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State Disability News Highlights

By Diane McComb posted 11-20-2015 11:46 AM


State Disability News Highlights for Period ending 11/20/2015


There will be no State Disability News next week.  We will return on December 4th.


Lead Story:  Iowa

Federal officials are heeding the thousands of Iowans who have flooded them with concerns about the state’s plan to privatize its Medicaid program, Democratic legislators said Wednesday. Three leading Iowa Senate Democrats met Wednesday morning in Washington, D.C., with Obama administration officials who will decide whether to approve Gov. Terry Branstad’s plan. The Iowa legislators want federal officials to at least slow down the shift to private Medicaid management, which is set to take place Jan. 1. “We were really glad to hear from the folks in the room that they had heard from Iowans,” Sen. Amanda Ragan of Mason City told reporters in a conference call Wednesday morning. Senate President Pam Jochum of Dubuque said federal administrators’ primary concern is whether the four managed-care companies would have sufficient networks of health-care providers participating in their plans. She said the administrators also want to ensure that the 560,000 Iowans using Medicaid would have consistent care during the changeover. The senators and other critics say neither condition can be met in the next six weeks. “I’m walking out of the meeting feeling much better than I did when I came to Washington to talk to them. … They get it,” Jochum said. She declined to predict whether the Branstad administration would get permission to shift almost all Iowa Medicaid beneficiaries to private management on Jan. 1. “We can only be hopeful that it won’t,” she said. Branstad contends the private management companies could offer more efficient and flexible service for the poor or disabled Iowans using Medicaid, which is jointly financed by federal and state governments. His staff has predicted the shift would save $51 million in the first six months. He also has repeatedly said that many other states have already made such changes. To read more -



Is Gov. Robert Bentley nudging closer to an attempt to expand Medicaid under Barack Obama's signature accomplishment as president: the Affordable Care Act (ACA), commonly called Obamacare?  Thursday the governor gave the most direct answer to date to that question. "We are looking at that (Medicaid expansion). We have not made a final decision on that yet, exactly on how that will work," said Bentley in response to a question from an audience of lawyers.  The question now:   Is Bentley nudging closer to supporting a state lottery to provide the critical state dollars that will be needed to expand Medicaid under the ACA?  Thursday Bentley said a major stumbling block to expanding Medicaid is financial. Bentley said if he decided to try to expand the program, which provides health care for about one million mostly poor Alabamians and children, the state would have to come up with $710 million in matching money to qualify for the roughly $7 billion the state could initially receive.  The governor acknowledged that there is currently no revenue source in the state close to being able to provide the matching money.  But Bentley did seem to offer one possible source, a state lottery whose proceeds he said he would want to see go entirely to the state's General Fund Budget, where Medicaid dollars are allocated.  In responding to a question from his audience about funding government, the governor said he expects a lottery to be proposed in the Legislature next winter and said that "might" be something in his long-term plans.
In a public appearance Friday the governor was asked a follow-up question about his lottery comment on Thursday. Asked if he was mulling over supporting a lottery, Bentley said:  "I think there has to be a long-term stream of money for the General Fund. I'm going to leave that up to the Legislature ...Whether a lottery is the solution, I don't know. But the Legislature has to look at all revenue streams."  To read more -



The state government is now expected to collect nearly $620 million less in taxes than originally assumed in the two-year, $40.5 billion budget plan that Gov. Dannel P. Malloy and Democrats in the legislature enacted in June. Budget analysts for the governor's office and the General Assembly lowered anticipated revenues by $217.9 million for the current 2016 fiscal year and by $401.8 million for the 2017 fiscal year.



When Gov. Jack Markell chaired the National Governors Association he led the effort to increase job opportunities for individuals with disabilities. In 2012, Markell signed legislation making hiring workers with disabilities the first option by law at Delaware agencies that provide services to people with disabilities. Today, the Department of Health and Social Services debuted the “Delaware Pathways to Employment” video featuring five Delawareans with disabilities who are employed, own their own business, or have an employment goal when they are old enough to work. DHSS Secretary Rita Landgraf says one the objectives is to educate business owners. “We’ve talked to large employers such as Walgreens, even to the smaller employers that are mom and pop shops and there are places where employment is available for individuals with differing abilities,” she says. In his 2015 State of the State address, Governor Jack Markell laid out plans to continue this effort. “Individuals with disabilities have the highest unemployment and underemployment rate of any minority population,” notes Landgraf. “Individuals with disabilities also face a higher level of poverty and individuals with disabilities are indeed an undertapped resource.”    The 8½-minute video will be used to advance employment opportunities among individuals with disabilities, their families and prospective employers.



When Aaron Harvey was born with a very rare disorder 21 years ago, doctors gave him a year to live. So you could infer the severely disabled young man's survival this long has been a miracle. Perhaps. But two extraordinary circumstances have benefited him greatly: an at-home nurse for a mother; and a place like ChildServe in Johnston, where he has been cared for since he was 12. In January, though, Aaron turns 22 and will "age out" of the place he considers home. His parents' problem is a national one: They've been unable to find a place for adults that has the room or medical expertise needed to meet his needs. Families of similarly fragile elderly adults transferred this year from the shuttered state mental hospital in Clarinda know too well the risks involved with that. Three of eight elderly psychiatric patients have died since they were transferred in June to nursing homes rated "below-average" or "much below average." Aaron Harvey is among a group of young people nationally with what's called "medical complexity," who are living longer and thus increasing in numbers. They need constant care because of a mix of complex diagnoses, from cystic fibrosis to congenital heart defects to childhood cancer. Nationally, they now number about 3 million and are growing at about 5 percent annually. No one knows exactly how many are in Iowa because they are cared for in different settings — at home, nursing homes, group homes and a few institutional settings. Nationally, youths like Aaron account for just 6 percent of children on Medicaid but 40 percent of the costs, according to the Children's Hospitals Association. The Harveys say their son's care costs from $750 to $950 a day. At $850, the cost would be more than $310,000 a year. The Harveys have tried to talk to a legislator about the lack of options here for medically complex youths who are aging out of care, but they say they were told to contact Iowa's Department of Human Services, which oversees Medicaid. They say they were told ChildServe discussed the issue with DHS Director Chuck Palmer a year ago, but no plan came out of that. To read more -



Three moderate Republicans who support Medicaid expansion have been removed from a House committee that oversees health care issues. The move is the latest in the fight over whether the state should extend the health care program for those with disabilities or low incomes under the Affordable Care Act. “Kansans oppose expanding Obamacare, a program that has busted budget after budget in states that have expanded it, House Speaker Ray Merrick said in a statement. Merrick, who makes House committee assignments, also moved moderates off key committees dealing with the budget and education Wednesday. He said the changes were “in the best interests of our caucus and state.” The lawmakers removed from the Health and Human Services Committee were Rep. Barbara Bollier of Mission Hills, a retired physician; Rep. Susan Concannon, R-Beloit, the vice chair who has a background in rural health; and Rep. Don Hill, R-Emporia, a pharmacist.  “I’m deeply saddened for the state that three of the most knowledgeable people on health care issues are being removed from all of the policy-making decisions … on one issue,” Bollier said. Kansas is one of 20 states that have not expanded Medicaid under the federal Affordable Care Act.



Kentucky Gov. Steve Beshear is warning his Republican successor against dismantling the state's health insurance exchange, which has added thousands to the insurance rolls in a state plagued by poor health. Beshear said the state would have to spend at least $23 million in taxpayer funds to scrap the exchange, known as "kynect," and transition to a federal exchange. He said insurance providers and the state's business community support kynect, which offers health insurance plans in accordance with the Affordable Care Act. Beshear, in his first public comments since the Nov. 3 election, said Friday that kynect is "the most successful exchange in this nation." About 100,000 people have used it to purchase private health insurance plans with the help of federal subsidies. "It's inconceivable to me, why, just to make a partisan political statement, Kentucky would want to go backward and become the first state to decommission a successful exchange," Beshear said at a news conference Friday in the capitol. Another 400,000 Kentuckians got free health insurance through the state's Medicaid program after Beshear expanded it to make more people eligible. As a result, Kentucky' uninsured rate dropped from 20 percent in 2013 to 9 percent this year, according to the Gallup-Healthways Well-Being Index, a major independent survey. But Republican Gov.-elect Matt Bevin has criticized kynect and the expansion as too expensive. Including the existing Medicaid program, taxpayers now pay for the health insurance of a quarter of the state's population. Bevin campaigned on a promise to roll back the Medicaid expansion and to get rid of kynect, arguing people can buy health insurance from the federal government's exchange. He said kynect "adds nothing of value." Bevin spokeswoman Jessica Ditto said in a statement Friday that Bevin's administration would "move forward in addressing Kentucky's health care needs in a deliberate and thoughtful fashion, consulting with Kentucky's health care stakeholders, his cabinet appointees and the General Assembly." Read more here -



When Dennis Marble took the reins at the Bangor Area Homeless Shelter in January 1996, it was just a job — a way to make ends meet. “This was a not a mission-driven decision,” he said in a recent interview. “I really just needed to earn a paycheck.” But 20 years later, as he prepares to retire as executive director at the end of this year, his perspective has changed. “This job has challenged me to use everything I know,” Marble said. “I have had to look inside, define my governing values and identify who I was serving. And for me, that means serving the community just as much as it means serving anyone who comes to our doors.” Marble, 66, is among scores of gray-haired Maine nonprofit leaders who are expected to retire in coming months and years, making room for big changes in mission-driven organizations supporting human services, the arts, education, health care, the environment and other public concerns. The figures in Maine track national percentages, but Maine’s fragile economy and its status as the oldest state in the nation confer extra significance. With about 6,500 nonprofits in Maine employing one in every seven Mainers, experts say the shift in leadership could have wide-ranging social and economic repercussions. According to a 2015 study by the organization Third Sector New England, nearly 43 percent of Maine’s nonprofit leaders are in the 55 to 64 age group and another 13 percent are 65 and older. Nearly 30 percent expect to leave their positions within the next two years, and another 35 percent between three and five years from now. To read more -



Gov. Mark Dayton and several prominent lawmakers say they intend to produce a broad package of reforms in the 2016 Legislature that would help Minnesotans with disabilities lead more independent and meaningful lives. “I want to take a look … and see what we can learn from other states that are doing this better than we are, and … how can we redirect existing funds to provide better support,” Dayton said in an interview with the Star Tribune. Their comments came just a week after the Star Tribune published a series of stories documenting the way Minnesota has fallen behind much of the nation in efforts to integrate people with disabilities into mainstream life. The stories found that thousands of Minnesotans with disabilities work and live in settings that are profoundly isolated, in conflict with a 1999 U.S. Supreme Court ruling on disability rights.  State officials already are looking at changes in reimbursement rates for disability employment programs, said Jennifer DeCubellis, an assistant commissioner for the Minnesota Department of Human Services, which oversees disability funding.



The state soon could be shelling out more than $19 million in damages for shortchanging blind Missourians’ benefits following a court decision Tuesday. The Western District Court of Appeals determined that a previous calculation of damages owed to about 3,000 blind residents receiving state benefits was too low. The new figure is around $19 million, up from a previous court’s determination of less than $200,000, said John Ammann, an attorney representing the blind. Blind residents have received monthly cash benefits from the state since the 1920s. State voters set up the pension plan through a constitutional amendment. These pensions are based on property tax revenues. But the Missouri Council of the Blind asserts that the state had been miscalculating the monthly pension amount since the early 1990s. Council representatives tried to talk to the state for years, but nothing came of it, said Chris Gray, council executive director. So, the organization filed a lawsuit in 2006. A court later determined the state was calculating the pension benefits incorrectly, according to court documents. Gray said that problem was addressed by the state and hasn’t occurred again, but the group has been battling the state over damages for years. The court of appeals decision Tuesday could be a resolution if the state doesn’t appeal. A representative for Attorney General Chris Koster said the office is reviewing the ruling. If there is no appeal, the state will have to find the $19 million to pay out to the estimated 3,000 recipients. That money could be added into the fiscal year 2017 budget, which begins July 1, or it could come from a supplement in the current year’s budget, which ends June 30. To read more -



A little more than a year from now, Nebraska Medicaid recipients will have their physical and mental health care -- and medications -- managed under a new program called Heritage Health. State Department of Health and Human Services officials recently announced they are sending out requests for proposals for two to three companies to make up the program.  Now, Medicaid recipients get their care through different programs. “We want to make sure that there’s plenty of time in this process, which I think is a lesson that we’ve learned from our own experiences as well as other states’ experiences," said Calder Lynch, director of the state's division of Medicaid and long-term care. The goal of managing care is to improve access to care, enhance health and reduce costs by eliminating inappropriate and unnecessary care through the use of preventive services and improved care coordination. Accountability will also be improved, Lynch said. Heritage Health will manage the care of some 230,000 Medicaid and Children's Health Insurance Program recipients.  The program has been designed to simplify the delivery of care. Enrollees will choose a plan in the fall. They will get packets in the mail and have an opportunity to get counseling on making their choices, Lynch said. The division brought in a national consultant to help focus and strengthen the expectations and protections in the proposal request. The department wants strong contracts with clear expectations for services and the performance of the plans, he said. To read more -



Marsha Rodriguez waited six months to get into a Nevada Medicaid waiver program providing home services so the disabled woman wouldn't have to move into a nursing home. Seven years later, the 72-year-old is still receiving those services along with 4,558 other people from three different vulnerable populations — the frail elderly, blind and disabled — through a state agency to help them live independently. “I really needed the program and I was blessed when I finally got on it," said Rodriguez at her home on Tuesday. She uses oxygen, has limited arm motion and suffers from alpha-1 antitrypsin deficiency, which is a disorder that might cause lung and liver disease. "If I didn't get the help, I would have to be in a nursing home. “But another 1,415 people are on a waiting list to receive the same services, and it's estimated that it would cost about $40.3 million to eliminate the backlog, according to data requested by the Las Vegas Review-Journal from the state's Aging and Disability Services Division, which administers the services. And the way these services are offered could change if the state moves forward to privatize them. It's unclear if the high costs were a driver for the efforts to pass legislation allowing the state to explore the possibility of offering those services through managed care, a health care system that controls costs by placing limits on physicians' fees and by restricting the patient's choice of physicians. “As Nevada continues to grow, so do the requests for community-based services," according to Jill Brenton, deputy administrator for the state's Aging and Disability Services. "At this time, there are more requests than available placements. “Prioritization is given to those who are in an institution upon discharge. Other prioritization is based on need, but some people receive state-funded services pending their Medicaid waiver slot, if they qualify. To read more -


New Jersey

A bill that would allow more than 300 developmentally disabled adults to remain in residential centers in other states was unanimously approved by a state Assembly Committee Monday, one of the last steps to officially end the controversial Return Home New Jersey program after years of protests from family members and their advocates. The bill formalizes an agreement between the Christie administration and state lawmakers that bars the transfer of individuals who object to it in writing. Sponsors said Monday they expected it to sail through a formal Assembly vote on Dec. 3 and to be signed by the governor shortly after that. “As countless advocates and family members told us, this program was disruptive, dehumanizing and disadvantageous to their loved ones who had been receiving the specialized care they needed for years,” Assemblywoman Valerie Huttle said in a statement. “I’m grateful that they will no longer be forced to return against their will.” Huttle also said that “under the spirit of the bill,” she and state officials would help the 170 people who had already moved to New Jersey to return to their previous residences. Arrangements have already been made for one young man with autism whose harrowing story became a rallying point for families who opposed the program. To read more -


New York

New York has received CMS approval for a State Plan Amendment to implement  Community First Choice.  To read the amendment and approval letter click here:


New York

Gov. Andrew M. Cuomo announced he would unilaterally establish a $15 minimum wage for all state workers, making New York the first state to set such a high wage for its public employees. The increase will place the pay of New York’s state employees far ahead of the current minimum wage in other states, and positions Mr. Cuomo at the vanguard of a national movement to address stagnant pay for millions of American workers. Using executive authority, Mr. Cuomo, a Democrat, would gradually increase the hourly rate: State workers in New York City would earn $15 an hour by the end of 2018; state workers outside of the city would also see wages rise, though more slowly, with rates climbing to $15 by the end of 2021. All told, some 10,000 workers — about 6.5 percent of the state’s permanent and seasonal work force — would see an increase in pay, according to the governor’s office, with the vast majority of those living upstate or outside the city. The governor’s action came on a day when fast-food workers across the country staged strikes seeking a uniform $15 hourly wage, a movement that he has championed in New York as a growing number of cities have acted to raise wages.


North Carolina

Cardinal Innovations, one of North Carolina’s state-funded mental health managed care organizations, announced last week it would be changing the benefits offered to people with mental health and substance use issues and intellectual and developmental disabilities, effective this Friday.  In a bulletin issued to service providers dated Nov. 11, Cardinal announced that people currently receiving services such as treatment from a Community Support Team, which provides “community-based mental health and substance abuse rehabilitation services” for people with “complex and extensive treatment needs,” will continue to receive those services. But effective Nov. 20, no new clients will be eligible for the service. All told, new clients in Cardinal’s catchment area, covering 16 counties throughout the Piedmont, will lose access to 11 services, including respite care, which gives a break to families caring for a loved one with complicated needs, and a program designed to provide intensive services for children with antisocial, aggressive or violent behaviors. Rep. Nelson Dollar (R-Cary), one of the architects of the state’s mental health MCO system, said he found the move “disturbing.” And officials at the state Department of Health and Human Services said they were still trying to get “clarification” on Cardinal’s announcement. To read more -



With Ohio’s aging population increasing demand for long-term care, state officials have stretched Medicaid dollars by boosting the number of elderly, disabled and mentally ill cared for at home. The strategy: care for more Medicaid beneficiaries at home at a lower cost and serve fewer in nursing homes and other institutions at a higher price. The shift has been dramatic. Ohio now serves 60 percent of those receiving long-term-care services through home and community care and 40 percent in institutional care. Less than a decade ago, the opposite was true. About 58 percent were in nursing homes and similar facilities and 42 percent at home. State officials project nearly two-thirds of Medicaid beneficiaries will be cared for at home by 2017. Ohio Medicaid Director John McCarthy said most people prefer to live in their own homes. To help them do that, the state eliminated wait lists for the popular PASSPORT home-care program and has invested in other home and community-based services. The Home Choice Program has been one of Ohio’s most successful efforts, moving more than 7,000 people from institutions and back into the community since 2008. About 1,400 more are working with caseworkers to locate housing and set up needed services. “It’s helped Ohio re-balance its long-term-care budget,” McCarthy said. According to the most recent statistics available, Ohio now devotes 62 percent of its long-term-care spending to home care, up from 50 percent a year ago. A recent report by the Kaiser Family Foundation found Ohio was leading the nation in transitioning individuals with mental illness, helping more than 1,900 return to the community. Overall, Ohio moved more people out of institutional care than any of the 43 participating states but Texas. To read more -



Blanchard Valley Center in Findlay has its sights set on helping meet a new state goal: to increase the number of foster care families for adults with developmental disabilities by 25 percent over the next 10 years. The Hancock County Board of Developmental Disabilities has hired a recruitment firm, REM of Mentor, to help with the local effort. REM was hired earlier this year by the board to help locate interested families, and train and screen them. The board agreed to pay the firm between $5,000 and $9,000 a year for its services. Blanchard Valley Center Superintendent Connie Ament said providing foster care for adults with developmental disabilities can provide a good income for individuals who are interested, or have a need to work from home. “It could be a good fit for single parents that find it difficult to work outside of the home, or empty-nesters who are lonely and would like some company,” Ament said. Part of REM’s job would be to match foster families with a Blanchard Valley Center client. “It can be a very successful model, if someone is matched appropriately with the right family,” said Jenny Rocco, an REM area manager based in Akron. “We have mentors who have worked with their people for 15, 20 or 25 years. Some have started before they had kids of their own. They travel together, vacation and go to family events, all together. They become family.” To read more -



Pennsylvania issues draft MLTSS RFP for the Pennsylvania Community HealthChoices (CHC) program, which will coordinate physical health services and long term services and supports (LTSS) under a new statewide managed care program. The state is requesting comments on the draft RFP, program requirements, and forthcoming eligibility and enrollment documents through the beginning of next year, in anticipation of a final RFP release in January 2016. The CHC program, scheduled to implement over three years beginning in 2017, will serve an estimated 450,000 individuals, including 130,000 with LTSS needs.  To read more -



A new report finds thousands of workers in nursing homes across Pennsylvania need food stamps and Medicaid to make ends meet. The Keystone Research Center report says low wages in the industry are being subsidized by taxpayers at a rate of about $118 million a year. Steven Herzenberg, the center’s director, says the center estimates that nearly 15,000 nursing home workers need public assistance to supplement their wages. "Which is one in six nursing home workers, and nearly one in three workers in occupations with an average wage in the industry below $15 per hour," he points out. The report says raising the starting pay of nursing home workers to $15 dollars an hour would put about $300 million into the hands of workers, and increase local and state tax revenues. Tisheia Frazier says she's been working in nursing homes for 10 years and is paid less than $12 an hour. A single mother, she says she depends on $200 a month in food assistance to feed her family, and says she needs other assistance to meet basic living expenses. "I have heating assistance in the winter, and our apartment is part of a low-income housing program,” she relates. “It's heartbreaking to work full time and barely be above the poverty line." Frazier adds most of her co-workers are on public assistance, and a raise to $15 an hour would make a huge difference in their lives. A bill just introduced in the General Assembly seeks to end poverty wages in nursing homes. State Sen. Daylin Leach says it would create a Living Wage Certification for facilities that provide a base hourly wage of $15 – and for those that don't, there would be penalties. "If they pay their employees an amount inadequate to support themselves, then the nursing home could be fined up to the amount the nursing home employee was getting from government assistance," he states. According to the Keystone Research Center report, nursing homes in Pennsylvania showed more than $400 million in profit last year.


Rhode Island

Three months into the current budget year a half-dozen state agencies are awash in red ink.  A newly released report on first quarter spending, in the budget year that began on July 1, projects over-budget spending at a potential $54 million. While that includes the rollover from one year to the next of unspent money from last year, and an uptick in the number of people enrolled in Medicaid, it also reflects an additional $31 million in spending over-and-above the amounts state lawmakers authorized last June. In fact, most of the overspending is attributed to agencies within the health and human services arena, including: the departments of Behavioral Healthcare, Development Disabilities and Hospitals; Human Services; Children, Youth & Families and the umbrella agency that oversees them: the Executive Office of Health and Human Services. Among the explanations for the deficit-spending: the Raimondo administration's after-the-fact approval of a first-ever state contract — that included 3-percent pay increases — for the at-home providers of state subsidized child-care, and the latest expansion of a computer project for determining eligibility for public assistance, including Obamacare subsidies.  Aside from these developments, the largest projected deficits are in BHDDH ($5.9 million), largely as a result of "increased utilization" of programs for people with developmental disabilities and in the Department of Corrections ($7.5 million). To read more -


South Dakota

It took handcuffs and a blast of pepper spray for police to drag a 72-year-old man from his downtown apartment. Neighbors had called for help after hearing banging and other noises. Ronnie Medenwaldt answered the door with a knife and refused to leave. He was arrested, charged and jailed for three months before a judge ordered a mental health evaluation. His journey through the justice system stalled there. Medenwaldt sat in the Minnehaha County Jail for another eight months waiting for a psychiatrist to determine what role his mental illness played in the confrontation with police. That Medenwaldt languished in jail for months while awaiting evaluation is not unusual in South Dakota, an Argus Leader Media investigation found. The legal purgatory raises questions about due process guaranteed under the U.S. Constitution, a potential civil rights violation that has sparked legal action in other states. South Dakota courts routinely jail mentally ill defendants like Medenwaldt for half a year or more without trial because of a backlog of court-ordered mental health exams, aggravated by a cap on evaluations at the state's mental health hospital. The time served waiting can count toward a sentence, if convicted. But if someone is deemed incompetent or not found guilty, that time is lost. To read more  -



Justin Mann of McKinney has been under a lot of pressure lately to find rides to get to work. He said he cannot rely on a service that has served him for several years in the Texoma Area Paratransit System (TAPS). He told News 8 he was born blind and uses a seeing eye dog named Garvey to get around. But his sales job is all the way in Frisco and he needs rides to get there five days a week. "This is one of the components to my independence," he said. Mann, along with many others, attended a public meeting held by TAPS and local leaders. TAPS is in serious financial trouble and is facing a deficit nearing $1.2 million, according to a spokesman. TAPS said it missed payroll three times in a row and this week drivers returned without getting paid. "This is right now utter transit Hell," Mann said as he wonders when his next scheduled ride would arrive. A spokesman told News 8 that On Demand rides, which Justin Mann arranges, is being cut 90 percent. Also on Thursday TAPS put out a media release saying Medicaid would cancel its contract with TAPS for non-emergency medical transportation. The release also stated that the Office of Inspector General "is conducting an investigation to determine if there has been fraud in the conduct of the Medicaid contract by TAPS." To read more  -



A new state forecast expects Virginia’s Medicaid costs to increase by nearly $1 billion through the next two-year budget. The $956 million increase is due primarily to a surge in enrollment by people who were eligible for program benefits but either did not know it or did not act on it until this year. Since July 1, more than 51,000 people have enrolled in the program, including 11,000 low-income parents who became aware they are eligible for Medicaid because of the debate over expanding the program and the requirement that individuals have some form of medical insurance under the federal health care law, the Richmond Times-Dispatch ( ) report. House Appropriations Chairman S. Chris Jones, R-Suffolk, said the forecast released Monday will leave little latitude for any new initiatives in the next budget. Gov. Terry McAuliffe’s spokesman, Brian Coy, said most of the increase is one-time, externally imposed expenses. “It’s not evidence of a long-term liability to the commonwealth for the program,” Coy told the newspaper. To read more -



The signing of the budget this week makes Virginia only the second state in the nation to offer compensation to victims of forced sterilization. The state is agreeing to pay $25,000 to each verified victim of the now-renounced Virginia Eugenical Sterilization Act that was in effect for more than 50 years. “This allows the victims to really move forward now,” said Mark Bold, a victims advocate based in Evington. “Our hope is the commonwealth will put in place policies that enable people to be compensated without delay.” Thousands of people deemed mentally unfit or inferior were sterilized in Virginia between the 1920s and 1970s. The state defended the practice in a landmark 1927 Supreme Court case, Buck v. Bell. In that case, Justice Oliver Wendell Holmes famously wrote of plaintiff Carrie Buck’s family, “Three generations of imbeciles is enough.” Nationwide, more than 30 states had compulsory sterilization laws on the books at some point. North Carolina became the first to offer financial compensation in 2013, and supporters hope the movement will continue to grow. “Virginia has led the nation in many other ways, and I hope by acknowledging this early we’ve set a standard by which other states will follow,” said Del. Ben Cline, R-Rockbridge, one of the legislative sponsors of the compensation effort. Bold said he’s already been contacted by people in California — which had by far the biggest sterilization numbers in the country — and is starting to reach out to lawmakers there. “I think it’s time for them to compensate as well,” he said, noting California carried out more than 20,000 of the about 65,000 sterilizations done in the United States. Virginia’s budget, signed by Gov. Terry McAuliffe on Thursday, sets aside $400,000 to create a victims compensation fund. The fund will offer a one-time payment of $25,000 to living victims of sterilization or the estates of victims who died after Feb. 1, 2015. Only a handful of confirmed victims have been identified to date; many live in the Lynchburg region and were sterilized at what now is the Central Virginia Training Center.   To read more -



People living with developmental disabilities -- conditions like autism and cerebral palsy -- often rely on experts, including people employed by the state of Washington, to decide what care and services they need. But when it comes to Washington's legislature, the KING 5 investigators found our legislators routinely ignore the advice of experts hired to weigh in on the best approach to caring for hundreds of developmentally disabled people living in state-run institutions. Four decades of scientific research conducted across the country and here in Washington conclude people with developmental disabilities live improved lives when they move out of such facilities. Washington, however, still has four large facilities open, well above the national average. Only 13 states operate more institutions for the developmentally disabled. "We're very behind the times (on this issue)," said Sue Elliott, executive director of the ARC of Washington, which advocates for the human rights of people with developmental disabilities. About 800 people still live in Washington's four institutions -- Fircrest in Shoreline, the Rainier School in Buckley, the Yakima Valley School in Selah and Lakeland Village in Spokane. The institutions are called Residential Habilitation Centers (RHCs) and are operated by the Department of Social and Health Services. They feature sprawling campuses and many therapeutic programs led by trained and caring staff, which include opportunities for the residents to work on the campuses, participate in art programs, and attend social events. But the national trend, based on science and legal interpretations of civil rights laws, is to close institutions and integrate people with disabilities into regular communities. That's what Dianne Laurine did in 1990. She has cerebral palsy and moved out of a private institution in Seattle after living there for 12 years. She struggled with the rigid schedule and lack of privacy. "(The institution was) a hell, a hell with no privacy," said Dianne. "(The day I moved out was) the happiest day of my life. The happiest day of my life. I was free. I was free." Dianne requires help with all of her basic needs, which she gets from around-the-clock staff in a shared home in Seattle run by Provail - an agency specializing in this kind of help. She says little things make her life better now, such as owning a dog. To read more -


West Virginia

More people use programs like Medicaid and SNAP during hard economic times, and with state revenue dropping, the Department of Health and Human Resources should expect to feel the pinch on both ends, state officials said Wednesday. Mark Muchow, deputy secretary for the state Department of Revenue, told people at a West Virginia Health Innovation Collaborative work group meeting on Wednesday that he expects the state to lose out on $250 million in revenue in 2016, and as much as $300 million in 2017. Those losses come from a more than 30 percent decrease in coal excise tax, low natural gas prices and steep competition, increased competition from bordering states in gambling and the lottery, and the lowest workforce participation in the nation. In October, Gov. Earl Ray Tomblin announced a 4 percent state budget cut — roughly $94 million. Muchow said it’s reasonable to expect similar cuts in the near future, as West Virginia sees continuing drops in revenue driven by a low international demand for coal, lottery revenue losses and low taxation rates. “It all depends on policy makers, but it could go a lot of different ways,” Muchow said.  “I think in five years we’ll still be struggling — hopefully we’ll have a balanced budget, but we’ll be struggling because we’ve relied for so long on the coal industry, and the coal industry will hopefully stabilize, but it will be a lot smaller than in the past.” “We’re in a difficult position in the department ... our mid-year cut was about $41.5 million. There are real consequences to that,” said Jeremiah Samples, DHHR deputy secretary for public health and insurance. To read more -