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Policy Round-Up: Public Right-Of-Way, AI, Medicaid Renewals, and More

September 19, 2024
Elliot Kennedy, Deputy Administrator for Policy and Evaluation

In this Policy Round-Up:

  • Implementing the Access Board’s Public Right-Of-Way Accessibility Guidelines
    • Input Needed: DOT’s Proposed Rule Adopting Guidelines
    • GSA Issues Final Rule Adopting Guidelines
  • Input Needed: Access Board Seeking Feedback on the Risks and Benefits of AI (Comments due 10/31)
  • CMS Renewals Guidance
    • Promoting Continuity of Coverage for Individuals Receiving Medicaid HCBS (Comments due 9/22)
    • Updated and New CMS Materials on Medicaid and CHIP renewals
  • Census Bureau Meeting with Stakeholders on Disability Data Needs
  • FCC Invites Membership Applications for Sixth Term of the Disability Advisory Committee
  • OCR Releases Section-By-Section Fact Sheet on New Section 504 Regulations
  • CMS Training Series on HCBS Provisions in Medicaid Access Rule
  • Social Security Administration Announces New Efforts To Simplify SSI Applications
  • Expanding Access To Housing
    • Mainstream Voucher Policy Changes To Support Community Living for People With Disabilities
    • HUD Awards Nearly $140 Million To Expand Affordable Housing for People With Disabilities
    • HUD-VA Supportive Housing Policy Changes
  • Input Needed: CMS Resources for States on Medicaid and CHIP Mental Health Parity and Addiction Equity Act Final Rule Compliance (Comments due 10/29)
  • Department of Labor Releases Toolkit With Resources To Help Employers Recruit, Hire, Retain, and Advance Workers With Disabilities

Implementing the Access Board’s Public Right-Of-Way Accessibility Guidelines

In August 2023, the Access Board published new guidelines that address access to pedestrian facilities in the public right-of-way, such as sidewalks and streets, crosswalks, curb ramps, pedestrian signals, on-street parking, and other components. These guidelines also address shared use paths, which are designed primarily for use by bicyclists and pedestrians for transportation and recreation purposes. The guidelines inform federal, state, and local government agencies on how to make their pedestrian facilities accessible to people with disabilities.

Input Needed: DOT’s Proposed Rule Adopting Guidelines

The U.S. Department of Transportation (DOT) seeks comments on a proposed rule adopting the Access Board’s public right-of-way accessibility guidelines. The proposed rule would apply the guidelines to new construction and alterations of transit stops, making them more accessible for people with disabilities.

Comments can be submitted online or by mail until September 23.

GSA Issues Final Rule Adopting Guidelines

The General Services Administration (GSA) recently published a final rule adopting the public right-of-way accessibility guidelines issued by the Access Board. Under the rule, which went into effect on September 3, GSA’s federal new construction, alteration, and renovation projects will have to comply with the Access Board’s guidelines.

For new and modified facilities this will mean ensuring accessibility, including by addressing:

  • Travel distances from on-street parking to building entrances, making it easier to access government buildings while increasing efficiency for everyone who uses street parking.
  • Sidewalk sizes and widths, making it easier for people to pass on the sidewalk, reducing accidental collisions, and better accommodating mobility aids such as walkers, rollators, and both manual and electric wheelchairs.
  • Ground slope at passenger loading zones to prevent them from being too steep for people with mobility disabilities to climb.
  • Audio and tactile warning systems, including audio signal warnings, truncated domes, and detectable warning pavers, to increase safety by alerting pedestrians to an imminent street crossing and to when they have the right-of-way to cross the street.

Input Needed: Access Board Seeking Feedback on the Risks and Benefits of AI

In August, the Access Board, held public hearings on artificial intelligence (AI) with members of the disability community and others. This series stems from the Board’s Memorandum of Understanding with the American Association of People with Disabilities (AAPD) and the Center for Democracy & Technology (CDT).

The hearings supported the Access Board’s work in fulfilling the executive order on the use of artificial intelligence to engage with disability community members and AI practitioners to learn about the risks and benefits of AI, and to issue recommendations and technical assistance to promote equity, accessibility, and inclusion for all.

In addition to those hearings, the Access Board is accepting written comments of 300 words or less until October 31.

Email comments to events@access-board.gov. Include “AI Written Comment” in the subject line. Include your name, organization if applicable, and specific AI topic with your comment.

CMS Renewals Guidance: Promoting Continuity of Coverage for Individuals Receiving Medicaid HCBS

The Centers for Medicare & Medicaid Services (CMS) recently released guidance to help people who are eligible for home and community-based services (HCBS) through Medicaid keep their coverage. HCBS are critical for many people with disabilities and older adults, allowing them to receive services and supports in their home or the community rather than an institution. Losing access to HCBS can have negative effects on people’s health or result in institutionalization.

The guidance outlines federal requirements, as well as flexibilities and strategies, that help to ensure people who are eligible for HCBS successfully renew their Medicaid coverage so they can continue receiving the critical services they need. It emphasizes that as states work to renew people’s Medicaid coverage, they must ensure that renewal practices and systems are accessible for people with disabilities, including by providing support, information, communication technology, and auxiliary aids and services at no cost to the individual.

It also highlights strategies that states can implement to help people keep their Medicaid coverage, including disregarding income, assets, or both at application and renewal for individuals receiving HCBS; partnering with local agencies to enhance “No Wrong Door” systems to assist individuals with maintaining Medicaid enrollment; and other strategies.

CMS Renewals Guidance: Updated and New CMS Materials on Medicaid and CHIP renewals

As we’ve discussed before, with the end of the COVID-19 public health emergency, all states are resuming their regular processes for renewing individuals’ Medicaid coverage. CMS has updated its Medicaid and CHIP Renewals Outreach and Educational Resources webpage with new and updated materials that community organizations, health providers, and other partners can use to help educate people in their communities about regular Medicaid and Children’s Health Insurance Program (CHIP) renewals, including updated training slides, a new Medicaid Basics Handout for Partners, and more.

Census Bureau Meeting with Stakeholders on Disability Data Needs

The Census Bureau will meet with disability community stakeholders on September 30 in the Washington D.C. metro area to better understand challenges in the availability of, and access to, disability data.

This meeting comes in response to feedback the Census Bureau received from the disability community on proposed changes to disability questions in the American Community Survey (ACS) and Puerto Rico Community Survey (PRCS). The ACS and PRCS are annual surveys conducted by the Census Bureau to provide current data on demographics and population changes happening around the country.

Commentors had raised concerns about the impact of the changes on disability data, which could potentially impact funding and services. The Census Bureau decided to retain the current disability questions and work with stakeholders and the public to determine what revisions, if any, are necessary.

The meeting will be livestreamed on September 30 from 10:45 a.m.-5:00 p.m. ET on Census Live.

FCC Invites Membership Applications for Sixth Term of the Disability Advisory Committee

The Federal Communications Commission (FCC) is seeking applications for the Disability Advisory Committee, which makes recommendations to the FCC regarding disability issues. Those issues may include:

  • Advanced communications services and equipment
  • Access to 911
  • Hearing aid compatibility
  • The National Deaf-Blind Equipment Distribution Program
  • Telecommunications relay services
  • Telecommunications services and equipment
  • Access to televised emergency information
  • Accessible user interfaces on video programming apparatus and access to program guides and menus provided by navigation devices
  • Audio description
  • Closed captioning

Applications can be submitted online or by mail until September 30.

OCR Releases Section-By-Section Fact Sheet on New Section 504 Regulations

The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has released a section-by-section fact sheet to provide a more detailed overview of a new rule it finalized in May that updates, clarifies, and strengthens HHS’ implementing regulation for Section 504 of the Rehabilitation Act of 1973.

The rule covers many critical issues including discrimination on the basis of disability in accessing medical care; value assessment methods used to determine whether a particular intervention will be provided; nondiscrimination in child welfare programs; information and communication technology, including web and mobile accessibility; accessible medical diagnostic equipment; and providing services in the most integrated setting appropriate to the person’s needs. This new fact sheet breaks each section of the rule down, providing a comprehensive look at the rule in its entirety.

For more on the rule, check out the following resources:

CMS Training Series on HCBS Provisions in Medicaid Access Rule

CMS is hosting a training series on the home- and community-based services (HCBS) provisions of the Ensuring Access to Medicaid Services final rule, often referred to as the Access Rule. The series will include training sessions on several key provisions of the Access Rule to ensure that all partners fully understand the provisions and have an opportunity to ask questions and provide feedback on implementation of the rule.

Dates and tentative topics:

  • October 9, 2024 at 3:00-4:00 p.m. ET: HCBS Measure Set
  • December 11, 2024 at 3:00-4:00 p.m. ET: Grievance Systems
  • February 12, 2025 at 3:00-4:00 p.m. ET: Timely Access, Waiting Lists, Person-Centered Planning Reporting Requirements, & Minimum Performance Levels
  • March 12, 2025 at 3:00-4:00 p.m. ET: Website Requirements
  • April 9, 2025 at 3:00-4:00 p.m. ET: HCBS Rate Transparency
  • May 14, 2025 at 3:00-4:00 p.m. ET: Medicaid Advisory Committee (MAC) and Beneficiary Advisory Council (BAC)
  • June 11, 2025 at 3:00-4:00 p.m. ET: Institutional Rule Provisions (Nursing Facility and Intermediate Care Facilities for Individuals with Intellectual Disabilities Rate Transparency provisions finalized in CMS-3442-F: Medicare and Medicaid)

Learn more and register.

Social Security Administration Announces New Efforts To Simplify SSI Applications

The Social Security Administration (SSA) has announced it will start to offer an online, streamlined application for some Supplemental Security Income (SSI) applicants starting in December as part of a multi-year effort to simplify processes for people who are applying for SSI. SSI provides monthly payments to people with disabilities and older adults who have little or no income and resources.

The new application will generally be available to first-time SSI applicants between 18 and 64 who never married and are concurrently applying for Social Security benefits and SSI. SSA aims to expand the streamlined application to all applicants in late 2025.

Expanding Access To Housing: Mainstream Voucher Policy Changes To Support Community Living for People With Disabilities

The U.S. Department of Housing and Urban Development (HUD) published guidance creating new policies that enable public housing agencies (PHAs) to better utilize Mainstream Vouchers to help people with disabilities transition from, and avoid, institutional settings or homelessness. Through HUD’s Mainstream Vouchers program, housing agencies provide rental assistance to people with disabilities between the ages of 18-61 who are transitioning out of institutional or other isolated settings, at serious risk of institutionalization, experiencing homelessness, or at risk of experiencing homelessness.

The policy changes announced include:

  • The minimum initial search term will increase from 60 to 120 days, giving participants more time to search for housing before they need to request an extension.
    PHAs will be required to approve all initial search extension requests for a minimum of 90 days.
  • PHAs cannot provide preference to applicants who are within their own jurisdiction. This is meant to ensure people who are experiencing homelessness or residing in an institution outside of the PHA’s jurisdiction can still access Mainstream Vouchers.
  • PHAs have the option to adopt a separate Mainstream Voucher waiting list, apart from their Housing Choice Voucher waiting list. PHAs with high utilization of their Mainstream Vouchers may find it unnecessary to establish a separate waiting list, but some may choose to do so to reduce burden in identifying eligible applicants.
  • PHAs may adopt admissions preferences that prioritize direct referrals from health care and disability agencies that support community living, so long as the referral source is not serving one specific disability type. PHAs can choose to adopt these preferences only for Mainstream Vouchers or to their overall Housing Choice Voucher program.

Expanding Access To Housing: HUD Awards Nearly $140 Million To Expand Affordable Housing for People With Disabilities

Last month, HUD awarded $138.5 million in grants for more than a dozen state housing agencies to expand the supply of housing and supportive services for low-income people with disabilities. The funding, through HUD’s Section 811 Project Rental Assistance (PRA) for Persons with Disabilities program will allow 18 state housing agencies to develop strategies to identify and refer low-income people with disabilities to eligible homes, and to provide them with rental assistance and supportive services.

The Section 811 program provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. The program also enables people with disabilities to live as independently as possible in their community and provides access to appropriate supportive services.

Awardees will work to address long-term housing security and affordability issues for people with disabilities within existing, new, or renovated multifamily developments and facilitate community integration. In collaboration with Medicaid and/or health and human services agencies, awardees will also connect individuals with community-based supports and services for the long-term.

Expanding Access To Housing: HUD-VA Supportive Housing Policy Changes

HUD recently released policy changes that will help more veterans receive assistance under the HUD-U.S. Department of Veteran Affairs (VA) Supportive Housing (HUD-VASH) program and improve their access to supportive housing developments.

The new policies adopt an alternative definition of annual income for applicants and participants of the HUD-VASH program that excludes veterans’ service-connected disability benefits when determining eligibility, allowing more veterans with disabilities to be eligible for the program. It also requires PHAs that administer HUD-VASH to use a higher initial income eligibility threshold than required previously, increasing the number of veterans eligible for the program.

Input Needed: CMS Resources for States on Medicaid and CHIP Mental Health Parity and Addiction Equity Act Final Rule Compliance

CMS has developed a new set of templates and instructional guides for state agencies to document how benefits provided through a state’s Medicaid managed care program, Medicaid alternative benefit plans, and/or CHIP comply with Medicaid and CHIP Mental Health Parity and Addiction Equity Act final rule requirements. These new tools are intended to standardize, streamline, and strengthen the process for states to demonstrate, and for CMS to determine, compliance.

CMS is seeking preliminary comments by October 29, 2024, on these templates and instructional guides through an informal request for comment and intends to take these comments into account before finalizing these tools. Furthermore, CMS plans to seek approval for the use of these tools through a formal process in accordance with the Paperwork Reduction Act before issuing these templates and instructional guides.

Department of Labor Releases Toolkit With Resources To Help Employers Recruit, Hire, Retain, and Advance Workers With Disabilities

The U.S. Department of Labor released a toolkit that includes strategies employers can use to promote hiring workers with disabilities and create environments where workers with disabilities can thrive. Topics covered by the toolkit include:

  • Setting commitments for hiring workers with disabilities.
  • Finding and targeting candidates with disabilities.
  • Showing your commitment to inclusion.
  • Being flexible in recruitment.
  • Partnering with local organizations.
  • Registered Apprenticeship and Pre-Apprenticeship programs.
  • Updating recruitment materials.
  • Using plain and inclusive language.
  • Paying workers a fair wage.

Last modified on 09/19/2024


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