Welcome to the Washington Connection, the legislative and information service of the American Council of the Blind. The Washington Connection is brought to you by the ACB national office. If you have any questions or comments on the information provided, don’t hesitate to contact us and ask to speak with Swatha Nandhakumar.
The Washington Connection is updated any time we have new information to share with you. The following articles are available as of May 15, 2023. All 8 messages are new.
- New! New Virginia Office Location
- New! Convention Registration for ACB Members Opens This Week
- New! Federal Judge Refused Lyft Ride with His Guide Dog
- New! Description of Coronation
- New! CMS Proposes New Rule Requiring At Least 80% of HCBS Medicaid Payments To Go Toward Worker Compensation
- New! Vispero® to Demonstrate Innovative Screen Reader Software for Accessible Point of Sale Systems at National Restaurant Association Conference
- New! Executive Order to Improve the Care Economy
- New! DREDF Survey on Accessibility in Hotels
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New Virginia Office Location
ACB’s Virginia office has moved! ACB’s new office address is 225 Reinekers Lane, Suite 660, Alexandria, VA 22314.
Convention Registration for ACB Members Opens This Week
Attention all members! ACB’s 2023 Conference & Convention registration opens for members this Thursday, May 18th with registration opening for all on May 25th. The virtual portion of convention begins June 19 with the Call to Order. Resolutions will take place from June 20-22, and Constitution and Bylaws will take place on June 23. The hybrid 2023 Conference and Convention begins June 30 and ends on July 7, with all in-person sessions taking place in Schaumburg, IL. Find instructions on how to register here.
Federal Judge Refused Lyft Ride with His Guide Dog
U.S. Judge David Tatel and his wife had just left a discussion of blindness in the Torah. He was headed from a Cleveland Park synagogue to the U.S. Court of Appeals in D.C., where he serves as a senior judge. But as soon as he got into his Lyft, Tatel said the driver got out and began shouting that he would not take his guide dog. “He went totally nuts; he screamed at us,” Tatel recalled of being berated with his German shepherd, Vixen. “You would have thought we were asking him to carry plutonium.” Refusing to accommodate service dogs is a violation of the Americans with Disabilities Act, as well as the D.C. Human Rights Act, as Tatel’s wife tried to explain to the driver. Tatel knows those laws well — in his three decades on one of the most influential appeals courts in the nation, he has written opinions on discrimination impacting institutions from D.C. public schools to the U.S. Foreign Service. But in the moment, he said, he felt as anyone would being shouted at on the street and refused service. Read the full Washington Post article here.
Description of Coronation
Did you watch the coronation of King Charles III? If so, the Audio Description Project would like to hear from you. Let us know whether the audio description was available in your city, and if so, what channel you were viewing it on. Also, please provide any positive feedback, or any constructive input that we can share with the networks and Descriptive Video Works, the company providing the description for the event. Send your comments to [email protected].
CMS Proposes New Rule Requiring At Least 80% of HCBS Medicaid Payments To Go Toward Worker Compensation
By Robert Holly
Originally published in Home Health Care News, April 27, 2023.
The U.S. Centers for Medicare & Medicaid Services (CMS) on Thursday announced a new proposed rule that would, among its provisions, establish a strict requirement for the amount of Medicaid payment going toward home care worker compensation.
Specifically, the proposed rule from CMS would require that at least 80% of Medicaid payments for personal care, homemaker and home health aide services be spent on compensation for direct care workers. That’s opposed to expenses such as “administrative overhead or profit,” according to the agency.
“If adopted as proposed, the rules would establish historic national standards for access to care regardless of whether that care is provided through managed care plans or directly by states through fee-for-service (FFS),” the CMS announcement explains. “Specifically, they would establish access standards through Medicaid or CHIP managed care plans, as well as transparency for Medicaid payment rates to providers, including hourly rates and compensation for certain home care and other direct care workers.”
Other aspects of Thursday’s proposed rulemaking announcement include:
- Establishing national maximum standards for certain appointment wait times for Medicaid or Children’s Health Insurance Program (CHIP) managed care enrollees
- Requiring states to conduct independent secret shopper surveys of Medicaid or CHIP managed care plans
- Mandating that states report every other year on the HCBS Quality Measure Set for their HCBS program
“With the provisions we’ve outlined, we’re poised to bring Medicaid or CHIP coverage and access together in unprecedented ways – a key priority that’s long overdue for eligible program participants who still face barriers connecting to care,” CMS Administrator Chiquita Brooks-LaSure said in the announcement.
Notably for home- and community-based services (HCBS) providers, CMS is likewise attempting to create new payment transparency requirements for states by requiring disclosure of provider payment rates in both FFS and managed care.
The goal, according to the agency, is to get “greater insight into how Medicaid payment levels affect access to care.”
Currently, demand for HCBS far exceeds service supply from providers. That’s partly because many providers, especially in personal care, continue to struggle with the recruitment and retention of workers.
“Access to most HCBS generally requires hands‑on and in‑person services to be delivered by direct care workers,” a CMS fact sheet explains. “However, direct care worker shortages are impacting beneficiaries’ access to services.”
As part of the transparency efforts under the proposal, states would have to publish the average hourly rate paid to direct care workers delivering personal care, home health aide and homemaker services.
“We are also proposing to require that states report annually, in the aggregate for each service, on the percent of payments for homemaker, home health aide and personal care services that are spent on compensation for direct care workers, and separately report on payments for such services when they are self‑directed,” the fact sheet continues. “We proposed that these requirements would be effective four years after the effective date of the final rule.”
States would also need to more rigorously report on waiting lists in section 1915(c) waiver programs, along with service delivery timeliness for personal care, homemaker and home health aide services.
The National Association for Home Care & Hospice (NAHC) called the Medicaid announcement a “mixed bag” for the program.
“We are heartened and excited to see that CMS is addressing issues related to waiting lists for home- and community-based services and delays in access to care, increasing transparency around provider payment rates and managed care contracting practices, and requiring states to provide more justification around their payment rate structures,” Damon Terzaghi, NAHC’s Medicaid director, said in a statement shared with Home Health Care News.
NAHC does have concerns about 80% of Medicaid payments going toward worker compensation, Terzaghi noted.
“We are concerned that CMS is not proactively addressing the chronically woeful state payment rates for home- and community-based services and instead is creating a new bureaucratic analysis that may or may not ever impact the wages of workers,” Terzaghi said. “We are further concerned that CMS has decided to forego ensuring adequate state payments in favor of applying an arbitrary requirement to pass through a proportion of the rates to direct care workers. This policy cannot be effective without consideration of the actual payment rates or the substantial administrative requirements that federal and state regulations place on providers.”
Vispero® to Demonstrate Innovative Screen Reader Software for Accessible Point of Sale Systems at National Restaurant Association Conference
Award-winning software for self-service devices enables restaurants to increase revenue and improve customer experience
To read the full press release, visit https://tinyurl.com/yc5fzpzr.
April 25, 2023, Clearwater, Florida – Vispero™ and TPGi® are pleased to announce that the most popular screen reader worldwide, JAWS®, is now available in kiosks and other self-service devices. This software will allow all enterprises, including restaurants, to increase their revenue by capturing the overlooked, underserved market of customers with visual impairments. It empowers users who are blind or have low vision to enjoy increased independence when performing tasks such as ordering at a quick-service restaurant or café.
JAWS for Kiosk software is an enterprise-supported screen reader which provides a text-to-speech audio output on self-service kiosks. It can be used with both Microsoft Windows and Android® operating systems. JAWS for Kiosk provides customizable, context-specific instructional messaging to assist users with disabilities and is available in more than 40 languages with a variety of voice options.
This innovative accessibility breakthrough has already been selected by some of the largest companies in the world and is highly scalable. The software has won three industry awards, including a Living the Values Award from one of the largest Quick-Service Restaurant (QSR) companies in the world as a Global Technology Provider that puts customers first and creates an inclusive environment.
“We are committed to making the world a more accessible place, and this innovation is an important part of our strategy to do just that,” said Bob Ciminera, CEO of Vispero.
TPGi will demonstrate JAWS for Kiosk at the National Restaurant Association, on May 20-23, 2023, in Chicago, Illinois.
Executive Order to Improve the Care Economy
On April 18th, President Biden signed an Executive Order (EO) aimed at improving the overall care economy, including childcare, long-term care, and early education. This order directs federal agencies including the Department of Health and Human Services (HHS) and the Department of Labor (DOL) to implement policies and regulations that would increase the number and quality of caregiving and care economy jobs by increasing compensation and investing in programs that train educators and caregivers and improving the accessibility of child and long-term care by increasing the availability and decreasing the cost of care, including child care for families and long term care for individuals with disabilities, so that more individuals may enter and stay employed, individuals with disabilities may seek long term care services in their communities without being institutionalized, and that all children, including those with disabilities, have the same opportunities for high quality education at an early age.
The EO directs HHS and the Centers for Medicare and Medicaid Services (CMS) to improve the compensation and benefits to child and long-term care workers providing federally funded services. It directs HHS and CMS to provide guidance to states on better connecting home- and community-based services (HCBS) providers and workers with Medicaid recipients, improve access to health insurance and federal retirement benefits for federally funded care workers, and improve compensation for elementary school teachers and make that comparable with Head Start grant recipients. This section aims to improve working conditions by decreasing turnover and improving access to mental health services to prevent burnout in the care workforce. It also addresses improving access to job training and apprenticeships for individuals looking to enter the care workforce. Data will be collected by both federal agencies and state and local agencies on compensation and general employment support, including language access, of care workers and early educators.
Section 3 addresses access to affordable child and long-term care services for low-income families. It directs agencies to explore ways to make care more affordable and lower the cost of care to families receiving benefits like Temporary Assistance for Needy Families (TANF) and other federal programs for low-income individuals. Agencies are also directed to provide guidance on how child and long-term care may be included as a supportive service for individuals working on federally funded projects, and how to better connect federal employees to professional associations and unions of care workers to increase availability and accessibility of such services for federal employees.
The final section of this order focuses on expanding options for home and community-based child and long-term care and early education. The HHS Secretary shall provide guidance and promulgate rules to expand access to HCBS under Medicaid. HHS will also explore ways to retain care workers to provide more families with high quality childcare. Access to early education and services for children with disabilities in early education will also be expanded, in addition to support for educators in meeting their obligations under the Individuals with Disabilities Education Act (IDEA), the Rehabilitation Act of 1973, and the Americans with Disabilities Act (ADA). DOL will provide guidance on expanding support and decreasing disincentives for individuals looking to open care centers and small businesses looking to support the care workforce.
DREDF Survey on Accessibility in Hotels
Ever frustrated because a hotel website doesn’t provide enough — or any — information to reserve the accessible room you need? Tired of having to call and get the run-around just to find out which room has the right accessibility features?
DREDF wants to hear about your experiences! They would like to include as many stories as possible about the realities of traveling while disabled — specifically, how hard it is to make hotel reservations and secure a room with accessibility features because of a lack of information about accessible features on the website. Take the survey at https://forms.gle/fg3REajZo6nbU7ZB7 before June 30, 2023.