Giving people the choice to move from insitutions is within our State's grasp

This issue is simple, people with disabilities should be given the choice of where they live.

Right now, over 2,000 persons with disabilities are living state institutions and over 5,700 persons with disabilities are living in nursing homes. On June 22, 1999, the United States Supreme Court held in Olmstead v. L.C. that the unnecessary segregation of individuals with disabilities in institutions constitutes discrimination based on disability. However, Georgia still spends only 39% of its Medicaid long-term care dollars on Medicaid home and community based waiver services.

States will get additional help from the federal government to support elderly and disabled Medicaid recipients who wish to live in the community rather than institutions, HHS Secretary Mike Leavitt announced on July 26th.

July 26th CMS's Press Release on MFP

Georgia's "institutional bias" has created real financial disincentives to offer these persons in institutions real choices where they can live.

You can help by adding your organization to the letter written to the Governor below that urges Georgia to adopt a policy that will allow money to follow persons from nursing homes and institutions into the community. You can add your organization to this letter with just one click.

July 26, 2006

Honorable Sonny Perdue
Office of the Governor
State Capitol
Atlanta, GA 30334

Dear Governor Perdue:

On June 22, 1999, the United States Supreme Court held in Olmstead v. L.C. that the unnecessary segregation of individuals with disabilities in institutions constitutes discrimination based on disability. The court ruled that the Americans with Disabilities Act requires states to provide community-based services rather than institutional placement for individuals with disabilities. This historic decision makes attainable a goal long-sought by the disability rights movement, a community first approach to long term care (LTC).

In the July/August issue of the Journal Health Affairs, H. Stephen Kaye’s, professor at the Institute for Health and Aging at the University of California - San Francisco noted that in recent years, there’s been a large and steady increase in the number of home and community based (HCBS) workers — from 264,000 in 1989 to 894,000 in 2004. The aging baby boomer generation will continue to increase demand.

After years of mounting evidence that the long term care system is failing people with disabilities, health policy experts agree, it's time to reduce our dependency on nursing homes and other institutions and implement a community first approach. Both the Olmstead decision and DRA present an opportunity to rebalance Georgia's long term care system. One of the biggest problems with Medicaid-financed long-term care has been its "institutional bias." Medicaid paid mostly for nursing home care and much less for home care over the years. That imbalance has been changing for a decade or more but still exists. In fact, according to CMS, as part of clinical assessments of all residents in Medicare or Medicaid certified nursing homes, 5,774 Georgians expressed a preference to return to the community. During the same year, Georgia spent $1,065,938,986 of its Medicaid long-term care dollars on nursing facility services (nursing homes, ICF/MR institutions, swing beds) (61%). In contrast, Georgia spent $419,092,665 (39%) of its Medicaid long-term care dollars on Medicaid home and community based waiver services (Community Care Services Program, Mental Retardation Waiver, Community Habilitation and Support Services Waiver, Model Waiver, Source Program, Dedicated Case management, and Independent Care Waiver Program).

The undersigned groups want to know which incentives in DRA you plan to utilize to meet Georgia’s commitment to people with disabilities. In particular we're interested in Money Follows the Person (MFP), a policy that Texas successfully implemented. CMS released the Request for Proposal (RFP) for MFP on July 26th and it is our expectation that Georgia will respond to this RFP and begin the long overdue journey to re-balancing the LTC system.

We'd appreciate a response by August 15. To sit on the sidelines would be a disservice to all Georgians. We look forward to working with you to prepare a sound proposal.


Sincerely,

The Undersigned

Why Georgia Needs a New Waiver...

The waiver is ready to be sent by DCH for approval by CMS, but has not been sent yet. However, we have learned that the Governor's office continues to be committed to the principles of the new waiver and is working with CMS (the federal department that oversees the approval process of our new waiver) and other entities to determine how to move forward. To see what the Governor said recently about the waiver and our recent success - read his letter that was published recently in Making a Difference Magazine in the post below.

Also, the memo below is from the Director for the Office of Developmental Disabilities and explains the potential changes that could come from this new waiver...

July 18, 2006

M E M O R A N D U M

TO: People with Developmental Disabilities, Their Providers, and Those That Care So Much About What Happens

FROM: Stephen R. Hall, Director - Office of Developmental Disabilities

SUBJECT: New Waivers for Georgia

For too long Georgians with disabilities have had to fit into an old vehicle knows as the original Medicaid Mental Retardation Waiver Program (MRWP). This vehicle has been modified, patched up, amended, and made more reasonable over the years. Over these same years other states have abandoned their old original waivers, stopped amending them, and have written new Medicaid Waivers for their citizens with developmental disabilities. It is now Georgia’s long overdue turn to send the New Options Waiver and the new Comprehensive Supports Waiver on to Baltimore, Maryland for federal approval.

1. A first ever Community Supports Waiver, called NOW, that will ensure real self-determination through individual budgets.
2. Fair funding with the statewide Supports Intensity Scale Assessment ensuring that the funding is determined based on the person’s exact need.
3. Transportation, dental, behavior, and support coordination services will all be within the new waiver so families can decide, based on their son or daughter’s individual budget, just how much of these new services they want and can afford.
4. Community Guide Services are in the new waivers. These Community Guides will work for and be employed by persons with disabilities and their families.

We have spent eight long months building a new efficient customer-driven system through two new Medicaid Waivers. It is time to say the last rights on the old MRWP and CHSS waivers and welcome the new NOW and COMP waivers. It is time for people with disabilities and their families to live in The New Georgia.

Governor Perdue comments on the proposed new waiver for people with disabilities

We have made great progress over recent years in meeting the needs of Georgians with developmental disabilities and their families including responding to the Olmstead mandate. During this next year we expect 100 people to move from state institutions into the community with the necessary support. This includes 44 children under the age of 21 who have been growing up in state facilities instead of with loving, supportive families.

We have substantially increased the number of Medicaid Waivers that support individuals with developmental disabilities. In 2005, funds were available to support 925 waivers; an unprecedented 1,500 were awarded this year, and we are committed to building on this progress in the future.

Georgia currently has the oldest Medicaid waivers in the country, ones for the most part, require that people fit into existing program. Today, the Department of Human Resources Office of Developmental Disabilities is rewriting the waiver program in order to give more people with developmental disabilities support based on their exact needs. Under the new waivers, people with disabilities such as Down syndrome, cerebral palsy and autism will be able to have more control over the types of home and community-based services they receive and who provides those services.

Instead of investing in outdated facilities, buildings and programs that segregate people with disabilities, Georgia is investing directly in individuals and families – individuals who want employment, housing, membership in civic and community organizations and families who want to keep their young children at home.

As a result of the new waivers, and consumer-driven services, Georgians with developmental disabilities and their families will have greater control and choice. You can expect the State of Georgia to continue its progress toward providing home and community-based services for our citizens with disabilities. And, as Governor, I look forward to our working together to improve the lives of individuals and families.


Sonny Perdue
Governor
Making a Difference Magazine, Summer 2006

Help ensure strong funding for programs like Partners In Policymaking

The National Association of Developmental Disability Councils is working to increasing the federal dollars that support the work of the Governor’s Councils. The Georgia Governor’s Council has a proven track record of supporting life changing programs such as Partners
in Policymaking for so it is important you strongly support for the work that they do by responding to this email.

We need you to contact Senator Johnny Isakson and Senator Saxby Chambliss and encourage them to support increased funding for Councils. The critical date is July 18th.

If you decide to call, ask to speak to the staffer who handles disability issues and tell them that you would,

"ask the Senator to provide $84.5 million to State DD Councils when the Senate Subcommittee marks-up its Labor, HHS, Education spending bill on July 18, 2006"

(202) 224-3643 Isakson: Staffer is Tyler Thompson

(202) 224-3521 Chambliss: Staffer is Steve Rebillot

Let us know automatically that you have helped by making your call.

If you decide to email, you will need to go to their website and cut and paste the text from below into the message box.

Johnny Isakson's Website or Saxby Chambliss' Website

Let us know automatically that you have helped by sending your email.

When the Senate Appropriations Subcommittee on Labor, HHS, Education and Related Agencies marks up its spending bill on July 18, 2006, it is imperative that State and Territorial Councils on Developmental Disabilities (DD) receive adequate funding in FY 2007.

I ask you and the Subcommittee to appropriate $84.5 million to DD Councils under the Developmental Disabilities Assistance and Bill of Rights Act (P.L. 106-402).

Councils struggle not only to meet their obligations under the DD Act, but also to address unmet needs within their States. When the 106th Congress reauthorized the DD Act in 2000, the authority for State Councils on Developmental Disabilities was increased to $76 million and “such sums as necessary” for FY 2001-2007, in recognition of the significant work of these entities within each State and Territory. To date, Councils have not been funded at this authorization level, nor have they received a standard cost of living adjustment in recent appropriations bills.

In FY 2001, 2002 and 2003, some Councils lost up to 20% of their funding as a result of a legislative drafting error when specific “hold harmless” language was inadvertently omitted during the drafting of the last reauthorization of the DD Act in 2000. Further, over the last two fiscal years, Councils have experienced a one- and two-percent rescission that dealt a serious blow to their individual budgets. During this period, our sister agencies authorized by the DD Act – University Centers for Excellence in Developmental Disabilities (UCEDDs) and Protection & Advocacy (P&A) agencies – have received appropriation increases. The intent of the DD Act is that all three entities in each State and Territory work in partnership to produce positive systems change. As Councils fall further behind in funding, they find it increasingly difficult to be full collaborators in these partnerships.

We, ask, therefore, that the Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies provide funding that makes up for these rescissions, as well as a cost of living adjustment.

Despite these cuts, Councils have continued to make a positive impact on the lives of people with developmental disabilities in each State and Territory. Their work has gone well beyond the original investment of Federal dollars. Still, Councils are struggling to fulfill their responsibility of improving the quality of life for individuals with developmental disabilities in this country. Thank you for your continued leadership on behalf of people with developmental disabilities in our State.