The State of Georgia for DD in 2005

I just received my copy of "The State of the States in Developmental Disabilities: 2005" and thought I would share with you where Georgia stands today for supporting people with disabilities in the community. I think it is important to know where you stand against other states so that we can more clearly set a direction for improvement in the future. We should only expect Georgia to be a leader in this area, and in order to get there, we should ask over and over, "How can we do better?"

There are 11 states that dedicate at 90% of their total resources to community services in 2004: Arizona, Colorado, District of Columbia, Hawaii, Maine, Michigan, Minnesota, New Hampshire, Oregon, Rhode Island and West Virginia. When the state's population is controlled for, Georgia is ranked 51st in the country for using community services.

There are serious problems in retention of direct support professionals throughout the country. I am sure you can relate as a parent to the uncertainty of your loved one's staff person changing. Research has confirmed that this turn over has a deterimental effect on the quality of support. The wages of those persons working in the community with our loved ones is on average $8.68 per hour - compared to the national poverty level of $8.49 per hour. Many states are currently involved in law suits that contend that low wages result in unnecceasry segregation and isolation of people with disabilities and violates Section 504 of the Rehab Act of 1973 as well as the ADA.

Georgia has moved from placing 44th in our state's fiscal effort for community spending in 2002 to ranking 45th in 2004.

In 2004, Georgia had 17,145 persons with MR/DD living with a caregiver over the age of 60. Families continued to share the majority of the responsibility of care for people with disabilities. Nationally, only 11% are supported in a supervised residential setting, while 13% own their own homes, 15% live with a spouse, and 61% live with a family caregiver.

Don Schanche says "Goodbye and good luck"

Mr. Schanche will be missed at the Macon Telegraph. He always willing to cover issues important to us in a fair and honest way. He has moved to the Atlanta bureau of the Associated Press where he will do more editing.

My head is full of ghosts: people whom I interviewed, people who lived and died, people who committed crimes, who spoke to city councils, who had traffic wrecks, who did hard jobs, who marched in demonstrations, who triumphed over disabilities, who had unusual hobbies, who wrote me angry letters, and who sometimes appreciated what newspeople do for a living.span>

Macon Telegraph | 12/18/2005 | Goodbye and good luck

Parents caught in Medicaid crunch | ajc.com

State legislators are looking for suggestions to solve this issue, which we believe really should come out of the Governor's office. However, some have suggested that (1) DCH correctly enforce the federal guidelines for eligibility and then (2) give parents who find themselves ineligible for the current Deeming waiver the option of buying into Medicaid coverage using a sliding scale that adjusts family income for costs related to the well being of the child with a developmental disability. Read the AJC article below and then click the link to give "Comment" on what you think the solution should be...

The Katie Beckett waiver helps middle-class families pay for therapy and other medical costs that private health insurance won't cover. It's part of Medicaid, which provides health coverage to the poor and disabled. However, the state hadn't been applying the strict federal standard for participation in the program, said Mark Trail, director of the Department of Community Health's Medicaid program. As a result, many children had been accepted who didn't meet the criteria of severe disability or medically fragile status. Under the state's old criteria, 6,278 children received the Katie Beckett waiver. As of September, 5,419 children were enrolled, Trail said. "Some might be new families, so I can't say what number were denied," he said. The Katie Beckett program costs the state $38 million a year, an average of about $502 per child per month. The state predicted $6 million could be saved by adhering to the federal institutional guideline.

Click here to read "Parents caught in Medicaid crunch" on ajc.com

Speaker Richardson outlines 2006 Session

This is an interesting preview into what to expect during the session this year. Expect a short session with few bills, as well as restraint on increased spending. To track legislation regarding disability issues go to AADD's Legislative Action Center There is also a very interesting article today in the Athens Banner on Georgia's budget surplus at Lawmakers analyze possible surplus

Speaker Glenn Richardson said Wednesday that Georgia House members plan to push for tougher laws on sexual predators and limiting government condemnation of private property when the 2006 General Assembly session opens next month...At a briefing for reporters, Richardson (R-Hiram) also predicted that the controversial requirement of a photo identification for voters will be debated by lawmakers for a second straight session...Richardson said lawmakers would put a high priority on approving a bill making it more difficult for governments to use the power of eminent domain...The speaker also told reporters he was skeptical of claims that the state may have enough money to give election-year refunds to taxpayers, as some Republicans have suggested. Richardson said the bulk of any budget surplus could be eaten up by higher Medicaid and education costs...The speaker said he had stressed to House members that he wanted a short session and as few bills as possible.

Click here to see read "Speaker spells out '06 agenda" on ajc.com

OnlineAthens.com | Opinion | Heard's remarks on poverty fight were misguided 11/11/05

The poverty rates of working-age people (ages 21-64) with disabilities in the United States, using data from the 2003 and 2004 American Community Surveys (ACS) can be found at www.DisabilityStatistics.org and are disturbing. The poverty rate for working-age people with disabilities increased from 23.3 percent in 2003 to 24.1 percent in 2004, in the US. While the poverty rate of working-age people without disabilities increased from 8.9 percent in 2003 to 9.1 percent in 2004, in the US.

Mayor Heidi Davison put Heard on the defensive, asking whether state legislators are willing to invest public money in education, transportation and economic development as a means of addressing issues with a direct relationship to poverty, both in Athens-Clarke County and around the state. As the mayor's remarks suggested, the state should be playing a major role in educating people for effective entry into the workforce or higher education, providing public transit to ensure that those who can't afford personal transportation have a way to get to work, and in bringing jobs into the state.

OnlineAthens.com Opinion Heard's remarks on poverty fight were misguided 11/11/05

Roberts Court Hears Its First Case in Federalism Debate - New York Times

The case involves a Georgia inmate, Tony Goodman, a paraplegic who has been in prison since 1995, when he was convicted of aggravated assault, possession of a weapon and intent to distribute cocaine...The federal district court and the United States Court of Appeals for the 11th Circuit, both in Atlanta, dismissed it, saying the state was immune under the 11th Amendment from a suit for damages under the disabilities law. The federal government entered the case at the appeals court stage to defend the constitutionality of the statute...Gregory A. Castanias, a Washington lawyer arguing for Georgia, said the inmate's claims in this case went well beyond constitutional requirements. Several justices then suggested that the law might be interpreted to apply only to constitutional violations. Justice Scalia asked, "To the extent that it includes constitutional violations, why isn't that lawsuit perfectly O.K.?" Coming from Justice Scalia, a strong ally of the states in this line of cases, the question was a surprise, and Mr. Castanias was taken aback. He asked for a moment to think of an answer. Then he said it would "not be congruent with the Constitution" for Congress to place disabled inmates in a privileged position to "assert rights that apply to all."

Privileged position?

Roberts Court Hears Its First Case in Federalism Debate - New York Times

Bill brings fiscal sanity a little closer | ajc.com

I found this sentence interesting...

Eliminate gimmicks, such as transferring or hiding assets, that middle-class families use to qualify for Medicaid long-term care.

Bill brings fiscal sanity a little closer ajc.com

Medicaid reforms could hurt poor | ajc.com

This piece does a good job at laying out some of the issues of Medicaid reform for Georgia.

The majority of Georgia Medicaid families have incomes below the poverty level ($16,090 for a family of three). Additional cost-sharing requirements for low-income families would further constrain their efforts to manage their already-limited financial resources. This could force families to choose between obtaining health care for their children or food, clothing, utilities and other necessities.

The first principle of any Medicaid reform should be to "do no harm" to the health care system. Pregnant women who drop Medicaid coverage due to the implementation of premiums will still give birth. Children whose families cannot afford co-payments, resulting in unfilled medications and missed doctor visits, will still get sick. Instead of receiving care efficiently and cheaply through Medicaid, they will receive care inefficiently and expensively in hospital emergency rooms and have more serious health problems when they do receive care.

Medicaid reforms could hurt poor ajc.com

Health agency commissioner takes job at UGA | ajc.com

It is telling that this happened quickly and that the replacement is from Florida. Jeb Bush recently passed his own Medicaid reform. Is this a sign for Georgia?

The commissioner of the state's main health agency is resigning to take a position at the University of Georgia, agency board members said Thursday.

The formal announcement of Tim Burgess' departure is expected today. Burgess will be replaced Dec. 1 by a former health official from Florida, Department of Community Health board members Christopher Stroud and Ann Parker said.

Health agency commissioner takes job at UGA ajc.com

A call to make good on 'promise deferred' | ajc.com

The Governor's Council on Developmental Disabilities hosted a VIP tour of disability issues. Here is a nice piece covering the issues of the event.

The Governor's Council on Developmental Disabilities had chosen the King Center
to make a point. It is just one of many landmarks in this city "too busy to
hate" tied to groundbreaking moments in the struggle for civil rights. But in
the march to freedom, the council wanted us to know, America's largest minority
group — people with disabilities — had been overlooked, in housing, in
classrooms, in the job market.

A call to make good on 'promise deferred' ajc.com

Why We Need Medicaid

We all know how true this is...

With the high cost of health care, we need programs such as Medicaid to help our nation's poor and even those in the middle class get the health care they need.

Statistics suggest that raising a child with a disability costs 3 times more than a child without a disability. Often families feel one hospital visit away from financial crisis.

Why We Need Medicaid

Wrong motivation for care of the mentally disabled

Don Schanche has been a reporter in Macon that always covered health care and disability issues well. Here is a recent article that attempts to make sense of the different points of view from all of those invested in the issue of closing institutions.

The conversation about what's best for the mentally disabled is almost schizophrenic. Advocates for the disabled come down on both sides of the fence when talking about the expected closure of Central State Hospital. Some say the clients will do better in a community setting rather than being institutionalized. Others aren't so sure. And both sides are wary that the funding to support the mentally disabled, no matter what the setting, will be cut, if not immediately, sometime in the future...At the very least, the state has to have services in place before institutions are shuttered. If it does not we could very well see our homeless and prison population rise again.

Macon Telegraph 10/25/2005 Wrong motivation for care of the mentally disabled

Don Schanche writes another piece on Central State

This time Mr/ Schanche attempted to cover the different points of view from all the parties affected by the transition.

Macon Telegraph | 10/23/2005 | Multiple interest groups involved in Central State debate

Plans to cut Medicaid, Medicare don't add up

Doctors would be big winners under the bill. It would set aside $11 billion to forestall a 4.4 percent cut in Medicare payments to physicians that it is scheduled to take effect Jan. 1.

An additional $800 million would help parents with severely disabled children retain Medicaid coverage and still earn wages above the poverty line.

Welcome to AJC! | ajc.com: "An additional $800 million would help parents with severely disabled children retain Medicaid coverage and still earn wages above the poverty line. "

From the Washington Post today

States Freeze, Reduce Medicaid Payments


All 50 states froze or reduced Medicaid payments to health care providers such as doctors and hospitals while 43 states targeted drug costs this year, and more cost controls are on the way, according to a survey.
The measures helped states slow growth in Medicaid spending and enrollment for the third straight year, according to the survey of state directors of the government health care program for the poor, released today by the Kaiser Commission on Medicaid and the Uninsured. As a result, the gap between increases in Medicaid spending and the growth of state tax revenue narrowed to its lowest level since 1999.
The success in slowing cost increases to a pace closer to growth of tax revenue is emboldening states to plan more cuts, the survey found.

http://www.washingtonpost.com/wp-dyn/content/article/2005/10/19/AR2005101902149.html

Macon Telegraph | 10/14/2005 | Leaders say Central State closings would harm clients, workers

Don Schanche wrote a piece on October 14th entitled, "Leaders say Central State closings would harm clients, workers" on the proposed transition of person currently living in Central State to community based supports in the Macon Telegraph.

He writes, "the proposal to close three units of Central State Hospital would cut as many as 500 jobs, throw mentally disabled clients to the mercy of the streets and add to the jail and prison population, a group of state and local leaders said Thursday...The state Department of Human Resources has proposed closing the Craig Nursing Home and the Allen and Freeman buildings in the coming fiscal year, which begins in July. Clients would be moved to "appropriate community settings," according to the proposal. DHR officials say it is more cost-effective and often more appropriate to serve mentally disabled people in their home communities...

The points the article raises include:

1. There aren't enough community supports.
2. These persons will end up in our state's jails.
3. Closing these facilities will be economically devastating for Milledgeville.
4. No one else wants to serve these individuals.

To read the article, click here:Macon Telegraph 10/14/2005 Leaders say Central State closings would harm clients, workers:

Please consider writing a letter to the editor by going to Unlock's Letter to the Editor webpage. We have included tips on writing letters, as well as some background information you can include in your letter.

Georgia GOP casting wide net for legislative proposals

Sometimes we need to look at other states for why things are being introduced in our own state.
Think tanks are good place to look to find ideas, such as the Heritage Foundation and The American Legislative Exchange Council offers conservative approaches to issues affecting state governments.

"As we go into more managed care for Medicaid, we'll be looking up at Tennessee's TennCare as a way not to do it,'' said Johnson. "With tort reform, we were able to watch Texas and Florida and see where they got bogged down and made mistakes.''

gwinnettdailypost.com

Gingrich calls for major changes in health care, politics

Former U.S. House Speaker Newt Gingrich sounded more like Newt Gingrich, M.D., on Friday, diagnosing major ailments in the way the government handles everything from health care to electing presidents, and prescribing major changes to cure them.

His health plan calls for Americans to be able to store and refer to health records online, setting up personal savings and reimbursement accounts, and changing prescription insurance coverage.

Though the topic was health care, the backdrop, as usual in the earliest primary state, was politics.

...if I go and I articulate these ideas and people like them, but the candidates don't pick them up, then probably, I'll run," he said.

AccessNorthGa.com - North Georgia's Newsroom

House GOP Vows Broad Cuts in Spending

House Republican leaders raised the stakes this week in a looming budgetary showdown, pledging to lift the target of entitlement cuts from $35 billion to $50 billion, impose across-the-board spending cuts and rescind spending already approved -- all to offset the cost of hurricane relief.

The move, announced at a closed-door meeting of House Republicans Thursday night, would cut tens of billions of dollars from entitlement programs for the poor, such as Medicaid, but could touch virtually every aspect of government.

House GOP Vows Broad Cuts in Spending

Natalie Tumlin passes away: Natalie was one of Georgia's Strongest Advocates for Disability Issues

Natalie's impact on Georgia is one in that we all aspire. Her efforts with her mom, Beth Tumlin, have had a lasting impact on services in Georgia for people with disabilities. We will truly miss her smiles and voice.

Other stories include:
AJC: Natalie Tumlin, 30, advocate for disabled

Marietta Daily: Natalie Tumlin, advocate for disabled, dies at 30

Below is a note from Natalie's mom, Beth:


Dear Friends, Family, Supporters, and Cheerleaders!

After consulting with the three physicians who had worked with Natalie over the past five weeks (our very caring Infectious Disease Specialist, the Gastroenterologist, and a Cardiologist), they all concurred that Natalie's immune system and nutritional status were not strong enough to pull her through the most recent infection that had gone to her heart.

Natalie and her family left Northside Hospital and moved a few blocks away into Vitas Hospice Home on Wednesday, September 28th. We smothered her with love, and they kept her pain free throughout the following three days. We were so grateful for this wonderful place that allowed the entire family total access with as much privacy as we needed. We had a birthday party for Bill in her room, and showed her the slide presentation (with some of her favorite music) that Tracy and her fiance, Darryl, had started preparing for her 30th birthday bash, and have finished for our Celebration of her life. We laughed with her, we recalled fun moments, we talked about so many of the very special people in her life who had helped her and/or brought her joy, and we thanked her for being in our lives.

Our sweet Natalie passed away very peacefully Saturday afternoon, October 1st, at 4:30 pm.

Her family would like for you to join us in Celebrating Natalie's Life on Tuesday, October 4th, 2005, anytime between 4:00 - 8:00pm, at our home at 5231 Rebel Road, Marietta, GA 30068-4721 (go to Mapquest.com). As Natalie would have loved it, this is a very informal and casual event to remember the fun and wonderful times we all shared with her. Because it is an Open House type affair, there will not be a designated time for sharing, but if you have fun stories or an experience that you would like to share with the family and others who attend, please bring with you (or e-mail: btumlin@comcast.net or fax to 770 640-1287 if you can't attend) just a paragraph or two that we can post on a board for all to enjoy.

Because time is short, and Natalie had so many friends who knew and loved her, we would truly appreciate it if you would call or forward this invitation to friends, families, and associates we have in common. I don't want to miss folks cause their e-mail has changed (or if we knew them before e-mail was invented!) Thank you for your help.

In lieu of flowers, the family requests that donations be sent to either:

G.C.S.S. - The agency that provided the supports for Natalie to live independently in the community the past six years. GCSS provides supports to over 1200 individuals and their families with a variety of services;
- or -
Unlock the Waiting Lists! Campaign - The Campaign we started in 1998 to eliminate Georgia's Waiting Lists for people with disabilities who need services in their
homes and communities, rather than institutions and nursing homes. To date, almost 3000 people have received services; however, 6000 others are still waiting!

Georgia Community Supports & Solutions (G.C.S.S.)
Attn: Carol Redman
1945 Cliff Valley Way, Suite 220
Atlanta, GA 30329

Unlock the Waiting Lists! Campaign
Attn: Dave Blanchard
1440 Dutch Valley Place, Suite 200
Atlanta, GA 30324


We will look forward to seeing y'all on Tuesday.

Bill, Beth, Jennifer & Mike, Tracy & Darryl
Natalie's Family

Bill & Beth Tumlin’s home: 5231 Rebel Road, Marietta, GA 30068-4721

Unlock Hosts introductions around the state on disability services

In collaboration with a number of organizations and advocates in your community, the Unlock the Waiting Lists Campaign presents an educational event we know you will want to put on your calendar: “Medicaid 101: An Introduction to Disability Supports in Georgia.” Speakers will include Dottie Adams, Governor’s Council on Developmental Disabilities and Dr. Steve Hall, DHR’s Director for the Office of DD. Local state legislators are also invited.

For more information go to:
http://www.unlockthewaitinglists.com/medicaid101.html

Brookings Institute asks why if more people are working, there are more living in poverty

"The direction we are headed in is making benefits [for the disadvantaged] more conditional on people helping themselves," Sawhill said. "But government needs to uphold its side of that bargain, as well, which is: If you work, you shouldn't be poor."

Brookings Ends Research on Welfare Reform

Georgia recieves Medicaid Waiver for victims of Katrina.

"Mark Trail, the Georgia Medicaid director, said the waiver approved Wednesday allows the state to provide health care services to low-income parents, pregnant women, children under 19 and those with disabilities, regardless of their residency plans or whose plans are unsettled."

For how long and what is the committment of Georgia to this long term care?

AccessNorthGa.com - North Georgia's Newsroom

Group Seeks More Medicaid Spending

The Joint Center for Political and Economic Studies say that lawmakers should consider spending more on Medicaid during economic downturns, much like they do when they extend the time limit for collecting unemployment insurance. Rate of unemployment remains around 70% for people with disabilities.

Group Seeks More Medicaid Spending

Mental Health receives 1.5 million in Savannah

"These youth can be productive and contribute to the community and not in a separate place,'' said Gwen Skinner, director of the Division for the Mental Health ...

http://www.savannahnow.com/stories/092205/3310869.shtml

An Op-Ed reaction to Olmstead from 1999

"But the disabilities many Gracewood patients have are much too severe to even think about putting them in a community housing setting. Some require constant medical supervision and others are much too confused or helpless to look after themselves...Regardless of what any law says, there will always be some persons who require institutional care."

http://chronicle.augusta.com/stories/081499/opi_089-5940.shtml

Senate OKs $3.5B in Katrina Home Vouchers

An estimated 250,000 refugees from the flooding, an overwhelming majority of them believed to be qualified for Medicaid, are now in Texas. For five months state matching funds that are part of the Medicaid program will be waived, said Paulitz.

Senate OKs $3.5B in Katrina Home Vouchers

Disabled evacuees languish | ajc.com

Hundreds more physically and mentally disabled and elderly evacuees who require supportive care are probably in Georgia, advocates and state officials say.

Disabled evacuees languish | ajc.com

Advocates meet with Office of DD

A group of advocates met with DHR's Director for the Office of DD, Steve Hall, today to discuss a list of agenda items developed by the Arc of Georgia's Julia Bowen. The conversation turned most interesting when we began to discuss the new waiver that is being developed for Georgia. Some possibilities for this waiver included:

• To get a flavor of where they are going, you need to look to waivers currently in Colorado and Oregon.
• Georgia has the oldest waiver in the Nation, 15 years old.
• Two new waivers will replace the current MRWP and CHSS waivers and will be a) Support Services or day supports and b) Comprehensive Supports or Residential.
• There will be as few as 3 categories of services.
• Individual budgeting will be based on needs and costs of services. Needs will be defined by SIS, age, type of disability and factors related to existing housing and supports.
• Dental and transportation will be added services under the new waiver.

There will be forums in late October to get input into this process - so stay tuned for locations and times.

The hope is that this new waiver will be written submitted for approval to CMS this fall and to be in place July 1st 2006.

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Lawmakers vow hurricane Medicaid boost

Lawmakers vow hurricane Medicaid boost

States Want Medicaid Coverage for Storm

States have asked Congress to pick up 100 percent of the costs for any Medicaid recipients added to their rolls as a result of Katrina.

States Want Medicaid Coverage for Storm

Evacuation plans leave people with disabilities behind

National Geographic magazine wrote in an article published in October 2004 about a possible hurricane scenario for New Orleans...In that article National Geographic predicted with eerie accuracy that more than a million people would evacuate, but some 200,000 would remain, including "the carless, the homeless, the aged and infirm." Welcome to AJC! | ajc.com

Atlanta has a 27.8% poverty rate

The Census Bureau also released a report on income and poverty in states, counties and large cities. Georgia was one of 12 Southern states with poverty rates higher than the national average. In 2004, the state had a poverty rate of 14.8 percent, which means that about 1.2 million people live in poverty, according to the report. The bureau also found that Atlanta has a 27.8 percent poverty rate, among the highest for cities of at least 250,000. Census says poverty rate rises for 4th straight year ajc.com

Poverty Rose in 2004, Medicaid enrollment increases

As poverty in America increase, programs like Medicare and Medicaid remain important in people's lives. "The portion of Americans without health insurance remained roughly steady at 16 percent, according to the bureau. A smaller percentage of people were covered by their employers, but two big government programs, Medicaid and military insurance, grew." Income Stagnated and Poverty Rose in 2004, Census Figures Show - New York Times

What happens when you leave High School?

Across America this month, about 90,000 families have faced this same bittersweet moment, as their disabled children "age out" of state education systems. Most states provide education and care until age 21 -- Michigan is an exception. After that, families are on their own to find services and meaningful activities for their children...That's why these commencement ceremonies feel different from most others. Parents wonder: What kind of life are their children commencing? Often, they go to programs far inferior to what they had in school, or they sit in their parents' homes (or group homes) and stare at TV.
CareerJournal When Disabled Children Get Too Old for Public Education

Georgia will save money by reducing Medicaid enrollment

Georgia's 1.5 million Medicaid patients likely will not see their benefits cut next year, but they won't receive additional services, either....Some consumer health advocates and hospital officials greeted Thursday's budget news with a sigh of relief. Last year's budget reductions resulted in substantial cuts to the PeachCare for Kids dental program. Previous reductions resulted in reduced Medicaid coverage for low-income pregnant women, and cuts in payments for speech therapists who treat children... Medicaid cuts unlikely in '06 ajc.com: "Some consumer health advocates and hospital officials greeted Thursday's budget news with a sigh of relief. Last year's budget reductions resulted in substantial cuts to the PeachCare for Kids dental program. Previous reductions resulted in reduced Medicaid coverage for low-income pregnant women, and cuts in payments for speech therapists who treat children."

Congress considers $10 billion cuts to Medicaid

The Senate Finance Committee is trying to find as much as $10 billion in savings from Medicaid, trimming anticipated growth by as much as 13 percent at a time when states such as Tennessee and Missouri are throwing tens of thousands of people off their Medicaid rosters. Critical Votes Loom For Hill Republicans

Department of Human Resources recommended 1,500 slots in 2007 budget

The DHR reccomended 1,500 slots in their budget reccomendation to the Governor. This is great news for disability advocates. See

Budget Proposal