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4.12.24 TDC Weekly Public Policy Update

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

Well, the end is in sight. I hear the Senate will submit their budget amendment next Wednesday and then, per usual, wait on the House for theirs. There are a couple big things on the table (including some of our things) that will likely see some resolution by the end of the week (maybe beginning of the following week). It’s not over yet, dear reader, so stay tuned and stay engaged. And to my GRASSROOTS friends, I haven’t forgotten about you, I’ve got some work for you this week to see if we can put a bow on our tough session. Hang tight for just a tad longer, TDC family, we’re almost there. 

 

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
    • We’re at the final, and, by far, highest hurdle for this bill now: finance (in both chambers)
      • That’s because our bill costs money, and a lot of it (according to fiscal review)
    • I made my case last week for why our fiscal note should be lower, and I made the case to our sponsors, the budget folks and fiscal review this week
    • This is where we’re gonna need the GRASSROOTS though – our legislators need to feel warm and fuzzy about this bill
    • Passage of and funding for this bill would be a BIG deal for the disability community
      • It does the things that it does – folks that are able can go to work, earn a living and keep their care
        • This is the important part
      • But it’s also a step toward *whispers* expansion
        • (but don’t tell anybody that)
      • It’s also a big spend, demonstrating that the GA thinks our community is worthy of large investments
      • And finally, it demonstrates that we, as a community, can and do make things move at Cordell Hull, and that when the TDC Family brings you something, it is worth your time and effort as a legislator
    • 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
    • Still waiting for a House floor date, but not to worry
      • I’m guessing early next week
        • They’ll start the Finance Dance soon enough and have 1 million floor sessions to fit it in
    • Once it passes the floor, we can move on to the big one
      • Pushing TennCare to enact the General Assembly’s resolution themselves
      • Or get to the hard work of legislating it into reality ourselves
    • Next up:
  • Right to Repair pt. 2 – this bill would require suppliers of power and manual wheelchairs to offer annual preventative maintenance, and creates a pathway for independent repair persons to do some types of simple, non-clinical repairs. 
    • We passed in the Senate this last week!
      • Easy peasy – 29 yays to 0 nays
    • We’re still waiting on the House side of things, but I’d expect it to be calendared early next week
    • 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
  • HB2497/SB2146 – IDD Residential Licensure Exemptions – this bill would establish a carve-out to the licensure requirements for residential facilities that serve individuals with intellectual and developmental disabilities, permitting the construction and operation of large scale, segregated and congregate facilities by two companies in the state
    • We’re still waiting to see this one on the calendar for the House finance committee
      • Like the others though, it’s now or never, so I’d expect to see it some time next week
    • It is on the calendar for Senate Finance next week on Monday though
      • And finance is the last step for this one
        • There is a fiscal note, so in order to enact the bill, Finance needs to appropriate money in its final budget amendment
    • Should the bill pass through finance on both sides, it is fair to reason that the final GA budget amendment includes the bill
    • Next up:

Other stuff

  • HB2297/SB2864 – Slots for KB Part B – this bill would require DIDD to add an additional 1,000 Katie Beckett Part B slots to serve eligible children with disabilities 
  • HB1202/SB1325 – Gun Carry in Schools – this bill would allow some school staff to carry guns in schools
    • One more stop here – House floor
    • And if you thought the Senate protests were wild, wait till this hits the House floor
      • Starting at 5pm too? When folks are off work?
    • Again, this is a horrible idea
      • And for as bad as the idea that teachers and staff should carry concealed weapons around for…. reasons, the part that drives me up the wall is the fact that information about who is carrying a gun in a building full of children is CONFIDENTIAL!
      • AKA, parents are not allowed to know which teachers are packin’
    • Should this bill pass, as a parent, I am VERY concerned about sending my child to a school where teachers carry guns
    • Next up:
  • HB1640/SB1769 – Jillian’s Law – this bill would allow for the involuntary commitment of people with IDD if found incompetent to stand trial for certain crimes
    • I’ve avoided this one to some extent in this little digest, because it’s a difficult bill
    • There are problems with the ability to implement this bill, however:
      • First, there are no beds for people with ID found incompetent to stand trial available in the state of TN
        • Harold Jordan has 8, which are nearly permanently filled
      • Second, there are no adequate community-based (out-patient in the bill) treatment options for people in this situation
        • See: ECF Groups 7 and 8
        • The bill requires involuntary commitment and release only upon “restoration of competency” AND “Mandatory Outpatient Treatment” (MOT) 
          • For the rest of their lives
      • Third, there is no money for any of that – commitment or a lifetime of MOT and surveillance 
        • And the fiscal note allocates just $2M
      • Fourth, because there is no adequate community-based treatment options, any incarceration into an institution of a person with a disability could be an Olmstead violation
        • And this bill specifically applies to people with disabilities
      • Fifth, eligibility to be committed via this law includes all felonies and misdemeanor A’s
        • Not just violent ones
        • This includes things like: sleeping under a bridge, evading arrest w/out use of a vehicle, theft of less than $1000, simple possession of marijuana or possession of drug paraphernalia
        • That could scoop up a whole lotta folks with ID
      • Sixth, the bill establishes a rebuttable presumption of danger to self and community
        • Meaning that a person with ID, who was just found incompetent to stand trial, would have to prove that they WERE NOT a threat of violence
        • I don’t know how one would prove that, let alone somebody just deemed unable to assist in their legal defense 
    • So, all that is to say, this is a problematic bill, and one that will surely face legal challenges for its constitutionality, as well as the effects of its implementation
      • It’ll pass though, I’m pretty sure
        • Which is bad
      • But again, I’d expect some fireworks in the House
    • Next up:

 

Federal Update

  • President Biden has renewed his calls for federal investments in Home- and Community-Based Services (HCBS)
    • As you might remember, some big ol’ investments and programs were laid out in the American Jobs Plan/Better Care Better Jobs plan
      • But, most got stripped out as the bill got skinnier and cheaper
        • As disability supports and services tend to be when the belt gets tightened
    • Specifically, his remarks highlighted the 700k person waiting list nationwide for HCBS
      • And asks for Congress to appropriate funds to reduce the list, including pay raises and benefits for DSPs and home health workers
    • He says he wants to pay for it with taxes raised through the expiration of some of the provisions in former President Trump’s Tax Cuts and Jobs Act
      • But we’ll see – we’ve seen promises before that haven’t been realized
      • And he’s gotta go through Congress, which seems to be in an intractable game of who can more closely resemble a petty middle schooler
      • And, we can barely fund the bare minimum to keep the Government open, let alone enact new spending
      • And, there are legitimate concerns about increased federal spending in the current economic cycle 
        • Amongst other spending and deficit concerns
      • And, it’s an election year, and I’d guess that no Republican is much interested in throwing Biden a win that he can tout to potential supporters
      • And even then, those funds would likely be funneled through the state of Tennessee (cough TennCare), which notably dislikes spending money
    • All that is to say, it represents welcome investment, it is desperately needed and would benefit a lot of people


GRASSROOTS Update

  • My GRASSROOTS friends, this might be my last ask of you during the 2024 Tennessee General Assembly session
    • *tear*
      • But don’t hold me to that if it isn’t
    • We’ve got one big push here at the end to get the members to allocate funding for our Pathways to TennCare bill in their final GA budget amendment
      • So please, if you have time, consider sending your legislators and the Gov a message asking them to find us some funding
    • You could also reach out to our sponsors, Rep Tim Hicks and Sen Bo Watson, and let them know that they are doing a good thing
      • Honestly, this goes a long way – they appreciate when they are noticed for being one of the good guys and gals
      • Here are their emails:
    • And the more they hear how wonderful they are (and they are), the more likely they are to be wonderful to us down the line
      • Which always helps
    • If this is my last ask of you, my GRASSROOTS warriors, let me say that you all are the ones that get things done
      • Nothing happens at Cordell Hull without your passion, your energy, your say-so and your support

 

Media Highlights

  • NYTimes – ah, the ol’ Medicaid clawback. We in the disability community know it too well, but I think it’s important that people realize just how restrictive and revanchist the Medicaid program is. Need some help? You must suffer. I also love the comment about hardship waivers that describe the process as “difficult and futile”. TennCare should print t-shirts with that phrase on it. 
  • WJHL – here I am talking about the lack of oversight and accountability that comes from the state of Tennessee’s preferred service-delivery model of outsourcing key government responsibilities – like keeping kids in state custody safe – to 3rd party (and sometimes 4th party) vendors. The context of this story is just one example (cough Consumer Direct TN cough).
  • Tennessean – what?! Nobody told me the Nashville Zoo was getting tiger cubs? That’s adorable. I love this article because I had all sorts of questions about the cubs, and it just goes ahead and answers them! When can I see them? 9-12. Do they know how to swim? Yes! Will they remain cute little tiger cubs forever and can you hold and snuggle them? No, unfortunately. 

 

We’ve almost made it, TDC Family. Of course, I’ll recap the whole thing after the dust settles, but now is a good enough time to begin to take stock of our work at the General Assembly this year. I, myself, try to take a minute before diving in, just so as to try to see things more clearly, but of course, that’s hard. But thinking about our successes and failures and impact helps guide our future work, of which there is much. Stay with me for just a week or so longer, TDC Family, then we can take a deep breath.