20. AOTA Federal Affairs staff, AOTPAC Chairman Paul Fontana and his wife, and Linda Savino, an occupational therapist from New Jersey, will be in Washington the week of January 17 for the second inauguration of President Bush. Ceremonies are to begin at noon on January 20. Go to the official Presidential Inauguration Web site at http://www.inaugural05.com/ for more information.
House and Senate Committee Vacancies Filled
Elections were not over for the House and Senate until leaders of the bodies were reelected and committee chairmen were chosen last week after members were sworn in. Vacancies on several key congressional committees with jurisdiction over health care and educational programs important to occupational therapy were filled the week of January 3. Committee vacancies occur when a member resigns or loses; members gain seats based on seniority and on party choices.
In the House of Representatives leadership, Representative Dennis Hastert (R-IL) will remain the Speaker of the House. Representatives Tom Delay (R-TX) and Roy Blunt (R-MO) were retained as Majority Leader and Majority Whip, respectively, while Democrats Nancy Pelosi (D-CA) and Steny Hoyer (D-MD) will continue as Minority Leader and Minority Whip. On the key Energy and Commerce Committee (responsible for Medicaid and Medicare Part B) new appointees are: Representatives Roy Blunt (R-MO), Sue Myrick (R-NC), Marsha Blackburn (R-TN), Michael Burgess (R-TX), and Tim Murphy (R-PA); and Democratic Representatives Mike Ross (D-AK), Tammy Baldwin (D-WI), and Jay Inslee (WA). The House Ways and Means Committee, responsible for all of Medicare and Social Security and a top prize coveted by most members, will see nine new faces: Representatives John Linder (R-GA), Bob Beauprez (R-CO), Chris Chocola (R-IN), Melissa Hart (R-PA), Thomas Reynolds (R-NY), Devin Nunes (R-CA), John Larson (D-CT), Mike Thompson (D-CA), and Rahm Emanuel (D-IL).
In the Senate, Senator Bill Frist (R-TN) will continue to serve as Majority Leader and Senator Mitch McConnell (R-KY) as Majority Whip, while Senator Harry Reid (D-NV) becomes the Minority Leader following the defeat of Tom Daschle and Senator Richard Durbin (D-IL) will be the Minority Whip. The Senate Health, Education, Labor and Pensions (HELP) Committee, responsible for education and many other programs, will be chaired by Senator Michael Enzi (R-WY) and joined by three new members including two new senators: Richard Burr (R-NC), Johnny Isakson (R-GA), and long-time Senator Orrin Hatch (R-UT) who previously served on the committee. Senator Chuck Grassley will continue to chair the Senate Finance Committee and will be joined by Senator Michael Crapo (R-ID), Ron Wyden (D-OR), and Charles Schumer (D-NY).
Take this opportunity to contact these Members of Congress by using the Legislative Action Center to express your interest and the importance of issues affecting occupational therapy that will be debated in the 109th Congress. The Federal Affairs department is available for you if you have any questions at FAD@aota.org or call 301-652-6611 ext. 2010.
Legislative Priorities for the New Congress
Therapy Cap Legislation
AOTA continues preparation to achieve a resolution to the $1,500 outpatient rehabilitation cap since the moratorium included in the Medicare Modernization Act of 2003 will expire December 31, 2005. This issue sits at the top of the priority list for AOTA staff and members in 2005. AOTA staff is continuing to work with the Centers for Medicare and Medicaid Services (CMS), Members of Congress, and the TriAlliance (AOTA, ASHA, and APTA) to work on an alternative way to save money (Congress' priority) and assure access to therapy (AOTA's priority). AOTA has hired a consultant to work with data to identify alternatives and has contracted with an independent lobbyist to provide additional counsel and strategic support. Senator John Ensign (R-NV) and Representative Phil English (R-PA) plan to reintroduce legislation to repeal the caps during the beginning of the 109th Congress. Continue to watch the Legislative Action Center at http://capwiz.com/aota/home/ for any new developments or calls to action.
Direct Access
AOTA's existing policies on direct access, adopted by the Representative Assembly in various years, support AOTA in working with states on their efforts to expand and support direct access, and call upon AOTA to inform Congress and others that if the Medicare physician referral requirement is eliminated for any therapy, it should be eliminated for occupational therapy as well. Direct access will be an issue to watch for AOTA members and staff in the 109th Congress. Watch the Legislative Action Center at http://capwiz.com/aota/home/ to read updates and developments with direct access legislation. See activities on this issue in the Newsroom on the AOTA Web site.
Appropriations
AOTA works along with the Health Professionals and Nursing Education Coalition (HPNEC) to achieve funding for Title VII and Title VIII of the Public Health Service Act. These programs aim to improve racial and ethnic diversity, geographic distribution, shortages, and the quality of the health care work force. AOTA will continue to work with HPNEC to improve funding for Title VII and VIII programs during the FY2006 appropriations process.
AOTA is also discussing opportunities for seeking additional project funding next year in collaboration with an occupational therapy education program. The funding received in 2003 for older driver was obtained in collaboration with the University of Florida and funding for training on dementia was obtained in 2004.
STOP Stroke Act
The Stroke Treatment and Ongoing Prevention Act of 2003, or the STOP Stroke Act, was introduced in 2003 and passed the House of Representatives, but died in the Senate. AOTA staff and a coalition of organizations supporting the legislation plan to work in the 109th Congress to dramatically advance the fight against stroke-our nation's No. 3 killer and a leading cause of significant, long-term disability.
The STOP Stroke Act will support federal efforts to improve the quality of stroke care, to educate the public about stroke warning signs and how stroke can be prevented, and to educate medical professionals in optimum practices, diagnostic approaches, technologies, and therapies. Watch the Legislative Action Center at http://capwiz.com/aota/home/ for information on how you can help the STOP Stroke Act during the 109th Congress.
75% Rule
The "75% Rule" requires that a rehabilitation facility show that at least 75% of patients would have to have 1 of 10 diagnoses identified in 1984-failing to take into account medical advances of the past 2 decades. The rule was issued by CMS last May, but the FY2005 Omnibus Bill, passed in December 2004, included a moratorium on the implementation of the rule until after the Government Accountability Office (GAO) completes a formal assessment of the rule's impact on access to rehabilitation services. AOTA and others have argued that the rule would reduce Medicare payments for many rehabilitation hospitals as well as deny placement of many patients who could benefit from rehabilitation hospital services. AOTA will continue to work with the GAO and Members of Congress to achieve a favorable resolution.
Home Health
The Medicare Occupational Therapy Coverage Eligibility Act seeks to make occupational therapy equal to physical therapy and speech-language pathology services as a qualifying service for Medicare home health services for non-nursing patients. It is still unclear whether Congress will move any Medicare legislation this Congress, but it is still important that AOTA members remain active in promoting the legislation. Watch the Legislative Action Center at http://capwiz.com/aota/home/ for any developments and information on how you can help advocate for occupational therapy in home health.
Medicaid
Medicaid is a health care program for the most vulnerable Americans-seniors, children, people with disabilities, and others that have no where else to turn. The current Administration has expressed interest in reforms to Medicaid that could possibly limit funding and benefits to its beneficiaries. AOTA is working with various coalitions to ensure that Medicaid will remain the safety net to those people who need health care the most. Watch the President's State of the Union address on February 2 for his proposals to trim this critical program.
Associated Health Plans
The Administration and Members of Congress believe that Associated Health Plans (AHPs) will again be debated in the 109th Congress. These plans would allow more flexibility for employers to obtain less costly insurance but would eliminate oversight of these programs by state insurance commissions. Most advocates believe the oversight by states and the mandates for covered services provide consumer protections that would be missing in AHPs. But others argue they would provide an option for employers to step up and provide some coverage. Watch the Legislative Action Center at http://capwiz.com/aota/home/ for any developments with AHPs during the 109th Congress.
Elder Falls Prevention Legislation
Legislation that would direct the U.S. Department of Health and Human Services to develop public education on fall prevention for the elderly and those involved with the elderly, and would expand research on approaches to fall prevention and treatment is expected to be reintroduced again in the 109th Congress. Falls are the leading cause of injury deaths among individuals over 65 years of age. AOTA will continue to work in coalition with other organizations in support of legislation addressing elder falls prevention.
Community-Based Long-Term Care
Two pieces of legislation addressed community-based long term care in the 108th Congress; the Medicaid Community-Based Attendant Services and Supports Act of 2003 (MiCASSA) and Money Follows the Person Act of 2003. MiCASSA was designed to allow individuals eligible for nursing facility services or Intermediate Care Facility Services for the Mentally Retarded (ICF-MR) the opportunity to choose an alternative, community-based attendant services and supports. MiCASSA does not take the place of the Money Follows the Person Act of 2003, which only serves Medicaid beneficiaries moving to community-based settings from institutional settings, whereas MiCASSA calls for Medicaid funding to be used for personal assistance services and supports for people of all ages whether they are currently in an institution or not. Continue to watch the Legislative Action Center at http://capwiz.com/aota/home/ to get updates on both pieces of legislation.
Education Related Items
Get an in-person update on the new IDEA law by attending one of the upcoming on-site continuing education opportunities brought to you by AOTA. On January 29-30, the new offering, Early Intervention and School-Based Occupational Therapy: Best Practice 2005, will be offered in Fort Worth, TX. The 2-day workshop will also be held March 5-6 in Charlotte, NC.
The IDEA regulatory process has begun. On December 29, 2004, the U.S. Department of Education published a notice in the Federal Register requesting comments and recommendations from the public prior to developing and publishing proposed regulations. The regulations are "rules" developed by the Department to implement IDEA, and they have enormous impact on children receiving early intervention, and special education and related services. This request provides two key opportunities for AOTA members to influence the proposed rules.
It is vital that the Department hear from occupational therapists and occupational therapy assistants. You can
- submit written comments to the Department by February 28, 2005; or,
- attend and provide comments at one of the informal public meetings in Atlanta, Newark, DE; Boston; Columbus, OH; San Diego; Laramie, WY; and Washington, D.C. (The first meeting will be Friday, January 28th from 3:30 pm-5:30 pm and 6:30 pm-8:30 pm at the University of Delaware Conference Center, John M. Clayton Hall, Room 106, 100 Pencader Way, Newark, DE 19716.)
AOTA will develop talking points to help you write your letters or provide testimony. Please contact AOTA federal affairs representative (fad@aota.org) if you are interested in submitting comments or attending one of the meetings.
For more information about the informal meetings, contact: Troy R. Justesen at the U.S. Department of Education, at (202) 245-7468. To read the Federal Register notice, go to http://www.ed.gov/legislation/FedRegister/proprule/2004-4/122904a.html.
AOTPAC
As noted previously, Paul Fontana, AOTPAC chair, and his wife will participate in the 55th Presidential Inauguration activities in Washington DC January 18 through 20, along with AOTA staff and Linda Savino an occupational therapist from New Jersey. AOTA members were challenged to make a yearly contribution to AOTPAC of "A Dollar A Day" and that if they made the full $365 payment before January 10, 2005, they would be entered into a drawing to win a trip to DC to participate in the Inaugural activities. Linda Savino of New Jersey was the winner of this trip.
All AOTA members are encouraged to participate in the new AOTPAC "Dollar-A-Day" program where they can make their contribution with a monthly charge to their credit card. Those interested should contact Darlene Dennis at the AOTA office by e-mail at aotpac@aota.org or by phone 1-800-SAY-AOTA ext. 2014. Anyone who participates in this program will be entered automatically to win various prizes throughout the year.
Applicants are being sought for a position on the AOTPAC Board of Directors for Region IV. Interested persons must be AOTA members (OT/OTA/student) and reside within the Region (Colorado, Minnesota, Missouri, Nebraska, New Mexico, North Dakota, Oklahoma, South Dakota, Texas, and Wyoming). Criteria and application are on the AOTA Web site under Issues and Advocacy/AOTPAC or you can contact Darlene Dennis at aotpac@aota.org or by phone at 1-800-SAY-AOTA ext. 2014 for more information. Please submit applications to Paul Fontana, Chair of AOTPAC, in care of Darlene Dennis, AOTA, PO Box 31220, Bethesda, MD 20824-1220.
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.
01/28/05