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State Disability News Highlights

By Diane McComb posted 12-10-2015 05:45 PM


State Disability News Highlights for Period ending 12/11/2015



Lead Story:  Ohio

Ralph (Joe) Magers, Pamela Steward, and Mark Felton produce floor samples for Seneca Re-Ad Industries, an Ohio-based sheltered workshop for workers with disabilities. Their job responsibilities include cutting floor tiles, printing labels, punching holes through tile pieces, chaining tile pieces together and packaging. For their efforts, they are paid $2.50 an hour. The Seneca County Board of Developmental Disabilities, which operates Seneca Re-Ad, argues these wages are legal because it is the holder of a special certificate from the Department of Labor. This certificate allows it pay subminimum wages to certain workers with disabilities perceived as unemployable, pursuant to the 1937 Fair Labor Standards Act. This program, however, is subject to multiple caveats, which are the subject of a petition filed recently with the DOL, asking for the agency to review Seneca County’s certificate. The petitioners are represented by attorneys from Disability Rights Ohio, the National Federation of the Blind, the Autistic Self Advocacy Network and Brown Goldstein & Levy. “Under the Fair Labor Standards Act, the workshop is permitted to pay less than minimum wage but only if the workshop follows the procedures laid out in the law, which wasn’t done here,” DRO Attorney Barbara Corner said in a news release, dated November 19. “Our clients’ disabilities do not preclude them from working hard and even using heavy machinery, and they deserve and want the opportunity to earn as much as workers without disabilities.” Under the FLSA, employers authorized to pay subminimum wages are nonetheless required to pay their workers “wages commensurate with those paid experienced nondisabled workers employed in the vicinity in which they are employed for essentially the same type, quality, and quantity of work.” To read more -



Surrounded by stacks of packages in a brightly lit room, Michael Palone gingerly folded a box and taped it shut. His eyes averted, he shuffled to the front of the warehouse to retrieve scissors, skirting by people and tables in his path. Palone, 26, has mild autism originally diagnosed as Asperger's syndrome. That makes it nearly impossible for him to socialize with others and adjust to the constant changes of a full-time job. Instead, he assembles packages with about 40 others at a Union City, Calif., work center run by The Arc of Alameda County. The Arc is a national nonprofit with chapters across the country that offer programs and services for people with developmental disabilities. "It means a lot to me," Palone says. "It gets me out of the house, and it helps me interact with people." Before joining the work activity center, Palone mostly stayed at home, in his room, playing computer games all day. He couldn't complete simple tasks like doing his laundry without his mother's help. But since he joined The Arc two years ago, his mother, Rosemary, said that the change in his behavior has been remarkable. "When I first found out how good the program was for him, it made me cry," she said. Now Michael voluntarily joins her on trips to the grocery store, sits with the family in the living room and even washes his own clothes without needing a reminder. Plus, his work is paid. He earns about $300 per month, which he uses to buy magic cards or to treat his niece to lunch. "We talk more now than we ever did throughout his entire childhood," Rosemary Palone says. But she fears that her son will return to his reclusive ways. Due to a lack of funding and the increasing cost of living in the San Francisco Bay area, the Arc can no longer shoulder the costs of running the program and plans to close the work center in a few months. Rosemary Palone worries that Michael and other clients like him will have nowhere else to go. "If he doesn't keep going to this program, all of the progress that he's made over the past two years will just be gone in two weeks," she said. But in the wake of The Great Recession, more than $1 billion in state budget cuts threaten the system. In a grimly-titled report, On the Brink of Collapse, the Association of Regional Center Agencies (ARCA) noted that state has the lowest funding in the country for individuals with a developmental disability who qualify for services. In addition, payments to service providers have been frozen since 2003, meaning that agencies are running on a rate model that was created over a decade ago. The situation is especially pronounced in the expensive Bay Area because provider rates are the same statewide. To read more -



The House of Representatives gave final legislative approval to a bill Tuesday night that closes the current budget deficit, mitigates bigger problems in the future, offers modest tax relief to businesses and restores a portion of funds cut this fall from hospitals and social services.  The Democrat-controlled chamber voted 75-65, largely along party lines, to send to Gov. Dannel P. Malloy a deficit-mitigation bill that also explores the closure of Southbury Training School and other facilities for the developmentally disabled. The Democrat-controlled Senate approved the measure 20-15 earlier Tuesday in another vote largely along party lines. “I’m here to say Connecticut is a great place to live and our quality of life ranks higher than just about any state out there,” said House Majority Leader Joe Aresimowicz, D-Berlin. “… I think it was a good bargain.” “We are adapting to the new normal, to the new economy,” Senate Majority Leader Bob Duff, D-Norwalk, said, noting that the legislature’s latest belt-tightening effort comes just six months after its last one. The biennial budget adopted last June approved spending hundreds of millions of dollars below the level needed to maintain current services, Duff said. “This is a significant response to our current fiscal situation,” added Senate President Pro Tem Martin M. Looney, D-New Haven, saying it not only balances finances in the short-term but begins to look at major policy changes that could save funds in the future. But Republican legislators charged the plan relies too heavily on fiscal “gimmickry,” using more than $130 million from specialized accounts and various one-time sources to support ongoing program expenses in the general fund. "I don’t think the high taxes, the high spending, the high borrowing is working,” House Minority Leader Themis Klarides, R-Derby, said, adding that Connecticut continues to lose population because its business climate remains poor. "... Here's where we are now," she said. "The people in this state do not trust us." The Democratic governor issued a statement afterward saying "the legislation passed tonight is not perfect, but it helps make progress for the State of Connecticut this fiscal year and beyond." To read more -



Six-year-old Aref Shabaneh is almost entirely blind, able to read only in Braille, walks with a cane, and is so sensitive to light his parents turn them off when he's home. For two years, he was enrolled in a taxpayer-funded health care program that provided specialists to help protect what little is left of his eyesight. In June, Florida health administrators declared in a memo that the little boy was "NOT clinically eligible." His severely detached retina had not been miraculously cured by doctors. Instead, state records show, Aref had been tossed from the program by state health employees looking to cut costs. They made the move after his mother failed to see the trap door hidden in a questionnaire from the Florida Department of Health — a "screening tool" that one judge declared invalid in September, but the Department of Health is fighting to reinstate. Emails and other records obtained by the Herald show the screening process imposed earlier this year was part of a deliberate attempt to reduce spending on kids like Aref — by making the number of youngsters in a program called Children's Medical Services shrink to line up with the money the state wanted to spend. "I was in deep shock," mother Reena Shabaneh said after a CMS nurse called to tell her both Aref and his older sister — who also suffers from retinal detachment and has severe vision problems — were removed from the program. "I went crazy. I did everything I was told. I didn't know what the problem was." Aref is among about 9,000 Florida children who have been purged from Children's Medical Services since May as part of a wholesale reorganization of the program in conjunction with a new state law. The law, passed in 2011, changed CMS from a Medicare-like fee-for-service plan, where the child goes to a doctor and the insurer pays the bill, into state-run managed care, in which the state sets aside a pot of money — which is capped — and hires insurers to divvy it up. To read more  -



At the Iowa Taxpayers Association's annual symposium on Friday, elected officials discussed Medicaid and the program's transition into management by four private, for-profit companies. The change is scheduled for January 1st, but many say this is a rushed deadline.  State Senate Majority Leader Mike Gronstal, a Democrat from Council Bluffs, says he anticipates that during the next legislative session, a lot of focus will be devoted to resolving Medicaid-related issues.  "The transition has not been going smoothly," says Gronstal. "The department has sent out letters with incorrect phone numbers on them. People are calling trying to get advice on which provider to pick. I think those are going to be nagging issues that take a lot of energy of the legislature to try and deal with those."  Gov. Terry Branstad says anytime there is a big transition there will always be complications, but he will not sway from having January 1st as the start date. That’s partly because the state legislature has based its budget on the cost savings related to implementation of Medicaid’s private management. "It's not a  rush, we announced it a year ago, and we're following the same path that a lot of other states have," says the governor. "The fact of the matter is, this has been a very  thorough, thoughtful approach."  Branstad projects privatization will save Iowa tax payers $51 million.  Due to violations during the application process, last month an administration law judge recommended that the state toss its contract with WellCare, one of the companies Iowa contacted with to manage Medicaid.  Next week the Centers for Medicare and Medicaid Services will visit Iowa to determine if the state can move forward with the transition to private Medicaid management.



Sam Brownback is among the 19 Republican governors who have consistently refused extra federal dollars under the Affordable Care Act to expand Medicaid for the poor. A Tea Party darling, Brownback of Kansas also cut his state’s income taxes three years ago, promising to make up the revenue through increased economic growth that never came. This year, facing a budget shortfall of more than $600 million, he decided to fill some of the gap using a strategy designed to draw more federal dollars to his state—through Medicaid. Since its inception 50 years ago, Medicaid has been managed by states but jointly funded with the federal government, which matches state contributions at least dollar for dollar. States are allowed to cover some of their portion by collecting taxes from Medicaid providers, such as nursing homes and managed-care organizations. That tax revenue allows a state to increase its contribution and attract more federal matching money. In Kansas, Brownback tripled the tax on managed-care groups, to 3.1 percent, and increased state spending by $33.4 million. With a federal match of $1.27 for every dollar Kansas spent, the gambit netted the state a bonus $47 million for its general fund. “This is the first time that I know of that they did this specifically to fill a budget hole, a hole that we created ourselves,” says Laura Kelly, the state’s Democratic Senate minority whip. A spokeswoman for Brownback declined to comment. To read more -



Expanding Kansas’ Medicaid program would generate enough offsetting savings to more than cover the cost of insurance for another 150,000 low-income Kansans, according to an analysis released Tuesday by six health foundations. The analysis done by Manatt Health Solutions, a national health care consulting firm, shows that expanding Medicaid would lower state costs in several areas by enough to cover the annual $53 million cost of expansion, perhaps with money to spare. “We think there is enough savings and new revenue that the cost of expansion can be covered through 2020,” said Deborah Bachrach, the lead author of the analysis and a former Medicaid director for the state of New York. “It’s even possible that the state may be able to generate additional dollars — that is dollars beyond those needed to cover the costs of expansion.” To read more -



Governor-elect John Bel Edwards on Monday (Dec. 7) named a transition committee to begin examining Louisiana's most pressing health care issues, including Medicaid expansion and the state's former charity hospital system. The co-chairs of the committee include Ronnie Goux, president of the Louisiana Nursing Home Association, and Dr. Gary Wiltz, CEO of Teche Action Clinic. Edwards said in a statement the 44-member committee has a mandate to expand access to health insurance for people in Louisiana who are uninsured. "Expanding access to healthcare for Louisiana's working families is one of my top priorities," Edwards said in a statement. "These are our tax dollars going to other states when we could be using them right here at home. Our budget challenges center on a deeply flawed healthcare system, and I've asked this committee to develop a strategy to address this that we can begin implementing on day one." Edwards said he wants solutions focused on "reducing costs to Louisiana taxpayers." The governor-elect made health care in Louisiana a major plank of his campaign platform; the cost of health care is one of the biggest budget drivers for government spending in Louisiana. Edwards will take office as the Department of Health and Hospitals faces a huge deficit in Louisiana's Medicaid program due to a surge in new enrollment. To read more -



Now that the melodrama about whether and when Department of Health and Human Services officials will appear before a legislative committee to answer questions about the Riverview Psychiatric Center looks settled, the facility’s managers and lawmakers must turn their attention to solutions. The hospital in Augusta has been without federal accreditation for more than two years. The most recent report from a court-appointed overseer of the facility chronicled numerous problems, especially with regard to staffing. Frustrated by confusing and vague responses to its inquiries, the Government Oversight Committee finally got serious last week and threatened to subpoena the superintendent of Riverview and the DHHS commissioner to compel them to answer questions from the panel. DHHS Commissioner Mary Mayhew said Thursday, in a press release, that it was “ludicrous” that any commissioner be expected to be at the “beck and call” of the legislative oversight committee. On Friday, she said she would meet with the committee next month, as will Superintendent Jay Harper. To read more -



Minnesota House Minority Leader Paul Thissen wants to break up the state’s massive human services department into five separate agencies, each with its own leader. The effort would be the most significant overhaul of the agency in recent history, designed to streamline delivery of services and increase accountability. Thissen’s announcement comes the day after Gov. Mark Dayton’s administration selected a new commissioner to oversee the embattled agency.  “It’s really too big to manage and have one person be responsible and accountable for everything,” said Thissen, DFL-Minneapolis. While welcoming Emily Johnson Piper as the new commissioner, Thissen said the transition is a good time to consider changing an agency that serves more than 1 million Minnesotans. “The solution is probably not found in a new organizational chart,” said Rep. Matt Dean, R-Dellwood, who is chairman of the powerful House Health and Human Services Finance Committee. “It’s probably found in new leadership and a change in culture.” The proposal’s fate in the upcoming legislative session is uncertain, but it could emerge as the foundation of a major rethinking of the agency if DFLers win control of the Legislature in the next election. The Department of Human Services has a two-year budget of $33.8 billion and more than 6,000 workers whose duties range from overseeing child protection to managing the Minnesota Sex Offender Program to providing health care for the needy. It oversees different populations, requiring vastly different skills. “The Minnesota Sex Offender Program and delivering health care to poor people have nothing in common,” Thissen said. Thissen says the reorganization would require no new employees or added cost. DHS would be divided into as many as five separate operational agencies. Health care services would run insurance and medical programs for the needy, drug treatment and mental health services; aging and disability services would administer programs for those populations; human services would manage operations related to child welfare and child care assistance programs, income assistance and social services grants; forensic services would run St. Peter State Hospital, the Forensic Nursing Home and the Minnesota Sex Offender Program; and direct care services would have jurisdiction over the Anoka Treatment Facility and State Operated Services, residential and treatment programs serving people with mental illness, developmental disabilities, chemical dependency and traumatic brain injury, and people who pose a risk to society. Most of the resulting new agencies, Thissen says, will still be among the largest in state government. Roberta Opheim, the state’s ombudsman for mental health and developmental disabilities, sees merit in the idea. DHS, she said, “is too big, and it’s too complex.” To read more -



A Minnesota law that created a union for home health providers for Medicaid recipients does not violate the state or U.S. constitutions, a federal appeals court held Thursday. A unanimous three-judge panel of the 8th U.S. Circuit Court of Appeals affirmed a ruling by a federal judge in Minneapolis that dismissed a 2014 lawsuit by six home health providers who sought to block the 2013 Individual Providers of Direct Support Services Representation Act. Similar laws are in place in California, Connecticut, Maryland and several other states. To read more -



The acting director of the Department of Health and Human Services of Nebraska's Division of Developmental Disabilities will become its permanent director. Courtney Miller fills a crucial position at the department, Gov. Pete Ricketts said Monday in announcing the appointment. “Her broad experience from across state government will aid her as she supports the entire team’s efforts to build a culture of continuous improvement at the department,” he said. Miller, of Lincoln, has been acting director of the division since the departure of Yolanda Webb, who was appointed in August, served five days and then resigned.  Webb, of New Orleans, didn't explain her resignation, other than to say her life went in a different direction. It was later made public that she had listed a degree on her resume she didn't have and resigned when it was discovered through a more extensive background search. Her salary had been set at $142,500. Miller was then appointed acting director. Since 2008, Miller has had jobs in the HHS Division of Medicaid and Long-term Care, including deputy director for the programs section. Before HHS, Miller worked as a records technician for the Nebraska State Patrol and a unit case manager and case worker for the state Department of Correctional Services.  She has been named an employee of the year for both HHS and Corrections. Miller has a Bachelor of Social Work degree from Briar Cliff University in Iowa and a Master of Public Administration degree from the University of Nebraska at Omaha. Her appointment begins immediately. She will be paid $135,000.


New Hampshire

After being forced by a lawsuit to spend more on mental health, New Hampshire is winning praise from a national advocacy group for increasing funding and passing bills in 2015 aimed at giving people better access to care. The National Alliance on Mental Illness on Tuesday released a report tracking state spending and legislation on mental health that shows New Hampshire is one of 11 states that has increased mental health funding every year since 2013. The new spending is due in part to a legal settlement New Hampshire signed with the U.S. Department of Justice in 2013 over inadequate community mental health services. The current state budget includes $23 million for the settlement over the next two years.


New Jersey

The families of people with intellectual disabilities weren’t able to stop the state from closing two developmental centers in 2014, but they may soon be able to find out how those shutdowns affected their loved ones.  The Legislature has passed a bill supported by these families that would require the state government to study how former developmental center residents who moved into community-based group homes are doing, including checking in with them five years after their moves.  In some instances the findings could be tragic.  Some families have circulated a list of 27 names of former Woodbridge Development Center residents who they say have died since living with family. To read more -



As her teenage daughter grew older and stronger, Kelly Meara was effectively housebound. Audrey’s rages spared no one. “She would not leave and she attacked everyone who came in the house,” Meara said. “I had to wear a helmet.” Obtaining short-term, residential treatment for older children with severe autism and behavioral problems is often impossible for Ohio families, and Meara struggled for years before she finally found a place for 17-year-old Audrey in August. Relief was short-lived. The new, 14-bed Elijah Glen Center – the only program of its kind in central Ohio – is closing at the end of the month after being open for less than a year. Not enough families could get the insurance coverage they needed, whether through Medicaid or private plans, to pay for the care, founder Marla Root said last week. The only option left for some was to relinquish custody in hopes that their county Children Services agency would pay for the residential treatment, Root said. To read more -



An organization that wages legal battles on behalf of people with disabilities has launched a new attack, this time on what it claims is Pennsylvania's lack of community-based programs for autistic adults. The Disability Rights Network of PA argues in a lawsuit it filed in U.S. Middle District Court on behalf of three men with autism that the state Department of Human Services is violating federal law, including the Americans With Disabilities Act. Because there aren't enough community-based residential programs for those with autism, one of their clients is being held in a county prison and the other two aren't being permitted to leave state psychiatric hospitals, the network contends. All three clients face the same dilemma, according to the suit: They can't be released because they have no place to go.  One is being kept in the Mifflin County Prison even though he is eligible for release from the sentence he is serving for setting a car on fire, the suit states. The jail must release him in January, although without a treatment program to go to he will be homeless, be arrested again or be placed in a psychiatric hospital, even though he would be better served in a residential program, the network claims. To read more -



Governor Tom Wolf and Department of Human Services (DHS) Secretary Ted Dallas today announced that the commonwealth has successfully transitioned the first Pennsylvanian into an apartment through the Section 811 Project Rental Assistance (PRA) program. “My administration has worked since day one to provide the best possible home health care for Pennsylvania,” said Governor Wolf. “Our hope is that we’re able to provide access to housing that enables more Pennsylvanians to live independently and safely in the community.” “For thousands of Pennsylvanians, finding a stable, affordable place to live is one of their biggest worries in life,” said Secretary Dallas. “This is an even bigger challenge for someone with a serious mental illness, or an intellectual or physical disability. Today we’re able to make someone’s load a little lighter.” DHS and the Pennsylvania Housing Finance Agency (PHFA) were awarded $8.6 million in March 2015 and $5.7 million in 2013 to prevent individuals with disabilities from being unnecessarily institutionalized or falling into homelessness. The funding for this demonstration grant was provided by the federal Department of Housing and Urban Development (HUD). Section 811 PRA provides an innovative housing solution for residents with disabilities. This grant provides rental subsidies for permanent affordable rental housing and ensures that needed supportive services are available to extremely low-income persons with disabilities, many of whom are hoping to transition out of institutional settings and back to the community. The award is part of $150 million in rental assistance to 25 state housing agencies. To read more -


South Carolina

Osprey Village has found a home. The local nonprofit group, which has wanted to build an inclusive community for adults with developmental disabilities since 2008, signed an agreement this week to buy a parcel of land in Bluffton.  The 38-acre plot is on Bluffton Parkway just south of Buckwalter Place. "This is a big deal for us," Osprey Village president David Green said Friday. "(The contract) is something we've been working on for quite some time." The plan for the initial phase of the project is to build six homes specially designed for adults with disabilities, as well a community center, pool and walking trails. Green estimates the land, infrastructure and construction costs for this initial phase will total about $2.2 million. Eventually, the plan is to add more homes and about 30 apartments to house support staff and relatives of the disabled residents as well as anyone interested in participating in the group's "intentional neighboring" community model. Intentional neighboring is a concept that involves developing communities in which people with and without disabilities live alongside one another, Green said. "It's essentially 'neighbor helping neighbor,'" he said. Green envisions Osprey Village as a place retirees may choose to live if they want to devote their golden years to volunteering and "continuing to make a difference in people's lives rather than just sit around and watch television." This community model is an alternative to group homes, where many adults with disabilities live when their families are no longer able to provide adequate support. These group homes are often "more tolerated than integrated" into their surrounding neighborhoods, Green said. Groundbreaking at the Osprey Village site is expected by next summer. To read more  -


South Dakota

Gov. Dennis Daugaard has proposed broadening eligibility for South Dakota's Medicaid program even though he shares some lawmakers' concerns about expanding it. The governor announced the plan Tuesday during his budget address. He acknowledged that some lawmakers may not be receptive to expanding the program for low-income and disabled people. Democratic legislative leaders have backed the move for several years. Senate Minority Leader Billie Sutton says now it looks like "a very real possibility." Daugaard says expansion is "not a done deal" because negotiations with the federal government remain ongoing. He says the state's cost for expanding Medicaid would have to be covered by other savings to move forward. House Majority Whip Don Haggar says he doesn't believe the Republican-held chamber will support expanding the program.



Texas has submitted a request to amend its 1115 demonstration “Texas Healthcare Transformation and Quality Improvement Program”, consisting of four different changes. These including adding STAR+PLUS Home and Community Based Services (HCBS) program slots to reflect additional capacity for beneficiaries, clarifying the electronic process for reviewing STAR+PLUS HCBS service plans, allowing a dentist to bill for services provided by a substitute dentist, and delaying the quarterly report due dates for quarters 1 through 3 by 45 days and combining quarter 4 with the annual report. The Federal public comment period will be opened from December 10, 2015 through January 9, 2016.  To read the pending application - View and submit public comments -



Gov. Gary Herbert will not propose another Medicaid plan and instead will wait to see what, if anything, legislators come up with, his office said Thursday. Lawmakers earlier this year rejected two plans backed by the Republican governor. They intend to tackle the issue again in 2016 after debating it for more than three years and failing to agree. But Herbert's chief of staff Justin Harding said it's possible Utah may wait until 2017, to see if a Republican wins the White House and offers the state more flexibility about who it will cover and how. Any plan the Legislature and governor approve must also pass muster with federal health officials. There is no deadline to approve an expanded Medicaid plan. But without one, Utah is missing out on federal money, and thousands of its residents remain unable to afford insurance. Harding said the governor's office and legislative leaders still hope to find a plan they can all agree on next year. But if lawmakers "choose to wait until 2017, I think we would support that as well," he said. To read more -



The large number of developmentally disabled adults living in state-run institutions puts Washington at risk of being sued by the federal government. Only a handful of states operate more institutions for people with developmental disabilities than Washington. And in Washington, more people live in these segregated settings than most of the rest of the country. Civil rights experts warn that this situation puts Washington in the cross hairs of the Department of Justice's Civil Rights Division, which since 2009 has made it a top priority to achieve desegregation of people with developmental disabilities. Since the 1970s when the deinstitutionalization trend started, 16 states have closed all of their institutions that once housed the developmentally disabled, including Oregon, Alaska, and Hawaii. And 21 states, including Idaho, have fewer than 100 residents total living in these types of public facilities. But in Washington, approximately 825 people with developmental disabilities -- people living with autism, Down syndrome, cerebral palsy and other disorders -- reside in one of the state's four large facilities: Fircrest in Shoreline, the Rainier School in Buckley, the Yakima Valley School in Selah, and Lakeland Village in Medical Lake. "I think Washington state is very much vulnerable to a lawsuit. It's very much likely to be a target and it will have a tough time explaining why it continues to follow a policy that other states have abandoned successfully," said Sam Bagenstos of the University of Michigan Law School. Bagenstos was the top Department of Justice attorney in the Civil Rights Division under the Obama administration when the government began an aggressive strategy to force states to integrate their citizens with developmental disabilities into the community. To read more -