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State Disability News Highlights

State Disability News Highlights

By Diane McComb posted 16 hours ago
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State Disability News Highlights for Period ending 10/14/2016

Lead Story:   Kansas

The employees of Cornerstone Supports gathered last week at a house in Olathe with their clients — adults with intellectual and developmental disabilities — to plan their last day together. Cornerstone will close later this month, and its 19 clients will have to find other companies to help them with daily tasks so they can stay in their own homes. The regular gatherings at the Olathe house where three Cornerstone clients live will end Oct. 28. “We should do something,” said Brandon Thompson, one of the clients. “What do you want to do?” asked Vickie Vermillion, Cornerstone’s owner. “A cookout or something,” Thompson said. As they planned the barbecue, another client sitting nearby started crying softly. Vermillion stopped to comfort him. Vermillion is closing Cornerstone at end of October because of a Medicaid reimbursement changethe state made in May to help close a budget gap. She said the state’s restructuring of the residential pay policy will result in a cut that’s too deep for her company to absorb. People who help Kansans with disabilities find support services say providers across the state are struggling to adjust to the policy change. Some smaller companies, like Cornerstone, are simply unable to do so. Derek Laney, director and CEO of a company that provides disability support services in southern Iowa and eastern Kansas, said he foresees more closures and consolidations. Laney said he knows of at least one other Kansas company that is closing and has approached his company, Kansas Focus, about taking on its clients. “We’re committed to doing that for as long as we can stay financially viable,” he said. Kansans with developmental and intellectual disabilities who want to receive the services have faced a waiting list for years. The loss of providers like Cornerstone could make it more difficult for them to find the services, even if the state has enough funding to pay for them in the future. Chad VonAhnen, executive director of Johnson County Developmental Supports, said that if the provider network shrinks, more Kansans with developmental disabilities will be unable to make the decision to live independently, which is less costly than institutional care. “The concern for us is this system is based on choice for people,” VonAhnen said. “When we start limiting provider options because they’re no longer able to provide services in this climate, that’s concerning.”   Under the residential pay policy.  A community developmental disability organization, or CDDO, assesses Kansans with disabilities to determine what services they need. VonAhnen’s organization is one of 27 CDDOs throughout the state. Kansans with disabilities are assigned to one of five tiers based on the level of services they need. Reimbursements for each tier are calculated on a monthly basis and split into equal payments for each day of the month. Those payments used to be made even if the client did not need services every day. The policy change the state enacted means that starting this month, providers are to bill only for the days when clients need services. “Before the policy in question was adopted, each person receiving residential supports was automatically authorized to receive services for each day of the month, ” Angela de Rocha, a spokeswoman for state agencies, said via email. “This authorization was not dependent upon true need or the provider delivering an actual service.” Jerry Michaud, executive director of Developmental Services of Northwest Kansas, said the change sounds reasonable on its face. But it makes it harder financially for providers to keep enough staff to have employees on call every day of the month in case one of their clients unexpectedly needs help. “That’s exactly what it was,” Michaud said. “We had staff in place, and if ‘Bob’ needed something that maybe wasn’t on that regular schedule, we were available.” The policy change was part of a package of $56 million in Medicaid cuts Gov. Sam Brownback enacted in May to balance the budget. Providers of the home and community-based services, or HCBS, were spared the 4 percent cut that providers of medical services had to absorb for Medicaid patients. But Laney said most providers like him would have welcomed a 4 percent cut rather than the residential pay policy change. He thinks that change will reduce payments to his company by 15 percent to 25 percent and the overall cut to all providers will be higher than the $1.3 million estimated by the state. “I honestly don’t know what the number will be, but we’re not talking just a couple million dollars,” he said. Laney said the change will create unintended consequences, including provider closures that mean clients will move to more expensive long-term care facilities or have more medical costs because they’re not getting support in their homes. Some states already reimburse providers for days served. Laney said that could work in Kansas, but state officials would have to increase the daily base rates. A change to those rates may be coming, but advocates fear it could go in the other direction.  To read more –


Another lead story – Litigation in West Virginia

A federal judge has certified a class action lawsuit for individuals affected by cuts to a Department of Health and Human Resources program that provides disabled Medicaid recipients with money for in-home and community-based services. U.S. District Judge Thomas Johnson certified the class-action on Sept. 30. The lawsuit, filed by Mountain State Justice on behalf of five West Virginians with disabilities, states that the Medicaid Intellectual/Developmental Disabilities waiver program violates the Americans with Disabilities Act. According to the suit, individuals with intellectual and developmental disabilities who qualify receive a certain amount of waiver benefits which, by law, must be based on individuals’ needs.Instead, the suit asserts the Bureau for Medical Services uses contracted firm APS Healthcare Inc. to generate benefit amounts “arbitrarily through a secret and proprietary computer algorithm that does not give appropriate weight to recipient need and the amount of waiver benefits actually authorized in prior years.” Individuals who qualified to receive I/DD Home and Community-Based waivers processed using the APS calculations on or after Oct. 1, 2014, are eligible to join the class action. The suit also states the Department of Health and Human Resources implemented a reduction or termination in benefits due to budgetary shortfalls without publishing a reduction policy or implementing it with due process. “DHHR has implemented these massive reductions and terminations of the waiver benefits needed by plaintiffs and the class unjustifiably, arbitrarily and unlawfully, despite the lack of any meaningful change in an individual’s actual need for services,” according to the court documents. The suit also claims DHHR instructed local care provider teams not to request necessary services previously provided if they would exceed the waiver budget. These cuts mean that many receiving in-home care could be institutionalized. One plaintiff, S.F. of Lewisburg, requires assistance with all daily tasks and functions on the level of an 11-month-old, according to the suit. In past years S.F. received more than $100,000 in waiver benefits. In 2015, under the new algorithm, she received $72,000 despite no change in her circumstances. She had two or three care staff working to cover her needs seven days a week, but the family can now only bring in 40 hours of home care a week, leaving her aging parents to provide 16 hours of personal care each weekday and 24 hours per day on weekends, the suit states. She is at risk of institutionalization because her parents are physically unable to lift her from bed to a wheelchair multiple times a day. In August, Johnson issued an injunction ordering the five plaintiffs’ waiver benefits be raised to the 2014 amount. A settlement conference is slated for Oct. 28 in U.S. District Court in Charleston.


A federal judge has released the state of Delaware from a 2011 settlement agreement with the U.S. Department of Justice, affirming that the state has reformed its public mental health system. Local news organizations report that U.S. District Court judge Leonard P. Stark signed the order Tuesday after the DOJ and the state filed a motion to dismiss the settlement agreement. The joint motion states that Delaware has implemented reforms to transform, expand and enhance its ability to serve people with serious and persistent mental illness. Judge Stark’s order follows a September report filed by court-appointed monitor Robert Bernstein, who found that the state was in “substantial compliance” with the requirements of the agreement. The agreement stemmed from a DOJ investigation into allegations of unnecessary institutionalization of individuals at the Delaware Psychiatric Center. To read more –


It’s about helping people, and by doing so, means hiring those with disabilities. In Indianapolis, it has done just that. Nick Rhoad, director of ‘Ability Indiana’ has done something new and different by designating the Circle City as the state’s first “Ability City” when it comes to employing individuals with disabilities. “We’re recognizing Indianapolis in their long-standing commitment to supporting the employment of Hoosiers with disabilities,” said Rhoad. “If you hire someone with a disability, you will never meet a harder working individual and someone that wants to contribute to their community.” On Tuesday, Indianapolis was awarded the designation through their embrace and support of employees with disabilities through different employment options by making sure that those with disabilities have the same job opportunities as the rest of us, despite whatever challenges they might face. Indianapolis Mayor Joe Hogsett joined ‘Ability Indiana’ for the official designation: “Indianapolis thrives when all of its residents are given the opportunity and means to thrive,” said Mayor Hogsett. “Ability Indiana brings together a willing and capable workforce with the needs of the business world, helping to lift all Hoosiers  through hard work and meaningful private-public partnerships. I am proud that Indianapolis is now recognized as a leader in supporting employment for all individuals throughout our city.”


Four days a week, Laura Kaufman rises early and packs her lunch. Some days, she stuffs it inside her Spider-Man backpack, some days a purple rolling bag. She then boards a CATA van shortly after 8 a.m. at the East Lansing home she shares with her father. Her destination: a community mental health program for adults with disabilities. Kaufman, 44, has Down syndrome. She likes bowling and coffee with friends on Mondays and shopping on Thursday mornings, all offerings of the community program. But what she looks forward to the most is her job at a manufacturing workshop where she earns just over $2 an hour doing simple repetitive tasks, alongside other workers with significant disabilities. “I like to work,” she explains. “I like the staff.” Low-paid jobs and workshops like Kaufman’s are at the heart of a heated debate that’s playing out in mid-Michigan and across the country. It’s sharply divided the disability community. Some critics call such places “sweatshops” or sheltered workshops that take advantage of vulnerable people by paying them little and segregating them. “What we’ve done with sheltered workshops over the years is that we’ve created a whole industry that’s built on the fact that we can pay people with disabilities below the minimum wage in segregated environments,” said Elmer Cerano, executive director of Michigan Protection & Advocacy Service, Inc., a nonprofit organization that advocates for people with disabilities. If workers are being paid a fraction of a wage because they are considered just 25% as productive as non-disabled workers, maybe they need to have more suitable jobs that fit their skills, Cerano reasoned. “Now we want to promote real employment opportunities for real people in the real community for real wages with benefits just like everybody else,” he said. Others fire back that the jobs are a choice that should be offered to workers where they have the support they need. Not everyone will be able to find a job in the community, they argue. Kaufman’s father, Dr. Matt Kaufman, a retired physician, is among those who think the advocates are going too far. He fears that their efforts, while based on good intentions, will actually hurt his daughter because she will not be able to find a job in community and the workshop’s future is in question. To read more –


Gov. Mark Dayton announced two new hiring initiatives Thursday designed to improve the low rate of employment of Minnesotans with disabilities in state government. Flanked by disability advocates at a news conference, Dayton said people with disabilities will now have an opportunity to demonstrate their ability to work in state agencies through a program called “Connect 700,” which gives candidates up to 700 hours of on-the-job work experience. A second, supported work program will offer people with disabilities up to 50 full-time positions in state agencies.  Since 1999, people with disabilities have fallen from 10 percent of state government employment to 6.2 percent. Under an executive order issued two years ago, Dayton has directed state agencies to increase that share to at least 7 percent by August 2018. “We need to lead by example,” Dayton said. “State government should reflect the people it serves, including those with disabilities.”


Minnesota’s Democratic governor said Wednesday that the Affordable Care Act is “no longer affordable” for many, a stinging critique from a state leader who strongly embraced the law and proudly proclaimed health reform was working in Minnesota just a few years ago. Gov. Mark Dayton made the comments while addressing questions about Minnesota’s fragile health insurance market, where individual plans are facing double-digit increases after all insurers threatened to exit the market entirely in 2017. He’s the only Democratic governor to publicly suggest the law isn’t working as intended. Dayton’s comments follow former President Bill Clinton’s saying last week that the law was “the craziest thing in the world” before he backtracked. “The reality is the Affordable Care Act is no longer affordable for increasing numbers of people,” Dayton said, calling on Congress to fix the law to address rising costs and market stability. The Democratic-driven criticism has emboldened Republicans in Minnesota and nationwide to try to scrap President Barack Obama’s 2010 law. Clinton faced backlash for the comments he made during a Michigan rally for his wife last week, and he later clarified his support for the law and called for fixes to address gaps in coverage. Few states have embraced the health care law more strongly than Minnesota under Dayton. Lawmakers created a state-run online market exchange for people who aren’t covered by employers or public programs to buy individual coverage. When those policies first went on sale in 2013, Dayton and state officials touted the lowest health insurance rates in the nation.  But after several years of steadily increasing premiums, top state regulators said this fall that Minnesota’s individual market is in “a state of emergency.” The state scrambled to stop all seven companies that sell insurance directly to consumers or through the state exchange, MNsure, from fleeing for 2017, but the state’s largest insurer, Blue Cross Blue Shield of Minnesota, is still exiting. Health care insurance shoppers will see premium increases that range from 50 percent to 67 percent on their plans for next year. Across the nation, insurers have sought double-digit premium increases while major companies – including Aetna and UnitedHealth – have pulled out of many state-based exchanges for 2017 after forecasting heavy financial losses. The Obama administration portrays the premium increases as a one-year market correction that can be absorbed or offset by larger financial help through tax credits. Minnesota lawmakers are mulling potential fixes to get costs under control and ensure the individual market can survive. While Dayton said that’s worth considering, he said the bulk of the problem lies at the federal level. “It’s got some serious blemishes right now and serious deficiencies,” he said.  To read more –

North Carolina

Weeks after the shooting death of Keith Lamont Scott by a Charlotte police officer, a former Gastonia resident continues to drive national conversations on how police and civilians interact. But while the focus has stayed on race relations, those who knew Scott believe his disability may have played a role in his death. Scott’s former neighbor in Gastonia, Anthony Scott, said medicine Scott took for a traumatic brain injury made the man sleepy, unresponsive. It may have affected his response to police commands. A nationwide effort is underway to help law enforcement recognize when someone’s behavior is affected by mental illness or disability and understand what to do. The issue is key — a March study commissioned by the Ruderman Family Foundation, a nonprofit focused on people with disabilities, showed at least a third of people killed by police have a disability.  In Gaston County, one of the people on a mission to teach police is Sara Osborne. When Osborne introduces herself to a classroom of sheriff’s deputies, local police and probation and parole officers, she tells the room about her three jobs. One of those jobs is executive director of The Arc of Gaston County, part of a national nonprofit that supports children and adults with disabilities as well as their families. The second job is the wife of a law enforcement officer, whose work she described as sensitive in nature and puts him in harm’s way. Her third job: mother to three children. Her oldest, Danny, 15, was born with Down syndrome, a genetic chromosomal disorder that causes intellectual impairment and physical problems. “You learn to fly by the seat of your pants,” Osborne said. “I say a quick prayer and hope God gives me the right words.” Danny’s disability doesn’t mean he showed the same behaviors as Scott’s traumatic brain injury. But both conditions can influence how someone reacts in a stressful situation and his or her ability to communicate. The training Osborne participates in comes twice a year. Officers spend 40 hours a week learning to interact with people that have addictions, post-traumatic stress disorder and other issues. At least 6,000 people have developmental disabilities in Gaston County, Osborne said. Law enforcement will interact with them more and more because of ever growing opportunities for those people to work, live and exist alongside others. To read more –

Shannon McCracken is a leader when it comes to supporting the needs of people with developmental and intellectual disabilities. After a decade of experience at the two largest SCL agencies in Kentucky, she made the decision to embrace a new opportunity and start her own company, Commonwealth Case Management. While in the field, Shannon has won numerous national awards and served in multiple leadership positions, most recently with the Kentucky Association of Private Providers (KAPP). From November 2009 - 2012, she served as the Vice-President of Public Policy for the KAPP Board of Directors and served as President from 2012-2015. In 2016, KAPP made a significant investment in its future and offered Shannon a full-time position as the State Executive Director. Being so involved has enabled Shannon to stay at the leading edge and have a great understanding of what it takes to support people with disabilities.

Shannon is a graduate of Western Kentucky University...wife to Tony, mom to Davis (19) & Caroline (17.)

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