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State Disability News Highlights for Period ending 10/23/2015

By Diane McComb posted 10-23-2015 01:03 PM


State Disability News Highlights for Period ending 10/23/2015


Lead Story:  New York

Several New York state lawmakers raised concerns Tuesday about federal and state policies to move more disabled people from institutions to community residences and managed care for behavioral treatment. The state Office for People with Developmental Disabilities currently supports 38,000 New Yorkers in residences and 80,000 with day services. It has about 400 people in institutional settings, a total the agency plans to reduce to 150, Deputy Commissioner Helen DeSanto told lawmakers. She said the state plans to close its Brooklyn Developmental Center campus at the end of this year, the Binghamton-area campus by next March 31 and the Queens campus by March 2017. But Assemblyman Thomas Abinanti, a Westchester Democrat, said the move to managed care raises many issues, including a shift from home care to behavioral and other services at brick and mortar locations and whether providers will locate there and accept those Medicaid reimbursements. "It seems to me like a disaster in the making," he said. Assemblywoman Aileen Gunther, who chairs the Mental Health and Developmental Disabilities Committee, said she agrees independence is best but each community and case has to be considered. She and Assemblywoman Donna Lupardo, a Binghamton Democrat, said many people in those facilities represent the most complicated cases of behavioral and health problems. Some are elderly, some incontinent, some can't feed themselves, some need the care of two staff people around the clock, Gunther said. "I'm not saying that person doesn't deserve independent living, but there's a reality of the situation how many dollars go around," Gunther said. "I don't know how you get to 150 without evaluating each and every person in a state facility, what exactly their needs are.  "These are families that are begging for quality of life for a child that's born with a disability," she said. "And I think it's our responsibility in government to make sure we can give them the assurances and that we do look at the individuals and the individual areas." In 1999, the U.S. Supreme Court called for ending segregation of disabled Americans, moving them to community-based services. New York subsequently developed plans to implement this move.



In a change of course, Gov. Robert Bentley Friday evening announced that the Alabama Law Enforcement Agency would return driver’s license examiners to 31 rural counties. A statement from the governor’s office said an examiner would spend at least one day each month in each of the counties slated to lose part-time examiners under budget cuts announced by ALEA at the end of last month. The schedule and timetable of the return was not immediately clear.  The moves set off a national controversy, with many expressing concerns that people in the affected counties, particularly black voters, would be unable to get identification required to vote. Bentley Friday denied any intention to deprive people of their voting rights. “I recognize the closure of the 31 driver’s license offices affects mostly rural areas of the state,” Bentley said. “To suggest the closure of the driver’s license offices is a racial issue is simply not true, and to suggest otherwise should be considered an effort to promote a political agenda.” The affected offices issued or renewed less than 9,000 driver’s licenses and identification cards in 2014; the counties had just over 551,000 active or inactive voters that year. The number represented less than one-half of one percent of the voting population. The totals were slightly higher in the 12 Black Belt counties that lost examiners: there, the offices issued or renewed 2,702 licenses and identifications in counties with 128,788 active and registered voters, or about 2.1 percent of voters. Legislators in the counties said any difficulty accessing the ballot would be a problem. U.S. Rep. Terri Sewell, D-Birmingham, asked the U.S. Justice Department to investigate the closings, and met with Gov. Bentley Thursday on the issue. Bentley had earlier met with members of the Alabama Legislative Black Caucus and Rev. Jesse Jackson on the examiner withdrawals. Sewell said in a statement the moves were "encouraging" but said the state needed to address the impact of budget cuts on rural Alabama.  To read more -



Arizona will become the first and only state to impose a one-year lifetime limit for impoverished households receiving federal benefits from the Temporary Assistance to Needy Families program – a move that will cut payments to about 1,600 families in July. “I think what we have in Arizona is an aggressive and intentional effort to undermine support for vulnerable families,” said Cynthia Zwick, executive director for the Arizona Community Action Association. “Well, I’m worried that many of those families will end up on the streets, they will become homeless. They will not have the resources they need for their children, that their children will be placed in unsafe circumstances.” The program, known as TANF, is supposed to help to parents as they look for jobs and provide a temporary financial safety net when they cannot work. A spokesperson for the Arizona Department of Economic Security declined to be interviewed, but in an email said the state expects to save $325,000 per month and $3.9 million per year. Cronkite News also made three requests for comment from Arizona Gov. Doug Ducey, but did not receive a response. The average family right now receives $195 each month. Part of the savings from the TANF program instead will go to Arizona’s Department of Child Safety to help with abuse and neglect investigations and foster care. To read more -



Arkansas will have a better chance of controlling its Medicaid budget if it hires managed care companies to manage long term services and supports for people in nursing homes, the aged, the disabled and patients with expensive medical needs. So said the state director of the Department of Human Services to legislators.  To read more -



Intellectual disability is a condition characterized by significant limitation in intellectual functioning and in adaptive behavior. Formerly known as mental retardation, this disability manifests before age 18 and impacts the ability to communicate, socialize, and take care of oneself. A few decades ago, it was common to hear doctors tell parents that the best place for their child would be an institution. Now, with the right training and education, people with intellectual disabilities can learn to do things on their own and even hold jobs.  But while the perception and its label have changed over the years, funding for agencies that provide services for this community has dropped severely in the last decade. Moreover, intellectual disability advocates express great disappointment with California Governor Jerry Brown. Tony Anderson, executive director of Arc California, an advocacy agency for parents of people with intellectual disabilities, stated that Brown, at the end of the budget process, convinced the Legislature to remove the developmental services increase and find a way to fund it in a special session. This was something the leadership in the Assembly, and the state Senate, expressed optimism for. However, it didn't bring any fruitful outcomes. The governor refused to use the budget estimates from the Legislative Analyst Office and used his own numbers; figures that are already over $700 million under actual state revenues. "During the special session," Anderson said, "there were six bills introduced by Republicans and Democrats that would provide funding increases for developmental disabilities, and only two received a hearing and neither received a vote on the floor. In just over the last four years, we have lost 500 group homes for people with developmental disabilities, thousands have lost their community day programs, and now almost 100,000 people are living at home with aging caregivers." For those who work in the intellectual disability community, the last rate increase was given in 1999. However, in 2006, the state gave a wage pass through, yet removed it for four years starting in 2009. Today's provider rates for most of the community programs are based on cost reports from 2000 – meaning they are operating with rates based on the cost of providing services in 1999. Additionally, the group homes for people with developmental disabilities currently operate with rates established back in a time when the homes used to support fewer people. Funding as a whole has increased each year because the population increases yearly, and once you're in the system, you never lose your disability. Thus, you never lose your eligibility.  To read more -



Rather than cut $4.7 million from mental health and substance abuse treatment providers, as Gov. Dannel P. Malloy called for last month, the state Department of Mental Health and Addiction Services plans to shift the cut elsewhere in its budget and delay the start of new programs. The tradeoff drew both criticism from proponents of one of the delayed programs and praise from those whose funding is being spared. One casualty of the shift is a new grant for hospital-based “community care teams,” which bring together health care and social service workers to help address the needs of people with mental illness or addiction who frequently visit emergency rooms. That cut, which totals $1.5 million this fiscal year, drew criticism from hospital officials, who called it short-sighted, since the model has saved money by reducing emergency-room visits. To implement the governor’s cuts, the department is also reducing the expected growth in caseload for young-adult services from 3 percent to 2 percent, and counting on spending less than was budgeted for services provided in new housing units for clients that are being developed. Because not all of the housing units are expected to be on line by the end of this fiscal year, the agency anticipates having some funding left over, and is using it to offset the cut to mental health grants, spokeswoman Mary Kate Mason said. To read more -



Alexander Knoll stayed after school one day recently to have a little chat with educators at the North Idaho STEM Charter Academy in Rathdrum. “I love helping people and I’m excited to tell you about the app I’m trying to develop called Ability App,” the Post Falls fifth-grader said. “The idea is simple.” This bright 10-year-old with red hair and freckles is getting good at addressing groups of adults, explaining his big idea and appearing confident and composed. “The simple-to-use app can be accessed for free on any computer or handheld device.”  In two weeks, Alex and his parents will jet off to Dublin, Ireland, so he can continue wowing people — this time, at the world’s largest Web conference — with his invention to help people with disabilities and their caregivers navigate shopping, dining, transportation, employment and other aspects of everyday life. “I believe we have the power to make the world a better place for those who need help,” he said in the presentation at his school. His inspiration for Ability App was watching a man in a wheelchair struggle to open the door of his grandparents’ old Black Sheep Sporting Goods store in Coeur d’Alene, before they opened a new store with accessible features. Alex wondered if there was an app to help people learn about access before they go somewhere, and when he realized there wasn’t, he set out to make one. Much like Yelp is to eating out, Ability App would give users such details as the locations of wheelchair ramps, accessible boat launches and hiking trails, service animal-friendly locations, and restaurants with Braille menus. It also would contain information on grocery delivery, occupational therapy, transportation and mobility, and disability-friendly job listings, among other services. Alex even imagined voice-activation and eye-tracking features for users who don’t have use of their limbs. His passion for drawing and design led him to create a clever logo that appears on the app’s Facebook page, website and business cards for the venture. His mother, Anne Knoll, has been at his side, assisting Alex on the computer. To read more -



With Illinois focusing on ramping up community-based care for its residents with developmental disabilities, the Seventh Circuit refused to block the closing of a large state-run facility.  Illinois operates seven institutions for citizens with developmental disabilities, serving approximately 1,800 residents, but the state has been lagging behind in the modernizations of its care.  Studies have shown that individuals get better care from smaller residential programs, and that such facilities are cheaper to operate, but Illinois had the second lowest percentage in 2013 of developmentally disabled persons living in apartments that house six of fewer persons.  Mississippi was at the bottom of the list. Meanwhile, 13 states no longer fund state-operated institutions that house 16 or more residents.  As part of an effort to focus on these community-based facilities, Illinois announced a plan in 2012 to close its Warren G. Murray Developmental Center in Centralia, Ill., and its center in Jacksonville.  The Illinois League of Advocates for the Developmentally Disabled quickly filed suit, contending that the state's $13 billion deficit was driving the measure.  With Illinois planning to have residents assessed for possible transfer to a community-based facility, a federal judge refused to issue an injunction.  A three-judge panel of the Seventh Circuit affirmed Thursday, noting that the Jacksonville center closed in the interim.  The Murray Center remained open "only because of this litigation," according to the ruling. It serves 229 residents, some of whom have the developmental level of an infant or toddler. A majority have additional behavioral problems requiring high levels of staff supervision.  "To be 'institutionalized,' whether in a prison, a madhouse, or a 'state-operated developmental center,' is to be frozen out of society - a situation that even a severely developmentally disabled person can experience as deprivation," Judge Richard Posner said, writing for the three-judge panel.  The court noted that residents of a community-based facility are more likely to have their own room, and have access to stores, parks and movie theaters - places where they can participate in society, even if under staff supervision, rather remaining isolated in a medical facility. To read more -



Indiana is expected to pay off a federal unemployment loan to relieve businesses from shouldering another year of penalties that are projected to reach $327 million next year. A committee staffed with state lawmakers and a budget leader authorized a plan Friday for the state to pay off the $250 million loan with an advance from the state’s general fund. The state must pay off the loan by early November so that businesses can avoid paying penalties in 2016 because of the debt. Those penalties are projected at $126 per employee, an increase from $105 this year. The loan dates to 2008, when the state had to begin borrowing from the federal government to meet unemployment demands as the recession took hold. Several lawmakers, including the Indiana House’s top Republican, lauded the committee’s action Friday. But the decision ultimately lies with Gov. Mike Pence, who has said his administration is exploring paying off the loan to provide “tax relief for job creators.” House Speaker Brian Bosma, an Indianapolis Republican, said the state’s ability to pay off the federal loan will save money for Hoosier employers. "This move is the right decision as we look to maintain Indiana's favorable business climate and keep our historic jobs numbers growing,” Bosma said in a statement. Under the plan, the state will be reimbursed by the end of the fiscal year in June. The plan allows the unemployment insurance trust fund to borrow from the state to pay off the federal government by the November deadline. Then the trust fund, which is filled by employer taxes, will pay back the state. To read more -



The contracts have been signed. A start date of January 1, 2016, has been set for the start of Medicaid managed care in Iowa. But critics of Governor Terry Branstad’s plan to move 560,000 beneficiaries continue to question the move, and are now asking whether the promised savings will materialize. At this week’s press conference, Brandstad defended the way his Department of Human Services (DHS) estimated the amount of savings—pegged at $51.3 million for the first 6 months—saying the Department relied upon seasoned actuaries who have worked for the agency for years. When asked about calls by Democratic legislators to produce documents about how the savings were calculated, Radio Iowa reported that the Republican governor said, “First of all, I don’t have any.” All information rests within DHS, he said.  Michael Bousselot, Branstad’s chief of staff, promised to “work with” legislators, as well as reporters, who have sought information on the estimates.  On October 9, 2015, the Branstad Administration announced it had signed contracts with 4 previously announced winning bidders to manage elements of Iowa’s $4.2 billion Medicaid program. Bidders were selected through a competitive process that began in the spring. The 4 contractors are Amerigroup Iowa, Inc.; AmeriHealth Caritas Iowa, Inc.; UnitedHealthcare Plan of the River Valley, Inc.; and WellCare of Iowa, Inc., according to DHS officials.  Together with these four partners, we are modernizing the Medicaid program in a way that focuses on patients’ individuals needs and on providing a higher quality of care,” Iowa Medicaid Director Mikki Stier said in a news release announcing the new contracts.  Iowa officials have tried throughout to emphasize the goals of improved quality and access to care, but Democrats say the goal is simply to cut cost and fear that access will actually deteriorate. They have criticized separate decisions to close a pair of mental health hospitals as a size of bad things to come. The Branstad administration said the experience of bringing elements of managed care to Iowa’s mental health care delivery has been positive overall—a point that has been confirmed by some advocates—and that the rest of the Medicaid system would benefit from more reliable budgeting and coordination.  Branstad Administration officials began warning last fall of the move to managed care because of the upward trajectory in Medicaid spending, which they said was not sustainable. Privatization is aimed to rein in a budget that grown 73% since 2003 to more than $4.2 billion. Democrats are not the only critics at this point. Losing bidders, including Aetna Better Health, Iowa Total Care, and Meridian Health Care Plan of Iowa, have challenged the selection process.



The Brownback administration struck back at former Gov. Kathleen Sebelius on Thursday after she criticized its handling of Medicaid.  Comments Sebelius made to the Lawrence Journal-World were “wildly inaccurate,” said Kari Bruffett, secretary of the Kansas Department for Aging and Disability. Bruffett’s response to Sebelius is the latest contribution to an argument that has dominated Kansas politics since a Brownback staffer sent an e-mail calling Medicaid expansion “morally reprehensible” earlier this week. That e-mail contended that expanding Medicaid prioritizes “able-bodied adults … who choose not to work” over disabled Kansans. The e-mail, set to Brownback’s grassroots supporters, got national attention, with some commentators saying the majority of people who would benefit from Medicaid expansion would be people who work but whose employers do not provide health insurance. Others have taken issue with the administration citing concern for the disabled community as a reason not to expand Medicaid. Brownback has said he will not expand Medicaid to cover 150,000 uninsured Kansans until the state gets disabled Kansans already on Medicaid off a waiting list for home services. States can expand Medicaid coverage to more residents under the Affordable Care Act. Kansas is among 20 states that have chosen not to expand so far.  Sebelius, who as U.S. Secretary of Health and Human Services spearheaded implementation of the Affordable Care Act before resigning last year, told the Journal-World that the comments from Brownback spokeswoman Melika Willoughby were “just nuts” and “flat-out wrong.”  “I think what the governor is probably talking about is that they have built an incredible waiting list because of budget shortfalls,” Sebelius told the newspaper. “And to somehow suggest that this is the moral high ground, to leave people without health care is, to me, just an unbelievable argument to make.” Bruffett blamed Sebelius for policies that caused the waiting list to grow in the first place, and praised Brownback’s efforts to reverse that.  “The Governor and the Legislature have made significant investments in increased funding to provide services to people with disabilities by investing in bringing people off waiting lists and into services, more than $65 million to date,” she said.  Bruffett said funding for services for people with intellectual and developmental disabilities “has increased every year the Brownback administration has been in office.” To read more -



Kentucky, one of the only Southern states to expand Medicaid under President Barack Obama's Affordable Care Act, could become the first state to repeal that expansion depending on the outcome of a closely contested governor's race. Kentucky voters have made it clear they don't like Obama or his policies, with the president's disapproval rating consistently at or above 60 percent in public polls. But when outgoing Democratic Gov. Steve Beshear used Obama's signature law to allow more people to qualify for taxpayer-funded health insurance, about 400,000 people signed up for it. Republican nominee for Governor Matt Bevin, along with the legislative leaders of his party, say the state cannot continue to pay for the health insurance of able-bodied adults. Taxpayers pay for health insurance for a quarter of Kentucky's population under the current expansion, which Bevin wants to repeal and replace with a different plan. Twice as many people signed up in the first year as state officials had predicted, more than doubling the expansion's estimated cost in 2017 from $33 million to $74 million. Those costs could swell to $363 million by 2021, further straining finances in a state wrestling with a multi-billion-dollar pension liability. Yet Kentucky's uninsured rate has dropped from a high of 20.4 percent in 2013 to less than 10 percent last year. Hospitals covered less than $60 million of uncompensated care last year, down from $160 million in 2013. New Medicaid enrollees received more than 54,000 preventative screenings, including for breast and colorectal cancer, of which Kentucky has some of the highest rates in the nation. To read more -



Governor Charlie Baker’s budget chief said this week that she is revising down the official estimate of how much money the state will bring in during the current fiscal year, a public warning that leaner budget times could be ahead. In a letter to top officials, Kristen Lepore estimated budgeted revenue will be $145 million less than expected due to a lower-than-forecast stream of state fees and other non-tax revenue.  Continue reading below  Asked whether her estimate means unilateral cuts are coming to the $38.1 billion state budget, Lepore said through a spokesman: “We are currently assessing next steps and whether corrective action is necessary.”



Health programs that help Minnesota seniors stay in their homes are getting a financial boost from the state. Department of Human Services Commissioner Lucinda Jesson on Friday announced more than $7 million in Live Well at Home grants. The funds were provided by the Legislature this year. The money will fan out to 62 organizations across the state that help seniors with daily tasks so they don't have to move into nursing homes or assisted living. Jesson says the money will help find creative ways to allow seniors to continue living independently. A Fergus Falls organization plans to use a grant to expand technology that helps monitor seniors to ensure they're safe.



A new union that has already negotiated benefits and working conditions for thousands of Minnesota personal care attendants came under new pressure Wednesday as federal appeals judges heard a pair of cases aimed at disbanding the labor unit.  In back-to-back hearings on separate lawsuits with the same goal, two 8th U.S. Circuit Court of Appeals panels raised doubts about their power to overturn the union for home care workers assisting the disabled and elderly. Judges in both cases dwelled on the voluntary nature of the unions, where none of the covered workers is compelled to join or pay dues.  It marked a new chapter in a years’ long fight by union opponents, who were unsuccessful in stopping the labor unit at the Legislature or in a lower court. They argued the Service Employees International Union shouldn't have been allowed to organize 27,000 workers that aren't full-fledged public employees.  William Messenger, an attorney with the National Right to Work Legal Foundation, told judges that while care attendants are paid using public health care money that doesn't make them eligible for unionization.  "Where do you draw the line? Where does it end?" he asked. "If exclusive representation is not confined to true employees, where does it end?"  Messenger added that the existence of a union infringes on First Amendment association rights of personal care attendants who didn't want a single representative speaking for them.  To read more -



(This action directly affects community disability agencies in Missouri) Gov. Jay Nixon announced Monday that he is withholding $46.1 million worth of state projects because of a lack of tobacco settlement funds.  In September, the Missouri Court of Appeals, Eastern District, overturned last year’s ruling by the St. Louis City Circuit Court that the state was owed $50 million under the Master Settlement Agreement. Attorney General Chris Koster plans to appeal the ruling. Advertisement: Story Continues Below “Both my administration and members of the General Assembly counted on these funds being available when the (current year’s budget) was passed,” Nixon said in a news release. “Now that this ruling has been overturned, this unexpected loss of funds must be accounted for through spending restrictions.” Because of this change, Nixon, a Democrat, picked 48 new programs and new spending increases to restrict.



Programs begun in the last two years to improve mental health services in Missouri are making substantial progress but much more work — and more money — are needed, state officials and mental health advocates said. Spurred by the deaths of 20 children and six adults at a school in Newtown, Connecticut in 2012, Gov. Jay Nixon's administration began looking to create or expand programs to help those with mentally illness, substance abuse or other behavioral health issues, said Mark Stringer, director of the Missouri Department of Mental Health. For fiscal year 2014, the state added $10 million to the department's budget for five programs — community health liaisons; coordinating care in emergency rooms and health centers; and three separate training programs to help law enforcement, the public and families deal more compassionately with the mentally ill. The money funded 31 Community Mental Health Liaisons to work with law enforcement officers who previously had little choice but to send someone with a behavioral problem to jail or to emergency rooms. Instead, the officers now refer troubled people to the liaisons, who will try to connect them with available services. Peggy Gorenflo, a liaison with the Tri-County Mental Health Services, works with 34 police and sheriffs' departments in three northwest Missouri counties. She said the program improved communication between law enforcement and mental health advocates. "It's just greatly improved our relationships in the area because I'm able to educate the officers, who didn't always know how to help these people," she said, adding that the program has encouraged some officers to seek help for mental health problems they or their family members are confronting. To read more -



When Stephanie Hill’s son was 3 years old, doctors diagnosed him with an autism spectrum disorder and predicted he might never speak. On Monday, Hill brought her now 11-year-old son, J.C., to sit before the Nevada Division of Health Care Financing and Policy as a testament to how important early therapy can be for children diagnosed with autism. “Most people wouldn’t know J.C. is affected,” said Hill, seated next to her son who wore khakis and a blue dress shirt. “The truth is he’s a miracle.” It’s a miracle that Hill fears won’t be repeated. Hill, a Las Vegas resident, was one of more than a dozen parents and advocates who spoke during a public hearing held by the division, which operates Nevada Medicaid and is preparing reimbursement rates for applied behavior analysis therapy. They are worried that the proposed reimbursement rate of $29.61 per hour for registered behavior technicians (RBTs) — effectively the wages of those who provide the bulk of therapy — is too low to attract and retain skilled providers. As of Jan. 1, more than 1,870 children with autism in Nevada will be eligible to receive ABA therapy, which doctors recognize as an effective treatment for autism, through Medicaid, per a mandate last year from the Centers for Medicare and Medicaid Services. “My son will be fine,” Hill said during the video conference meeting between Las Vegas and Carson City. “I have fought tooth and nail for him. But we have a population we are setting up to simply disregard.” Nevada Medicaid held three public workshops this year, raising its proposal five different times from a low of $17.33 to $29.61, state spokeswoman Chrystal Main said. The state determined the rate based on average wage information and normal business costs, such as health care, sick leave, vacation and supervision, among others. Autism advocates, however, said the proposed rate fell below the $40 to $50 per hour Medicaid reimbursement rates for RBTs in many other states. The Center for Autism and Related Disorders, which has a location in Henderson, called Nevada’s rate calculation “critically flawed.” “The proposed RBT rate of $29.61 would be, if finalized, the lowest in the country, and CARD would regrettably have no choice but to close its Nevada location,” said Dana Aronson, a case supervisor representing the Center for Autism and Related Disorders at the meeting. To read more -


New York

Anthony Battisti's parents have known for a long time that when their son turns 21 in December, he will join a growing population of young adults with very few options. Anthony has severe autism, and has spent years in a day program for young people who have intellectual developmental disabilities. But when his birthday rolls around this year, he'll age out of that program and have no place else to go, his family said. So Sherry and Michael Battisti of Ogden decided to take matters — and hammers and nails — into their own hands. Michael Battisti, a home builder locally for the past 40 years, is building a group home for his son and five others with intellectual developmental disabilities at 925 Hinchey Road in Gates. The home will have enough room for six residents, and the Battistis said they are hoping Lifetime Assistance will provide the programming for the new home. “The town of Gates has agreed to allow the group home to go there, and now we’re waiting for plans to be drawn up for permit purposes,” said Michael Battisti. The Battistis said they decided to build the home after becoming increasingly frustrated trying to find options for Anthony. To read more -


New York

The state Assembly plans to hold a public hearing to examine the adequacy of support and services for disabled New Yorkers. Assemblywoman Aileen Gunther, who chairs the Mental Health and Developmental Disabilities Committee, says they'll take testimony Tuesday on how effective New York's efforts have been at ensuring people with disabilities are effectively integrated into society and their needs met. In 1999, the U.S. Supreme Court's Olmstead decision called for integration appropriate with individual needs, followed by New York's implementation plan. Transitions from institutions to community-based programs and residences were meant to also address employment, self-directed services and managed care reimbursements. According to the state Office for People with Developmental Disabilities, it's supporting 38,000 New Yorkers in residences and 80,000 with day services.



With no budget deal in sight, a group of House Republicans called Monday for Pennsylvania to restart funding for domestic violence programs, cancer screening and other areas the legislators said should not fall victim to political gridlock. “This is just the next avenue that we’re going to try to get this money moving to the people that do not have a dog in this fight,” said Rep. Dan Moul, R-Adams. “We have no business holding them hostage.” Mr. Moul and Rep. Steven Bloom, R-Cumberland, are proposing appropriations bills that would allow the state to resume funding for rape crisis programs, higher education assistance grants and county child welfare services, among other programs. More than a dozen Republican representatives stood with them at a news conference Monday. School districts and some social services providers are operating without state funding as Gov. Tom Wolf and the Republican-led House and Senate continue to disagree on the state budget for the fiscal year that began July 1. Mr. Wolf, a Democrat in his first year in office, has said new recurring revenues — such as an increase in the personal income tax — are needed to balance the budget and deliver a significant boost in education funding. Republicans have opposed raising the personal income or sales taxes and have called instead for changes to the pension systems for state and public school workers and an end to the state business in wine and liquor sales. Mr. Wolf vetoed a Republican-crafted budget that stopped short of his proposals and then a Republican stopgap spending measure, as well as bills containing the GOP pension and liquor proposals. His spokesman, Jeffrey Sheridan, said Monday that the state needs a full budget. “The governor absolutely understands the hardships that are being faced by human service agencies and school districts,” Mr. Sheridan said. “That’s why he’s trying to reach agreement on a final budget.” Rep. Joe Markosek of Monroeville, the ranking Democrat on the House Appropriations Committee, said he supports the funding lines themselves but believes the state needs to “bite the bullet” and increase its revenue gatherings. To read more -



Vermont is tied with Massachusetts for having the lowest rate of uninsured residents in the country. But that success might be coming at a high price.  An unexpected spike in Medicaid costs has put the program and its thousands of new enrollees under heightened scrutiny. It's been less than three months since the start of the state fiscal year, but analysts say it already looks like Medicaid costs could come in as much as $60 million over budget in the 2016. The picture for next year isn't any rosier. Neither the Legislature nor the Shumlin administration has offered any hard projections yet. But officials familiar with the situation say unanticipated increases in Medicaid expenses could end up doubling the $50 million to $70 million budget gap already looming in the fiscal year 2017 budget. "This issue has really grown to something that is unmanageable from the state's financial portfolio," says House Minority Leader Don Turner. The Affordable Care Act expanded Medicaid eligibility by raising income levels needed to qualify for the program. Gov. Peter Shumlin and Democratic lawmakers seized on the federal.  To read more -



Two researchers from UW-Madison's School of Education are collaborating with partners from across Wisconsin and the nation on two new initiatives designed to provide technical assistance to state vocational rehabilitation (VR) agencies in their efforts to help people with disabilities obtain employment and increase their opportunities to be involved in their communities. The state-federal VR program serves about 1 million individuals per year and spends more than $2.5 billion annually in helping people with disabilities achieve their independent living and employment goals. Nonetheless, these state agencies vary in their employment outcomes. The first project — the "Vocational Rehabilitation Technical Assistance Center for Targeted Communities: Educate, Empower, and Employ (Project E3)" — will work with state vocational rehabilitation agencies and their partners across the United States to address these issues. This initiative will work specifically with people from economically disadvantaged communities to better identify and address the persistent, pervasive, multi-layered economic and disability-related barriers to employment for marginalized groups with disabilities. The $12.5 million, five-year federal grant is being led by a team at Southern University, along with co-principal investigators Timothy Tansey and Fong Chan, both faculty members in the Department of Rehabilitation Psychology and Special Education. Tansey and Chan will receive $2.5 million in grant support to evaluate the effectiveness of the initiative. To read more -