June 08, 2012

June 8 Washington Update


Greetings from Washington.  This week has been relatively slow with respect to health policy in DC, although there is some good news relating to the F2F funding bill and a federal development of special interest to the autism community. 

F2F funding bills (S. 2123 and H.R. 4083)

Two more Senators have joined as cosponsors to the Menendez bill - Senator Daniel Akaka (D-HI) and Senator Al Franken (D-MN).  Good job, advocates in those states!  That brings the tally to nine Senate cosponsors in addition to Senator Menendez. There were no new cosponsors on the House bill this week, so the current tally remains 10 House cosponsors, in addition to sponsor Representative Pallone (D-NJ). 

If we hope to get the F2Fs re-funded, Members of Congress will need to hear from F2Fs about how effectively they are spending their federal grant funds, and from families about how important F2F services have been in their lives.

If you would like to discuss how best to make this happen, please feel free to contact the policy team.  (Contact information below.)

As we've said before, if your Members of Congress have not yet cosponsored the legislation, please contact them to ask that they do so.  See the guidance at the end of this update or click here now to send a pre-drafted letter to your Representative.  Also, please forward this information to your family, friends, and health care providers, and ask them to contact their Members of Congress as well.  And, if you haven't done so already, please thank your Senator(s) and Representative who have cosponsored the legislation. You can find their contact information by clicking on their names on the list of cosponsors at the end of this update.

Federal employees' health insurance will start to cover ABA therapy

In April, the federal Office of Personnel Management (OPM), which administers the Federal Employee Health Benefits (FEHB) program, issued guidance to the insurance companies selling policies to federal employees.  It was not until May 30, however, that the guidance became public.  It reads:

"The OPM Benefit Review Panel recently evaluated the status of Applied Behavior Analysis (ABA) for children with autism. Previously, ABA was considered to be an educational intervention and not covered under the FEHB Program. The Panel concluded that there is now sufficient evidence to categorize ABA as medical therapy. Accordingly, plans may propose benefit packages which include ABA."

This simple paragraph has tremendous implications.  Although OPM is not requiring any FEHB plans to offer ABA coverage, they are now free to do so, which could directly benefit federal employees whose children need ABA therapy (costing as much as $60,000 per year).  About 250 health plans are offered to the nation's 8 million federal employees. 

Second, the determination that ABA therapy is a "medical," rather than educational, intervention may encourage other insurance companies to offer the benefit, since the federal health insuirance program often serves as a model for insurers generally.  In the past, insurers have resisted covering ABA therapy with the argument that it is educational, not medical.

According to a blog entry on the Autism Speaks website, some families are worried that school districts offering ABA therapy may now cease to do so.  Legally, however, the OPM decision does not have any impact on the right to a "Free and Appropriate Public Education" guaranteed under federal law.

Advocates have worked for many years trying to persuade the OPM to change its policy, so this is a significant accomplishment.  For more information, see an article in "Disability Scoop" at http://www.disabilityscoop.com/2012/06/04/feds-aba-medical-benefit/15771/ or check the Autism Speaks blog at http://www.autismspeaks.org/blog/2012/06/06/aba-decision-closer-look.

Senate Appropriations

On June 12th, the Senate Appropriations Subcommittee with jurisdiction over funding for health and education programs is expected to vote on FY 2013 funding levels for key health and disability programs, including the Maternal and Child Health Block Grant, early intervention, and other programs that are important to children with disabilities. 

You can send a message to your Senators asking them to protect such programs through the Easter Seals website at https://easterseals.capwiz.com/easterseals//issues/alert/?alertID=61400811.

Illinois "Katie Beckett" (MFTD) waiver

As reported last week, Illinois is poised to severely curtail eligibility and payments under its expiring Medicaid waiver that allows medically fragile and technology dependent children to be cared for at home (the MFTD waiver).  If you are from Illinois, the most effective thing you can do is write to your state legislators and Governor to oppose changes to the MFTD program.  For more information about the situation, see http://savemftdwaiver.com/index.html.  (To get contact information for Illinois policy makers, click on the "Advocacy" tab.)  Anyone can also sign a petition expressing support for the waiver at http://www.change.org/petitions/director-of-the-il-dept-of-healthcare-and-family-services-not-cut-the-medicaid-waiver-for-medically-fragile-tech-dependent-children.  

Consumer Assistance Grants - Opportunity for F2Fs?

On June 7, Health and Human Services (HHS) Secretary Kathleen Sebelius announced a new round of funding to support state-based Consumer Assistance Programs (CAPs).  These programs help consumers who have questions or concerns regarding their health insurance.  Grantees can be state or territorial agencies, but states and territories may partner with non-profit organizations that have a track record of working with consumers.  CAPs are supposed to help consumers find health coverage and file appeals against health plans.  In addition, they are required to track consumer complaints to help identify problems and develop solutions.  In October of 2010, CAP grants were awarded to 35 states, the District of Columbia, and four territories.

For more information on CAP Grants, including a map that shows what support is available in each state, visit: http://www.healthcare.gov/law/features/rights/consumer-assistance-program/

For the new Funding Opportunity Announcement, visit: http://www.grants.gov, and search for CFDA number 93.519. 

Supreme Court.  Still waiting ...


As always, please feel free to contact us with any questions. 

Brooke Lehmann, MSW, Esq.

Janis Guerney, Esq.


NOTE:  Past issues of the Washington update can be found on the Family Voices home page by scrolling down in the "News Feed" section.


Cosponsors of House F2F funding bill, H.R. 4083, sponsored by Rep. Frank Pallone (D-NJ):

Rep Langevin, James R. [RI-2] - 2/17/2012
Rep Norton, Eleanor Holmes [DC] - 2/17/2012
Rep Pingree, Chellie [ME-1] - 2/17/2012
Rep Cicilline, David N. [RI-1] - 2/17/2012
Rep Michaud, Michael H. [ME-2] - 2/17/2012
Rep Engel, Eliot L. [NY-17] - 2/17/2012
Rep Green, Gene [TX-29] - 3/5/2012
Rep Rangel, Charles B. [NY-15] - 3/8/2012
Rep Roybal-Allard, Lucille [CA-34] - 3/20/2012
Rep Carson, Andre [IN-7] - 4/26/2012


Cosponsors of Senate F2F funding bill, S. 2123, sponsored by Senator Robert Menendez:

Sen Bingaman, Jeff [NM] - 2/17/2012
Sen Conrad, Kent [ND] - 2/17/2012
Sen Snowe, Olympia J. [ME] - 2/17/2012
Sen Whitehouse, Sheldon [RI] - 2/17/2012
Sen Lautenberg, Frank R. [NJ] - 2/17/2012
Sen Kerry, John F. [MA] - 3/13/2012
Sen Klobuchar, Amy [MN] - 5/8/2012
Sen Akaka, Daniel K. [HI] - 6/4/2012
Sen Franken, Al [MN] - 6/5/2012


Contacting your Members of Congress about F2F funding bills


All of you who are concerned about the future of F2Fs should contact your Members of Congress to urge that they cosponsor the Menendez or Pallone bill. You can call them through the Capitol switchboard at 202-224-3121.  (To find the names of your Members of Congress, go to http://www.congressmerge.com/onlinedb/index.htm.)  When you speak to the receptionist, state that you are a constituent and ask to speak to the staff person who handles health issues.  If that person is not available to talk, you can leave a BRIEF message identifying yourself as a constituent who has a child with special health care needs (if applicable) and asking that the Representative/Senator cosponsor a bill that would extend funding for Family-to-Family Health Information Centers.  Refer to the appropriate bill number and sponsor - in the Senate, S. 2123, sponsored by Senator Menendez; in the House, H.R. 4083, sponsored by Rep. Pallone.  Leave your home phone number and email address.


You can also write to your Representative (even if you call) via the "Advocacy" section of the Family Voices website, where you will find a pre-written letter that you fill in with your personal information.  (You do not need to know the name of your Representative.)  Please ask families you have worked with, friends, and relatives to write their Representatives through the Family Voices website also.  The URL is http://www.familyvoices.org/action/advocate.   At this time, the website is not configured to automatically send the letter to Senators, but simple instructions about how to contact your Senators, and text to copy and paste, can also be found on that page.  (You do not need to know the names of your Senators.)


Remember:  Federal resources may not be used for lobbying activities.


Please feel free to call Brooke or Janis (contact information above) if you have any questions.