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2.12.24 TDC Weekly Public Policy Update

The Tennessee State Capitol building lit up at night and behind a set of ascending stairs

And a happy (Monday) to you, dear friends!

So sorry to keep you waiting for this little dispatch – our intrepid Communications Director Tom and I spent Friday in beautiful Chattanooga working with some GRASSROOTS to get some media buzz around TennCare for Working Adults. However, excuses aside, I’ve got some stuff for you below, so I’ll get it served up hot and fast:

 

2024 TDC Priority Bills

  • TennCare for Working Adults – this bill would create an option for working adults with disabilities to pay a premium to access TennCare services (like HCBS), while having income and assets above the current Medicaid eligibility threshold\
    • All good things so far here – it hasn’t hit the committee (or subcommittee) calendars yet though
      • Next up in our journey is working out the fiscal note
        • Quick reminder: the fiscal note is how much they think a given bill would cost if it passes 
      • Our fiscal note will be in the millions of dollars per year range, which is a pretty big fiscal note 
        • So it behooves us to run our own numbers, both so the final fiscal note is realistic, and is as low as possible
        • And we’ve got some stuff going for us:
          • Participants in programs like this are cheaper to the state than if they were in a standard Medicaid program
          • ~80% of enrollees were already in a Medicaid program
          • Higher incomes = more spending = more state revenue
          • Participants pay a premium, so that’s 5% of their income every month to the state
          • Plus, this is the right thing to do, which doesn’t help our fiscal note, but is always worth noting
        • And, if you’ll recall, we think we can tap into TennCare’s “shared savings” to pay for this one, which means it would be at no additional cost to the state
    • Anyway, enough dollars and cents, once the fiscal note is back, we’ll likely get this puppy on the calendar
      • And we’ll need some GRASSROOTS for that, so keep yourselves sharp!
    • Next up:
      • The fiscal note battle
  • Paid Family Caregiving Resolution – this resolution would urge the state (and TennCare) to work with community stakeholders in developing a comprehensive statewide paid family caregiving policy and program
    • I’m hoping to see this one on the calendar for next week, but that’s ultimately up to our lovely sponsor, Senator Ken Yager
    • But once it hits the calendar, it’ll be important that those sitting in committees that might see this one come through (cough Senate Health cough) hear from the GRASSROOTS about how necessary this is
      • I’ll put together something to make that as easy as possible for you, dear reader
    • Of interesting note, Representative Antonio Parkinson and Senator Richard Briggs are running a bill to permit family members to be paid as caregivers regardless of where they live
      • And that’s ultimately what we want!
        • So our GRASSROOTS should also think about supporting this one, because if they’ve built us a ladder, we ought to take it, right?
    • Next up:
  • Right to Repair pt. 2 – this bill would require suppliers of power and manual wheelchairs to offer twice-annual preventative maintenance and to repair malfunctions, and creates a pathway for independent repair persons to do some types of repair. 
    • Only minor, behind the scenes progress on this guy this week 
      • Remember, we’re only submitted as a caption bill thus far
      • BUT, we got a copy back from legal this week, it looks good, but they have questions
        • And we want to answer those questions so that our bill does what is intended to do, and doesn’t do unintended bad stuff
    • Hopefully, TDC, our partners and legal can be on the same page by the beginning of next week, so we can get this train rollin’
      • And next week would be great, because DDH – February 28th – is comin’ on fast and hot
    • I mention DDH, because this bill will need all the GRASSROOTS it can get, and what better time than when 200+ Tennesseans with disabilities and their families come to Cordell Hull to talk priorities?
      • Including fixing wheelchairs in the quickest and most efficient way possible!
    • Next up:
  • TCA Placard Cleanup – this bill would update language related to disability placards found in the Tennessee Code that refers to people who use wheelchairs as “confined to a wheelchair”; this bill would modernize that language
  • Tennessee Disability and Aging Act – this bill establishes a new Department of Disability and Aging to serve the state’s population of Tennesseans living with disabilities
    • No action yet, but that’s 100% cool, neat, ok, rizz and expected
    • We’re hoping to get our hands on a redline copy, which would make things a bit easier
      • (redline copies show exactly what the changes are to the code so that one doesn’t have to go back and forth to figure out what is new in a bill)
    • Remember, VVGB here, so it’s important we get this thing right
      • I don’t anticipate a ton of opposition to this bill, but if the devil remains causing a ruckus in the details, we just might run into some “no” votes
        • So as hard as it is (I see you champing at the bit), we’ll take our time and make sure to get this right
    • Next up:
      • Details, details, details

 

Other stuff:

  • HB2468/SB2787 – The Voucher Bill – this bill would create a statewide private school voucher program 
    • Whelp, I was going to wait until we saw the details of the much-anticipated, much-talked about primary gubernatorial legislative initiative this year – a huge expansion of the state’s private school voucher program
      • But I worry that if we wait too long to let the GRASSROOTS know, we’ll find ourselves trying to catch a speeding train
      • Currently, private school vouchers (known as ESA’s) are only available to families earning under twice the free lunch threshold ($78k for a family of four) AND living in Davidson, Shelby or Hamilton Counties (or in the Achievement School District)
    • So what does the bill do? 
    • But if the bill is anything like the accidentally filed one, I’ve got some concerns:
      • Large and bolded caveat – public schools have failed more than a few children with disabilities and their families – I wouldn’t begrudge a person in the slightest if they pursued a different option because of it
      • Here are my concerns:
        • Private schools do not have to abide by IDEA in the way that public schools do, meaning students have a drastically diminished right to SPED services and protections
        • The types of services that are offered in private school are very often generic in nature, and very limited in scope
          • They more closely resemble common accommodations, like extra time on assignments or help with taking notes, rather than services like speech, OT or intensive academic interventions
          • And it is very unlikely that they are delivered by a trained SPED teacher or licensed professional 
        • Private schools do not have to accept or keep students with disabilities
          • Unlike public schools, private schools are not required to serve every student, regardless of need, and they operate as such
        • The bill permits unaccredited schools to set up shop in TN
          • And fly-by-night pop up schools are among the worst private schools – it’s a race to the bottom to be the cheapest available school, which comes with the cheapest available education – think “the Amazon effect”
        • And unrestrained proliferation of new schools spreads finite, already inadequate resources even thinner 
        • And there are other concerns that are only disability-adjacent – state budget, local school finances, quality of public school, who uses an ESA (and do they actually need it?), etc.
    • Bottom line here (at this point): this proposal is controversial, with substantial risks to communities like ours – this is an issue that should be debated in public and debated extensively
      • While the use of a caption can have the benefit of the doubt for now, should it prove to be a sidestep of public debate and accountability, that would be a problem 
    • Next up:
      • The light of day, I hope
  • HB2261/SB2117 – “Homes for the Aged” Licensure – this bill reclassifies homes with 3 or fewer unrelated persons as a “tier 1 home”, creating an easier pathway to state licensure to serve aging persons in community-based residences
    • Got another VGB here – TDC and much of the aging community has been begging the state to make it easier to establish small, community-based homes for aging folks to live
      • After some fits and starts, this looks like one that can finally get across the finish line
    • This bill (and stay with me for a second) lowers the requirements for obtaining a license to house 3 unrelated persons in independent or semi-independent living circumstances
      • By lower, I mean has a different set of requirements that are easier to meet
        • Think, semi-regular check-ins for cleanliness, rather than full inspections for modern sprinklers – it’s easier to keep a clean fridge than pay for industrial fire sprinklers
    • This could lead to an increased number of small, community-based homes for aging folks to pick from, which is a good thing!
      • And allows for greater choice: to choose familiar neighborhoods, be closer to family, to age in place and/or be near important community resources
    • A Very Good Bill, folks, let’s make sure to put our GRASSROOTS in support when the time comes
    • Next up:
      • Committee calendars 

 

 

Federal Update

  • So there was some big time controversy about a proposed change to how the census counts Americans with disabilities in the past few months
    • Traditionally, the census asks participants if they identify as having one of 6 disability categories
      • The proposed change would ask respondents to “rate” how disabled they are
        • Like, rate “how difficult” a task is for somebody – “cannot do at all” or “a lot of difficulty”
    • Estimates said that it would have reduced the country’s disability count by 40%
      • Which presents some issues, like how much money the country sets aside for things like SSI/SSDI, who qualifies for protection under the ADA, etc.
    • Well, sounds like the Census folks heard all that controversy, because last week they walked back the proposed change
      • The phrasing of the response seems to leave open the possibility that they’ll continue to reconsider the question beyond the 2025 census
        • But that’s a fight for another day

 

GRASSROOTS UPDATE

 

Media Highlights

  • The Atlantic – this one came out this summer, but I thought it would be something you all might be interested in. The author tells the story of reconnecting her sister after 40 years, after she was sent to Willowbrook State School at age 2. It’s a tough read (and a long one), but a good reminder about why we do what we do – see the follow up piece here. 
  • Disability Scoop – Teddy Rosenbluth of Raleigh News and Observer highlights the dearth of options available to provide services to people with complex behavior needs, an issue we know intimately in Tennessee. 
  • The Tennessean – because it already seems like one of those weeks, here are a bunch of pictures of puppies who got adopted at the Music City Puppy Bowl at the Nashville Zoo. Enjoy.

 

Sorry again for my tardiness – when Chattanooga calls, you can’t put that city on hold. Some things are starting to move and I’m getting pumped to see the GRASSROOTS crew really get a chance to fire up those engines. And I’m super pumped to see everybody at DDH – we’ve got a ton of great stuff planned and I personally plan to put all of you to work passing legislation that makes our state a better place to live. 

And, because I was late this week (or last week, whatever), I’m gonna drop a hint here that we will be adding a new and important bill to our TDC priority bill list that I think you might be a tad pumped about. Hang in there till next week when I hope it’s official! Until then, stay pumped!