Federal Legislative Issues Update - July 2006
July 2006
Washington Highlights
Members of Congress came back to Washington on July 10 for three weeks of legislating before they return to their districts for a politics-laden August recess. July will likely be filled with a vast list of legislative agenda items, including legislation on stem cell research, voting rights, immigration, appropriations, and defense issues.
This year's August recess will be a great and critical time to meet with your elected representatives in your district. The entire House of Representatives is up for election and one-third of the Senate is up for election. Contact AOTA's Federal Affairs office for information on ways to connect with your elected representatives during this time. fad@aota.org
Congress will return from its August recess on September 5, the day after Labor Day, to finish up 3-4 weeks of the legislative calendar before breaking again in October for the November elections.
Join Your Colleagues for AOTA's Annual Capitol Hill Day Kick-Off September 5
Plans for AOTA's Annual Capitol Hill Day Kick-Off are moving forward! The plan is for everyone to meet at AOTA headquarters on September 5, 2006, in the morning (time TBA) for a legislative briefing on policy issues that affect you. After the briefing, participants will take the Metro to Capitol Hill to meet with their representatives. Individuals will be responsible for making their own appointments.
If you cannot attend on September 5 but wish to come to Washington another time, Federal Affairs will provide support for your own "Hill Day" any time in September.
More details about the Kick-Off will become available soon, but make your plans now and RSVP to AOTA Federal Affairs office at fad@aota.org TODAY!
AOTA Successful in Advocacy Regarding New Citizenship Documentation Requirements
AOTA, in conjunction with the Consortium for Citizens with Disabilities (CCD), sent a letter to the Secretary of Health and Human Services, Michael O. Leavitt, raising concerns about a draft of a proposed rule that placed significant burdens on citizens and immigrants for documenting citizenship for the purpose of Medicaid eligibility.
AOTA's participation in opposition to the new rules is directly related to the Representative Assembly's (RA's) charge (B27 Charge 416) protecting the right to practice and provide health care for individuals regardless of their citizenship status, passed at the 2006 RA in Charlotte, North Carolina.
The rules could affect elderly individuals who have no or few birth records, or others such as individuals with mental retardation who have been institutionalized for virtually their whole lives. Lack of appropriate paperwork could jeopardize access to health care services. The interim final rule can be viewed on the Centers for Medicare & Medicaid Services (CMS) Web site (pdf)
In response to advocacy, CMS did not substantially change the final rule in regard to immigrant requirements. However, it did broaden the ways in which citizenship could be proven under the new regulations by exempting current SSI and Medicare beneficiaries and allowing searches of state electronic vital statistics databases to qualify as proof of citizenship as well.
AOTA will continue to advocate on this issue because significant concerns remain for vulnerable populations of citizens and non-citizens alike. A copy of the letter sent from AOTA and CCD can be viewed on the AOTA Web site.
Emergency Preparedness
AOTA was recently invited to participate in a national working conference on emergency preparedness for people with disabilities. The invitation was received due to AOTA's ongoing advocacy efforts in this area and our participation on the Consortium for Citizens with Disabilities (CCD) Emergency Preparedness Taskforce.
AOTA member Frank Pascarelli, MS, OTR/L, NMSE, CPI, attended on behalf of AOTA and brought an occupational therapy perspective to the conference. Pascarelli works at the Centers for Disease Control on issues of preparedness related to bio-terrorism. He is also a member of the Air Force Reserve, in which he has been deployed in response to disasters and traumatic events to bring his occupational therapy expertise to both military and civilian response efforts.
More information about the conference can be found at the official Web site located at: http://www.add-em-conf.com/
Rehabilitation Research
AOTA, in partnership with the NCMRR Coalition (National Center for Medical Rehabilitation Research), is working to have an impact on the reauthorization of the National Institutes of Health (NIH). The goal of the coalition is to raise the profile and funding of NCMRR in order to increase the amount and quality of rehabilitation research funded through the NIH. Coalition efforts have included letters to NIH and Congressional leaders, testimony before NIH advisory councils, and direct lobby visits in support of the coalition's legislative agenda. Recently, the coalition provided staff of the Energy and Commerce Committee, for their consideration, draft comments to be included in report language that would go along with the reauthorization bill. The language supports the coalition's overall mission to increase funding, visibility, and the leadership role of NCMRR related to rehabilitation research.
Although NIH reauthorization was being considered during late June and early July, Congressional action is now expected to be delayed until after the November elections. Check the Legislative Action Center for future updates on this issue.
Medicaid
Significant activity related to regulatory changes has been swirling around the Medicaid program. The Centers for Medicare & Medicaid Services (CMS) has been busy working on new regulations stemming from implementation of the Deficit Reduction Act (DRA) and administrative changes proposed in the President's 2007 Budget Proposal.
The three issues with the most direct impact on occupational therapy are: administrative efforts to narrow the definition of rehabilitation services, administrative efforts to eliminate Medicaid coverage for school-based, IDEA-related transportation and administrative claiming, and the implementation of documentation requirements resulting from passage of the DRA. At this point, occupational therapy is not the direct target of any of these efforts but could be affected by changes and restrictions that reduce the overall amount of federal funding for Medicaid. Such reduced funding would shift additional costs to states and cause reductions in optional services such as occupational therapy. Impact could be most felt in school-based services reimbursement.
More information and updates about these issues, as well as AOTA actions, will be available at the Legislative Action Center as events unfold.
Appropriations Update
As reported under the Legislative Action Center the FY2007 Labor-HHS-ED Appropriations bill, will see some action this month. The House is having problems bringing their version to the House floor for a vote because of a contentious amendment changing minimum wage laws. The Senate is scheduled to mark up and vote on their bills the week of July 17.
In order to ensure appropriate funding to vital health and education programs in the FY2007 Labor-HHS-ED Appropriations bill, all AOTA members are encouraged to contact their representatives to urge their support for restored funding to Title VII programs, NIH research programs, and other important health and education programs. Go to the Legislative Action Center for more details and to use the form letter provided to contact your elected representatives.
Campaign To Raise Awareness Regarding Uninsured Children
AOTA is participating in a coalition effort to highlight the problem of uninsured children. The Campaign for Children's Health Care, which launched on July 11, 2006, is a coordinated effort of consumer, provider, and health care policy advocacy organizations to bring awareness to the growing problem of uninsured children in America. More than 45 million Americans are uninsured, including 8.4 million children, which is about 11.4% of all children. The statistics also cast the issue in terms of health disparities because of variability in percentage of coverage for racial and ethnic minorities and children living below the poverty line, which is significantly worse than those of all children. Further information can be found at the Campaign's Web site.
Older Americans Act
Both chambers of Congress have recently taken up legislation that would reauthorize
the Older Americans Act, which was originally enacted in 1965 and last reauthorized in 2000. The act has come to be an important foundation for services to seniors throughout the country. The House has passed its version of OAA reauthorization-known as the Senior Independence Act of 2006 (HR 5293)-and the Senate has unanimously passed its version-titled Older Americans Act Amendments of 2006 (S. 3570)-out of the committee of jurisdiction, which is the Health, Education, Labor, and Pensions Committee. The bill still awaits a floor vote in the Senate.
Although the bills are not identical, they are similar and include improvements in mental health services and emergency preparedness for seniors. They both also further expand the role of Area Agencies on Aging for administering OAA projects and for directing social services for older Americans in their vicinities. AOTA supports the reauthorization of the OAA with these changes and will continue to advocate on this important issue. Under the OAA, opportunities exist for occupational therapy to be included in programs administered by Area Agencies on Aging, but local advocacy is essential to ensure that the contributions of occupational therapy can be realized.
AOTA Submits Comments on the Standard Occupational Classification
AOTA Federal Affairs staff have submitted comments to the Bureau of Labor Statistics at the Department of Labor in regard to its revision of the Standard Occupational Classification (SOC) system. The SOC is the official government classification and definition of occupational therapist and occupational therapy assistants for labor purposes. There has been a long-standing problem in the title of occupational therapy assistants because the SOC has them listed as occupational therapist assistants; a term appropriate to physical therapy but not occupational therapy. Complicating AOTA's effort to remedy this situation is the fact that the SOC is revised only every 10 years; the current revision process will end in the new SOC being released in 2010. AOTA's comments centered on the therapy assistant issue and also sought to update the description of both occupational therapists and occupational therapy assistants while trying to maintain the format and style of the SOC's previous descriptions.
The comments will soon be available on the AOTA Web site in the Issues and Advocacy section.
Health Information Technology (Health IT)
The Senate passed the Health Information Technology Act (S. 1355) in 2005 and the House of Representatives is working on two competing bills that have recently been marked up independently in the Energy and Commerce and Ways and Means Committees. These bills have implications for the future of documentation, coding, and reimbursement beyond simply technological progress and innovation. Health IT legislation is very controversial because of issues surrounding incentivizing; inter-operability of systems; affordability; and linkages to coding, billing, and payment systems and schedules. AOTA is monitoring progress related to Health IT legislation and advocating to ensure that the interests of occupational therapy are protected.
AOTA Staff and ITEM Coalition Members Meet with CMS
AOTA staff and ITEM [Independence Through Enhancement of Medicare and Medicaid] Coalition members met with Dr. Barry Straube, Chief Medical Officer of the Centers for Medicare & Medicaid Services (CMS), in support of Medicare coverage of the iBOT 4000 Mobility System.
The iBOT is a unique powered mobility device with a combination of features that is unlike any wheelchair ever created. The iBOT will allow its user to power across sand, gravel, grass, and other uneven terrain; to easily climb curbs up to 5" and steps; and to rise to an "eye-level" position and hold a conversation, even when the user is on the move. Its main operating functions include:
4-Wheel - traveling uneven terrain
Balance - raising yourself to eye-level
Stair - getting you from here to there
Standard - proceeding with confidence
Remote - taking your iBOT® with you
AOTA participated in the meeting to encourage CMS to allow for Medicare payment of the device because it could significantly improve the functional capacity of certain Medicare beneficiaries with mobility impairments. Continue to watch the Legislative Action Center and AOTA Regulatory and Reimbursement section of the AOTA Web site for up-to-date information.
The ITEM Coalition, of which AOTA is a strong member, is a consumer-led group of 75 organizations whose mission is to improve access to and coverage of assistive technology, devices, and related services for people with disabilities of all ages.
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, MD 20824-1220
Telephone: 800-729-2682
Fax: 301-652-7711
7/14/06