State by State Disability News 11.18.16

Lead Story:   Idaho

On October 24, 2016 a federal judge approved a preliminary settlement between the Idaho Department of Health and Welfare and developmentally disabled Idaho residents. The settlement, if finalized, will end a class action lawsuit brought against the Department in 2012 by the Idaho American Civil Liberties Union (ACLU) of Idaho on behalf of 12 Idaho residents with severe disabilities. The lawsuit alleged that the Department cut the residents’ benefits provided through Idaho’s developmentally disabled Medicaid waiver program by as much as 40 percent, and refused to disclose how it calculated such reduction in benefits (claiming the calculation formula was a state “trade secret”), which made it nearly impossible for the residents to appeal the benefit cuts. Judge B. Lynn Winmill, enjoined the cuts, which resulted in the restoration of approximately $30 million in Medicaid assistance annually. The Department appealed, but the injunction was upheld by the federal Ninth Circuit Court of Appeals. According to the ACLU of Idaho website, the settlement will impact about 4,000 people across Idaho, plus all future program participants. Under the settlement agreement, the state must change its Medicaid waiver program for adults with developmental disabilities in five main ways:  A new model for setting personal support budgets will be developed, which process must involve program participants and an outside expert. The state will have to reveal the standards it uses to calculate benefit determinations and ensure all participants obtain assistance in receiving the benefits they need or appealing their budgets. While the new model is being developed (defined in the settlement as the “Bridge Period”), program participants will be allowed to appeal their budget amounts, and obtain assistance with, or free training about, their appeals. A new written “health and safety” standard will be developed which defines what a participant will need to show to receive a higher budget. Each participant will be able to make copies of all of his or her Scales of Independent Behavior –Revised (SIB-R) information, including the scoring book that the assessor fills out. Budget notices will better explain changes to a participant’s budget, and will address the appeal process, including whether a participant wishes to represent his or herself or would like help with the appeal. To read more – http://www.natlawreview.com/article/settlement-expands-developmental-disabilities-benefits-idaho

 

Alabama

Alabama legislators are trying to take a fresh look at decades-old issues that hobble the state’s ability to pay for critical services such as prisons, courts, law enforcement, mental health care and Medicaid. A 14-member budget reform task force met at the State House today and discussed familiar issues, including how Alabama earmarks more of its tax dollars for specific programs than other states, limiting the flexibility to address the most urgent needs. They discussed how to better account for federal funds that go to state agencies and money left over at the end of the year. They talked about state contracts, tax credits and other issues. The governor of Illinois and their legislature have been at a budget impasse going on two years now without passing a budget and withholding funding.  Funding levels for services in Illinois are 51st in the nation.  This is a horrific article, and while lack of funding is just a part of the problem, “we” must hold our government officials accountable to act responsibly and GOVERN.  Passing a budget, adequately monitoring and providing technical assistance to agencies, and adequately funding this system is critical.  To read more – http://www.al.com/news/birmingham/index.ssf/2016/11/alabama_lawmakers_try_fresh_ap.html

 

Connecticut

When Connecticut lawmakers return to the state Capitol in January for the new legislative session, a new report shows they will have less money to spend in the state’s main account. Revenue estimates released this week for the upcoming two-year state budget indicate the general fund will have about $208 million less in fiscal year 2017-18 and about $297 million less in fiscal year 2018-19. The general fund budget typically is about $18 billion. Connecticut operates on two-year budget cycles. The first new fiscal year begins July 1. The estimates, agreed upon by Democratic Gov. Dannel P. Malloy’s budget office and the General Assembly’s nonpartisan Office of Fiscal Analysis, were greeted with concern by the legislature’s Republican leaders, who are also worried about a shortfall in the current fiscal year. For months they’ve sought meetings on the state’s budget situation. “Now that elections are over, I hope that all lawmakers will finally be willing to begin that conversation with us,” said Senate Minority Leader Len Fasano, whose caucus won enough seats on Tuesday to create a tie in the now-Democratic controlled Senate. The new session begins in January. “In the past few weeks not only have we seen this year’s deficit grow, we have also seen budget shortfalls in future years grow by over $500 million,” he said. “These are problems that we cannot wait to address.” To read more – http://www.theday.com/statenortheast/20161111/connecticut-to-expect-less-revenue-in-next-2-year-budget

 

Delaware

Delaware might have to budget an additional $100 million annually if President-elect Donald Trump repeals and replaces the Affordable Care Act and completely overhauls Medicaid. Policy changes related to the Affordable Care Act could significantly impact Delaware’s Medicaid Program, state health secretary Rita Landgraf said on Tuesday during a budget hearing in front of the Office of Management and Budget. States like Delaware chose to expand Medicaid under ACA. That expansion was funded completely by the federal government and helped the state leverage more federal matching dollars. People who earn up to 138 percent of the federal poverty level, which is an annual income of $11,670 for an individual, can apply for benefits. In Delaware, an additional 10,909 Delawareans enrolled. To read more – http://www.delawareonline.com/story/news/health/2016/11/15/trump-medicaid-cuts-could-mean-extra-100m-delaware/93882522/

 

District of Columbia

District of Columbia lawmakers have given final approval to a bill that would allow terminally ill patients to end their own lives with the help of a doctor. The “Death with Dignity” bill was approved Tuesday on an 11-to-2 vote and goes to Mayor Muriel Bowser for her signature. Once the bill becomes law, it will be sent to Congress for review. The bill would allow patients with six months or less to live to request lethal medication. Physician-assisted death is legal in five states. The bill could set up an early test of the District’s ability to advance a liberal local agenda with Republicans controlling the presidency, the Senate and the House. Congress can undo city laws by either passing a disapproval resolution or by amending other legislation. https://www.washingtonpost.com/politics/federal_government/dc-council-to-take-final-vote-on-death-with-dignity-bill/2016/11/15/6156ad4a-ab17-11e6-8f19-21a1c65d2043_story.html

 

Illinois

The house had no address; the dead man had no name. Illinois officials blacked out those details from their investigative report. Nobody else was supposed to learn the man’s identity or the location of the state-funded facility where his body was found. The investigation was closed as it began, with no public disclosure, and the report was filed away, one of thousands that portray a hidden world of misery and harm. No one would know that Thomas Powers died at 3300 Essington Road in unincorporated Joliet, in a group home managed for adults with developmental and intellectual disabilities. Or that his caregivers forced a 50-year-old man with the intellect of a small child to sleep on a soiled mattress on the floor in a room used for storage. Or that the front door bore a building inspection sticker that warned, “Not approved for occupancy.” Not even Powers’ grieving family knew the state had looked into his death and found evidence of neglect. As Illinois steers thousands of low-income adults with disabilities into private group homes, a Tribune investigation found Powers was but one of many casualties in a botched strategy to save money and give some of the state’s poorest and most vulnerable residents a better life. In the first comprehensive accounting of mistreatment inside Illinois’ taxpayer-funded group homes and their day programs, the Tribune uncovered a system where caregivers often failed to provide basic care while regulators cloaked harm and death with secrecy and silence. The Tribune identified 1,311 cases of documented harm since July 2011 — hundreds more cases than publicly reported by the Illinois Department of Human Services. Confronted with those findings, Human Services officials retracted five years of erroneous reports and said the department had launched reforms to ensure accurate reporting. To circumvent state secrecy, the Tribune filed more than 100 public records requests with government agencies. But state files were so heavily redacted and unreliable that the newspaper had to build its own databases by mining state investigative files, court records, law enforcement cases, industry reports, federal audits, grant awards and Medicaid data. The Tribune found at least 42 deaths linked to abuse or neglect in group homes or their day programs over the last seven years. Residents fatally choked on improperly prepared food, succumbed to untreated bed sores and languished in pain from undiagnosed ailments. Other residents suffered forced indignities and loss of freedom, state records show. Some were mocked for their intellectual limitations, barricaded in rooms, abandoned in soiled clothing and deprived of food. A male group home resident, accused of stealing cookies, was beaten to death by his caregiver. Employees at one home bound a woman’s hands and ankles with duct tape, covered her head with a blanket and left her for several hours on the kitchen floor. For their own amusement, employees at another home repeatedly ridiculed residents to provoke outbursts, a game the caregivers called “breaking them.” And, all too often, vulnerable residents’ health and safety has been left to unlicensed, scantly trained employees. Front-line caregivers failed to promptly call 911, perform CPR or respond to medical emergencies that resulted in death. In hundreds of cases, the department allowed employees of group homes to investigate allegations of neglect and mental abuse in their own workplaces, the Tribune discovered. That alliance between group homes and Human Services’ investigative arm, the Office of the Inspector General, is not specifically disclosed in state investigative reports…. State officials have touted group homes as a preferred option, citing cost savings that can be used to fund more community care. The annual cost of care for an institutionalized resident is about $219,000 compared with $84,000 at a group home, according to state records. But Illinois has not increased reimbursement rates for group home staff wages in nearly nine years, leading to what industry leaders say are catastrophic conditions in which even the best operators are struggling to provide basic care. Illinois ranks among the five worst states for adequately funding community options, according to federal reports and studies by advocacy groups. To read more – http://www.chicagotribune.com/news/watchdog/ct-group-home-investigations-cila-met-20161117-htmlstory.html

 

Illinois

Republican Gov. Bruce Rauner‘s budget office estimates the state’s backlog of unpaid bills will hit a record $13.5 billion by July if the governor and Democrats who control the General Assembly remain deadlocked over a complete spending plan, a bleak reminder of what’s at stake as negotiations begin anew. The projection came as the comptroller’s office announced the bill backlog hit $10.6 billion on Wednesday, a situation that’s turned thousands of vendors and small businesses into creditors for state government as they’re forced to wait months to be paid for services rendered. Despite the grim prediction, Rauner and Democratic leaders gave little indication much will change to reverse that trend, as both sides seized on the figures to plead their case. Democrats led by House Speaker Michael Madigan pointed to the numbers as proof that it’s time for Rauner to set aside the economic agenda he’s made a condition of a larger budget deal, saying the state’s budget problems are more pressing and changes would not bring about immediate savings. Rauner countered that Democrats aren’t focusing on the big picture, saying quick budget fixes will mean nothing in the long term if Illinois doesn’t take steps to help businesses grow and improve the overall economy. The figures were among the topics up for discussion as Rauner and legislative leaders met for the second day in a row ahead of the expiration of a temporary stopgap spending plan at the end of the year. To read more – http://www.chicagotribune.com/news/local/politics/ct-rauner-madigan-illinois-budget-met-1117-20161116-story.html

 

Kansas

State officials are asking Kansans with physical disabilities to contact them if they believe they were improperly dropped from a waiting list for support services through Medicaid. Brandt Haehn, the state’s commissioner for home and community-based services within the Kansas Department for Aging and Disability Services, said the state is prepared to make service offers to those who step forward.  “If you think you are on the waiting list and have not received an offer, we want to hear from you,” Haehn said. The state reported in August that the waiting list for physical disability support services provided under Medicaid had been eliminated. But that announcement came after controversy over how the state culled the list since taking it over from Centers for Independent Living that serve Kansans with disabilities throughout the state. Megan Buck, an official with the federal Centers for Medicare and Medicaid Services, sent the state a letter last month saying the CMS regional office has received reports of Kansans with disabilities who were dropped from the list improperly — something the Centers for Independent Living had warned of for years. To read more – http://www.khi.org/news/article/state-seeks-kansans-with-physical-disabilities-dropped-from-wait-list-for-m

 

Kansas

An analysis of KanCare performed by a former Republican governor’s think tank found that the switch to managed care Medicaid in Kansas has delivered on cost-cutting promises but not on quality of care. Leavitt Partners, a policy consulting shop founded by former Utah Gov. Michael Leavitt, performed the analysis between May and October by interviewing KanCare providers and reviewing federal and state data. “Across the providers that we interviewed and surveyed, there was general agreement that KanCare has not met its original rationale and commitments,” Robin Arnold-Williams, a principal at Leavitt Partners who specializes in Medicaid, said in a written summary of the analysis. The Kansas Hospital Association, Kansas Medical Society and Kansas Association for the Medically Underserved sponsored the analysis. Arnold-Williams, a former executive director of the Utah Department of Human Services, testified Thursday at a meeting of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight. She told legislators that better communication among state officials, KanCare companies and Medicaid providers is key. Robin Arnold-Williams is a principal who specializes in Medicaid for Leavitt Partners, a policy consulting shop that analyzed the KanCare system at the request of the Kansas Hospital Association, Kansas Medical Society and Kansas Association for the Medically Underserved. Arnold-Williams spoke Thursday before the Legislature’s KanCare oversight committee. View larger photo “Providers are not saying, ‘We’re fed up. We don’t want to help improve this,’” Arnold-Williams said. “They’re saying, ‘We’re ready to improve this system. We want it to be the best it can be for Kansans who are on Medicaid.” To read more – http://www.khi.org/news/article/report-kancare-delivered-on-cost-not-quality-of-care

 

Minnesota

A new disability rights directive from the Obama administration has cast fresh doubts on the future of Minnesota’s decades-old system of subsidizing specialized workshops that employ people with disabilities. In a 13-page guidance issued in late October, the U.S. Justice Department said millions of Americans with disabilities spend the majority of their hours in segregated work centers known as “sheltered workshops” and in adult day programs. Many are capable of joining the mainstream workforce, but lack services that would enable them to succeed. That is “unnecessary segregation,” the agency said, and likely violates the 1990 Americans with Disabilities Act, or ADA. The strongly worded statement comes as the Justice Department steps up efforts to protect the civil rights of people with disabilities and is seen as a signal that the agency will pursue legal action against states that have fallen behind. Some national disability law experts say Minnesota is particularly vulnerable because of the large numbers of people here who continue to work in sheltered workshops. A Star Tribune investigation in 2015 found that many individuals with disabilities feel trapped in sheltered workshops because they lack transportation, job coaching and other support services that would allow them to find and retain more meaningful work. Only 11 percent of Minnesotans with developmental disabilities who received state services in 2014 worked in the community alongside people without disabilities — the sixth lowest rate in the nation. “Clearly, if you look at the numbers, Minnesota is a potential target” for legal action, said Alison Barkoff at the Center for Public Representation, a national public interest law firm. “This is like the police saying, ‘Hey, you guys, we’re watching.’ ” To read more – http://m.startribune.com/doj-guidance-on-disability-rights-could-put-a-bull-s-eye-on-minnesota/400956785/

 

Montana

Gov. Steve Bullock called for a modest spending increase in his proposed budget for the next biennium despite revenue declines from key sources over the last two years. “I think Montanans expect us to invest in areas that help grow our economy,” Bullock said at a Tuesday press event announcing the plan. “Despite revenue challenges, Montana must ensure the continuation of core services.” Bullock’s plan amounts to a 1.4 percent increase in spending over the biennium. It includes $292 million of infrastructure and building investments through grants and loans; an expansion of business tax credits for capital investments as well as new credits for offering on-the-job training; the expansion of the income tax credit to match the federal rate; the end of a tuition freeze at public colleges; a higher tax rate for families making more than $500,000; a 1-percent pay increase for state employees in November 2018 and another 1 percent increase a year later. The budget includes funding for education, preschool, senior services, child protective services and mental health services — especially for teen suicide prevention. To read more – http://billingsgazette.com/news/government-and-politics/bullock-releases-new-biennial-budget-calling-for-modest-spending-increase/article_8954141f-b574-518a-a773-67870e2308cb.html

 

New Mexico

Today, the New Mexico Department of Health (NMDOH) launched a new campaign to better support New Mexicans with intellectual and developmental disabilities. The campaign, called, “Know Your Rights” is focused on engaging more New Mexicans with these types of disabilities with communities and resources designed to improve their independence and quality of life. The Department of Health’s Developmental Disabilities Supports Division will coordinate this campaign to raise awareness for the rights of individuals with intellectual and developmental disabilities to participate in integrated living, vocational, educational, recreational, social and leisure activities in the community. “People with disabilities have a right to live, work, and participate in the greater community,” said Lynn Gallagher, Department of Health Secretary Designate. “We are committed to ensuring that the rights and dignity of all New Mexicans with intellectual and developmental disabilities are fully realized.” A primary focus of the “Know Your Rights” campaign is to create communication with participants, family members, stakeholders, and advocacy groups throughout implementation of the Transition Plan. DDSD is scheduling a series of “Know Your Rights” forums designed to ensure providers, partner organizations, and advocacy groups are familiar with the rights afforded to participants under the Final Rule and are kept abreast of critical activities and milestones. To read more – http://krwg.org/post/know-your-rights-support-new-mexicans-intellectual-and-developmental-disabilities

 

Oregon

Two days after Donald Trump was elected president of the United States, two Portlanders have submitted a petition for a 2018 ballot initiative to have Oregon secede from the United States. On Thursday morning, Jennifer Rollins, a lawyer, and Christian Trejbal, a writer, filed the Oregon Secession Act. “Oregonian values are no longer the values held by the rest of the United States,” Trejbal said over the phone Thursday. Those values? “Life, liberty, the pursuit of happiness,” Trejbal said, “plus equality.”  “Obviously,” he said, the ballot proposal “came about partially in response to the election results on Tuesday.” “But,” he added, “it’s been developing over time.” Trejbal said that he and Rollins are hoping to start a serious conversation in Oregon about what it would mean to peacefully leave the United States. They opted for 2018 to give Oregonians some time to really think about what seceding from the union would mean. Some Californians have already expressed interest in seceding and the language of the Oregon proposal includes the option to bring other states into a “Constitutional Convention.” Trejbal said that joining forces with other states like Washington, California and Nevada is “a viable way to go forward.” These states, he said, “could all get together and form a nation that uphold the values that we share.” To start the ballot title drafting process, the Oregon Secession Act must receive 1,000 signatures. Trejbal said he and Rollins would be at Pioneer Courthouse Square in Portland on Thursday night to begin the process of getting those signatures. http://www.oregonlive.com/politics/index.ssf/2016/11/after_trump_victory_oregonians.html

 

Rhode Island

Rhode Island is on pace to collect $44.8 million more in revenue during the 2016-2017 fiscal year than anticipated in the budget approved by lawmakers over the summer, according to state budget analysts. The estimates for the year starting July 1, reached in last week’s Revenue Estimating Conference of House, Senate and Raimondo administration budget officials, gives Governor Raimondo some additional money to spend in her budget plan for the next fiscal year, which will be unveiled over the winter. The positive revenue figures are driven by a number of state revenue sources beating estimates made in May and used in the budget, including personal income tax, which is $18.4 million ahead of forecast. To read more – http://www.providencejournal.com/news/20161114/state-revenue-running-448-million-ahead

 

West Virginia

West Virginia Gov. Earl Ray Tomblin ordered state agencies Tuesday to cut their spending by another 2 percent, a move expected to save $59.8 million. Tomblin said the mid-year across-the-board cuts are needed to help make up for an $87 million shortfall in the state’s general revenue fund.  “This was a tough decision that stemmed from sustained budgetary challenges, but we must continue acting responsibly and taking the necessary steps to keep our state strong,” Tomblin said. “While the cuts we’re enacting won’t be easy, we must ensure a balanced budget, long-term financial stability for West Virginia and smart decisions that allow for continuity of essential services for West Virginians.” The spending cuts include an $11 million reduction to the state’s school aid formula, which funds K-12 schools. The state’s Medicaid program will be hit with a one-time $25 million cut.  To read more – http://www.wvgazettemail.com/news-politics/20161115/tomblin-orders-mid-year-2-wv-budget-cuts-

 

Wisconsin

The future of President Barack Obama’s Affordable Care Act may be in doubt, but so far it doesn’t seem to be affecting enrollment underway on Healthcare.gov, the federal marketplace used to purchase health insurance in Wisconsin and other states. There has been concern that the election of Donald Trump, a foe of the ACA, would dissuade people from signing up for coverage, but Caroline Gomez-Tom of Covering Wisconsin, a group that helps people use the marketplace, said the exchange has actually seen a surge of enrollments. The last two weeks have been the busiest signup period in the last four years, she said. Enrollment nationally doesn’t seem to have been affected by the election. On Wednesday, the U.S. Department of Health and Human Services reported 100,000 people signed up for coverage, the highest single-day total so far during this enrollment period. Covering Wisconsin received calls the day after Tuesday’s election inquiring whether the ACA was still in effect. People were “just asking if there’s anything they should be concerned about regarding their health insurance,” Gomez-Tom said. The deadline to enroll or change a plan for 2017 through the marketplace is Dec. 15. To read more – http://www.wpr.org/aca-enrollment-spikes-after-presidential-election