WICS Live: Around the States

Connecticut, Arizona Strike Budget Deals; Pennsylvania Remains Without Budget: Nearly two months into the current fiscal year, Pennsylvania is the only state without a FY 2009 budget Type In Connecticut, Governor Jodi Rell (R) announced September 2nd that she will allow a biennial budget written by Democratic lawmakers to take law without her signature on September 8th, ending the longest budget battle in state history. The two-year, $37 billion budget includes an increase in the state income tax for certain individuals, reduces the estate tax and increases the cigarette tax by $1 to $3 per pack. Rell did exercise her line-item veto authority, cutting about $8.3 million in spending. Arizona’s budget battle ended Friday, September 4th. Governor Jan Brewer's (R) mix of vetoes and bill signings. However, work remains to close a $4 billion spending gap. Read more!

WICS Live: Around the States

Medicaid: States Can Get 90% FFP for Medicaid Administrative Activities Related to Adoption of EHRs: A new State Medicaid Directors letter offers preliminary guidance on State expenses related to activities in support of the administration of incentive payments to providers for the adoption of electronic health records. While 100% match for provider incentive payments to adopt ERHs will not be immediately available, the letter reminds states that they can begin to receive the 90 percent federal financial participation (FFP) match for some initial planning activities related to the administration of the incentive payments. The letter is available at http://www.cms.hhs.gov/smdl/downloads/SMD090109.pdf. Read more!

WICS Live: Around the States

Washington: Restraining Order Lifted, State May Implement Law Prohibiting Payment for In-home Support Services Provided by Agency Employees Related to the Client: The U.S. District Court for the Western District of Washington ruled August 12 that a group of Medicaid beneficiaries and individuals who provide supports and services in the home through agencies were not likely to prevail on their claim that the new law, SBH 2361, violated their rights under the Americans with Disabilities Act or the Medicaid Act. SBH 2361 prevents the state Department of Social and Health Services from paying a home care agency for services provided by a family member of the client. The law applies only to home care agency-associated providers (APs) and does not prevent Medicaid beneficiaries from obtaining services from their relatives as “individual providers” (IPs), the court said. In making its decision, the court noted that the question before it was whether the state statute violated the constitutional rights of the beneficiaries or the personal care services providers, not whether the Washington Legislature had made an appropriate legislative policy decision. Read more!

WICS Live: Around the States

Utah: State Failing to Make Medicaid Fraud Recoveries: Results released in mid-August of a legislative audit shows that the state is losing $20 million in funding it could recover in Medicaid funding The Department of Health’s Bureau of Program Integrity, which is charged with checking for waste, fraud, and abuse in the state’s Medicaid program, failed to follow policies regarding prior authorization for services, and, due to an outdated cost-recovery tool, failed to review 78% of inpatient medical records, according to the audit. Read more!

WICS Live: Around the States

Louisiana: Impact of Medicaid Cuts Still Unknown: As of August 4th, payment rates for Medicaid providers in the state were reduced, in some cases more than 6%. The move is intended to close a $100 million budget gap in the current fiscal year. While providers and advocates are concerned of the long-term effects of the cuts, it is still too early to tell what the effects will be. Read more!

WICS Live: Around the States

Florida: Study Shows Medicaid Pilot Saves Money: A new study shows that the state’s Medicaid pilot program, which enrolled Medicaid beneficiaries in Duval and Broward Counties into manages care plans, is accomplishing one of its goals: saving money. The new report from the University of Florida found that the program, cut the size of beneficiaries’ medical bills over the programs first two years, compared with traditional Medicaid. The report also found that monthly spending on beneficiaries with disabilities dropped an average of $26 dollars while it rose $150 for beneficiaries in other counties. The new report—and the pilot program—are not without critics. Some critics belief that the report shows only short-terms savings, and long-term savings won’t be realized. The pilot was originally intended to be expanded statewide. The state faces a $300 million penalty from the federal government if it doesn't expand the program by 2011. Read more!

WICS Live: Around the States

Colorado: Governor Announces Medicaid Rate Cuts: Governor Bill Ritter (D) announced the cuts Tuesday, August 18th, reducing rates by 2.5% for providers of behavioral health and developmental disability services and by 1.5 % for medical providers to help close a $318 million budget shortfall. Such cuts should save the state $34.2 million in the fiscal year that ends June 30, 2010. The latest reductions follow a 2% rate cut for Medicaid providers on July 1st that was used to bridge a $1.4 billion budget gap that had existed previously. The Legislature also passed a bill creating a new fee on hospital beds beginning this fiscal year that is expected to allow more uninsured Coloradans to receive health coverage and to increase the provider reimbursement rates slightly. Read more!

WICS Live: Around the States

California: Court Again Upholds Injunction Against Medi-Cal Reimbursement Rate Cuts: In the ongoing legal battle over Medi-Cal rate reductions, the U.S. Court of Appeals for the Ninth Circuit August 7th issued another decision blocking Medi-Cal reimbursement rate cuts, this time for medical transportation and home health care services. The Appeals Court rules that a federal trial court properly issued an injunction preventing the state from reducing rates, solely because of the state's need to reduce expenditures, without complying with Medicaid Act requirements that the state to consider the effect of those cuts on efficient access to economical and high quality care. The appeals court also found that the petitioners, including Independent Living Center of Southern California Inc., demonstrated that they were likely to suffer irreparable harm if the injunction were denied. There was evidence before the trial court that state Medicaid transportation providers and home health care agencies already were reducing the scope or range of services because of the cuts, the Ninth Circuit said. Read more!

WICS Live: Around the States

Arizona: Medicaid Enrollment Increasing Rapidly, Adding to Budget Woes: Officials with the Arizona Health Care Cost Containment System, the state’s Medicaid agency said in normal year, new enrollments increase about 60,000. But with the downturn in the state’s service and construction industries, the state anticipates adding up to 300,000 new enrollees this year. The state is already having difficulty keeping up with the program’s current costs and is contributing to the state’s current budget standoff between Governor Jan Brewer (R) and the Republican-controlled legislature. They are at odds over the Governor’s 1% sales tax increase to close a $3 billion budget gap. Read more!

WICS Live: Around the States

Alaska: Lawsuit Filed Over Waiver Service Moratorium: As a result of HHS’ July moratorium on all new Medicaid waiver services, a class action lawsuit was filed in mid-August by four named individuals and others who all have medical and other disabilities and wish to receive services in their homes. The suit alleges that HHS Secretary Kathleen Sebelius of overstepping her authority in imposing the ban and also says the state’s Department of Health and Social Services’ Commission should have never agreed to the moratorium. The state was supposed to submit a detailed report to CMS by September 1st. Read more!

Bipartisan Senate “Gang of Six” Health Care Negotiators to Talk by Phone on September 4th

The group of six Finance negotiators include Finance Chairman Baucus(D-MT) and Ranking Member Grassley (R-IA), Democratic Senators Jeff Bingaman (N.M.) and Kent Conrad (N.D.), and Republican Mike Enzi (WY) and Olympia Snowe (ME). The group met once during the August recess, with no breakthroughs in the talks. The call is rumored to be the means of “jump starting” talks on Finance health care legislation following the August recess. The Senate Finance Committee expects to unveil its health care proposal by September 15th.
Read more!

Congratulations to Tim Kral and ORA on Oregon Nonprofit Award

The Oregon Rehabilitation Association was named a 100 Best Nonprofit by the Oregon Business Magazine. The award ceremony will be held in September. Visit ORA’s website for more information on this prestigious award. Read more!

UPDATE: HUD Releases Section 811 NOFA

The Department of Housing and Urban Development (HUD) released the 2009 Notice of Funds Available (NOFA) for Section 811 funds. The deadline for application submission is now December 16, 2009. Read more!

Deadline Extended to September 11, 2009 - Encourage Your DSPs to Participate TODAY!

ANCOR, through the National Advocacy Campaign, is gathering information on the proficiency and use of certain technologies by the direct support workforce both personally and in their work. This information is being collected by ANCOR to study and consider ways in which certain technologies may:

1. Mitigate the anticipated impact of the growing direct support workforce crisis on our industry and ability to deliver quality supports;

2. Improve the efficiency of supports provided by DSPs;

3. Provide cost saving opportunities for providers.

This survey is intended for response by DSPs only. This survey is anonymous and poses questions related to proficiency, usage and opinions of Direct Support Professionals (DSPs) related to technology, in general.

ANCOR will use the results of this survey to recommend practices and policies for better use of technology, resulting in more efficient delivery of supports provided by the direct support workforce to people with disabilities.

We encourage agencies to share this survey with their DSPs and solicit their participation.

We also encourage DSPs that are interested in participating in this survey to notify their agency and/or immediate supervisor of their interest prior to completing the form.

The survey is active now through September 11, 2009.

Click here to access the survey.

We appreciate your involvement as we work to develop sound policies and practices that strengthen the ability of providers and DSPs to efficiently deliver quality supports to their clients.

Thank you in advance for your participation. Please contact Jeff Britt at jbritt@mwcllc.com should you have any questions.
Read more!

ANCOR Meets with White House Officials on Home and Community Based Services

On August 27, as a follow-up to the meeting that President Obama had with disability community representatives on July 24, ANCOR, as part of a group of advocates for home and community-based long-term services and supports met with Nancy-Ann DeParle and other senior staff at the White House to discuss the Community First Choice Option.

The meeting participants had a frank and productive discussion concerning the possible opportunities and barriers of including a Community First Choice Medicaid State option (CFC Option) in the final health reform legislation. The CFC Option is a broadly supported proposal that emerged from discussions with Senator Harkin's office and Representative Davis's office as a way to make progress on home and community-based services and supports under Medicaid and a way to lay the foundation for later enactment of the Community Choice Act.

The disability representatives thanked the President's staff for his strong leadership on enacting comprehensive health reform that will help advance the goals of the Americans with Disabilities Act by eliminating disability-based discrimination in health care coverage and barring pre-existing condition exclusions. They also thanked the White House Staff for their time and support for expanding choices in long-term services and supports, and all agreed to keep open the lines of communication as health care reform heats up again when Congress returns from the August recess.

Attending the meeting from the White House were Nancy-Ann DeParle, Director of the White House Office of Health Care Reform; Jeff Crowley, Director of the White House Office on National AIDS Policy and Senior Advisor on Disability Policy within the Domestic Policy Council; Kareem Dale, Special Assistant to the President for Disability Policy; and Keith Fontenot from the Office of Management and Budget.

Those invited to meet with White House staff were Mike Oxford and Cassie James from ADAPT, Kelly Buckland and Lou Ann Kibbee from the National Council on Independent Living, Marty Ford of The Arc/UCP Disability Policy Collaboration and Consortium for Citizens with Disabilities (CCD), Chester Finn of Self Advocates Becoming Empowered, Daniel Fisher of the National Coalition of Mental Health Consumer Survivor Organizations, Ari Ne'eman of the Autistic Self Advocacy Network, Suellen Galbraith of ANCOR and CCD, Lee Page of Paralyzed Veterans of America, Andy Imparato of the American Association of People with Disabilities, and Bob Williams, President Clinton's Deputy Assistant Secretary for Disability and Long-term Care Policy who attended as a private citizen.
Read more!

President’s Council of Advisors on Science and Technology (PCAST) releases report assessing H1N1 preparations

A Presidential advisory group released a report assessing the Obama Administration’s preparations for the expected fall resurgence of H1N1 virus and outlining key steps officials can take to minimize the virus’s impact on the nation.

The report concludes that the 2009 H1N1 virus will most likely not resemble the pandemic of 1918-1919 however, it “poses a serious health threat” to the nation when compared to the benign swine flu from 1976. The H1N1 virus is not deadlier than previous viruses, rather it affects more people because it is a new virus that few people have immunity to.

The group lists several prime recommendations including: accelerating the preparation of flu vaccines for distribution to high-risk individuals; clarifying guidelines for the use of antiviral medicines; upgrading the current system for tracking the pandemic’s progress and making resource allocation decisions; accelerating the development of communication strategies—including Web-based social networking tools—to broadcast public health messages that can help mitigate the pandemic’s impact; and identifying a White House point person with primary authority to coordinate key decisions across the government as the pandemic evolves.
For more about PCAST, visit: http://www.ostp.gov/cs/pcast.

The Obama administration is already taking action based on the recommendations of PCAST. The CDC is expected to release revised flu treatment guidelines by the end of the month.

At the same time, problems with vaccine production are arising. The government expected to have 120 million vaccines available October 15th, however it now estimates it will only have 45 million vaccines ready and 20 million more would be ready each week through the end of December. Read more!

State Updates on H1N1 Virus

New York and Arizona both have had changes to the handling of the H1N1 virus.

The New York State Health Department is requiring health care workers across the state to be vaccinated for the seasonal flu and the H1N1 virus. The regulation affects workers and volunteers who come into contacts with patients at hospitals, in home health care agencies, and in hospice care, but through a technicality in state law, not in nursing homes.

Banner Hospitals across the state of Arizona have discontinued using the one-hour H1N1 virus test. The decision to halt use of the test, which was primarily used in emergency rooms, came because of the high number of false negatives the test produced. According to Banner microbiologist, roughly 50% of patients with negative results actually had the virus. Banner hospitals will now rely on the standard H1N1 test that takes 24 to 72 hours to complete.
Read more!

CDC Releases Business Plan for Upcoming Flu Season

The Department of Commerce Secretary Gary Locke, Department of Health and Human Services Secretary Kathleen Sebelius, and Department of Homeland Security Secretary Janet Napolitano announced new guidance for businesses to plan for and respond to the upcoming flu season. The CDC designed the guidance to help employers prepare for the impact the seasonal and 2009 H1N1 virus could have this fall and winter on their employees and operations.

The guidance may be found at http://www.flu.gov/plan/workplaceplanning/guidance.html. CDC has also produced a communication toolkit for businesses and employers, which is attached and may also be found at http://www.flu.gov/plan/workplaceplanning/toolkit.html.
Read more!

Effective Emergency Management: Making Improvements for Communities and People with Disabilities

EAD & Associates along with The National Council on Disability (NCD) released a report titled Effective Emergency Management: Making Improvements for Communities and People with Disabilities. The report recommends changes in emergency management and goes over practices that would better address the needs of people with disabilities. The report dives into examples of existing successful practices and evaluates emergency preparedness, disaster relief, and homeland security program efforts taken by both public and private sectors. Read more!

No COLA for Social Security and SSI Beneficiaries Possible for 2010

The recent Social Security Trustees report indicates the possibility of no cost of living adjustment (COLA) for Social Security and SSI beneficiaries for 2010. Annual Social Security benefits increases are, by law, based on the rate of inflation in the third quarter of the previous year; the law prevents benefits from being reduced based on negative inflation. Since it is predicted that this years' third quarter (July through September) will show no increase in inflation, the expectation is that there will be no COLA for benefits in 2010. Advocates for Congressional intervention point out that an automatic increase in Medicare prescription drug program premiums will result in reduced funds available to meet beneficiaries' monthly expenses. The Social Security Administration typically reports on the up-coming COLA amounts in mid-October. Read more!