AMSI Expresses Concern Over Proposed Medicaid Cuts and Their Impact on Direct Support Services

 

February 26, 2025 – Policy & Funding Update

 

The American Support Standards Institute (AMSI) is deeply concerned about the House budget resolution proposing significant reductions to Medicaid funding. The resolution, narrowly passed by a 217-215 vote, seeks to cut approximately $880 billion from Medicaid over the next decade.

 

Source: https://www.theguardian.com/us-news/2025/feb/25/republicans-spending-deal-medicaid-cuts

 

These proposed reductions could have severe consequences for individuals with intellectual and developmental disabilities (IDD) and the direct support professionals (DSPs) who provide essential services. Medicaid is a critical lifeline for over 70 million low-income Americans, including many people with disabilities.

 

Source: https://nymag.com/intelligencer/article/republicans-medicaid-cuts-budget.html

 

A Flawed Approach: Budget Cuts Without Structural Reforms

 

Rather than improving Medicaid fund distribution to ensure resources effectively reach final recipients, including people with IDD and their support staff, Congress has opted for across-the-board cuts without addressing systemic inefficiencies.

 

This approach is analogous to:

✔ Reducing power generation instead of modernizing the power grid to improve efficiency and distribution.

✔ Cutting regulations without improving existing ones or understanding the specific regulatory framework necessary for an industry.

 

AMSI’s Proposed Solution

 

To address these concerns and prevent a workforce crisis in direct support services, AMSI has published:

 

Preventing Workforce Crisis in Direct Support Services: Aligning Standard Occupational Classification (SOC), Support Standards, and Medicaid Fund Distribution

 

This article highlights:

✔ The importance of aligning SOC definitions with clear support standards to strengthen service delivery.

✔ The need for Medicaid fund distribution reforms to improve efficiency and accountability.

✔ The role of voluntary consensus standards in structuring direct support services more effectively.

 

Call to Action

 

AMSI urges policymakers, service providers, and advocates to focus on structural improvements rather than broad funding reductions. The future of IDD services, DSP workforce stability, and person-centered support depends on solutions that enhance efficiency, quality, and accessibility rather than simply reducing expenditures.

 

Read the full article "SOC & Support Standards in Medicaid Wage Distribution" on the AMSI website: https://amsi-inc.org

 

Related Articles

 

✔ Big Medicaid Cuts Look More Likely. Hospital and Insurer Stocks Are Down.
https://www.barrons.com/articles/medicaid-cuts-hospital-healthcare-stocks-741fedc1

✔ House Budget Tees Up Steep Medicaid Cuts and Big SALT Fight. Here's What's Next.
https://www.marketwatch.com/story/house-budget-tees-up-steep-medicaid-cuts-and-big-salt-fight-heres-whats-next-3a2f283a

✔ Republicans Are Starting a War Over Medicaid Cuts.
https://nymag.com/intelligencer/article/republicans-medicaid-cuts-budget.html

 

 

Governor Hochul Announces $850 Million Investment to Strengthen Developmental Disability Services in New York

 

February 2025 – Policy & Funding Update

 

Governor Kathy Hochul has unveiled an $850 million investment aimed at enhancing affordability for developmental disability service providers in New York. This initiative is designed to ensure higher wages for frontline workers, strengthen non-profit service providers, and reinforce New York’s commitment to being the most worker-friendly state in the nation.

 

Key Highlights of the Investment:

✔ Reimbursement Rate Adjustments for Non-Profit Providers – This funding will allow non-profit service providers to offer more competitive wages, helping to retain and attract skilled direct support workers (DSWs).
✔ Addressing Workforce Challenges – Higher reimbursement rates will improve recruitment and retention, reducing staff shortages and enhancing quality of care for individuals with intellectual and developmental disabilities (IDD).
✔ Long-Term Commitment to Workforce Development – This initiative builds on Governor Hochul’s broader workforce strategy, positioning New York as a leader in worker-friendly policies and sustainable disability support services.

 

What This Means for the Support Service Industry

This investment is a significant step toward improving financial stability for service providers while ensuring direct support workers receive fair compensation for their essential work. By strengthening workforce retention, service providers can continue delivering high-quality, person-centered care to individuals with IDD.

 

Next Steps:
Service providers should review reimbursement rate changes and assess how these adjustments will impact wage structures and service quality improvements. AMSI will continue to monitor developments and provide insights on how funding can be aligned with support service standards.

For more information, visit: https://www.governor.ny.gov/news/governor-hochuls-850-million-investment-makes-new-york-more-affordable-developmental

 

 

 

New York State Legislature Passes the Health Information Privacy Act (HIPA)

 

January 22, 2025 – Legislative Update

 

On January 22, the New York State Legislature passed Senate Bill S929, known as the New York Health Information Privacy Act (HIPA). This landmark bill is designed to strengthen protections for health information privacy, introducing new compliance requirements for businesses, service providers, and organizations handling sensitive health-related data.

The bill will now move to the New York Governor for signature. If enacted, HIPA will bring significant changes to how health data is collected, stored, and shared, aligning with broader national and global privacy frameworks.

 

Why This Matters:

➢ Enhanced Privacy Protections – Stricter regulations on how organizations manage personal health information.
➢ Compliance Requirements – Businesses and service providers will need to review and update their data policies.
➢ Impact on the Support Service Industry – Providers of services for individuals with disabilities and other vulnerable populations must prepare for potential policy shifts.

 

AMSI is monitoring the developments closely and will provide updates on how the New York Health Information Privacy Act may impact professionals and organizations in the support service industry.

 

Next Steps:

Stay informed and prepare for compliance adjustments once the bill is signed into law.

Full text of Senate Bill S929: https://legislation.nysenate.gov/pdf/bills/2025/S929

 

 

 

Recent Federal Policy Changes: Impact on Inclusion

 

January 21, 2025

 

Termination of Federal Diversity, Equity, and Inclusion (DEI) Programs
 

On January 21, 2025, President Trump issued an executive order terminating federal DEI programs. The order emphasizes evaluating individuals based on character rather than race, directing the Office of Management and Budget (OMB) and the Office of Personnel Management (OPM) to dismantle programs deemed discriminatory under DEI initiatives. While this reflects the ideal of a society where individuals are judged by the content of their character, it also raises critical questions about how federal laws and policies related to inclusion—particularly in support services for people with disabilities—are implemented with consistency, transparency, and measurable quality outcomes, including safety-related considerations.

Support service standards should ensure the effective implementation of federal inclusion laws, reinforcing inclusion principles in practice while maintaining full compliance with safety regulations. For further insights into how support service standards contribute to performance-based regulatory frameworks, visit our Standards & Resources section, particularly The Role of Support Service Standards in Meeting Performance-Based Regulations.

 

Restriction of Federal Recognition to Two Sexes
On the same day, another executive order titled "Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government" was signed. This executive order restricts federal recognition to only two sexes—male and female—based on reproductive anatomy and cuts funding for transgender-related services.

At AMSI, we remain committed to promoting equitable, inclusive, and person-centered standards that drive quality outcomes across all areas of support services. Our work prioritizes the rights, dignity, and well-being of every individual, including those with diverse gender identities, ensuring that all individuals are treated with respect and care.

 

 

IRS Increases ABLE Account Contribution Limits for 2025

 

January 11, 2025

 

The IRS has announced an increase in the annual contribution limit for ABLE (Achieving a Better Life Experience) accounts for 2025. This adjustment reflects ongoing efforts to provide greater financial opportunities for individuals with disabilities and their families.

 

What Are ABLE Accounts?

ABLE accounts are tax-advantaged savings accounts specifically designed for individuals with disabilities. They allow individuals to save money for disability-related expenses without jeopardizing eligibility for essential benefits like Medicaid.

 

Key Features of ABLE Accounts:

 

1. Eligibility: Individuals with a significant disability that began before age 26 are eligible to open an ABLE account. This eligibility remains even if the individual no longer receives Social Security benefits due to income thresholds.

2. Contribution Limits: The updated contribution limit for 2025 allows more savings flexibility. The funds in an ABLE account can cover a wide range of expenses, including education, healthcare, housing, and employment support.

3. Protection for Benefits: Deposits into an ABLE account are not counted toward the $2,000 asset limit for Medicaid, ensuring continued access to critical healthcare services.

 

This increase in contribution limits underscores the importance of financial inclusion for individuals with disabilities. For more information about ABLE accounts and the recent updates, visit the IRS ABLE account page or consult your financial advisor.

 

 

Think Differently Database Act Signed into Law

 

January 9, 2025

 

On January 4, 2025, President Biden signed into law the "Think Differently Database Act" (H.R. 670), marking a significant milestone for individuals with disabilities, their families, and caregivers. This legislation directs the Department of Health and Human Services (HHS) to create a centralized, user-friendly website that consolidates critical resources and support services for the disability community.

 

Key Highlights of the Think Differently Database Act:

 

1. Centralized Resource Database:

• The Act mandates HHS to develop an accessible platform that consolidates information on healthcare, education, housing, transportation, employment, and more.

2. Targeted Users:

• Designed for individuals with disabilities, caregivers, and families, the database simplifies the process of finding and utilizing essential services.

3. Accessibility Standards:

• The website will adhere to strict accessibility guidelines, ensuring it meets the diverse needs of users with disabilities. Features such as screen reader compatibility, multilingual support, and intuitive navigation will be prioritized.

 

Why This Matters:

 

The Think Differently Database Act addresses a critical gap in how individuals with disabilities access information about available programs and services. By consolidating fragmented resources into a single, user-friendly platform, this legislation empowers users to make informed decisions and enhances coordination among federal, state, and local service providers.

 

Challenges Ahead:

 

1. Effective Implementation:

• Developing a user-friendly and accessible platform that meets the needs of the disability community will require significant resources and collaboration.

2. Ongoing Updates:

• Ensuring the database remains current and relevant with the latest information on programs and services will be critical.

3. Promotion and Awareness:

• Outreach efforts are essential to inform the target audience about the database and its capabilities.

 

Stay tuned for more updates as this groundbreaking initiative progresses.

 

 

 

Congress Passes the Autism CARES Act of 2024: A Landmark Moment for Autism Support

 

January 2, 2025

 

On December 16, 2024, the U.S. House of Representatives passed the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2024, also known as H.R. 7213, with overwhelming bipartisan support. This legislation, now signed into law by President Biden, represents a significant step forward for autism-related initiatives in the United States.

 

Key Highlights of the Autism CARES Act of 2024:

 

1. Funding Allocation:

Approximately $1.95 billion is authorized over five years to support autism-focused programs across federal agencies, including the NIH, CDC, and HRSA.

 

2. Program Reauthorizations:

• The Developmental Disabilities Surveillance and Research Program (CDC) continues its critical work in monitoring and researching developmental disabilities, including autism spectrum disorder (ASD).
• The Autism Education, Early Detection, and Intervention Programs (HHS) will enhance early diagnosis and support strategies for individuals with autism.

• The Interagency Autism Coordinating Committee (IACC) ensures coordination of federal efforts concerning ASD.

 

3. New Reporting Requirements:
The Government Accountability Office (GAO) will now assess strategies to address the shortage of developmental-behavioral pediatricians, a critical area in autism care.

 

Legislative Journey:

 

• The Act passed the Senate on November 22, 2024.
• It received final approval from the House on December 16, 2024.
• President Joe Biden signed the Act into law on December 24, 2024, ensuring continued support for autism programs through 2029.

 

Why This Matters:

 

The Autism CARES Act of 2024 secures essential funding and enhances critical programs for individuals with autism and their families. By prioritizing research, early intervention, and professional training, the Act is a major step forward in building a more inclusive and supportive future for individuals with autism spectrum disorder across the U.S.

 

Learn More:

 

To explore the full details of this legislation, visit the official bill summary: https://www.congress.gov/bill/118th-congress/house-bill/7213

 

 

 

A New Chapter for Support Services: Shaping the 2028 SOC for a More Inclusive Future

 

December 19, 2024

 

In 2024, the U.S. government began revising the 2018 Standard Occupational Classification (SOC) system to establish the 2028 SOC, which will define the national landscape of services for the period 2028-2038. The SOC is more than just a framework—it’s a comprehensive list of services’ definitions that act as a legal foundation for recognizing services across all governmental, legislative, judicial, and business entities nationwide.

 

Inclusion for individuals with intellectual and developmental disabilities (IDD) means ensuring they receive equitable services alongside everyone else. The Executive Office of the President, Office of Management and Budget (OMB), maintains the SOC with broader, flexible definitions of services, designed to apply equitably to all populations, including those with IDD.

 

Support services for individuals with IDD are included within the SOC services’ definitions. Therefore, it is essential to develop support service standards aligned with the SOC framework to clarify and specify how the SOC-defined services address the needs of individuals with IDD and their direct support workers. The primary objective of the American Support Standards Institute (AMSI) initiative is to create these support service standards and support their development by others, ensuring that support services are practical, inclusive, and universally recognized.

 

To learn more about the SOC and its role in support services, visit the Standards & Resources section on the AMSI website. Within this section, clicking on Standard Occupational Classification (SOC) will provide access to the 2018 SOC Manual, a key reference for understanding service definitions and classifications.

 

As the year ends, we wish you happy holidays and a great New Year. Let’s work together to make a positive difference in support services! ✨

 

 

 

Transportation Secretary Announces Sweeping Protections for Airline Passengers with Disabilities

 

December 16, 2024

 

Newly Released Final Rule Marks the Expansion of Rights for Passengers with Disabilities 

 

Washington, D.C. — U.S. Transportation Secretary Pete Buttigieg today announced that the U.S. Department of Transportation (DOT) has issued new protections for people with disabilities in commercial air travel. These new rules will ensure that passengers with disabilities can fly safely and with dignity, addressing long-standing issues faced by individuals using mobility devices such as wheelchairs.

 

Earlier this year, DOT issued a record-breaking penalty against American Airlines for unsafe and undignified treatment of passengers with disabilities. This new rule aims to prevent such incidents from happening again by setting clear and comprehensive standards for airlines to follow when accommodating passengers with disabilities.

 

Key provisions of the rule include:

 

Safe and Dignified Assistance: Airlines must provide safe assistance to passengers with disabilities, ensuring that they are not at risk of bodily injury and that their autonomy and privacy are respected.

Enhanced Training: Mandatory hands-on training for airline employees and contractors who assist passengers with disabilities and handle their mobility devices, ensuring that they can provide competent assistance.

Prompt Assistance: Airlines must ensure prompt assistance during enplaning, deplaning, and connecting flights, and that personal wheelchairs are available to passengers when they deplane.

Accountability for Mishandled Devices: Airlines must return wheelchairs in the same condition they were received and address mishandling with a rebuttable presumption of violation, ensuring accountability.

Reimbursement and Support: The rule requires airlines to reimburse passengers for any extra costs incurred due to wheelchair mishandling and provide a loaner wheelchair when necessary.

 

The rule also mandates that airlines provide timely notifications to passengers regarding the status of their wheelchairs or scooters, including when these devices are delayed, damaged, or lost. Passengers will also be given the option to choose their preferred repair vendor and receive reimbursements for any necessary repairs.

 

These changes come after DOT's efforts to enhance accessibility for people with disabilities in the airline industry, including:

- The issuance of a landmark $50 million penalty against American Airlines in October 2024 for violations of disability rights in air travel.

- New regulations requiring accessible airline lavatories, finalized in July 2023.

- The establishment of the Airline Passengers with Disabilities Bill of Rights to help educate passengers about their rights.

 

As of January 16, 2025, airlines will be required to comply with these new rules. The final rule can be accessed here: https://www.transportation.gov/airconsumer/latest-news

 

For more information about disability rights during air travel, visit FlightRights.gov. Travelers can also file complaints about airline services through the Department of Transportation’s platform.

 

Support service standards can provide airline staff with clear guidance on best practices for safely assisting passengers with disabilities, including proper handling of mobility aids and respecting personal boundaries during assistance. For further insights into how support service standards contribute to performance-based regulatory frameworks, visit our Standards & Resources section, particularly The Role of Support Service Standards in Meeting Performance-Based Regulations.