Lance's Corner

CDC Highlights ADA Anniversary

Jul 25, 2024

Per the notice below, the Centers for Disease Control and Prevention (CDC) is highlighting the anniversary of the Americans with Disabilities Act (ADA).

CDC’s Commitment to Disability Inclusion

 

This year, as we recognize the 34th anniversary of the Americans with Disabilities Act (ADA), CDC celebrates the significant advances the public health community has made to reduce health disparities and improve inclusion for the disability community. However, there is still much work to do to ensure people with disabilities can access the same health care as people without disabilities and achieve positive health outcomes.

People with disabilities experience significant disparities across health conditions, affecting how they participate in their communities and how they are served during an emergency. With more than 1 in 4 people in the United States having a disability, people with disabilities are part of every community. Building a public health infrastructure—including data, communications, and policies—that better identifies and includes people with disabilities is essential to achieving health equity.

Together with our partners, we work across public health disciplines to improve disability inclusion and considerations in ongoing data monitoring systems, disease prevention and health promotion programs, and emergency preparedness and response efforts. We are working to ensure disability inclusion:

Data

Two colleagues presenting data

We are working to ensure that people with disabilities are included in public health data. This involves addressing multiple areas where people with disabilities are not represented, or are underrepresented, in public health data collection. These data are essential for addressing health disparities and enhancing quality of life for people with disabilities across the lifespan.

Improving disability representation in data enables us to close gaps in health disparities, plan and prepare for unique needs during emergencies, and evaluate public health programs and policies. The following work provides examples of the value of ensuring people with disabilities are included in data. Together, we can better:

Improve representation in public health data by engaging people with intellectual disabilities and/or developmental disabilities (ID/DD)

To improve representation of people with ID/DD in disability data, we are engaging the population through qualitative interviews, cognitive testing, and a feasibility study to develop a set of plain language questions that are easily understood by people with ID/DD. The final product will be an accessible checklist adapted from standard disability question sets to better identify people with ID/DD.

Promote health and wellness

We launched a Prevention Research Centers project called Disability and Health Data Collaborative: Using Data to Promote the Health and Wellness of People with Disabilities, which aims to implement a multisite research study and establish a framework for a Disability and Health Data Collaborative using state Medicaid data and data linkages. This study will help characterize and evaluate the health and wellness of people with ID/DD. Over time, this work will include additional geographic areas and data sources. Findings may also inform healthcare policy and resource allocation decisions and evaluation of interventions and their outcomes.

Inform policies and practices that address health disparities and support people with disabilities

Our Disability and Health Data System (DHDS) is an online interactive source of state, regional, and national data on the health and demographics of adults with disabilities. States rely on this information to understand the health status of their population with disabilities and to tailor health programs for this population. Through DHDS, states can easily identify disability status by approximately 30 measures of health (such as smoking, physical activity, obesity, hypertension, heart disease, and diabetes) and can use this information to inform policies and practices that address health disparities and support people with disabilities.

Monitor health and well-being before, during, and after public health emergencies

We collaborate with the Association of State and Territorial Health Officials (ASTHO) and the Council of State and Territorial Epidemiologists (CSTE) National Syndromic Surveillance Program Community of Practice to better identify emergency department visits by people with disabilities. This work will have a sustainable impact on national, state, and local response capacity to detect and monitor the health and well-being of people with disabilities during current and future public health emergencies.

Improve health department capacity to respond during public health emergencies

We work with CSTE to assess current practices for collecting data on people with disabilities during emergencies and to identify existing disability-related data elements states and territories can include on their Emergency Operations Center Situation Reports.

 

Health Care

Trainers helping a Paralympics athlete stretch

We work with community partners to develop, evaluate, and disseminate inclusive health practices focused on people with ID/DD and people with mobility limitations.

We fund the Special Olympics Healthy Athletes® and Healthy Communities Programs to provide Special Olympics athletes with increased access to free health screenings, education, services, supports, and referrals for follow-up health care as well as year-round health promotion and disease prevention programs. Our partnership with Special Olympics focuses on reducing barriers to inclusive health services and programs, challenging misperceptions, eliminating stigma, and improving the health of people with ID/DD by

  • Training healthcare professionals to conduct and support Healthy Athletes screening events throughout the United States.
  • Increasing the availability of data during and after screening events using digital health technology to evaluate effectiveness and provide critical health information on this population.
  • Providing disability awareness training to healthcare professionals, community wellness partners, schools, and other collaborators who have limited or no experience working with people with ID.

CDC’s partnership with the National Center on Health, Physical Activity and Disability (NCHPAD) primarily focuses on reducing health disparities and improving the health of people with mobility limitations by delivering health promotion programs and expanding the capacity of healthcare and community-based providers to serve the health needs of people with mobility limitations.

Through CDC funding, NCHPAD developed a comprehensive, evidence-based set of wellness modules that help tailor health promotion programs to the unique needs of people with a range of disability and mobility issues. This includes a new training module for healthcare providers who are involved in referring patients to specialists to educate them on disability awareness and reducing ableism in medical care.

Become a Disability A.L.L.Y.
A square graphic with a graphic of a female healthcare provider and male patient. It is captioned with A- Acknowledge different disabilities, L Learn about disabilities, L- Lead the Change, Y- Yield the floor. The bottom has a graphic of stethoscope and captioned with 'I am a Disability ALLY'

CDC launched a new digital toolkit with shareable graphics and sample social media posts to help partners advocate for inclusion and accessibility in healthcare settings. This toolkit includes information on how providers can make small changes in their practice to increase accessibility and inclusion for people with disabilities and their families. Videos in the toolkit, featuring Special Olympics athletes, amplify the voices of people with lived experience on why disability allyship is important. Voices of healthcare providers who are passionate about disability inclusion and allyship are also included. When healthcare providers champion inclusive practices, everyone benefits. Resources and trainings for healthcare providers are available to help build a more inclusive practice.

 

Community

Teammates with hands together cheering

We invest in State Disability and Health Programs to improve health outcomes among people with mobility limitations and intellectual disabilities. These programs have reached 3.2 million people nationwide through the implementation of 39 evidence-based strategies and interventions focusing on physical activity, nutrition, diabetes, and other health topics significant for this population. The programs strengthen partnerships and design, create and implement projects to improve the health of people with disabilities in their states.

In 2021, we began a new 5-year cycle with ten State Disability and Health Programs, with an increased focus on engagement with high-quality routine preventive healthcare; adoption of healthy lifestyle behaviors; and early identification, management, and control of chronic disease and mental health conditions among people with ID/DD and people with mobility limitations. These programs will implement and evaluate Living Well in the Community, a training designed to assist people with disabilities in setting goals to support their overall quality of life and well-being.

 

Emergencies

Folder with emergency plan

We have partnered with ASTHO and the National Association of County and City Health Officials to embed disability specialists in state, territorial, and local health departments’ public health emergency preparedness and response programs to ensure issues impacting people with disabilities are considered in planning and response efforts. This project has demonstrated that disability specialists can enhance the capacity of local health departments to include people with disabilities in their preparedness, response, and ongoing public health data collection and programs.

During the COVID-19 pandemic, we supported a technical assistance and training center through the Association of University Centers on Disabilities. The role was to disseminate emergency preparedness and response resources, along with the development of a central, online repository of practice-based materials on emergency preparedness tailored for people with disabilities, caregivers, and the emergency and healthcare providers who serve them. Through these efforts, an online toolkit called Public Health is for Everyone now contains more than 100 COVID-19 resources relevant to people with disabilities.

 

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc