Get Breaking Disability Policy Updates in Tennessee
On
Hide

Accessibility & Language Options

3.4.24 TDC Weekly Public Policy Update

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

Happy March, TDC Family!

As is the standard tradition for every General Assembly session, we are obligated to exclaim about the passage of each month into a new one, and note how quickly the previous month passed. Thus: it’s March already! Can you believe it? Me neither! And this month is a big one for our GRASSROOTS and the disability community. Our bills are gonna be hot out of the gate this week (and month), so we’ll need tons and tons of support to gather some momentum and clear these first hurdles. So check out this week’s updates on ways to plug in, and let’s do our GRASSROOTS thing! Get excited!

 

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
    • Here we go! This one is off the starting line with House Insurance Sub on Tuesday
      • Here is how I (very optimistically) hope to see this one go:
        • Pass House Insurance Sub and Full (Tuesday 3/5)
        • Go to and pass House Finance
        • BUT, we’ll be placed behind the budget because of our inevitable fiscal note
        • Pass Senate Commerce
        • Pass Senate Finance (thanks sponsor Sen. Watson!)
        • Pass both floors
        • Included in final General Assembly budget
      • Things to consider:
        • Going behind the budget isn’t a big deal – pretty much everything that beats the budget to the respective Finance Committees goes there as well
        • It’s a VGB – it makes too much sense to not exist in TN and I know that our legislators know that. It really was/is just about the funds to pay for it
        • We believe we have a legit source of funding for this bill in shared savings, and the bill is written as such
  • You can check out the legislator lineup for Insurance Sub here, just in case you wanted to drop them a note before Tuesday next week and let them know you like this bill
  • Also, tune in here to watch – Robby will be there to testify!
  • Next up:
  • 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
  • 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. 
    • This one is right there too, but this guy is boldly being heard in TWO committees next week
      • It’ll be with its buddy “TennCare for Working Adults” in Insurance Sub, but it’s also calendared in the forbidding Senate Health and Welfare Committee
        • Forbidding, yes, but Senate Health is not without a few friends of the disability community
    • But, I’m feeling good about this one
      • DDH was a HUGE help for this – a lot of people spoke glowing praise for the bill on Wednesday
        • Plus, it shouldn’t cost any money
        • Plus, the wheelchair manufacturers and suppliers like it
        • Plus, TennCare doesn’t seem to care too much
        • Plus, it’s a VGB, if I do say so myself
      • But, like its House Insurance sub companion, we’ll certainly need help getting to the finish line
        • So, if you’re already dropping a note to Insurance sub, you could mention this guy as well
        • Samesies with Senate Health
    • 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
    • If you recall, this puppy passed both the House and Senate floor last week
      • Now it awaits the Gov’s signature 
    • Next up:
  • 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
    • This VGB and all-around Big Deal passed House Health full this week
      • The only comments of note from committee-members were in favor of the bill or conveying the support of stakeholder groups
        • So it’s on to Gov Ops next on the House side 
    • Not without some intrigue, this bill was rolled in Senate Gov Ops on Wednesday
      • But only one week
        • Which was sort of a bummer for the DDH early birds who wanted to watch
    • Nothing to worry about here – I haven’t seen, nor do I expect to see, any substantial opposition to this one in the GA
    • Next up:
  • Super-Secret 6th TDC Priority Bill of 2024 – this bill is a super-secret until I see it amended, posted to the GA website and smiles from everybody
    • Nope, not quite yet on this one – still waiting on legal, then on our lovely sponsors to get it on the calendar
      • Hopefully next week!!!!!
    • Next up:
      • The sponsors’ desk and the pages of this little dispatch

 

Other stuff:

  • HB2404/SB2349 and HB2166/SB1747 – Facilities for Kids in State Custody – these bills redefine which children in state custody are eligible for detention in a juvenile justice facility, and creates a mechanism by which a judge can render them detained based on “risk of harm”
    • HB2404, the one that makes kids who have an “unmet” mental health need through “no fault” of their parents eligible for state custody and/or detention, passed Children and Family Affairs sub this last week
    • So this is a big win for the disability and mental health communities 
      • “Unmet need” was a copout to avoid actually making the investments necessary to provide services to meet that need
    • Rep. Slater, to his credit, said he heard from numerous child welfare and juvenile justice advocates on their concerns with the bill, and changed his mind
      • This is what I like to see out of our elected officials – he listened, actually heard concerns and considered them thoroughly, and then took action based on this new information
    • HB2166/SB1747 remains, but the line between the state failing to care for kids with disabilities and/or mental health needs and the ability to lock them away for no crime at all has been substantially disrupted
      • This one was rolled in Senate Judiciary two weeks ago, hopefully while the sponsors reconsider?
        • And again, to their credit, I know they’ve heard concerns, so it seems like they are doing the right thing in more thoroughly examining the impacts of this bill
    • Next up:
  • HB2468/SB2787 – The Voucher Bill – this bill would create a statewide private school voucher program 
    • And also: HB1183/SB503 – aka the House Version!
      • That’s right! TWO voucher bills
        • Because the House and Senate are already failing to see eye to eye on this one
    • The House Version is more “omnibus” that it is “voucher”
      • It’s got a bunch of (expensive) incentives to try to win over opponents of a universal school voucher program
        • Now, I haven’t read the whole thing, but I hear the incentives add teachers to the state employee health insurance plan, sets aside per-pupil funds for school infrastructure projects and rolls back some standardized testing requirements
          • Will those things be enough to win over skeptics? 
            • I’m not so sure
    • That said, the House Version passed K-12 sub last week, overcoming a good 2+ hours of interrogation of the bill
      • Members from both sides of the aisle were unhappy to be voting on a bill that they received less than 24 hours in advance
    • This one has a long way to go, and is bound to change in some substantial (and in some cases minor) ways
      • And then the House and Senate have to make friends and make their bills look alike (if they indeed pass)
    • From the disability perspective, here is what I say (my talking points):
      • the right to special education supports and services is substantially diminished in a private school and those supports and services that are offered are likely to be more generic and lesser in quality
      • civil rights protections and due process rights are not extended to students with disabilities enrolled in private schools
      • the unrestrained proliferation of schools will stretch an already thin and finite cadre of special education teachers and specialists even thinner
        • And these things can have a negative impact on the education of kids with disabilities
    • I believe our place in this voucher conversation is when we’re invited in – there are a lot of moving parts, interested parties and money at stake here
      • I’ll expand on this further in a later update, but I urge our community to advocate in a tempered, cautious manner here
        • This is a BIG fight, with lots of national eyes and dollars on it, and we need to be sure that our place in the fight is in our lane and is in the best interest of our community in the long term
        • That is not an argument to stay out of the fight – I believe the talking points above are true and concerning, and I have other, broader concerns too
        • But if we want to impact the fight, we need to be aligned, narrow and outcome-oriented, and speak up at the right time
          • And I don’t think that the fight is quite there yet
            • But I’ll let you know when I think it is
    • Next up:
  • Other other stuff:

 

Federal Update

  • Last month, in a party-line vote, the US House passed the “Protecting Health Care for All Patients Act of 2023”, which banned the use of QALY’s when determining a patient’s course of care
    • QALY’s are “Quality Adjusted Life Years”, and represents an economic evaluation of the care options available to folks
      • These metrics are used to determine if, given the health status of a given patient, the cost of a certain medication, procedure or treatment is “worth it”
        • And the disability community has been highly critical of them for years
    • Proponents of QALY’s say they’re necessary to limit health care spending
      • And reduce “over-prescribing” and excessive intervention in order to charge insurance for them
        • An example that proponents might use is ordering an unrelated surgery (lap-band, etc) for somebody with advanced-stage cancer
    • From the disability perspective, the practice necessitates defining folks by their health status, and choosing cost-effectiveness over benefit to the patient when making health care choices
      • And we’d like our health care choices, regardless of disability, to be a choice between provider and patient
    • It’s unlikely this could pass the Senate, given the partisan nature of this vote
      • But it’s worth keeping an eye on – QALY’s have been the target of opposition and advocacy for a while, at some point that might just break through

 

GRASSROOTS Update

  • Take a breather (but just a short one), GRASSROOTS brigade – you all did AWESOME at DDH
    • We had over 300+ folks show up this year, which, without evidence to the contrary, HAS to be a record
      • And it was fantastic to meet so many of you on Tuesday and Wednesday – the passion of this community and the drive to make the world a better place is just awe-inspiring
    • But your break cannot be long – we’ve got bills up in committee this week, they’re already trying to call game down here at the capitol, and we’ve got a world to make better
      • And we’ve got a bit of opposition bubbling on some of our work
        • So in the meantime, talk to anybody and everybody about the importance of R2R2 and Pathways to TennCare this week
          • Including your legislators if you can
    • And stay tuned, because even though the GA wants to get out of here, we’ve got to make them stay and pass our bills!

 

Media Highlights

  • NY Times – as we try in Tennessee to establish a paid family caregiving program, other states, like Indiana, are dramatically rolling back their own programs, citing the end of pandemic-era federal funding. It’s a good read, and emblematic of the perpetually tenuous nature of state support, and a good reminder that the fight is never over. 
  • The Tennessean – details of the new proposed East Bank development, in the area surrounding the old/new Titans stadium, have been released. Of note to our community is a promise for more affordable housing to be included in the development. The proposal is for 695 affordable. Quick reminder that, according to our own Tennessee Disability Scorecard, the state is short 14,165 affordable AND accessible housing units statewide. This proposal represents, if they are indeed accessible units, only a teeny tiny dent when we have a huge, once-in-a-generation opportunity. 
  • Disability Scoop – as we approach Spring Break season, accessibleGO, a new startup, wants to make planning and travel for folks with disabilities and their families just a tad easier. Thinking about a warm spot? Maybe a cozy, snowy chalet? I say go for it, you all and the GRASSROOTS deserve it.

 

Sorry I’m late, dear reader, I spent Friday plus the weekend moving with my family (what up, Goodlettsville?) and just ran out of time. Likewise, I apologize for the relative lack of GIF-yness. But I also want to take a moment to thank you all with everything I’ve got for last week – it was soooo great to talk to everybody at Fat Bottom on Tuesday night, and even better to see Cordell Hall absolutely swarming with disability advocates on the big day. I always feel so renewed after DDH, mostly because our community is so, so awesome. So I hope you feel renewed too, and y’all are willing to stick with me over the next 5 weeks or so, and we can make Tennessee a better place for everybody to live. Much love, TDC family, much love. 

 

Two updates, since it’s Monday and I know some new stuff:

  • We’re going to roll R2R2 to next week, because the insurance companies are having some heartburn over paying for it, which is a bummer
  • Pathways to TennCare got its fiscal note (the estimate of how much it costs), and it is HUGE (and wrong), so we’re going to have to work to get that down (and accurate)