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State Disability News Highlights

By Diane McComb posted 12-03-2015 03:36 PM


State Disability News Highlights for Period ending 12/04/2015



Lead Story:  Tennessee

By July, the last of the Tennesseans with intellectual disabilities who have been confined — in some cases since childhood — to large and often isolated state facilities will move into neighborhood homes, ending an era in which institutionalizing people with autism or Down syndrome was standard practice. The closure of Nashville's 92-year-old Clover Bottom Developmental Center this month and the expected closure of Greene Valley Developmental Center in East Tennessee next year will save the state tens of millions of dollars each year on intensive, 24-hour institutional care. Those funds will be directed toward a new program intended to serve people with disabilities such as autism, cerebral palsy, spina bifida and people with IQ's below 70, who currently receive no services. The new budget proposals were presented to Gov. Bill Haslam on Tuesday by the state's TennCare program and the Department of Intellectual and Developmental Disabilities. More than 6,000 people are on a wait list for state services. Some have been on the list for more than a decade. The proposed new program — the Employment and Community First CHOICES — will cost the state approximately $24 million in its first year and serve up to 1,700 people. The program will provide job training and in-home services designed to keep people with disabilities as independent as possible in their own homes and with families. About $5 million of the new costs will come directly from the savings in closing Greene Valley, where the per person cost of 24-hour institutionalized care topped $420,000 last year. At Clover Bottom, the cost of care was approximately $500,000 per person annually, more than twice the national average at similar institutions. Nationally, other states are also in the process of shutting down similar facilities. The budget presentations by TennCare and the Department of Intellectual and Developmental Disabilities, or DIDD, are among 26 that Gov. Haslam will hear this week as he weighs his own comprehensive budget proposal to the legislature. Haslam has asked each agency to present a plan with a 3.5 percent cut. Democrats have criticized Haslam's efforts to pare budgets, citing higher-than-expected state revenues this year. To read more -



John Dunnam of Warrior works 12 to 20 hours a week as a janitor. He collects a small salary that barely covers rent, food and other bills. It certainly wouldn't cover the monthly cost of health insurance on the federal exchange. The 32-year-old Dunnam doesn't earn enough to qualify for a tax credit that would offset the cost of health insurance, and he also doesn't qualify for Medicaid. Dunnam falls into the Medicaid gap, a group of patients who were supposed to be covered by an expansion of Medicaid – the health care program for low-income adults under Obamacare. The U.S. Supreme Court ruled in 2012 that states could opt out of Medicaid expansion, and Alabama did, along with several other states led by Republican governors. "I can't even afford my bills on what I make," Dunnam said. "If I was on the marketplace, I would pay between $300 and $400 a month. On a limited income, it's not possible." On Wednesday, the Health Care Improvement Task Force unanimously recommended that the governor and legislature reverse their earlier decision and close the coverage gap for nearly 300,000 patients like Dunnam. About half of those who fall in the Medicaid gap work, according to research from Enroll America. About 14 percent of the state's population remains uninsured, and about a third of the uninsured fall into the coverage gap. "After thorough study and deliberation, we find that the most serious obstacle to achieving your stated goals is the coverage gap that makes health insurance inaccessible to hundreds of thousands of Alabamians and places our entire health care infrastructure in financial jeopardy," wrote several task force members in a white paper explaining their position. Thirty states and the District of Columbia have expanded Medicaid since 2013, and in those states the program covers adults who earn up to 138 percent of the federal poverty level, or about $16,000 a year for an individual. With the unanimous support of the task force, it looks increasingly likely that Governor Robert Bentley might try to push the state in the same direction. The move would financially benefit Dunnam and others who cannot afford health insurance, but what are the costs to the state? To read more -



Arizona's finances appear to be in solid shape headed into the new year. But Republican state lawmakers say that's no reason to start spending more money. At the annual Arizona Tax Research Association conference last week, Joint Legislative Budget Committee Director Richard Stavneak said Gov. Doug Ducey and the Legislature can expect to kick off the legislative session and budget process in January about $555 million in the black. He estimated $218 million of that could be used for ongoing new expenditures without putting the state into a financial hole. Ducey said he was proud to have helped get the state back in the black with his budget this year. "We inherited a $1 billion budget deficit," he said. "I made an unwavering pledge to get our budget in balance. We took our medicine and we balanced the budget in my first year." He promised to keep the budget balanced as long as he's in office.​ State leaders at the conference were mum on details, but did hint at legislation that will likely be introduced next session. The broad topics mentioned include: Decreasing business regulations. Cutting taxes; Ducey mentioned income taxes; Senate President Andy Biggs mentioned property taxes. Rep. David Livingston, R-Peoria, has already introduced a bill proposing to cut insurance premium taxes. Others include Body cameras for law-enforcement officers; Transportation infrastructure; School-funding reforms, including phasing out the $220 million in "desegregation funding" that 18 districts are allowed to access by levying higher property taxes and possibly eliminating bonds and overrides. Warnings of lessons past Both Stavneak and Republican lawmakers warned they've been at these crossroads before. In both 2008 and 2015, the governor and Legislature anticipated budget surpluses and spent more money only to have to cut back the following year when revenue didn't pan out. "I've seen this show before and I know how it ends," said Rep. Justin Olson, R-Mesa, chairman of the House Appropriations Committee. "It ends with budget reductions." He said the $555 million cash balance should not be spent on ongoing expenses. He also said surplus revenue really only exists on paper, mentioning that the state is still using financial gimmicks to balance its budget. State agencies across the board are seeking a piece of the ongoing $218 million in additional revenue: schools want more money per student, even on top of the additional funding they'll get from the lawsuit settlement deal; the state's child welfare agency is seeking an additional $100 million; some want funding restored to high school career and technical education programs; and the universities are seeking more money. Sen. Don Shooter, R-Yuma, the Senate Appropriations Committee chairman, said his goal for the session will be to maintain the financial status quo. To read more -



Many programs and services for Californians with developmental disabilities are ending because of financial challenges, KQED's "State of Health" reports (Hellmann, "State of Health," KQED, 11/27). Under the 1977 Lanterman Developmental Disabilities Services Act, California created 21 not-for-profit regional centers to coordinate services for individuals with developmental disabilities. The regional centers are responsible for distributing payment to the agencies that provide care. However, some advocates say the rates paid to regional centers have been frozen about 20 years. In addition, more than $1 billion was cut from the state Department of Developmental Services during the economic recession (California Healthline, 10/22). Several of the California regional centers established under the Lanterman Act have had to shut down programs and services because of financial strains. For instance, a work center run by the Arc of Alameda County will close in a few months because of a lack of funding and the increased cost of living in the area. In addition, Contra Costa ARC closed a program serving children with developmental disabilities and autism this week. A report earlier this year by the Association of Regional Center Agencies found that the state "continues to lose ground," adding that California has the lowest funding in the U.S. for services for qualifying individuals with developmental disabilities. "All of these challenges now mean that more people have to wait to get into a program," Eileen Richey, executive director of ARCA, said, adding, "[E]veryone throughout the system ends up having to do more with less ... continually worsening the quality of life for people with developmental disabilities and their families." Meanwhile, provider reimbursement rates for such organizations have been frozen for more than a decade.  To read more -



California lawmakers are staring down a $1.1 billion hole in next year’s health budget after failing to come up with a way to replace e state’s “managed care organization tax” on health insurance plans that serve Medi-Cal managed care recipients. It’s a hole big enough that state Gov. Jerry Brown recently used it as a reason to veto 15 health care and other bills sent to him by the state legislature.  And unless it’s filled, Brown, a Democrat, is expected to issue a preliminary state budget in January with sizeable cuts to health and human services programs. This KHN story also ran on KQED. It can be republished for free (details). So far, the governor’s efforts to fill the void haven’t paid off. Brown in June had called a special legislative session to find other revenues to replace the tax, which the federal government says doesn’t meet regulations. That session is ongoing, and an informational hearing on the managed care organization tax is scheduled for Dec. 1 in Los Angeles, but getting everyone back to the negotiation table is proving difficult. At the same time, state officials face other pressures on their Medi-Cal program, which has a total budget of $91.6 billion.  After much delay, health officials only recently came to agreement in principle with the federal government on how to fund reforms in Medi-Cal services.  And federal officials approved less than half the $17 billion the state had originally sought. Some observers say they don’t expect a deal on the managed care organization tax until the middle of next year, when federal officials have said the tax must end. While there may be closed-door discussions between insurers and state officials to find a solution, no one will talk publicly about them. “In some ways, people are willing to walk away right now because they still have time,” said Shannon McConville, research associate at the Public Policy Institute of California. The prospect of more than billion in budget cuts, however, could provide motivation for a deal. To read more -



Legislative leaders and Gov. Dannel P. Malloy said they’re considering a special legislative session the second week of December to address the 2016 budget shortfall.  However, both Democrats and Republicans emerged from Tuesday’s closed-door meeting without anything substantive to share with the press. Each of the caucuses and Malloy have their own proposal for how they would solve the $350 to $370 million budget shortfall. Those proposals were shared with the media over the past two weeks. Senate President Martin Looney, D-New Haven, said the sides were “moving substantially closer to an agreement.” It’s unclear whether a retirement incentive will be part of the final deal. Senate Minority Leader Len Fasano, R-North Haven, said the legislature’s nonpartisan Office of Fiscal Analysis ran some numbers, which show the savings estimated from the retirement incentive are far less than initially projected. To read more -



The state's failure to provide proper support or placement for thousands of adults with intellectual disabilities is scandalous. Because unlike many tragedies, the hardships imposed on thousands of the intellectually disabled and their families could be dramatically lessened if our leaders had the courage to reform a broken and fundamentally unjust state system. Study after study shows that the Department of Developmental Services' budget could serve many more people. But this will only happen if serving as many people as possible becomes more important than the unthinking preservation of an outdated, inefficient and ultimately unsustainable system. According to DDS' own studies, for example, the annual cost per person in a state-run group home is $283,000, compared with $133,000 for a private group home providing high-quality services to individuals with similar levels of service needs. Connecticut's anachronistic and woefully inefficient public institutions (institutions that should — but evidently do not — embarrass a state that thinks of itself as progressive) unnecessarily waste even more money, averaging $329,000 per person. It is encouraging that Gov. Dannel P. Malloy has proposed modest first steps in converting a small number of the public group homes to private group homes. But these steps are too small and too tentative to make much of a difference.  Where is the sense of urgency and crisis that motivated the governor to take bold steps in criminal justice reform and veterans' homelessness? Is there something about people with intellectual and developmental disabilities that make them less worthy of attention than others who have been the focus of his reforms?  Connecticut has dramatically altered its public policy when it comes to thousands of individuals and families in need of residential services. The new policy — that there will be no placement until the last caregiver dies or is permanently incapacitated — has been implemented by budgetary fiat, with no announcement of its implementation, no debate on its merits or fairness, no discussion of alternatives and no notice to those it has so disastrously affected. It was only after several years of this waiting list shell game that people figured out that they were the victims of a cruel charade.  To read more -


District of Columbia

An overwhelming majority of District residents support a proposal before the D.C. Council to give each worker in the city 16 weeks of paid time off to care for a newborn or for a dying family member, according to a Washington Post poll. There’s just one hitch: More than half of those polled also say they don’t want workers to have to pay for it themselves. The wide contrast in support underscores a deep political divide nationally on the issue. It also sets up a major hurdle for proponents in the District to build a consensus around a plan to give employees the most-generous family-leave benefit in the nation. Under a bill that District lawmakers will begin debating Wednesday, private employers in the city would be required to pay the equivalent of as much as 1 percent of all employees’ salary costs into a citywide fund to cover the universal benefit. [Read The Washington Post poll]  The Post poll, conducted in mid-November, found that among District residents, 82 percent support the plan if employers are footing the bill, including large majorities across all parts of the city, all income levels and all racial groups. But support falls to 45 percent citywide in a follow-up question asking about funding the program through a new tax on workers instead of businesses, as would be the case for federal workers. Fifty-one percent oppose an employee-funded measure. Because the District cannot require the federal government to pay such a tax, the bill would set up two classes of workers in the city: employees of private companies, who would have their leave funded by a new tax on employers, vs. federal employees and others, who would be required to pay the tax themselves. To read more -



A Channel 2 Action News investigation uncovered a state crackdown on Medicaid fraud is putting thousands of Georgians with disabilities are at risk of being cut-off from services. Whitney Fuchs heads the non-profit Georgia Community Support & Solutions, which operates 28 group homes and similar facilities for the disabled in metro Atlanta.  "That would have put us out of business,” Fuchs said. Fuchs told Channel 2’s Matt Belanger he was handed a $1.5 million dollar penalty after a recent audit by the state. Fuchs said the audit did not find fraud in his operation. He said the errors were paperwork mistakes made by his staff like incorrect signatures or incomplete documentation. “This is not fraud. People are still receiving services,” Fuchs said. Our investigation uncovered many facilities for the disabled across Georgia are feeling similar pressure from the state. We revealed the state’s “zero tolerance” policy treats paperwork errors as serious infractions. In some cases, the penalty amounts to tens of thousands of dollars for each mistake. “That makes me mad. We need to fix that,” said State Representative Pat Gardner, D- 57th District. Gardner said in some cases the Medicaid repayments are threatening to bankrupt facilities already struggling to keep up with overwhelming demand for services. The waiting list for Medicaid services in Georgia contains more than 7,000 people. Further, Gardner said the money recouped by the state is not earmarked for people with disabilities. Rather, it’s returned to the state’s general fund. To read more -



Governor Rick Scott is recommending $1.2 billion in total funding for APD, an increase of 23.6 million. This historic investment will eliminate the critical needs waiting list for the third year in a row, and help Floridians with disabilities live, learn and work in their communities. Governor Scott said, “Florida has made significant investments in supporting individuals with disabilities, and I am excited to announce that we will continue on that path by eliminating the critical needs waiting list for the third year in a row. This historic investment will provide opportunities for Floridians with disabilities to receive the services and assistance they need to live more independently, find a great job, and achieve their dreams in our state.” The “Florida First” proposed budget includes: $15 million to enroll more than 700 individuals with developmental disabilities on the critical needs waiting list to the APD Home and Community-Based Services Medicaid waiver. This is the fourth year the Governor has recommended money to serve those on the waiver waiting list; $10 million to reinstate Department of Education funding for the Adults with Disabilities program; $1 million for the Employment Enhancement Project to serve people on the waiting list who want to go to work. This funding will pay for supported employment and supported internship services for people with developmental disabilities; $2.6 million for staff to perform customer needs assessments using the Questionnaire for Situational Information; $400,000 for a Medicaid waiver Provider Rate Study. To read more -



Much attention is being focused on a Dec. 1 sit-down between Gov. Bruce Rauner and legislative leaders as Illinois approaches the five-month mark without a state budget.  But there are other dates approaching that may be far more important to hopes for a deal on a spending plan since getting there has as much to do with political timing as getting everyone in the same room or agreeing on what and how much to fund. For politicians, the calendar often dictates motivations. And considerations such as the primary election in March and whether they will face opposition could be as big a factor as anything in getting a deal before spring. Among the tough votes lawmakers may have to cast are for a likely tax increase to help a close a revenue gap or for pieces of a pro-business agenda the Republican governor is pushing to weaken labor unions' bargaining power. Democrats say his proposals would hurt working families and shouldn't factor into talks over how to close a multibillion-dollar budget hole; Rauner says they're necessary to improve Illinois' economy. Next week's meeting is expected to bring Rauner together with House Speaker Michael Madigan and Senate President John Cullerton, both Chicago Democrats, and GOP leaders Rep. Jim Durkin of Western Springs and Sen. Christine Radogno of Lemont for the first time since the fiscal year began. To read more -



A judge has ordered Illinois to pay more than $13 million to cover the cost of health insurance for home health care workers. SEIU Healthcare Illinois took legal action against Gov. Bruce Rauner and Comptroller Leslie Munger earlier this month to force the payments. The union says nearly 5,000 health care assistants could lose insurance Dec. 31 if the state doesn't pay. Rauner's office said there wasn't spending authority to make the payments because of an ongoing budget impasse. To read more -



A generation ago, a high school diploma could open doors, especially to well-paying manufacturing jobs. But today, with technology radically reshaping the U.S. economy, many of those doors have closed. The high school diploma is as important as ever — but as a stepping stone to a higher degree, no longer as a destination.  That's one reason Indiana lawmakers are rewriting their state's graduation requirements. They want to make the path to a diploma more challenging and the diploma itself more valuable. Changes could include requiring students to take more math credits and a broader range of electives. The requirements would also apply to all students, and that's raising concern that some kids simply wouldn't be able to meet them.  Nash Huffman already struggles to keep up under the current system. He's a freshman at Noblesville High School just outside Indianapolis. Nash has Down syndrome and an individualized education plan. That means he splits his time between a general education classroom and working individually with a special education teacher. But, according to his mother, Jan, now that Nash is in high school, he's expected to do the same work at roughly the same pace as everyone else.  "You can't modify the work," she says. "You can accommodate the work, which is very different."  Nash struggles mainly in his math and science classes. After school one day, he and his parents meet me at the public library to talk. He's already had a full day and is tired. Later, it's back home to meet with a math tutor.  "Earth-Space Science is driving me crazy," Nash says. Why?  "Because it's real."  In Indiana, Nash must meet the same learning standards as other students and the same graduation requirements if he wants a diploma. He's currently working toward the state's General Diploma, which requires two years of math, including Algebra 1. But Nash's dad, Jeff, says his son isn't ready to take that class, so he's in another, remedial math class to help him prepare.  To read more -



The Iowa Hospital Association on Monday questioned whether Iowa has reached agreements with heath care providers on more than 12,000 contracts to provide Medicaid services through for-profit management companies. Federal officials will not allow Iowa to move forward with Gov. Terry Branstad’s privatization plan on Jan. 1 unless the state has an adequate number of health care professionals who agree to accept Medicaid. At least 560,000 poor or disabled Iowans depend on the $4.2 billion annual program for their health care. The hospital association, which represents more than 100 Iowa hospitals, claimed Monday it has found discrepancies between the list of health care providers the Iowa Department of Human Services released last week and the businesses that have actually signed contracts.  “The IHA believes this lack of accuracy calls into question all of the (managed care organization’s) data that purports to show the number of Iowa providers that have signed contracts,” said Scott McIntyre, vice president of communications for the association, which along with 11 individual hospitals has filed a lawsuit to delay or halt the plan's implementation. At least some of the initial lists provided by the companies and released by Human Services last week erroneously included companies that had not yet signed contracts. Neither the governor’s office nor the DHS by late Monday were able to provide an accurate list of the 12,000 contracts the governor said had been signed. Agency spokeswoman Amy Lorentzen McCoy said her office continues to work on that list and expects it to be released within the next week. She said she remains confident the 12,000 figure is accurate. “My apologies for the error and as soon as the new file is ready I will provide that to you,” Lorentzen McCoy stated in an email to The Des Moines Register. A closer examination of the summary data shows that each of the four companies selected to manage Medicaid has signed between 7 percent to 37 percent of the total 17,240 current Medicaid providers listed in six key medical categories across the state. To read more -



A registry that was created to flag people applying for adult care jobs who have been found to have abused their charges in previous settings has been quietly building since it was created last year. The caregiver misconduct registry was created after Gov. Steve Beshear signed Senate Bill 98, which passed unanimously in the House and Senate. The registry includes the names of paid employees and volunteers at adult care facilities such as nursing homes who have had complaints of abuse or neglect substantiated against them by the Cabinet for Health and Family Services. In the year since it was established, 51 people with proven histories of abuse or neglect of adults in professional care have been placed on the list. While the word "registry" invites comparisons with the publicly accessible state sex offender registry, the caregiver misconduct registry is not open to public inspection; the misconduct registry can only be reviewed by agencies such as nursing homes who want to check on prospective or current employees. People who work in the adult caregiver industry can also check their names on the registry. A similar registry exists for child care facilities, where day care center officials can check potential employees for incidents of past child abuse. "The law requires the ‘vulnerable service providers' to check prospective employees," said Dondra Meredith, staff attorney for the Cabinet for Health and Family Services. Prior to the creation of the registry, adult care businesses had to ask the potential employee's permission to look into their background for substantiated complaints of abuse. "They would have to get the prospective employee to sign a release of information," said Teresa James, commissioner for the Department of Community Based Services, which is part of the Cabinet for Families and Children. To read more -



Governor-elect John Bel Edwards called expanding Medicaid "among the highest priorities" of his new administration, though he said Sunday (Nov. 22) he may not be able to approve an expanded program on Day One. Edwards has said for months that he would accept the expansion of Medicaid, which requires executive approval, in the early days of his administration. But he said new questions have been raised about a funding mechanism the Legislature finished building in the spring. There is "a difference of opinion" in interpretations of how the bill was drafted and passed, Edwards said. But he did not appear concerned that ultimately the state would have to find a way to raise money to pay for the federal matching funds required starting in 2017. The Louisiana Hospital Association brokered a deal with lawmakers that would allow hospitals to pool their money to help pay for a percentage of the federal match. The rest of the money would be raised through fees on insurance premiums and other revenue sources that are not expected to result in tax increases. To read more -



State Education Secretary Jim Peyser suggested Tuesday that the Baker administration will seek new state funding for vocational education. “We’re certainly planning on investing new resources,” Peyser told reporters, after joining Governor Charlie Baker and two other Cabinet secretaries for a job training announcement at online retailer Amazon’s Kendall Square offices in Cambridge. Baker, who took office in January, has suggested that improving vocational education will be a centerpiece of his economic development agenda. He has cast the push as part of a larger effort to close the so-called “skills gap,” the distance between the needs of Massachusetts employers and the talents of the state’s workforce. At Amazon, the governor announced a first set of recommendations for addressing the problem from his Workforce Skills Cabinet, a collaborative effort by Peyser, Housing and Economic Development Secretary Jay Ash, and Labor and Workforce Development Secretary Ronald L. Walker II, who chairs the effort. In addition to calling for expanded access to “high-quality” vocational education, the Cabinet also announced the creation of the Governor’s BizWorks Team, a collection of executive-level staff from the three secretariats — education, housing, and economic development, and labor and workforce development — that will serve as a contact point for businesses looking to move to, or expand in, Massachusetts. The group also announced a third initiative: the launch of a regional planning process designed to get education, business, and labor leaders collaborating on the development of the worker skills required in their particular corner of the state. Baker said the state needs to be “more of a demand-driven and customer-centric supporter for businesses and industries that are looking to grow here in the Commonwealth.” To read more -


New Jersey

The long-running struggle over whether New Jersey’s government will force adults with disabilities who live outside of the state to return to New Jersey is set to come to an end.  A bill (A-4781/S-3117) advancing in the Legislature would make permanent the terms of an agreement reached by lawmakers and Gov. Chris Christie during the summer. The deal prevents state officials from requiring that adults with intellectual disabilities who live in other states transfer to group homes in New Jersey. The bill is receiving a warm response from some of these residents’ families, who say that the New Jersey group homes were ill prepared to serve their loved ones. The bill also allows those who’ve been required to live in New Jersey to move back to their out-of-state placements if their guardians request it. As of March, 170 people had transferred back to New Jersey, while 382 remained outside of the state, mostly in residential institutions.  The people with disabilities were placed outside of New Jersey, in some cases several decades ago, by the state government. Under a program named Return Home New Jersey, the state attempted to find group-home placements for all of them. Some families objected that group homes are unable to match the services provided at out-of-state residential facilities.   After Gov. Chris Christie vetoed a bill last year that would have put a moratorium on transfers back into the state, family members and legislators appealed to the governor. In July, lawmakers and the administration announced an end to the forced transfers, but bill sponsors say that the legislation is needed to make the terms of that agreement permanent.  To read more -


New York

Bill Liblick was shocked to learn that his sister, a disabled woman with the mind of a 1-year-old, had repeatedly been sexually assaulted at a state-run group home. Then, after her death, he was astonished again when he received a $1.6 million bill from the state for the cost of her care. Liblick says it was a coldhearted attempt by the state to get its hands on the money her estate eventually won in a lawsuit over her abuse. "They were found negligent and grossly negligent and now they want to be rewarded?" said Liblick, who secured a $2.5 million verdict against New York last month for the assaults Paula Liblick endured in 2009. At least three times in recent years, New York has pursued Medicaid reimbursement of $1 million or more from those who allegedly suffered devastating, even deadly, mistreatment while in state care. In two of those cases, the state eventually dropped its claims after the families contested them. To read more -


New York

New York state will now compensate parents who are family caregivers to adults with special needs. Last week, Governor Andrew Cuomo signed a new law adding parents to New York’s Consumer Directed Personal Assistance Program (CDPAP), a Medicaid-funded home care program. Previously, CDPAP supplied resources so distant family members, like brothers- or sisters-in-law, could be personal assistants to a loved one with special needs. Now, parents are included on that list. California is the only other state with such a program for parents, according to the Democrat and Chronicle. “Often, the parent knows how to give the best care,” Assembly Majority Leader Joseph Morelle, who co-funded the bill, told the paper. “This is wonderful news for families all across New York State,” Morelle told WHAM. “There is no one who understands the complex needs and challenges of a child with a disability better than a parent.” The new law is scheduled to go into effect April 1, 2016. For more on this bill, 


New York

CSEA today expressed bitter disappointment in Gov. Andrew Cuomo's veto of legislation (A. 7332) that would have ensured a better future for individuals and families living with developmental disabilities. "This legislation, passed unanimously by both houses of the legislature, would compel the Office of People with Developmental Disabilities (OPWDD) to show a true commitment to the well-being of individuals with developmental disabilities by ensuring access to a range of treatment and living options that appropriately consider their needs," said CSEA President Danny Donohue. Instead, the veto continues the state's misguided reading of the Supreme Court's Olmstead ruling concerning care of individuals with developmental disabilities. While that ruling requires care be provided in the least restrictive environment, it also holds that the needs of individuals must be addressed. There are many individuals in state operations in particular, who have a wide range of multiple disabilities and health-related needs, who require more intensive care and supervision. CSEA believes that the state selectively interprets Olmstead to diminish its obligations to provide appropriate levels of care. The administration's murky plans for future housing, services and supervision have raised intense concern and criticism from parents, staff and other advocates across the state – much of it expressed at a series of recent public hearings. "OPWDD needs to listen to the concerns that have long been raised," Donohue said. "Families are rightly concerned that their loved ones will continue to receive the care they need. Staff are rightly concerned that they will be able to provide the care that is needed and have the help to do it." "The answers are not simple and unilateral decisions by New York state won't make it any easier," Donohue said. CSEA represents about 18,000 workers in the developmental disabilities field. Most are delivering state operated services, but the union also represents nearly 2,000 employees in not-for-profit agencies that are contracted by the state. All are concerned about the state's future plans for the system.



The Oklahoma Health Care Authority (OHCA) moved forward on the care coordination model selected to serve the aged, blind, and disabled (ABD) Medicaid population. OHCA has selected a fully capitated statewide model, rather than a managed fee-for-service arrangement. OHCA issued an RFI to solicit input on the model design and has entered a quiet period around the development of a request for proposals (RFP), which will be released in June 2016. A draft RFP is set to be publicized in March 2016. Depending on final RFP and contract design, the statewide ABD managed care program could cover more than 177,000 beneficiaries with annual Medicaid spending of up to $2.5 billion. Per the current timeline, a draft RFP will be released in March 2016, with a final RFP to follow in June 2016. OHCA’s website indicates that proposals would be due in August 2016. The implementation dates below are based on OHCA presentations indicating that no RFI respondents saw an issue with a targeted implementation in 2017. To read more -



A group of mental health adult foster care providers are protesting a cut in their rates that have been negotiated by the state labor union, saying they will go out of business if the new contract goes into effect unchanged in January. Members of SEIU 503 are set to vote on the contract by 5 p.m. Wednesday. About a dozen foster care providers held signs in front of the Oregon State Capitol on Tuesday, in hopes of raising awareness of the new payment system that they say will cut their income by up to 60 percent. On the other hand, union officials say that the cuts were necessary to make the program, which is under Oregon Health Authority, sustainable. Mike and Jen Murdock, who owns five mental health adult foster care homes, say they will be in the hole $12,000 per month with the upcoming rates. They employ nine full-time workers, including themselves, to care for 25 residents, he said. "Everyone will be running in the negative," Mike Murdock said at the rally. Katie Coombes, the union's care provider division director, said the care providers received a 50 percent raise in the 2013 rate negotiations, and the expenses were costing the state $2.4 million above budget per month. The union pushed back multiple times when the state unilaterally tried to reduce the rates before the term was up, she said. Stephanie Tripp, an OHA spokeswoman, confirmed via email that the program was operating at a deficit and the state pursued a change with the union. "This decision was made to not only ensure that patients are receiving an appropriate level of services that meet their needs, but also to ensure that expenditures for these services are sustainable in the long-term," Tripp wrote in the email. "OHA and the union both recognize the need for sustainability: this change is best for the program and its’ clients, and best for Oregon. And although there are reductions in rates being paid, similar adult foster home providers for other populations are paid rates that are commensurate with the rates for mental health AFH." The rate decrease, which comes with a new assessment tool called Level of Service Inventory, was necessary to avoid more drastic consequences down the road, Coombes said. But providers say the rate assessment tool doesn't adequately address mental health needs of their clients. To read more -



It appears the state House is ready to start the process of ending the five-month-old state budget impasse that has interrupted money from flowing to school districts, human service agencies and other vendors who do business with the commonwealth. Following a three-hour closed-door discussion with his caucus on Tuesday, House Majority Leader Dave Reed, R-Indiana, emerged to share his cautiously optimistic view that a budget package could land on Gov. Tom Wolf's desk awaiting his signature over the next week. "We have a lot of tough decisions to make over the next week and we're going to work together with our Senate colleagues and the House Democrats as well as the administration to get this done," Reed said. "It's December 1. It's time to bring this budget to an end." The state has been operating without an enacted budget since July 1. To read more -



Gov. Bill Haslam said Tuesday that a program to help people with intellectual disabilities find jobs makes sense, but he wants to learn more about it before investing $19 million. The Republican governor heard from state health officials during a week of budget hearings at the state Capitol. He's scheduled to hear from 26 state agencies as he crafts his annual spending proposal that will likely top $34 billion. State health officials on Tuesday told Haslam that the job service would target people receiving home- and community-based services through TennCare, the state's version of Medicaid, and that it's part of a unique program where "employment and independent living is the first and preferred option" in assisting Tennesseans with intellectual and developmental disabilities. Haslam told reporters following the hearing that he favors the program but wants to dig down further and understand how it will work. "Obviously, $19 million is a big chunk of new money," he said. "The program does make sense to me." TennCare Director Darin Gordon said the program moves away from a "one-size-fits-all" approach to one that more appropriately meets the needs of individuals who are seeking services. "But also offers additional avenues for employment, which is something we've never done really intentionally as we should in the past," Gordon said. There are currently about 8,000 people that receive home- and community-based services, according to TennCare spokeswoman Kelly Gunderson. She said the program would also benefit hundreds of people on a waiting list to receive those services, as well as developmentally disabled individuals. A majority of people with disabilities want to work, but less than 15 percent are employed in a job in the community, earning at least minimum wage, according to TennCare officials. The program would help those who want to work, as well as help provide them with the skills to do so through an array of providers working with the state, officials said. To read more  -



Texas consistently ranks at or near the bottom on funding services for people with intellectual and developmental disabilities. But there’s a new pool of money rolling out that could help change that. It comes from Obamacare. It’s an entitlement program. And Texas is one of five states taking part, thanks to legislation by one of the state’s most conservative senators. The program, called Community First Choice, represents a relatively new idea of what housing for people with special needs should look like. The idea is that they should live in the community, in their own homes or apartments, instead of nursing homes and state institutions. It’s a change in thinking that Texas has been slow to adopt. The state’s system of mental institutions spends about $581 million to house just 3,362 people. Meanwhile, more than 102,000 people are stalled on waiting lists for money that could help them live in the community. Frustrated by those waiting lists, some North Texas parents started Community for Permanent Supported Housing to create housing options for their children. In the past year, the group has secured affordable housing in the area for more than 50 disabled adults, with more co-ops on the way, in the hope that these options can take advantage of funding through Community First Choice. To read more -



For at least the ninth year in a row, Vermont is looking at a budget gap for the coming fiscal year — a situation in which projected revenues do not meet projected demand for spending. Here’s a primer on why this keeps happening. Vermont’s economy has been growing by 3 to 4 percent a year, while state general fund spending has been growing at just over 5 percent, said Administration Secretary Justin Johnson. That has left lawmakers scrambling at the end of each session to close the gap with a series of cuts matched with tweaks to sales and other taxes — all designed to minimize the pain, but none achieving anything like a long-term solution. At bottom may be that the appetite for spending exceeds the appetite for raising taxes. At a budget briefing on Tuesday, lawmakers were told Vermont faces a budget gap of about $40 million for the current fiscal year, which ends June 30, and $58.5 million for fiscal 2017, which starts July 1. Medicaid. Vermont has seen a big expansion of the public health care program since the advent of the federal Affordable Care Act. About a third of the state’s population now has health insurance through the program and its offshoots. Gov. Peter Shumlin last January proposed a 0.7 percent payroll tax to shore up the Medicaid program, an idea that didn’t fly with lawmakers. Now some $53 million — about 90 percent — of next year’s budget shortfall is being attributed to Medicaid.  To read more -



There's a movement across the country to stop institutionalizing people with developmental disabilities.  According to academic and legal experts, the current best practice is to care for this population in regular neighborhoods with proper support. The theory is that people with disabilities should be integrated into the general population where they can experience and be part of their communities. But a small, vocal minority is fighting to keep the four facilities in Washington state open. Advocates for the institutions include the unions representing state workers who staff them, and relatives of those living in them.  The family members said taking their loved one's home away from them would be cruel and dangerous. “I would feel very uncomfortable if she were in the community at large because she’s not traffic safe,” said Candy Braley, whose sister lives at Fircrest in Shoreline. “I feel very comfortable that she is in a very save environment. The staff knows her and understands her and she can wander the campus,” Braley said. Besides Fircrest, there are three other remaining institutions for people with developmental and intellectual disabilities in Washington: the Rainier School in Buckley, the Yakima Valley School in Selah, and Lakeland Village in Medical Lake near Spokane. Together, approximately 800 people reside in the facilities. Only a handful of other states have more people living in institutions than Washington. The Department of Social and Health Services (DSHS) runs the facilities and refers to them as Residential Habilitation Centers (RHCs.) To read more -



A psychiatric patient “head-butted” a nurse so hard she fell back and her head was slammed against a door, causing injures that kept her home for three months. An agitated patient knocked a nurse onto a concrete floor, causing injuries that forced him out of work for seven months. A nurse who tried to stop a patient attack was in hurt so seriously that her recovery took more than two years. Hundreds of employees at Washington state’s largest psychiatric hospital have suffered concussions, fractures, bruises and cuts during assaults by patients, resulting in millions of dollars in medical costs and thousands of missed days of work. In some cases, the attacks led to charges of assault and even attempted murder, according to court records. Costs in the millions for assaults on staff at Western State Hospital  Federal regulators have threatened to cut millions in funding at Western State Hospital four times this year over patient safety concerns, and attacks on medical staff have contributed to worker shortages, which they say are the root cause of continuing violence at the 800-bed facility. To read more -