"Brainstorm" is an experience of brain injury, produced by Rogi Riverstone of People with Disabilities Powered Radio
It will be airing on KUNMfm http://kunm.org on Sunday, May 4 at 11am. Tune in! Different frequencies in different parts of New Mexico, and you can listen online.
Monday, April 28, 2008
Sunday, April 27, 2008
Aging centers grant money
http://www.cms.hhs.gov/newfreedominitiative/emailupdates/ItemDetail.asp?ItemID=CMS120903
You may have to paste above URL into your browser; for some reason, blog software won't post it correctly. Moderator corrected manually.
FY 2008 Real Choice Systems Change and Aging and Disability ResourceCenter/Area Aging Grant RFPFri, 18 Apr 2008 09:11:00 -0500
Date: 04/18/2008
Subject: FY 2008 Real Choice Systems Change and Aging and DisabilityResource Center/Area Aging Grant RFP
Content: CMS has available approximately thirteen million dollars inavailable funding to continue to support States' efforts to addresscomplexissues in long-term care reform. In addition to approximately eightmilliondollars in Real Choice Systems Change Grant funding, CMS was alsoawardedfive million dollars for Aging and Disability Resource Center/AreaAgencieson Aging grants. The FY 2008 Grant Category: Development andImplementationof a Person-centered Hospital Discharge Planning Model.
The new grant solicitation will build upon the successes and directionofearlier Real Choice Systems Change and Aging and Disability ResourceCentergrant opportunities by providing targeted assistance to States' in theirefforts to improve hospital discharge planning through collaborationwith,Aging and Disability Resource Centers(ADRCs), Area Agency on Aging andCenters for Independent Living. Specifically, this grant opportunityfor FY2008 is designed to:
1. Promote the development and implementation of enhancedhospital discharge planning models that meaningfully engageMedicaid-eligible individuals with disabilities (and their informalcaregivers);
2. Increase the capacity of existing , and develop new,singleentry points (including ADRCs) to provide critical linkages to availablelong-term care services in the community and much needed supports forinformal caregivers themselves;
3. Inform CMS, other Federal agencies and Congress onnationalpolicy related to hospital discharge planning, person-centered planning,andcaregiver assessment.
States, territories and the District of Columbia are eligible to applyforfunding under this solicitation. Applications are due no later thanJuly17, 2008 and must be submitted electronically on the grants websitefoundbelow in the links outside of CMS. The full solicitation can also befoundin the links inside CMS above.
You may have to paste above URL into your browser; for some reason, blog software won't post it correctly. Moderator corrected manually.
FY 2008 Real Choice Systems Change and Aging and Disability ResourceCenter/Area Aging Grant RFPFri, 18 Apr 2008 09:11:00 -0500
Date: 04/18/2008
Subject: FY 2008 Real Choice Systems Change and Aging and DisabilityResource Center/Area Aging Grant RFP
Content: CMS has available approximately thirteen million dollars inavailable funding to continue to support States' efforts to addresscomplexissues in long-term care reform. In addition to approximately eightmilliondollars in Real Choice Systems Change Grant funding, CMS was alsoawardedfive million dollars for Aging and Disability Resource Center/AreaAgencieson Aging grants. The FY 2008 Grant Category: Development andImplementationof a Person-centered Hospital Discharge Planning Model.
The new grant solicitation will build upon the successes and directionofearlier Real Choice Systems Change and Aging and Disability ResourceCentergrant opportunities by providing targeted assistance to States' in theirefforts to improve hospital discharge planning through collaborationwith,Aging and Disability Resource Centers(ADRCs), Area Agency on Aging andCenters for Independent Living. Specifically, this grant opportunityfor FY2008 is designed to:
1. Promote the development and implementation of enhancedhospital discharge planning models that meaningfully engageMedicaid-eligible individuals with disabilities (and their informalcaregivers);
2. Increase the capacity of existing , and develop new,singleentry points (including ADRCs) to provide critical linkages to availablelong-term care services in the community and much needed supports forinformal caregivers themselves;
3. Inform CMS, other Federal agencies and Congress onnationalpolicy related to hospital discharge planning, person-centered planning,andcaregiver assessment.
States, territories and the District of Columbia are eligible to applyforfunding under this solicitation. Applications are due no later thanJuly17, 2008 and must be submitted electronically on the grants websitefoundbelow in the links outside of CMS. The full solicitation can also befoundin the links inside CMS above.
Cuts in
Sorry, but this piece is too long for the moderate the edits. Forgive strung-together words; it's a fault of the blog software, not of the publishers.
-- Coalition Has Health Plan Idea
By Winthrop Quigley
April 7, 2008 Albuquerque Journal; Journal Staff Writer
Business opponents of Gov. Bill Richardson's health coverage plan have this advice for legislators attending the special session planned for this summer: Spread the pain around. Instead of taxing employers to create a healthy workforce fund, as originally proposed, consider a broad-based tax to expand existing coverage programs, said two members of a state business coalition that opposed universal healthcare coverage legislation the Richardson administration crafted.
"The main thing we were against was the expense was all on the backs of employers," said New Mexico Restaurant Association CEO Carol Wight. "We understand there needs to be employer participation, but all of us need to participate," said Association of Commerce and Industry President BeverleeMcClure.
"It may be if we find a way for all of us to participate through the gross receipts tax or other mechanism, you might find ACI would participate in looking at those options," McClure said.
Richardson announced in February, after what he called a "productive"meeting with state Senate leaders, that he will call a special session some time this summer to enact a program to bring health care coverage to New Mexico's 400,000 uninsured residents. In its regular 30-day session that ended Feb. 14, the Legislature first gutted then killed a Richardson plan that, among other things, would have taxed employers who didn't offer health insurance to workers. Richardson said at the end of the session that he would propose the identical bill in a special session. Thursday, he said legislators and members of his administration would look for consensus before the special session convenes. Aside from the burden on employers, Wight and McClure said, their groups are skeptical the original plan would have got that many more people insured. The bill said individuals had to find some coverage, but nothing in the bill, had it become law, would have forced anyone to get it, McClure said. She said that about half of the state's uninsured already qualify for some kind of coverage or public program, and they still don't sign up. Wight said her members have tried to get their employees to sign up for State Coverage Insurance, a low-cost, state-subsidized health insurance product that requires both employers and employees to pay some of the cost.
"They refuse it," she said. "They want to pay their cable bill. They want to pay their cell phone bill." A place to begin, McClure said, is improving recruitment of qualified peoplei nto existing public programs, especially Medicaid. Under the governor's plan, the employer tax would feed a fund that could have been used for pretty much anything, McClure said.
A better idea would be to create a fund dedicated to expanding existing public programs, she said.
Pegging coverage to employment won't work, Wight said. "I'm going to say over half of those (400,000) people are not employed," Wight said. "They're students, children and retirees, possibly, who don't fit into Medicare yet. If we're counting on employers to pick up that tab, we're approaching it incorrectly because so many of them are not employed. A better solution would be a broader tax and make it the responsibility of all New Mexicans."
The Greater Albuquerque Chamber of Commerce broke with other business organizations and supported Richardson's plan, saying that while the plan had its flaws, the cost of doing nothing was too great. The chamber took heat from some Republican lawmakers at committee hearings for supporting the bill, and the Greater Las Cruces Chamber of Commerce blasted its Albuquerque counterpart for "consistently" backing legislation "contrary to the interests of New Mexico businesses and in direct opposition to the welfare of small businesses in the state." In a letter it provided to the Journal, the Las Cruces chamber called the Albuquerque chamber's support of Richardson's bill "unfathomable." Referring to the chamber's board, the Las Cruces group said, "We do not believethat a small group of 18 individuals representing big business interests, heavily state regulated industries and a few of your chosen suppliers have the right to represent yourselves as the business community. We resent andrejectyour on-going claims that you make to the public and legislators thatyou arethe voice of business, especially small businesses which you clearly donotrepresent." Albuquerque chamber President Terri Cole said in an e-mail to theJournal thatbusiness pays for uncompensated health care already, through higherpremiums andtaxes, so providing universal coverage ultimately reduces costs tobusiness. "The bill represented a solution we support- universal coveragewithoutover-burdening those businesses who provide coverage and those who donot," Colesaid. "The bill provided an incentive for businesses that don't providecoverage toseek out existing, low-cost, under-utilized programs," she said. "Webelievethat approach was a win-win for everyone."
Medicaid Budget Short
By Winthrop Quigley
April 7, 2008 Albuquerque Journal; Journal Staff Writer
Weeks after asking legislators to provide health care coverage foreveryone, the Richardson administration is trying to overcome amultimillion-dollar Medicaidbudget deficit by slowing enrollment growth.The state legislative session that ended in February added $14.5 millionto the Medicaid budget to offset what the Human Services Department saidwould be a $24.5 million shortfall in the fiscal year that ends June 30,leaving a $10 million deficit. The Medicaid budget for the followingfiscal year is $25.8 million less than the department requested.State Medicaid officials will try to overcome the current fiscal year'sdeficit by slowing Medicaid enrollment from 299,000 children by June,which is the number of children the state could afford to cover hadlegislators approved the entire HSD requires, to 294,000. About 275,000low-income children and 143,000 low-income adults- most of them disabledor elderly- were enrolled in November 2007, the last month for which HSDhas complete data."In 2009, we have a much bigger problem," said state Medicaid directorCarolyn Ingram. "What we're looking at is trying to flatten outenrollmentgrowth of kids so it's not so steep."That's an about-face from the department's goal at the beginning of thefiscal year, when the state intended to enroll as many eligible childrenas possible. The belief was that getting children access to consistenthealth care reduces costs in the long term.Instead, efforts to reach families of Medicaid-eligible children to getthe kids enrolled will be curtailed.HSD will also slow growth in State Coverage Insurance, which targetslow-income adults.The department wants to reduce spending on personal in-home careprovidedto elderly and disabled Medicaid recipients. HSD will try to limit newMedicaid enrollment by disabled and elderly people to emergency cases.If that does not reduce spending enough, HSD will consider reducingpayments to medical providers, Ingram said. "That is not the mostfavoredoption," she said."We just spent two years increasing provider rates."
Finally, HSD will consider reducing Medicaid benefits. One potentialtarget is expenses incurred by a caregiver who accompanies a Medicaidrecipient whoreceives treatment out of state. Gov. Bill Richardson had asked the 2008 Legislature to enact severalprovisions designed to expand public programs to cover New Mexicanswho could not obtain private coverage. The governor's universal healthcoverage package failed. "It is clear from the funding of the Medicaid program that was notanarea (the Legislature) could put money toward at this time," Ingramsaid. "There were other priorities." One advocacy organization said the most vulnerable group is takingtheworst hit. "The bottom line here is that kids will suffer," said Bill Jordan,policy director of New Mexico Voices for Children. "Their health carewill be interrupted. Kids shouldn't be the ones caught in the middlewhen lawmakers cannot agree on a dollar amount." Much of the state Medicaid budget of more than $3 billion isprovidedby the federal government. However, the state general fund willprovide $711.2 million this fiscal year and $787.4 million next fiscalyear to support Medicaid. State officials have estimated that 50,000 children who are eligiblefor Medicaid are not enrolled. HSD has sponsored several efforts toincrease enrollment in the past several months. "We'll definitely be slowing our outreach initiatives," Ingram said.
"We won't be running television commercials. We won't be running radioads." Enrollment efforts instead will focus on finding eligiblechildren at small, low-income school districts, she said. HSD will continue to support efforts by insurance brokers to sellState Coverage Insurance to employers and their low-income employees,but state officials will stop promoting enrollment through speechesand other events.
Charlotte Roybal
Health Care for All Campaign
Health Action NM
roybalhanm@aol.comwww.healthactionnm.org
505-867-1095 (o)
-- Coalition Has Health Plan Idea
By Winthrop Quigley
April 7, 2008 Albuquerque Journal; Journal Staff Writer
Business opponents of Gov. Bill Richardson's health coverage plan have this advice for legislators attending the special session planned for this summer: Spread the pain around. Instead of taxing employers to create a healthy workforce fund, as originally proposed, consider a broad-based tax to expand existing coverage programs, said two members of a state business coalition that opposed universal healthcare coverage legislation the Richardson administration crafted.
"The main thing we were against was the expense was all on the backs of employers," said New Mexico Restaurant Association CEO Carol Wight. "We understand there needs to be employer participation, but all of us need to participate," said Association of Commerce and Industry President BeverleeMcClure.
"It may be if we find a way for all of us to participate through the gross receipts tax or other mechanism, you might find ACI would participate in looking at those options," McClure said.
Richardson announced in February, after what he called a "productive"meeting with state Senate leaders, that he will call a special session some time this summer to enact a program to bring health care coverage to New Mexico's 400,000 uninsured residents. In its regular 30-day session that ended Feb. 14, the Legislature first gutted then killed a Richardson plan that, among other things, would have taxed employers who didn't offer health insurance to workers. Richardson said at the end of the session that he would propose the identical bill in a special session. Thursday, he said legislators and members of his administration would look for consensus before the special session convenes. Aside from the burden on employers, Wight and McClure said, their groups are skeptical the original plan would have got that many more people insured. The bill said individuals had to find some coverage, but nothing in the bill, had it become law, would have forced anyone to get it, McClure said. She said that about half of the state's uninsured already qualify for some kind of coverage or public program, and they still don't sign up. Wight said her members have tried to get their employees to sign up for State Coverage Insurance, a low-cost, state-subsidized health insurance product that requires both employers and employees to pay some of the cost.
"They refuse it," she said. "They want to pay their cable bill. They want to pay their cell phone bill." A place to begin, McClure said, is improving recruitment of qualified peoplei nto existing public programs, especially Medicaid. Under the governor's plan, the employer tax would feed a fund that could have been used for pretty much anything, McClure said.
A better idea would be to create a fund dedicated to expanding existing public programs, she said.
Pegging coverage to employment won't work, Wight said. "I'm going to say over half of those (400,000) people are not employed," Wight said. "They're students, children and retirees, possibly, who don't fit into Medicare yet. If we're counting on employers to pick up that tab, we're approaching it incorrectly because so many of them are not employed. A better solution would be a broader tax and make it the responsibility of all New Mexicans."
The Greater Albuquerque Chamber of Commerce broke with other business organizations and supported Richardson's plan, saying that while the plan had its flaws, the cost of doing nothing was too great. The chamber took heat from some Republican lawmakers at committee hearings for supporting the bill, and the Greater Las Cruces Chamber of Commerce blasted its Albuquerque counterpart for "consistently" backing legislation "contrary to the interests of New Mexico businesses and in direct opposition to the welfare of small businesses in the state." In a letter it provided to the Journal, the Las Cruces chamber called the Albuquerque chamber's support of Richardson's bill "unfathomable." Referring to the chamber's board, the Las Cruces group said, "We do not believethat a small group of 18 individuals representing big business interests, heavily state regulated industries and a few of your chosen suppliers have the right to represent yourselves as the business community. We resent andrejectyour on-going claims that you make to the public and legislators thatyou arethe voice of business, especially small businesses which you clearly donotrepresent." Albuquerque chamber President Terri Cole said in an e-mail to theJournal thatbusiness pays for uncompensated health care already, through higherpremiums andtaxes, so providing universal coverage ultimately reduces costs tobusiness. "The bill represented a solution we support- universal coveragewithoutover-burdening those businesses who provide coverage and those who donot," Colesaid. "The bill provided an incentive for businesses that don't providecoverage toseek out existing, low-cost, under-utilized programs," she said. "Webelievethat approach was a win-win for everyone."
Medicaid Budget Short
By Winthrop Quigley
April 7, 2008 Albuquerque Journal; Journal Staff Writer
Weeks after asking legislators to provide health care coverage foreveryone, the Richardson administration is trying to overcome amultimillion-dollar Medicaidbudget deficit by slowing enrollment growth.The state legislative session that ended in February added $14.5 millionto the Medicaid budget to offset what the Human Services Department saidwould be a $24.5 million shortfall in the fiscal year that ends June 30,leaving a $10 million deficit. The Medicaid budget for the followingfiscal year is $25.8 million less than the department requested.State Medicaid officials will try to overcome the current fiscal year'sdeficit by slowing Medicaid enrollment from 299,000 children by June,which is the number of children the state could afford to cover hadlegislators approved the entire HSD requires, to 294,000. About 275,000low-income children and 143,000 low-income adults- most of them disabledor elderly- were enrolled in November 2007, the last month for which HSDhas complete data."In 2009, we have a much bigger problem," said state Medicaid directorCarolyn Ingram. "What we're looking at is trying to flatten outenrollmentgrowth of kids so it's not so steep."That's an about-face from the department's goal at the beginning of thefiscal year, when the state intended to enroll as many eligible childrenas possible. The belief was that getting children access to consistenthealth care reduces costs in the long term.Instead, efforts to reach families of Medicaid-eligible children to getthe kids enrolled will be curtailed.HSD will also slow growth in State Coverage Insurance, which targetslow-income adults.The department wants to reduce spending on personal in-home careprovidedto elderly and disabled Medicaid recipients. HSD will try to limit newMedicaid enrollment by disabled and elderly people to emergency cases.If that does not reduce spending enough, HSD will consider reducingpayments to medical providers, Ingram said. "That is not the mostfavoredoption," she said."We just spent two years increasing provider rates."
Finally, HSD will consider reducing Medicaid benefits. One potentialtarget is expenses incurred by a caregiver who accompanies a Medicaidrecipient whoreceives treatment out of state. Gov. Bill Richardson had asked the 2008 Legislature to enact severalprovisions designed to expand public programs to cover New Mexicanswho could not obtain private coverage. The governor's universal healthcoverage package failed. "It is clear from the funding of the Medicaid program that was notanarea (the Legislature) could put money toward at this time," Ingramsaid. "There were other priorities." One advocacy organization said the most vulnerable group is takingtheworst hit. "The bottom line here is that kids will suffer," said Bill Jordan,policy director of New Mexico Voices for Children. "Their health carewill be interrupted. Kids shouldn't be the ones caught in the middlewhen lawmakers cannot agree on a dollar amount." Much of the state Medicaid budget of more than $3 billion isprovidedby the federal government. However, the state general fund willprovide $711.2 million this fiscal year and $787.4 million next fiscalyear to support Medicaid. State officials have estimated that 50,000 children who are eligiblefor Medicaid are not enrolled. HSD has sponsored several efforts toincrease enrollment in the past several months. "We'll definitely be slowing our outreach initiatives," Ingram said.
"We won't be running television commercials. We won't be running radioads." Enrollment efforts instead will focus on finding eligiblechildren at small, low-income school districts, she said. HSD will continue to support efforts by insurance brokers to sellState Coverage Insurance to employers and their low-income employees,but state officials will stop promoting enrollment through speechesand other events.
Charlotte Roybal
Health Care for All Campaign
Health Action NM
roybalhanm@aol.comwww.healthactionnm.org
505-867-1095 (o)
Administrtion restricts access to Medicaid services
Administrative Actions Would Restrict Access to Critical Medicaid Services
Background
Medicaid is a lifeline for people with disabilities. It is the nation’s primary way of financing and delivering community-based health and long-term services to children and adults with disabilities. Medicaid serves nearly 60 million low-income Americans, including an estimated 9.9 million people with disabilities and accounts for an estimated 86% of public spending on developmental disabilities services.
Over the past year, the Bush Administration’s Centers for Medicare and Medicaid Services (CMS) has issued six Medicaid rules, in either proposed or final form, which together would have a devastating impact on Medicaid beneficiaries or the safety net providers that serve them. Taken together, these rules will reduce federal financing for Medicaid by $15 billion over five years. The President’s FY 2009 budget proposes $17.4 billion in legislative changes to Medicaid over five years and additional administrative rules are likely pending. These regulatory changes will shift significant Medicaid costs to states at a time when the economy is in a downturn and many states are either experiencing declining revenues—or bracing for revenues to start falling. Preventing implementation of these regulations is the top priority for all Medicaid stakeholders, including the disability community.
Three of the six rules will be particularly harmful to Medicaid beneficiaries with disabilities and their providers. If implemented, these regulations will result in the loss of critical services for Medicaid eligible children and adults with developmental disabilities. Rehabilitation Services
Option
CMS issued a proposed rule on 8/13/07 which would generate $2.3 billion in savings over 5 years by restricting the scope of eligible rehabilitation services and eliminate coverage for day habilitation services for individuals with developmental disabilities. The proposed rule appears to prohibit people with “mental retardation and related conditions” from receiving nearly all services through the rehabilitation option. In particular, longstanding day habilitation programs for persons with developmental disabilities would be eliminated (these programs enable an individual to maximize independent living skills) under the rehabilitation and clinic options. The only way that Medicaid could pay for habilitation services would be through waiver programs or ICF/MR programs. Since waiver programs are capped with waiting lists, this would reduce the number of individuals who can access these critical services. In addition, since eligibility criteria for the rehab option differs from eligibility for the waiver, there will be some people who will lose services if habilitation is covered only through the waiver.
2) School-Based Administrative and Transportation
CMS issued a final rule on 12/28/07 that would generate $2.8 billion in cuts over 5 years by prohibiting Medicaid payments for administrative activities (including outreach, enrollment and support in gaining access to Medicaid’s Early, Periodic, Screening, Diagnosis and Treatment (EPSDT) benefits services) performed by schools and transportation of school-age children. School districts believe that this rule, if implemented, would force them to significantly reduce related services (e.g. physical, occupational and speech and language therapies) and classroom aides provided to students with disabilities in special education.
3) Case Management
CMS issued an interim final rule on 12/04/07 that becomes effective on 03/03/08 that would generate $1.3 billion in cuts over five years by restricting the scope of case management services and targeted case management (TCM). The TCM rule makes it significantly more difficult for individuals transitioning from institutions to the community by limiting federal reimbursement for transitional case management from the last 180 days of an individual’s institutional stay to the last 60 days. In many cases, due to the lack of affordable and accessible housing and challenges in securing support services, it is difficult to impossible to transition to the community in 60 days.
Action Taken by Congress
The Medicare, Medicaid, and SCHIP Extension Act of 2007 (P.L. 110-173) contains a six month moratorium (until June 30, 2008) for CMS’ rehabilitative services and school based administration/transportation rules. Rep. John Boozman (R-AR) has introduced a one year moratorium bill (H.R.4355).
Senator Norm Coleman (R-MN) and Rep. Keith Ellison (D-MN) have introduced legislation (S. 2578/H.R. 5173) to impose a one year moratorium on the Medicaid interim final case management rule.
Senators Edward Kennedy (D-MA) and Gordon Smith (R-OR) and Reps. John Dingell (D-MI) and Ed Whitfield (R-KY) introduced the Protecting Children’s Health in Schools Act of 2007 (S. 578/ H.R. 1017), which clarifies that schools can use Medicaid funding for certain transportation and administrative claims, and tightens reporting and documentation requirements to avoid abuse.
RecommendationsExtend the six month moratoria on the CMS rehabilitative services and school based administration/transportation rules through H.R. 4355 or other legislative vehicles;Co-sponsor legislation (S. 2578/H.R. 5173) to impose a one year moratorium on the CMS case management rule; and Co-sponsor the Protecting Children’s Health in Schools Act of 2007 (S. 578/H.R. 1017).
Relevant Committees
Senate Finance Committee
House Energy and Commerce Committee
For more information, please contact The Arc and United Cerebral Palsy Disability Policy Collaboration (202-783-2229), Association of University Centers on Disabilities (301-588-8252), American Association on Intellectual and Developmental Disabilities (202-387-1968), or National Association of Councils on Developmental Disabilities (703-739-4400).
Background
Medicaid is a lifeline for people with disabilities. It is the nation’s primary way of financing and delivering community-based health and long-term services to children and adults with disabilities. Medicaid serves nearly 60 million low-income Americans, including an estimated 9.9 million people with disabilities and accounts for an estimated 86% of public spending on developmental disabilities services.
Over the past year, the Bush Administration’s Centers for Medicare and Medicaid Services (CMS) has issued six Medicaid rules, in either proposed or final form, which together would have a devastating impact on Medicaid beneficiaries or the safety net providers that serve them. Taken together, these rules will reduce federal financing for Medicaid by $15 billion over five years. The President’s FY 2009 budget proposes $17.4 billion in legislative changes to Medicaid over five years and additional administrative rules are likely pending. These regulatory changes will shift significant Medicaid costs to states at a time when the economy is in a downturn and many states are either experiencing declining revenues—or bracing for revenues to start falling. Preventing implementation of these regulations is the top priority for all Medicaid stakeholders, including the disability community.
Three of the six rules will be particularly harmful to Medicaid beneficiaries with disabilities and their providers. If implemented, these regulations will result in the loss of critical services for Medicaid eligible children and adults with developmental disabilities. Rehabilitation Services
Option
CMS issued a proposed rule on 8/13/07 which would generate $2.3 billion in savings over 5 years by restricting the scope of eligible rehabilitation services and eliminate coverage for day habilitation services for individuals with developmental disabilities. The proposed rule appears to prohibit people with “mental retardation and related conditions” from receiving nearly all services through the rehabilitation option. In particular, longstanding day habilitation programs for persons with developmental disabilities would be eliminated (these programs enable an individual to maximize independent living skills) under the rehabilitation and clinic options. The only way that Medicaid could pay for habilitation services would be through waiver programs or ICF/MR programs. Since waiver programs are capped with waiting lists, this would reduce the number of individuals who can access these critical services. In addition, since eligibility criteria for the rehab option differs from eligibility for the waiver, there will be some people who will lose services if habilitation is covered only through the waiver.
2) School-Based Administrative and Transportation
CMS issued a final rule on 12/28/07 that would generate $2.8 billion in cuts over 5 years by prohibiting Medicaid payments for administrative activities (including outreach, enrollment and support in gaining access to Medicaid’s Early, Periodic, Screening, Diagnosis and Treatment (EPSDT) benefits services) performed by schools and transportation of school-age children. School districts believe that this rule, if implemented, would force them to significantly reduce related services (e.g. physical, occupational and speech and language therapies) and classroom aides provided to students with disabilities in special education.
3) Case Management
CMS issued an interim final rule on 12/04/07 that becomes effective on 03/03/08 that would generate $1.3 billion in cuts over five years by restricting the scope of case management services and targeted case management (TCM). The TCM rule makes it significantly more difficult for individuals transitioning from institutions to the community by limiting federal reimbursement for transitional case management from the last 180 days of an individual’s institutional stay to the last 60 days. In many cases, due to the lack of affordable and accessible housing and challenges in securing support services, it is difficult to impossible to transition to the community in 60 days.
Action Taken by Congress
The Medicare, Medicaid, and SCHIP Extension Act of 2007 (P.L. 110-173) contains a six month moratorium (until June 30, 2008) for CMS’ rehabilitative services and school based administration/transportation rules. Rep. John Boozman (R-AR) has introduced a one year moratorium bill (H.R.4355).
Senator Norm Coleman (R-MN) and Rep. Keith Ellison (D-MN) have introduced legislation (S. 2578/H.R. 5173) to impose a one year moratorium on the Medicaid interim final case management rule.
Senators Edward Kennedy (D-MA) and Gordon Smith (R-OR) and Reps. John Dingell (D-MI) and Ed Whitfield (R-KY) introduced the Protecting Children’s Health in Schools Act of 2007 (S. 578/ H.R. 1017), which clarifies that schools can use Medicaid funding for certain transportation and administrative claims, and tightens reporting and documentation requirements to avoid abuse.
RecommendationsExtend the six month moratoria on the CMS rehabilitative services and school based administration/transportation rules through H.R. 4355 or other legislative vehicles;Co-sponsor legislation (S. 2578/H.R. 5173) to impose a one year moratorium on the CMS case management rule; and Co-sponsor the Protecting Children’s Health in Schools Act of 2007 (S. 578/H.R. 1017).
Relevant Committees
Senate Finance Committee
House Energy and Commerce Committee
For more information, please contact The Arc and United Cerebral Palsy Disability Policy Collaboration (202-783-2229), Association of University Centers on Disabilities (301-588-8252), American Association on Intellectual and Developmental Disabilities (202-387-1968), or National Association of Councils on Developmental Disabilities (703-739-4400).
SSA employment incentive guidelines
NYAPRS
Note: The Social Security Administration has released the 2008 Red Book: A Summary Guide to Employment Supports for Individuals with Disabilities under the SSD and SSI Programs. Keeping with the NYAPRS mission of highlighting and providing information on the many incentives there are for people to become employed we want to share this guide with you. A complete copy of the guide in English and Spanish can be found at:
http://www.socialsecurity.gov/redbook/
The Red Book is a general reference tool designed to provide a working knowledge of SSD/SSI work incentives. The Red Book is written for educators, advocates, rehabilitation professionals, counselors, and individuals with disabilities.
Brief Summary of changes in SSA work incentives as outlined by the guide:
SSA increased the Substantial Gainful Activity (SGA) amount for individuals with disabilities, other than blindness, from $900 to $940 for 2008. SSA increased the SGA amount for individuals who are blind from $1,500 to $1,570 for 2008. SSA increased the monthly earnings amount that is used to determine if a month counts for the Trial Work Period (TWP) from $640 to $670 for 2008. For 2008, SSA increased the Supplemental Security Income Federal Benefit Rates (FBR) from $623 to $637 for an eligible individual and from $934 to $956 for an eligible couple. SSA increased the income amounts that will have no effect on eligibility or benefits for SSI beneficiaries who are students. For 2008, SSA increased the monthly amount from $1,510 to $1,550 and the yearly maximum from $6,100 to $6,240. For 2008, the monthly Medicare Part A Hospital Insurance Base Premium is $423, and the 45 percent Reduced Premium is $233. The Part B Supplementary Medical Insurance monthly Base Premium is $96.40.
For more information contact Mat Mathai at mathewm@nyaprs.org.
Note: The Social Security Administration has released the 2008 Red Book: A Summary Guide to Employment Supports for Individuals with Disabilities under the SSD and SSI Programs. Keeping with the NYAPRS mission of highlighting and providing information on the many incentives there are for people to become employed we want to share this guide with you. A complete copy of the guide in English and Spanish can be found at:
http://www.socialsecurity.gov/redbook/
The Red Book is a general reference tool designed to provide a working knowledge of SSD/SSI work incentives. The Red Book is written for educators, advocates, rehabilitation professionals, counselors, and individuals with disabilities.
Brief Summary of changes in SSA work incentives as outlined by the guide:
SSA increased the Substantial Gainful Activity (SGA) amount for individuals with disabilities, other than blindness, from $900 to $940 for 2008. SSA increased the SGA amount for individuals who are blind from $1,500 to $1,570 for 2008. SSA increased the monthly earnings amount that is used to determine if a month counts for the Trial Work Period (TWP) from $640 to $670 for 2008. For 2008, SSA increased the Supplemental Security Income Federal Benefit Rates (FBR) from $623 to $637 for an eligible individual and from $934 to $956 for an eligible couple. SSA increased the income amounts that will have no effect on eligibility or benefits for SSI beneficiaries who are students. For 2008, SSA increased the monthly amount from $1,510 to $1,550 and the yearly maximum from $6,100 to $6,240. For 2008, the monthly Medicare Part A Hospital Insurance Base Premium is $423, and the 45 percent Reduced Premium is $233. The Part B Supplementary Medical Insurance monthly Base Premium is $96.40.
For more information contact Mat Mathai at mathewm@nyaprs.org.
Campaign to reverse "sneaky" Medicare cuts
PDF of study sited: http://www.familiesusa.org/assets/pdfs/bad-medicine/new-mexico.pdf
When families are already struggling, the last thing they need is to be told that their jobs are in jeopardy.
Yet that is exactly what may happen in New Mexico , unless Congress does something.
Very sneakily and without asking Congress, President Bush last summer proposed major changes in the rules for how states could receive federal funding for Medicaid – threatening massive cuts in the program and having a ripple effect through the State’s economy.
In New Mexico alone, these cuts will eliminate 4,000 jobs and cost the state $134.6 million in wages, not to mention an 364.7 million in lost business activity, according to a new study by Families USA .
Just this week, the House of Representatives overwhelmingly passed legislation to put a hold on these harmful regulations. Now it's time for the Senate to act.
Tell your Senator to put a stop to the Administration's harmful Medicaid Regulations. Click here to send an email or call 1-800-828-0498.
This legislation will protect New Mexico 's economy and health care.
The regulation changes issued by the Bush Administration restrict funding for a variety of Medicaid services, including rehabilitation services, school-based transportation, as well as Medicaid administrative services, such as outreach, enrollment, and case management.
At this time, the rule changes can either be halted or implemented.
Tell your representative to stop the rule changes. Act now.
Congress didn't get to review or debate these changes last summer because of the President's tricky tactics. Now they have that chance.
Thank you,
Julia EismaneAdvocacy Coordinator
Visit the web address below to tell your friends about this. Tell-a-friend!
If you received this message from a friend, you can sign up for Families USA.
--------Families USA 1201 New York Ave., NW, Suite 1100 , Washington , DC 20005
www.familiesusa.org info@familiesusa.org
When families are already struggling, the last thing they need is to be told that their jobs are in jeopardy.
Yet that is exactly what may happen in New Mexico , unless Congress does something.
Very sneakily and without asking Congress, President Bush last summer proposed major changes in the rules for how states could receive federal funding for Medicaid – threatening massive cuts in the program and having a ripple effect through the State’s economy.
In New Mexico alone, these cuts will eliminate 4,000 jobs and cost the state $134.6 million in wages, not to mention an 364.7 million in lost business activity, according to a new study by Families USA .
Just this week, the House of Representatives overwhelmingly passed legislation to put a hold on these harmful regulations. Now it's time for the Senate to act.
Tell your Senator to put a stop to the Administration's harmful Medicaid Regulations. Click here to send an email or call 1-800-828-0498.
This legislation will protect New Mexico 's economy and health care.
The regulation changes issued by the Bush Administration restrict funding for a variety of Medicaid services, including rehabilitation services, school-based transportation, as well as Medicaid administrative services, such as outreach, enrollment, and case management.
At this time, the rule changes can either be halted or implemented.
Tell your representative to stop the rule changes. Act now.
Congress didn't get to review or debate these changes last summer because of the President's tricky tactics. Now they have that chance.
Thank you,
Julia EismaneAdvocacy Coordinator
Visit the web address below to tell your friends about this. Tell-a-friend!
If you received this message from a friend, you can sign up for Families USA.
--------Families USA 1201 New York Ave., NW, Suite 1100 , Washington , DC 20005
www.familiesusa.org info@familiesusa.org
ALS Campaign Features Edgewood Resident
Edgewood Resident Featured in National
NOTE TO EDITORS: The MDA Web page featuring Deborah Basile will go live on May 5, 2008. Please contact MDA if you want to view the page in advance.
FOR IMMEDIATE RELEASE
Contact: Bob Mackle
Vice President - Public Information
(520) 529-5317
bobmackle@mdausa.org
MDA NATIONAL ALS AWARENESS CAMPAIGN FEATURES EDGEWOOD RESIDENT
TUCSON, Ariz., April 25, 2008 — The Muscular Dystrophy Association has included Deborah Basile of Edgewood in its national campaign promoting awareness of ALS (amyotrophic lateral sclerosis, or Lou Gehrig’s disease), a devastating neuromuscular disease. May marks the 17th annual national ALS Awareness Month.
During May, Basile will be one of 31 people featured (one per day) in the MDA online series “ALS: Anyone’s Life Story.” The series highlights how people have learned to live with ALS, gaining new perspectives on life even as the disease progressively steals their ability to move, eat and breathe.
Basile, 54, learned she had ALS in 2005. Her photo and a brief biographical profile will appear Monday, May 5, on MDA’s ALS Division Web site (www.als-mda.org) and the Association’s main site (www.mda.org).
Prior to ALS, Basile was active as a physician substitute, volunteer emergency medical technician and horse trainer. These days, she says she has learned to be more tolerant and appreciative of the little things in life. She works daily on compiling her family’s genealogy so she can pass it on to her children.
Average life expectancy of people with ALS is three to five years after diagnosis. The disease attacks the nerve cells that control muscles, ultimately resulting in paralysis of all voluntary muscles, including those used for breathing and swallowing.
The “Anyone’s Life Story” series grew from the personal saga of fitness pioneer and entrepreneur Augie Nieto, who received a diagnosis of ALS at age 47 in 2005. A leader in the fitness equipment industry, Nieto underwent a dramatic shift in his life’s priorities after his diagnosis, from striving for business success to searching for personal significance and fulfillment. He and his wife, Lynne, are co-chairs of MDA’s ALS Division, and the driving force behind MDA’s Augie’s Quest research initiative.
MDA is the world leader in providing health care services for people with ALS, and in funding research that seeks treatments and a cure for the disease and some 40 other related diseases. The Association supports 225 hospital-affiliated MDA clinics across the country, of which 38 are designated MDA/ALS centers. The MDA clinic at University of New Mexico Hospital and the MDA/ALS Center at UNM Health Sciences Center – both in Albuquerque – serve residents with ALS, muscular dystrophy and other neuromuscular diseases in the Albuquerque area.
— MDA —
For more information about ALS, including an online MDA Reporter’s Guide to ALS, and a schedule of MDA events being held nationwide to observe the 17th annual ALS Awareness Month, visit www.als-mda.org/media.
NOTE TO EDITORS: The MDA Web page featuring Deborah Basile will go live on May 5, 2008. Please contact MDA if you want to view the page in advance.
FOR IMMEDIATE RELEASE
Contact: Bob Mackle
Vice President - Public Information
(520) 529-5317
bobmackle@mdausa.org
MDA NATIONAL ALS AWARENESS CAMPAIGN FEATURES EDGEWOOD RESIDENT
TUCSON, Ariz., April 25, 2008 — The Muscular Dystrophy Association has included Deborah Basile of Edgewood in its national campaign promoting awareness of ALS (amyotrophic lateral sclerosis, or Lou Gehrig’s disease), a devastating neuromuscular disease. May marks the 17th annual national ALS Awareness Month.
During May, Basile will be one of 31 people featured (one per day) in the MDA online series “ALS: Anyone’s Life Story.” The series highlights how people have learned to live with ALS, gaining new perspectives on life even as the disease progressively steals their ability to move, eat and breathe.
Basile, 54, learned she had ALS in 2005. Her photo and a brief biographical profile will appear Monday, May 5, on MDA’s ALS Division Web site (www.als-mda.org) and the Association’s main site (www.mda.org).
Prior to ALS, Basile was active as a physician substitute, volunteer emergency medical technician and horse trainer. These days, she says she has learned to be more tolerant and appreciative of the little things in life. She works daily on compiling her family’s genealogy so she can pass it on to her children.
Average life expectancy of people with ALS is three to five years after diagnosis. The disease attacks the nerve cells that control muscles, ultimately resulting in paralysis of all voluntary muscles, including those used for breathing and swallowing.
The “Anyone’s Life Story” series grew from the personal saga of fitness pioneer and entrepreneur Augie Nieto, who received a diagnosis of ALS at age 47 in 2005. A leader in the fitness equipment industry, Nieto underwent a dramatic shift in his life’s priorities after his diagnosis, from striving for business success to searching for personal significance and fulfillment. He and his wife, Lynne, are co-chairs of MDA’s ALS Division, and the driving force behind MDA’s Augie’s Quest research initiative.
MDA is the world leader in providing health care services for people with ALS, and in funding research that seeks treatments and a cure for the disease and some 40 other related diseases. The Association supports 225 hospital-affiliated MDA clinics across the country, of which 38 are designated MDA/ALS centers. The MDA clinic at University of New Mexico Hospital and the MDA/ALS Center at UNM Health Sciences Center – both in Albuquerque – serve residents with ALS, muscular dystrophy and other neuromuscular diseases in the Albuquerque area.
— MDA —
For more information about ALS, including an online MDA Reporter’s Guide to ALS, and a schedule of MDA events being held nationwide to observe the 17th annual ALS Awareness Month, visit www.als-mda.org/media.
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