September 30, 2016
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In Memory of Dan Timmel
NASUAD is profoundly sad to announce that Dan Timmel passed away on September 27.  Dan was the co-recipient of the 2016 Arthur Flemming award at the HCBS conference last month for his outstanding contribution to the Medicaid program. 

Dan's primary role at CMS focused on the well-being of persons served in institutions.  He was a masterful public servant with a passion for looking after "the other 1 million Medicaid beneficiaries" who live in nursing facilities or other institutions. One of Dan's many responsibilities at CMS was oversight of the federal Preadmission Screening and Resident Review program, commonly known as PASRR.  PASRR ensures that all persons with disabilities who enter nursing facilities get the specialized services and supports they need. 
Dan took this one small, largely unrecognized program, and through his leadership, educational outreach, and masterful use of collaborations with states, PASRR professionals, vendors and others, he turned it into a powerful tool to identify persons who could be served in the community versus a nursing facility, and to identify the services critically needed by in nursing facilities, improving the lives of thousands of seniors and people with disabilities across the nation.

In addition to his work on the PASRR program, Dan played a key role on a wide range of Federal initiatives, including the Federal HCBS regulations, the 1915(i) program, and the MACPro initiative. 

"The field has lost a true unsung hero," said Martha Roherty.  "Dan will be remembered for his creativity and compassionate in designing solutions for state Medicaid programs.  His unflagging devotion to being the voice for the institutionalized Medicaid recipients will be missed, but his legacy will live on in all of us that had the good fortune to work with him."

Memorial donations may be made in his name to Heifer International or Gilchrist Hospice.
National I&R Center Webinar: Understanding Medicare
The National Information & Referral Center is hosting a webinar on Understanding Medicare. With Medicare Open Enrollment beginning October 15, now is a key time to enhance or refresh your understanding of key components of the Medicare program. Join this webinar to learn about Medicare eligibility and coverage options as well as educational resources from Medicare Made ClearTM that can assist I&R/A agencies and the consumers they serve. Our guest presenter is Kathy Spenler, Associate Director, Marketing, UnitedHealthcare Medicare & Retirement. Pre-registration is required for this webinar. Space is limited so register today!
Click here to register. 
HCBS Clearinghouse
This section of  Friday Update highlights reports that have been added to the HCBS Clearinghouse within the past week. Visit for more information.
Medicaid & CHIP: July 2016 Monthly Applications, Eligibility, & Enrollment
The Centers for Medicare & Medicaid Services (CMS) released their monthly report for July 2016 on Medicaid and CHIP application, eligibility determination, and enrollment data. States provide data to CMS on factors related to key application, eligibility and enrollment processes using the Medicaid and CHIP Performance Indicator Project. The data is then used to inform CMS on the operations of the programs in each state and to share state performance data publicly.

Click here to view the publication. 
How Can States Help Workers Keep Their Jobs After Injury, Illness, or Disability?
Mathematica Center for Studying Disability Policy published a policy brief explaining how states can help workers keep their jobs after injury, illness, or disability. After workers leave the labor force they often have issues navigating the systems necessary for them to receive services and programs. The brief offers information about how states can intervene early and offers several recommendations including: Introduce employment and accomodation subsidies in worker compensation; enhance states' STFI programs; enhance disability insurance programs for state employees; bolster state VR agencies' job retention services; pilot-test the Centers of Occupational Health and Education (COHE) model for
non-occupational cases; and improve employee assistance program (EAP) benefits for state employees. 

Click here to view the publication. 
From the Administration
Administration for Community Living
U.N. International Day of Older Persons
October 1 was designated by the United Nations in 1990 to recognize the vital contributions of older people to the global community and to encourage member nations to thoughtfully address the aging of the population. At the Administration for Community Living, we are working to ensure that this includes the supports and services necessary for older people to live and contribute in their communities.

This year, the United Nations has designated the 2016 International Day of Older Persons theme as, "take a stand against ageism" in order to draw attention to and challenge negative stereotypes and misconceptions about older persons and aging. Ageism is the systemic stereotyping of and discrimination against people because they are considered old.

To learn more about the International Day of Older Persons, click here.
Elder Justice Coordinating Council Public Meeting
The Elder Justice Coordinating Council (EJCC) will host leaders from across the federal government to address issues of elder justice nationally. Council members include the leaders of federal departments, agencies, and entities administering programs related to abuse, neglect, or financial exploitation.

Acting Assistant Secretary for Aging and ACL Administrator Edwin Walker will join federal leaders in convening the Fall 2016 EJCC meting on October 5, 2016, from 10:00 AM to noon EDT. The meeting will cover federal accomplishments, cross-agency collaborations, lessons-learned, and next steps for EJCC member agencies.

The meeting will be held at the Holiday Inn (550 C Street, SW, Washington, D.C 20024). Members of the public are invited to observe the meeting in person or watch a live online webcast.

If you are interested in attending in person or watching online, RSVP as soon as possible to, Ms. Nokelby will provide the logistical details for participating in person or via the web.
Centers for Medicare & Medicaid Services 
Long-Term Care Facility Final Rule
September 28, 2016, the Centers for Medicare & Medicaid Services (CMS) released a Final Rule that updates Federal requirements for long-term care (LTC) facilities. The Rule will affect approximately 15,000  LTC facilities and close to 1.5 million Americans, and is the first major update to LTC regulations since 1991. There are a number of significant provisions in the Rule, including: prohibiting the use of pre-dispute arbitration agreements; improving LTC staff ratios as well as their training on caring for residents with dementia; greater flexibility for dietitians and therapy providers, and; improving person-centered care and care planning. The Rule becomes effective on November 28, 2016. 

Click here  for more information regarding the new LTC facility Final Rule.
Public Comment on Medicaid Quality Measures- Deadline Extended
The Center for Medicare & Medicaid's Center for Medicaid and CHIP Services and the Medicare-Medicaid Coordination Office are seeking public comment on measure specifications and justification for quality measures currently under development and testing. The measure concepts address the following areas and/or populations:

1.  Medicare-Medicaid (dual) beneficiaries and Medicaid beneficiaries using home and community-based services.
2.  Medicaid beneficiaries in managed long-term services and supports programs.
3.  Medicaid beneficiaries with complex care needs and high costs.
4.  Medicaid beneficiaries with substance use disorders.
5.  Medicaid beneficiaries and Medicare-Medicaid (dual) beneficiaries with physical-mental health integration needs. 

The deadline for submitting public comments on Medicaid quality measures has been extended to Friday, October 7All comments must be submitted to .

Click here to view the memos listing questions. 
Department of Health and Human Services
HHS Announces Winners of Challenge to Improve the Medical Bill for Patients
The Department of Health and Human Services (HHS) announced the winners of the HHS "A Bill You Can Understand" challenge, a design and innovation challenge to solicit new approaches and draw national attention to a common complaint with the health care system: that medical billing is a source of confusion for patients and families. HHS received submissions from health care organizations, technology companies, and design agencies, and today we are unveiling the two winning designs, which will be further evaluated for testing or implementation in six health care organizations across the country that are working to improve the patient billing experience.

Click here to learn more.
Department of Transportation
Safety Guidelines Released
The U.S. Department of Transportation (DOT) recently released the Federal Automated Vehicles Policy that sets forth a framework for proactive safety guidelines for manufacturers, consistent state policies regarding automated vehicles, and proposes new regulatory tools to improve agency flexibility. The policy primarily focuses on highly automated vehicles (HAVs)-that is, vehicles that can take full control of driving tasks. The policy has four key sections:
* Vehicle Performance Guidance for Automated Vehicles, including a 15 point "Safety Assessment";
* Model State Policy;
* Current Regulatory Tools; and
* Modern Regulatory Tools.
DOT sees potential for improving safety and mobility for older adults and individuals with disabilities. Particularly, the new policy articulates standards for when occupants of a self-driving vehicle do not require a driver's license-a key point of concern. Although most of the policy is effective upon publication, DOT is continuing to accept public comment on the entire rule. For additional information regarding the policy, see Press Release, and  Policy Guidance.    
From Other Organizations
American Association of People with Disabilities 
REV UP Campaign National Organizing Call
The REV UP Campaign will be hosting a National Organizing Call on Tuesday, October 4th at 4:00 p.m. ET. This call will focus on how to engage in Get-Out-The-Vote (GOTV) activities leading up to Election Day on November 8th.
Most states will reach their voter registration deadlines at some point during the month of October. As such, it is time to shift the focus from voter registration to Get-Out-The-Vote (GOTV) activities as it approaches Election Day. If you have any questions regarding the call, please contact Zach Baldwin

Click here to register for the call. 
Disability Research Consortium
Presentations from DRC Fourth Annual Meeting
The Disability Research Consortium (DRC) held its fourth annual meeting on August 3, 2016, in Washington, DC. The annual meeting featured findings from 12 projects designed to examine the factors that impact disability program enrollment and costs, influence the well-being of people with disabilities, and affect the relationship between health insurance and disability insurance. These findings will help inform the debate as policymakers work to better serve people with disabilities by providing improved and cost-effective programs.

Research summaries and presentations for the 2016 DRC Annual Meeting can be found here.
Center for Health Care Strategies
Issue Brief on Considerations for a National Risk-Adjustment Model for MLTSS Programs
Center for Health Care Strategies has released a new issue brief which examines considerations in developing a nationally available risk-adjustment model for Medicaid managed long-term services and supports (MLTSS) programs. It also explores research needed to develop a robust model that predicts expected long-term services and supports (LTSS) costs as accurately as possible. Risk adjusting capitation rates paid to health plans helps ensure more equitable payments to each plan based on expected costs of its enrollees. Several risk-adjustment models exist for plans providing medical services, but currently there is no standardized risk-adjustment model for MLTSS programs. The development of a standardized, nationally available MLTSS risk-adjustment model for state Medicaid agencies could reduce the burden on states to establish their own models and facilitate comparisons about the key drivers of LTSS costs within and across states.

Click here to view the issue brief.
National Task Group on Intellectual Disabilities and Dementia Practices
NTG Workshops on Dementia and Intellectual Disability
The National Task Group on Intellectual Disabilities and Dementia Practices has partnered with several ACL Alzheimer's Disease Initiative grantees to provide workshops for administrators, clinicians, staff, and caregivers on dementia and intellectual disability. The workshops are scheduled for Wisconsin (October 3-4), New York (October 26-27), and Hawaii (November 14-16).  A third day 'train-the-trainer' option is available for staff development personnel.  The workshops are designed to encourage local aging and disability agencies to develop and provide dementia-related services for people with Down syndrome and other intellectual disabilities. 

Click here for more information and to register.
National Quality Forum
Measuring Home and Community-Based Services Quality Project
The final report for NQF's Measuring Home and Community-Based Services (HCBS) Quality Project was released on September 27. The Quality in Home and Community-Based Services to Support Community Living: Addressing Gaps in Performance Measurement report  represents two years of work by the HCBS Committee and contains the Committee's final set of recommendations for how to advance quality measurement in home and community-based services.  Camille Dobson, NASUAD's Deputy Executive Director, and Patti Killingsworth, Assistant Commissioner for Tennessee's Medicaid program, Chief of Long-Term Services and Supports, and NASUAD Board member, represented the states' perspective on the Committee.
It describes key components of a conceptual foundation for home and community based services (HCBS) quality measurement, specifically an operational definition of HCBS, a list of characteristics describing high-quality HCBS, and a measurement framework of 11 domains and 40 subdomains. The goals of the domains and subdomains are to stimulate evidence-based research in support of quality measure development, guide quality improvement efforts, and highlight the important areas for measure development. The report also contains multistakeholder recommendations on how to advance HCBS quality measurement so individuals who use HCBS can be assured they are receiving high-quality, effective services.

Click here to view the final report.
2016 ANCOR Technology Summit & Showcase
The American Network of Community Options and Resources (ANCOR) is hosting the "2016 ANCOR Technology Summit & Showcase." The summit will feature peers, advocates, and experts presenting ways that technology can help the Intellectual/Developmental Disabilities (I/DD) community achieve the triple aim of better health, better care, and lower costs. The event will take place in Broomfield, Colorado on Friday, October 7, 2016.

Click here to register
AUCD 2016 Conference
The AUCD 2016 Conference, "Navigating Change: Building our Future Together," highlights both the change that comes at the end of a Presidential term as well as our need to work together to create a future in which children and adults with disabilities are able to participate fully in all aspects of life as valued members of their communities. Join us to engage in powerful, important, and inspiring personal and professional discourse on December 4-7 in Washington, DC. Click here to learn more.

Jobs & Internships
2017 AAPD Summer Internship Program
AAPD has announced the opening of applications for the 2017 Summer Internship Program. The AAPD Summer Internship Program develops the next generation of leaders with disabilities and offers host employers access to a talented, diverse workforce. Each summer, AAPD places college students, graduate students, law students, and recent graduates with all types of disabilities in paid 10-week summer internships in Congressional offices, federal agencies, non-profit, and for-profit organizations in the Washington, DC area.

Each intern is matched with a mentor who will assist them with their career goals. AAPD provides the interns with a stipend, transportation to and from Washington, DC, and fully-accessible housing. All applications must be received by November 7, 2016

Click here to view the internship announcement. 
Funding Opportunities 
CMS Announces a New Funding Opportunity for Track 1 of the Accountable Health Communities Model
CMS, in January 2016, released a new Funding Opportunity Announcement (FOA) for a model called the Accountable Health Communities (AHC). This Center for Medicare & Medicaid Innovation model focuses on the health-related social needs of Medicare and Medicaid beneficiaries. The AHC Model is based on emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. The original FOA requested applications for three different scalable tracks featuring interventions of varying intensity that would address health-related social needs for beneficiaries. After receiving inquiries and stakeholder feedback, CMS has decided to make modifications to the Track 1 application requirements and is releasing a new FOA specific to Track 1 of the AHC Model. Track 1 will support bridge organizations to increase a patient's awareness of available community services through screening, information dissemination, and referral. Track 1 award recipients will partner with the state Medicaid agency, community service providers and clinical delivery sites to implement the Model. The modifications to the Track 1 application include the following: (1) Reducing the annual number of beneficiaries applicants are required to screen from 75,000 to 53,000; and (2) Increasing the maximum funding amount per award recipient from $1 million to $1.17 million over 5 years.

Under this announcement, CMS is accepting applications from community-based organizations, health care practices, hospitals and health systems, institutions of higher education, local government entities, tribal organizations, and for-profit and non-for- profit local and national entities with the capacity to develop and maintain relationships with clinical delivery sites and community service providers. All applicants, including those who applied to
Tracks 1, 2 or 3 in the previous FOA, are eligible to apply to this FOA.
Applicants that previously applied to Track 1 of the AHC Model under the original FOA (# CMS-1P1-17-001) must re-apply using this FOA (# CMS-1P1-17-002) to be considered for the Model.

The AHC Model is accepting applications for Track 1 at through November 3, 2016. For more information about the AHC Model, visit CMS at

Paul Marchand Internship Fund
Paul Marchand Internship Applications Due October 1 
The Paul Marchand Internship Fund will provide $3,000 per semester or summer session to assist interns interested in pursuing careers in public policy advocacy for people with intellectual and/or developmental disabilities (I/DD). For 38 years, Paul Marchand was a dedicated disability policy advocate and recognized leader working on behalf of people I/DD and the larger disability community. Upon his retirement in 2011, The Arc, with substantial contributions from United Cerebral Palsy, other organizations, and individuals with whom Paul worked during his decades in Washington, established an internship to honor Paul and to continue to cultivate disability policy advocates. All applications must be submitted by October 1, 2016

Click here to view more information. 

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