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State Disability News Highlights for Period ending 10/09/2015

By Diane McComb posted 10-09-2015 10:25 AM


State Disability News Highlights for Period ending 10/09/2015


Lead Story:  Kansas

The state said Tuesday that it will delay a major overhaul in the way it provides services for the disabled.  The announcement comes after people with disabilities, their family members, providers and care takers voiced major concerns with the state’s nine-month time line to switch a complex system of care for some of Kansas’ most vulnerable populations. “This is probably the single biggest change this system has seen” in nearly 20 years, said Dee Staudt, director of the Sedgwick County Developmental Disability Organization. In 1995 the state passed a law, guaranteeing certain rights for people with developmental disabilities.  The state’s overhaul of disability services would affect thousands of people who are developmentally or intellectually disabled, are elderly and frail, have a traumatic brain injury, are physically disabled, have serious emotional disturbances or who need long-term medical care. Right now, those people receive what’s called a Medicaid waiver. Medicaid is the state and federal health care program for people with low income or who are disabled. The waiver provides additional services usually not allowed by Medicaid. The services provided by the waiver help people stay in their homes rather than be institutionalized. The state currently offers seven waivers based on disability type. Two state agencies in charge of the waivers, the Kansas Department of Health and Environment and the Kansas Department of Aging and Disability Services, wanted to condense all seven waivers into one universal waiver by Jan. 1 and switch everyone over to the new universal waiver by July 1.  The events unfolded fast; the state announced the plan in August. To read more -



Caught between conflicting moral arguments, Gov. Jerry Brown, a former Jesuit seminary student, signed a measure Monday allowing physicians to prescribe lethal doses of drugs to terminally ill patients who want to hasten their deaths. Brown appeared to struggle in deciding whether to approve the bill, whose opponents included the Catholic Church. “In the end, I was left to reflect on what I would want in the face of my own death,” Brown wrote in a signing message. “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.” The new law is modeled after one that went into effect in 1997 in Oregon, where last year 105 people took their lives with drugs prescribed for that purpose. The California law will permit physicians to provide lethal prescriptions to mentally competent adults who have been diagnosed with a terminal illness and face the expectation that they will die within six months. The law will take effect 90 days after the Legislature adjourns its special session on healthcare, which may not be until next year — January at the earliest, November at the latest. To read more -



The cost of 24-hour out-of-home care through the state's regional centers for children with developmental disabilities will drop for some parents in California. Gov. Jerry Brown (D) this week signed into law AB 564 by Assembly member Susan Talamantes Eggman (D-Stockton). The new law raises the threshold for paying a parental fee for those families with a child in 24-hour out-of-home care through the regional centers, so that families earning between 100% and 200% of federal poverty level can now be exempted from the fee. State officials estimate the change will cost the state about $190,000 a year. Roughly 4,200 developmentally disabled children use 24-hour out-of-home care through the regional centers. The 21 regional centers are not-for-profit private corporations that contract with the state's Department of Developmental Services to provide services and supports for individuals with developmental disabilities. The law will change the threshold for the parental fee requirement for children receiving 24-hour out-of-home care, from above 100% of federal poverty level to those who earn more than 200% of federal poverty level; allow the Department of Developmental Services to grant a temporary waiver to families undergoing certain financial events; and establish a parental fee credit for removing a child from 24-hour out-of-home care placement for a home visit for six or more consecutive hours.  The law will go into effect in June 2016. 



A Florida Senate panel on Wednesday demanded answers from a state Department of Health official about how many special-needs children have recently lost services as the state transitions to a new Medicaid system --- and why. Several members of the Senate Health and Human Services Appropriations Subcommittee said they'd had calls from constituents --- "in tears," in the words of Sen. Aaron Bean, R-Fernandina Beach --- over losing critical health-care services for their children. They asked DOH Chief Operating Officer Jennifer Tschetter how youngsters are faring in Children's Medical Services, which serves kids with "serious and chronic" conditions, and Early Steps, which serves babies and toddlers with developmental disabilities or delays. In February, blaming a budget shortfall, the Department of Health cut 13 full-time positions from the Early Steps central program office, which was most of the staff. In June, led by Senate Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah, and Senate President Andy Gardiner, R-Orlando, lawmakers agreed to pour $13 million into the program. Now, Tschetter said, the Department of Health "is confident about its ability to stay within its appropriation this year for the Early Steps program." But lawmakers pressed Tschetter for details about how the program was doing beyond administrative matters like managing contracts and determining eligibility. "I've enjoyed all the technical information that you have shared, but at the root of all this is the children," Sen. Lizbeth Benacquisto, R-Fort Myers, told Tschetter. "And if at some point in your presentation, you could tell us about outcomes and how the kids are doing, now that they have increased access to the program --- what's working well, what needs some more tweaking --- because we invest this much money through the leadership of the chairman. We do this because these children need assistance, so I'd like to know how they're doing." Meanwhile, the Children's Medical Services Network remains mired in controversy, stemming from the state's transition to Medicaid managed care last year. Under the new system, state officials hope to whittle the CMS program's rolls down to children with the most serious problems. Children's health advocates contend that DOH has used a new eligibility-screening tool to deliberately screen kids out of the program and into less-expensive managed-care plans. Thousands of kids have been screened out of the CMS Network since May, although Tschetter did not know how many. To read more -



Richard Tego hasn’t coped well with the recent cutoff of services to help him deal with autism. “He will sit and cry because he can’t go see his friends,” his mother, Veronica Morse of Carlinville, said recently. “He’s going back into his shell.” Richard, 13, an eighth-grader at Carlinville Middle School, is among more than a dozen children who were cut off from services at The Autism Program of Illinois’ Springfield center in late August because of the ongoing state budget impasse. The regression Morse has seen is what Autism Program officials fear will happen to hundreds of children statewide as the impasse continues to cause unprecedented damage to a network of autism diagnostic and treatment services that began to be developed in 2003. “We’ve built an infrastructure over 12 years,” Russell Bonanno, the not-for-profit program’s former state network director, said late last month. “Basically, we’ve built a bridge, and the bridge is no longer short a brick. The lack of a budget basically blew up the bridge, and it’s going to take time to rebuild it.” Bonanno was among four administrative employees of The Autism Program — two in Springfield, one in Chicago and one in the Champaign area — who were laid off last week because of the state budget impasse. The Autism Program, part of Springfield’s Hope Institute for Children and Families, hasn’t received any of its normal $4.3 million in annual state funding since the previous fiscal year ended June 30. Cutbacks resulting from that lack of funding are starting to accelerate, said Clint Paul, Hope’s president and chief executive officer. Diagnostic services and treatments for children with autism have stopped at not-for-profit agencies in Chicago and Charleston that receive state funding through The Autism Program, Bonanno said. A program in Rockford that gets money from the program soon may run out of cash. Training for educators and other professionals statewide also has stopped, Bonanno said. The program’s Springfield center stopped accepting low-income children into its diagnostic and treatment programs in early August. And by the end of the month, the program no longer could afford to continue serving families without private insurance or other means to pay, Paul said. To read more -



Gov. Sam Brownback’s press office blasted Medicaid expansion as an “Obamacare ruse” in an e-mail to supporters Tuesday, signaling that the governor won’t back expansion anytime soon. Melika Willoughby, the governor’s deputy director of communications, pushed back against the claim that the state’s refusal to expand Medicaid helped cause the closure of Mercy Hospital in Independence. “Those who say Medicaid Expansion would save the Independence Hospital are lying. It wouldn’t,” Willoughby said in an e-mail to the governor’s supporters. “Instead, this Obamacare ruse funnels money to big city hospitals, creates a new entitlement class, and fails to rightly prioritize service for disabled citizens.” Hospitals have sought to expand Medicaid, which provides health care for low-income and disabled Kansans, under the Affordable Care Act. Via Christi, the largest hospital system in the state, has said it will continue to push for expansion in the next legislative session because of declining revenue. Willoughby’s e-mail comes as the administration is encouraging state workers to sign their children up for the federal Children’s Health Insurance Program, better known as CHIP, something only possible through the Affordable Care Act. To read more -



A failed federal lawsuit and subsequent appeal by Gov. Paul LePage’s administration, both of which were turned down by the U.S. Supreme Court, cost Maine taxpayers $108,000 in legal fees paid to a private law firm. The Department of Health and Human Services released the fees paid to Portland-based Roach, Hewitt, Ruprecht, Sanchez & Bischoff after a records request from the Sun Journal. The administration and DHHS Commissioner Mary Mayhew retained nongovernmental lawyers and pursued the case after Maine Attorney General Janet Mills declined to represent the state but did permit LePage to hire outside attorneys. The case, litigated in 2014 and early 2015, stemmed from the administration’s efforts to remove about 6,000 people — 19- and 20-year-old single adults — from the state’s Medicaid program, known as MaineCare. Adrienne Bennett, a spokeswoman for LePage, said the governor’s office was essentially forced to seek private attorneys to represent the state when Mills refused to do so. Bennett also said a subsequent case involving the state’s ability to set rules for locally administered General Assistance welfare programs and immigrants, and in which Mills also refused to represent the state, LePage prevailed and saved taxpayers more than $1 million. To read more  -



Lawmakers in St. Louis, Mo. are considering a bill to exempt disabled people from an upcoming minimum wage increase. While some say it’s unfair, others argue it’s to make sure certain charities stay afloat. The exemption will soon be debated by the city Board of Aldermen. It successfully passed through committee Thursday with a 4 to 1 vote. The move to include an exemption is to help sheltered workshops, which employ disabled people as a form of charity. The current law, passed in August, will increase the minimum wage across the city to $11 an hour by 2018. It did not include an exemption for disabled workers. “Sheltered workshops have been providing services to developmentally disabled people in St. Louis and Missouri for a long time,” Democratic Alderman Scott Ogilvie, who sponsored the exemption, said during a hearing according to St. Louis Public Radio. “Within the minimum wage bill, part of that bill would have made it very difficult for them to continue operating.”



State lawmakers got some good news recently when they learned the state’s cash reserves — money left over after the budgeting process — were $90 million higher than anticipated at the June 30 end of the fiscal year. Fiscal analysts say the additional funds resulted from higher than anticipated income tax collections and lower than anticipated expenditures. The fiscal analysts said they are awaiting more data and will give lawmakers a more exact explanation of where all the additional funds came from in December. But with that extra money, the state’s cash reserves top $450 million, a tidy sum for a sparsely populated state like Montana, and more cash than the state needs to keep on hand. The surplus sets Montana apart from many other states that are struggling with large deficits and facing hard decisions on tax increases that could be a drag on their economies. The burgeoning surplus should also have state officials considering their options. Some fiscal hawks will favor returning some of the extra cash to taxpayers. There is precedent for that, and the idea certainly demands serious consideration. Another option would be to revisit some of the business left undone at the end of the last legislative session earlier this year. To read more  -



Nevada has agreed to pay the city of San Francisco $400,000 to settle a lawsuit claiming that the state bused patients, many of them poor and mentally ill, from a Las Vegas hospital to the Bay Area without plans for their care, Governor Brian Sandoval's office said on Tuesday. The settlement, which must still be approved by the San Francisco Board of Supervisors and the Nevada Board of Examiners, includes attorneys' fees and a plan for better management and transfer of patients. "We look forward to working with California to ensure all patient transfers to and from both states are managed using these best practices and adhering to conditions detailed in the agreement," Sandoval's office said in a statement. The San Francisco City Attorney's Office declined to confirm the proposed settlement or comment on the matter on Tuesday. The state-run Rawson-Neal Psychiatric Hospital in Las Vegas came under fire in April 2013 after the Sacramento Bee newspaper reported that hospital staff had given as many as 1,500 patients one-way bus tickets to California and 46 other states between 2008 and 2013. San Francisco's City Attorney Dennis Herrera said the hospital had sent at least two dozen patients to the city via Greyhound bus, adding that shortly after their arrival most of the patients required medical care and shelter costing some $500,000 in city funds.  Herrera filed the suit against Nevada in September 2013 and said it could pave the way for other California jurisdictions to seek restitution from the state for damages similar to those San Francisco claimed. To read more -


New Hampshire

During the budget-writing phase, Gov. Maggie Hassan's office criticized lawmakers for counting on rolling nearly $50 million in surplus into the next budget. Hassan's office said the surplus will help strengthen the state's rainy-day fund and improve the state's financial outlook. She said the Legislature should consider using some of the money to address public school funding concerns. Senate President Chuck Morse said the surplus shows the state is living within its means and appropriately budgeted for fiscal year 2015. He said he's concerned about $20 million in unspent money for services for people with developmental disabilities.



Gov. Tom Wolf on Monday described an upcoming House vote on his tax proposals as “a once-in-a-generation vote” but said that regardless of the outcome, he sees no way to balance the Pennsylvania budget without recurring tax increases or deep cuts to education. “I have not seen any alternative way to get to a truly balanced budget,” the Democratic first-year governor told reporters during a briefing at the governor’s residence. Mr. Wolf and the Republicans who control the House and Senate have been locked in an impasse since the governor vetoed a state budget that sidestepped his priorities on June 30. Mr. Wolf and his staff said he is talking to House members ahead of the vote, scheduled for Wednesday, and working on revisions to the proposal itself, which he said he would deliver today. In March, the governor called for raising the personal income and sales taxes and expanding the sales tax to additional goods and services, while also raising the cigarette tax and imposing a new tax on natural gas drilling. He said those changes would allow Pennsylvania to significantly increase its funding for K-12 education and subsidize local property taxes while closing a budget shortfall. Last week, as the state neared the end of its third month without a current budget, the Republican House and Senate leaders said they would bring Mr. Wolf’s tax package to a vote to see if — contrary to their expectations — it has the support to pass. Even with the support of all 84 Democrats, 18 Republicans would need to vote yes for the governor’s proposal to pass. Mr. Wolf had dismissed a previous House rejection of his tax proposals as “a stunt,” but he said Monday that he is taking the vote planned for this week “at face value.” To read more -



Following an outcry from dozens of state lawmakers, Texas’ top health agency announced Thursday it will make less drastic cuts than originally planned to a therapy program for children with disabilities, even if that means spending more than lawmakers budgeted for the program. Texas Health and Human Services Executive Commissioner Chris Traylor said in a letter to Texas Senate leadership that his agency would work to “preserve access to care even if it means” the full budget cuts lawmakers passed this year “cannot be achieved.” The announcement comes amid expanding turmoil — including a lawsuit, vocal protests and lawmaker backpedalling — over legislative efforts to trim costs in the Medicaid-reimbursed programs. Therapy providers said the cuts would impede about 60,000 children from getting needed speech, physical and occupational therapy. State lawmakers this year ordered the health agency to cut $100 million over two years in payments to those therapists. But the therapy providers cried foul, saying many of their businesses would close under what amounted to a roughly 20 percent revenue reduction. Families of children with disabilities, who said they would lose access to medically necessary services, also filed suit against the state. And more than 60 lawmakers, who crafted the budget ordering the cuts, wrote Traylor urging him not to harm the children using the services. On Wednesday, Lt. Gov. Dan Patrick and lead Senate budget writer Jane Nelson, R-Flower Mound, wrote to Traylor to defend the cuts, but in doing so told Traylor he had “the flexibility to strive for achieving $100 million savings in Medicaid therapy services while preserving access to services.” To read more -



There are 13 state supported living facilities across the state. Thousands of Texans with intellectual and developmental disabilities call the campus-like settings home.  "When you look at our system of providing services to persons with intellectual and developmental disabilities, it really begs for reform for the long-term," said Chris Traylor, executive commissioner of Texas Health and Human Services. Following a series of compliance issues and the costs associated with upkeep, state officials have been looking to reform the way the system operates.  "We really need to look at 10, 20, 30 years down the road to determine what services and what will be available to those persons not only as they get older but as the population increases," Traylor said. A lot of the debate surrounds whether to close some of the facilities. During the last legislative session, a bill that would have closed Austin's facility didn't quite make it to the governor's desk.  "Too often, this debate is over-simplified and it becomes about whether the Austin facility is going to close or how many of the facilities are going to close," said John Davidson, Center for Health Care Policy, TPPF. "In reality, we need to start thinking about a more comprehensive long-term solution that's about more than whether a particular facility is going to close." One of the ideas is shifting away from institutionalized care to a more community based system in smaller group homes.  "There are a lot of really passionate views on either side of the issue so we want to facilitate a discussion on how to move forward in the interim so in 2017 we don't have the same result as we did in this last session," Davidson said. For now, all 13 of the state's facilities remain open.



Hundreds packed the State Capitol to learn more about a proposed Medicaid expansion plan, Tuesday. It was the first time lawmakers publicly presented their Utah Access Plus plan, the latest attempt at filling the coverage gap for more than 100,000 Utahns. “If that is the only thing that will get the other chamber, the House, involved and to agree to it, that for the greater good I’m willing to support it,” said Sen. Brian Shiozawa, R-Cottonwood Heights. Shiozawa helped craft the failed Healthy Utah Plan. For the last few months, he’s been working on an alternative solution with other lawmakers, together known as the Gang of Six. “I’m conflicted on this, clearly,” he explained. The conflict stems from the division that has already occurred within the medical community since details of the plan were released last week. Under Utah Access Plus, medical providers would be taxed in order to generate the funding to support an expansion.  To read more -


West Virginia

Gov. Earl Ray Tomblin on Monday announced an across-the-board 4 percent cut for most state government agencies, a move he said is necessary due to “unexpected and unprecedented” drops in the state’s severance tax collections. State aid to public schools, which has been spared in recent years of budget cuts, will see a 1 percent cut this year, Tomblin announced. State officials are projecting a $250 million budget deficit for fiscal year 2016, which started July 1 and ends in June 2016. That includes a projected $190 million shortfall in severance tax revenues, collected from coal, oil, gas and timber. As of Sept. 30, just three months into the fiscal year, general revenues were more than $60 million behind estimates, a news release from Tomblin’s office said. That number is five times larger than the $12 million deficit that the state had at the end of August, just one month prior. Severance tax revenues dropped a whopping 36 percent during July and August, after dropping 31 percent in April, May and June, Tomblin said. “This is a difficult decision that results from several factors beyond our control,” the governor said in a prepared statement. “We are taking this action based on trends we see in the first three months of the fiscal year that we expect to continue throughout this budget cycle. While the cuts we’re enacting today will not be easy, we must maintain a balanced budget and this will help us do that. “The just-announced cuts come at a time when the state’s finances are already stretched thin. The new cuts come on top of two consecutive years of 7.5 percent budget cuts to most state agencies. Meanwhile, the governor’s Blue Ribbon Commission Highways estimates the state will need an additional $1 billion to be able to adequately build and maintain the state highway system. At the same time, the state Legislature has announced its intentions to reform the state tax code. The Legislature’s Committee on Tax Reform heard, on Monday, from the conservative Tax Foundation which touted repeal of the state personal property tax, a move that, with no offsets, would blow a $300 million hole in the state budget. House Speaker Tim Armstead, R-Kanawha, blamed the Obama administration’s “anti-coal policies” for the budget problems. “These figures show West Virginia’s economy is in a deep crisis,” Armstead said, in a prepared statement. “In the coming legislative session we will need to act carefully to be good stewards of the taxpayers’ money. However this situation also underscores the need to take bold, aggressive steps to dramatically improve our business climate, attract new investment and create jobs, which will all in turn generate more revenue for the state. “The 4 percent cut to state agencies will not be enough, by itself, to fill the budget gap, Tomblin’s office said. The cuts represent more than $100 million, but the state will also “use one-time appropriations to close the budget gap,” according to the statement. Tomblin’s office did not specify the nature of those appropriations. – To read more -