Friday, October 24, 2008

Exciting News! Our New Waivers Are Here November 1, 2008

M E M O R A N D U M

TO: Persons with Developmental Disabilities; His or Her Family and Providers of Services

FROM: Stephen Hall, Ph.D., Director, Office of Developmental Disabilities

RE: Exciting News! Our New Waivers Are Here November 1, 2008

DHR Regional Offices: Please Immediately Distribute Widely to all Persons with Developmental Disabilities, Their Families and Providers of Services. If you receive this after November 27, 2008, please notify the Georgia Office of Developmental Disabilities.

Well finally! After three years of trying, the Federal Medicaid Office (CMS) and the Georgia Department of Community Health and those of us working in the Office of Developmental Disabilities within MHDDAD have our new waivers and services ready to go live on November 1 and we have a CMS approved waiver implementation plan to transition everyone into the new services over twelve months beginning this November.

And yes, everybody will have an individual budget based on his or her needs. Providers want to know what their big budget will be for the coming year and here it is: providers can safely predict it will be almost identical to last year’s budget. We have been spared cuts in services for persons in waiver services. Remember the big deal for Georgia’s new Medicaid waivers is our shift from a provider-centered system to person-centered system where individual families get their son or daughter’s budgets in the month that is two months before their son or daughter’s birthday month. This will give persons with disabilities plenty of time to choose their providers over the next twelve months.

Of course some providers are worried about how much money there will be and whether the person and their family will still choose them. Not to worry – there has been a legislative approved increase in funds to serve persons with developmental disabilities again this year and information from the seventeen other states that now offer self-directed supports and individual budgets says that 95% of families will stay with their current provider the first year, and only 10% of families every year will choose a different provider. Good providers already understand that a system that gives the family –the customer the choice—will bring more and more families.

and the necessary funding their way. In fact, good providers can expect to grow two to three times larger from families choosing to have their allocated funds given to these good providers.

So information about each person’s individual budget will flow first to the Support Coordinator who will inform the family so they can begin deciding what services will be provided in agreement with the needs identified in the person’s individual service plan, and they, the family will decide how much of the money goes to which providers that they choose. This turns the Developmental Disability system into a much more free American system where families are in charge of service and funding rather than the money going from the government to a provider and then the family having to go there to find out how much they got. I know this new way of doing business empowering families will make some providers nervous, but if you are a good provider you have nothing at all to worry about. They will still choose you.

Despite telling good providers that they can stop worrying about the money, worrying if families will choose them, some providers will still be worried. Again, good providers have nothing in the world to worry about. Mediocre providers probably do. Families will look out after their own son and daughter’s best interests and they will make sure that the taxpayer’s dollars they are using go to those providers that can do their son or daughter the most good.

We have conducted over 54 community forums and have spoken in person to more than 9000 families directly about these changes. And while an overwhelming number of persons with disabilities and their families love and will love these changes, as do most providers of services, there are some, some even good providers who are afraid they are going to lose funds to provide services. They must not be! In fact most providers will experience no change but receive the potential for increased funding, that is if the family chooses them to do all of their son or daughter’s services.

This is an exciting time for Georgians receiving these new individually funded waivers based on each person’s exact need, but not everybody wins.

Taxpayers win because their money is used to meet the exact needs of the individual person through individual allocation to meet that particular person’s exact needs. Families win because so many things that were not possible for their loved ones to be supported in the community during the day, in the evenings, and weekends are now possible in the new waivers. Providers win because good providers know what they are and will use the new funding to serve even more people. The only losers when the customer is in charge are mediocre providers that had the false security of a government contract for the money. Now it will be the families’ choice.

Safeguards are already in place to ensure that only DHR regional offices approved funds go to pre-authorized vendors of services. A lot of people have to say “yes” before the public funds are used but this time the first yes comes from the person and their family.

We will be fighting rumors and deliver on our promises to families who have fought so hard for these changes in Georgia. If you have something good to say or have a success story to tell, please share it with everyone. Nobody knows everything and we will make some mistakes in this month by month transition. We will stay in touch through our new website and as always by direct communication in your local communities. November 2008 through October 2009, the new Developmental Disability waiver transition months are truly great days for Georgians with developmental disabilities.

Monday, October 20, 2008

Peace, Love, Harmony . . . and the IFSP/IEP?

Developing an Effective Partnership
with your Child's Special Education Team
Training in Gwinnett County
7pm - 8:30pm
Wednesday, October 22, 2008
Five Forks Public Library
Five Forks Trickum and Ronald Reagan
Lawrenceville, GA


Join Parent to Parent of Georgia and learn how you can become an effective communicator and be a more effective partner with your child's IFSP/IEP team.

This interactive 2-hour workshop will teach effective communication,
good listening skills, tips to defuse conflict, how to organize and
plan for meetings and includes information about how an IEP Buddy
can help you be an effective team member.

For more information, contact:

Parent to Parent of Georgia
1-800-229-2038
www.parenttoparentofga.org.

Thursday, October 16, 2008

2008 Regional Conference on Down Syndrome and Other Disabilities

Celebrating the Journey:
YESTERDAY TODAY & TOMORROW

Nov 7–9, 2008

Atlanta Perimeter Marriott Hotel

JOIN FELLOW MEMBERS, NEW PARENTS, SELF-ADVOCATES AND PROFESSIONALS TO LEARN OF THE LATEST ADVANCES BY AND FOR PEOPLE WITH DOWN SYNDROME, NETWORK WITH OTHERS, AND CELEBRATE AT THE 30th ANNIVERSARY GRAND GALA DINNER DANCE!

BRIAN SKOTKO, KATHRYN SOPER, MITCHELL LEVITZ, PAT BAUER, ALL PROMINENT NATIONAL SPEAKERS PLUS EXCELLENT LOCAL PROFESSIONALS WILL OFFER YOU DOZENS OF WORKSHOPS AND PRESENTATIONS THAT WILL EDUCATE, INSPIRE, AND EMPOWER YOU!

About the Keynote Speakers:

Friday November 7
Mitchell Levitz is a Disabilities Specialist at the Westchester Institute for Human Development, a University Center of Excellence in Developmental Disabilities affiliated with New York Medical College. He currently serves on the Board of Directors of the National Down Syndrome Society and was the recipient of the 2004 Dan Piper Self-Advocacy Award. In addition to Count Us in: Growing Up with Down Syndrome, Mitchell contributed material to eight books including authoring two chapters “Voices of Self-Advocates” in Human Rights of Persons with Intellectual Disabilities: Different but Equal published by Oxford University Press in 2003 and “Self-Advocacy for a Good Life in Our Older Years” in Aging Rights, and Quality of Life: Prospects for Older People with Developmental Disabilities published by Paul H. Brookes in 1999.

Sunday November 9
Patricia E. Bauer is a journalist who has served as senior editor of the Los Angeles Times Sunday Magazine; special assistant to the publisher of the Washington Post; reporter and bureau chief at the Washington Post, and pundit on public affairs television in Los Angeles. Bauer is a former member of an Institutional Review Board (IRB) at UCLA, where she participated in the ethical review of federally funded medical research on human subjects, and has addressed national and regional conferences on the rights of patients and people with disabilities. During the Carter years, she worked in the White House press office as editor of the White House News Summary. Bauer and her husband are among the founders of the Pathway Program at UCLA, a post-secondary program for young adults with intellectual disabilities. They are the parents of two young adults, one of whom has Down syndrome and is a survivor of leukemia.

Saturday November 8
Kathryn Lynard Soper is a mother of seven children, teenage to toddler; her youngest, Thomas, has Down syndrome. She is editor of Gifts: Mothers Reflect on How Children with Down Syndrome Enrich Their Lives (Woodbine House, 2007) and is currently working on a companion volume. Her memoir about mothering Thomas, The Year My Son and I Were Born, will be published by the Globe Pequot Press in March, 2009. Kathryn is the founder and president of The Segullah Group, a nonprofit organization which produces literary works to benefit individuals, families, and communities. Her website is www.kathrynlynardsoper.com

Friday November 7
Brian Skotko, M.D., M.P.P., a resident physician at Children's Hospital Boston and Boston Medical Center, has dedicated his professional energies toward children with cognitive and development disabilities. In 2001 he co-authored the national award-winning book, Common Threads: Celebrating Life with Down Syndrome. He is a graduate of Duke University, Harvard Medical School, and Harvard’s John F. Kennedy School of Government. Brian recently authored major research on how physicians deliver a diagnosis of Down syndrome to new and expectant parents. He has been featured in The Wall Street Journal, The New York Times, The Washington Post, The L.A. Times, NPR’s On Point, and ABC’s Good Morning America. Brian serves on the Board of Directors for the Massachusetts Down Syndrome Congress and the National Down Syndrome Society. He further serves on the Professional Advisory Council to the National Down Syndrome Congress. His website is www.brianskotko.com

Click here for more information.

Register for the 30th Anniversary Gala Celebration – Banquet, Program, and Dance. Send name(s) and check for $65 per adult to DSAA, 4355 J Cobb Parkway #213, Atlanta, GA 30339. Or click here to register online.

Click here for the Program.

Governor Perdue Announces September Revenue Figures


Governor Sonny Perdue announced October 8 that net revenue collections for the month of September 2008 (FY09) totaled $1,632,334,000 compared to $1,561,749,000 for September 2007 (FY08), an increase of $70,585,000 or 4.5 percent.

The percentage decrease year-to-date for FY09 compared to FY08 is 2.6 percent.

Please click here for the detailed document.

NOTES FROM THE SENATE
BY SENATOR JACK HILL,
4th DISTRICT

October 3, 2008

Here's the "Skinny" on the Constitutional Amendments on the General Election Ballot.

There are three Amendments to the Georgia Constitution on the Ballot Georgians will be voting on in the next three weeks. At least one of the Amendments is controversial but all three can be difficult for the casual reader to learn about. A good place to start is the website of the Association of County Commissioners, www.ACCG.org which has good information including a video on each amendment.

First of all, these amendments if passed, would AUTHORIZE STATE LAW to be passed to put these provisions into effect. So the passage of the Constitutional Amendments is not the final word on the content of the provisions. Secondly, it is also useful to remember that of all of the possible constitutional amendments introduced, only these three garnered the two thirds majority in the Legislature to be placed on the ballot, so they all had to have bipartisan support for you to have the opportunity to consider them.

AMENDMENT ONE - Would put into place a structure that would allow forestland owners to keep properties of over 200 acres from being subject to rising property values and valuation. The owner would agree not to develop the property but to leave in natural state for at least 15 years. Local governments would be compensated for the loss in tax revenue through a state program.

This is seen as a way to promote "Green Space" without the state actually purchasing properties and taking them completely off the tax rolls. If the owner reneges on the agreement, there are severe penalties to include obligation for the property taxes that would have been levied if the property had not been in the program. The Amendment also authorizes the payment of grants to local governments in lieu of the ad valorem taxes.

So far, conservationists and others such as the Georgia Forestry Association are supporting the amendment because it would protect lands in fast-growing areas from development and perpetuate the states tree-growing industry. County Governments are generally supportive, but the state School Board group is opposed because of the potential the state might not back up its commitment to replace the funds and school districts would be losers.

AMENDMENT TWO - Legalizes and restores a process that was ongoing before the State Supreme Court disallowed it. Redevelopment projects or Tax Allocation Districts (TADs) had become very popular in the Metro part of the state as a vehicle for development of blighted or non-tax producing properties. Again as in Amendment One, TADs involve freezing property tax values while redevelopment is going on. Tax revenue increases are reinvested in the properties. When finished, new taxes are collected when properties are sold or utilized based on the increased, developed value. School taxes, which can make up to TWO THIRDS of local property taxes are an important part of any approach such as this but their participation had been ruled unconstitutional by the Court. Under this amendment, school districts retain rights to decline participation. Without this amendment, most projects will not generate the savings to make investment in some areas feasible. Again, local governments are generally favorable to this amendment.

AMENDMENT THREE - Would authorize "private communities" to obligate future landowners for repayment of development costs. These self-contained communities have been developed in Florida and basically involve the complete costs of developing a community to be borne by the taxes and income from the residents and property owners of the development. This normally includes all infrastructure costs including roads, schools, etc.

Local governments have the say-so under this amendment to approve or disapprove these developments. Some are opposed because future property owners would owe payments to both the development and property taxes to local governments. Proponents say that potential buyers would have to be satisfied at the value of the property to make the investment and that these "planned communities" will offer the amenities wanted by future owners at no cost to local property taxpayers. Local governments have been generally supportive of the present form of this amendment.

VOTING EARLY
In case you had not noticed, voting early this year is more accessible and voter-friendly than ever before. Early voting started September 22, 45 days from Election Day. Today and until Friday, October 31, voters can go the local elections office or designated location and vote on the spot, no excuses needed. Just show a valid ID and vote early. For absentee ballots, you can pick up an application and mail it back to the Elections Office. Upon verification of signatures, a ballot will be mailed to the voter who can then mail it in or even fax the ballot in.

Georgia is expecting over one million voters to vote before Election Day with another three million possibly voting on Election Day.

Friday, October 31 is the last day for voting early.
Info? Try www.sos.ga.gov/ElectionCenter

234 State Capitol, Atlanta, GA 30334
(404) 656-5038 (phone)
(404) 657-7094 (fax)
E-mail at Jack.Hill@senate.ga.gov
Or Call Toll-Free at
1-800-367-3334 Day or Night
Reidsville office: (912) 557-3811

Monday, October 06, 2008

Urgent message from GAO

The Georgia Advocacy Office has asked for our help in getting this message out to families who have been denied the Katie Beckett Waiver. Please send this out to your networks.
------------------------------------------------------------------------------
To: Katie Beckett Parents

From: Georgia Advocacy Office

Date: October 3, 2008

RE: Katie Beckett Appeals and Motions for Summary Determination


It has come to our attention that many of you are being contacted by attorneys representing the Georgia Department of Community Health (DCH) about Katie Beckett appeals that you filed back in 2006 and 2007. We are concerned that DCH is employing scare tactics to get families to withdraw their appeals. Unfortunately, the GAO does not have the resources to provide individual legal representation to the hundreds of families affected by DCH’s actions. We are, however, committed to providing technical assistance in public forums and through communications on our website and through listservs to families so that they may be able to effectively advocate on behalf of their children.

We would like to briefly clarify a couple of matters about the appeal process:

• The lawyers for DCH have been filing what is called a Motion for Summary Determination with the Office of State Administrative Hearings (OSAH). Under the OSAH rules (found at www.osah.ga.gov/documents/procedures/rules%20of%20procedure.pdf), you have twenty (20) days to respond to this motion.

• If you are going to be unable to respond within the 20 day time period, please fax a letter to OSAH staff attorney Jill Shotzberger, fax # (404)818-3716, at OSAH requesting a thirty (30) day extension to file a response to the Motion. Send a copy of your letter to the lawyer for DCH who sent the Motion for Summary Determination. Your letter should indicate your child’s name, a case number if you have one and an indication that you are appealing pro se (i.e., not represented by an attorney).

• If you have missed the twenty (20) day response time, don’t panic. You should still fax a letter to Ms. Shotzberger informing her that you have missed the filing deadline and that you wish to pursue your appeal and you request a thirty (30) day extension of time to respond. Send a copy of your letter to the lawyer for DCH who sent the Motion for Summary Determination.

• Please know that if your request for an extension is granted, it may be for less than the 30 days you have requested.

We are developing sample documents that you may wish to use in your appeal. One of those documents will be a sample Response to the Motion for Summary Determination. We will let you know when those documents are available and how to obtain them via email and listservs.

Please visit the OSAH website, http://www.osah.ga.gov/. Two helpful links are “About OSAH” and “Proceeding Pro Se: How to Present My Case.” The procedural rules for your appeal OSAH are located through the link “About OSAH” where you will click on “Procedural Rules” and then click “Administrative Rules of Procedure.”

If you are going to withdraw your appeal, we suggest that you sign a settlement agreement that clearly states that the State will not seek any reimbursement for any services or treatments paid for by DCH/Medicaid in exchange for your withdrawal of the appeal. Do not agree to give up your right to re-apply for Katie Beckett in the future.

We will be providing more information about Katie Beckett at a public forum on Tuesday, October 7th, from 1 pm to 4 pm at the State Bar Headquarters at 101 Marietta Street, 3rd Floor, Atlanta, GA 30303. (www.gabar.org/parking_deck/ - See bottom of the web page for directions, MARTA information, and parking) We are exploring other options for providing educational opportunities for families in the near future about this very important topic.



This document should not be construed as legal advice and this document does not create an attorney-client relationship.

Friday, October 03, 2008

DHR Memorandum: Exciting News! Our New Waivers Are Here November 1, 2008

September 26, 2008

M E M O R A N D U M

TO:Persons with Developmental Disabilities; His or Her Family and Providers of Services

FROM:Stephen Hall, Ph.D., Director, Office of Developmental Disabilities

RE:Exciting News! Our New Waivers Are Here November 1, 2008

DHR Regional Offices: Please Immediately Distribute Widely to all Persons with Developmental Disabilities, Their Families and Providers of Services. If you receive this after November 27, 2008, please notify the Georgia Office of Developmental Disabilities.

Well finally! After three years of trying, the Federal Medicaid Office (CMS) and the Georgia Department of Community Health and those of us working in the Office of Developmental Disabilities within MHDDAD have our new waivers and services ready to go live on November 1 and we have a CMS approved waiver implementation plan to transition everyone into the new services over twelve months beginning this November.

And yes, everybody will have an individual budget based on his or her needs. Providers want to know what their big budget will be for the coming year and here it is: providers can safely predict it will be almost identical to last year’s budget. We have been spared cuts in services for persons in waiver services. Remember the big deal for Georgia’s new Medicaid waivers is our shift from a provider-centered system to person-centered system where individual families get their son or daughter’s budgets in the month that is two months before their son or daughter’s birthday month. This will give persons with disabilities plenty of time to choose their providers over the next twelve months.

Of course some providers are worried about how much money there will be and whether the person and their family will still choose them. Not to worry – there has been a legislative approved increase in funds to serve persons with developmental disabilities again this year and information from the seventeen other states that now offer self-directed supports and individual budgets says that 95% of families will stay with their current provider the first year, and only 10% of families every year will choose a different provider. Good providers already understand that a system that gives the family –the customer the choice—will bring more and more families.

and the necessary funding their way. In fact, good providers can expect to grow two to three times larger from families choosing to have their allocated funds given to these good providers.

So information about each person’s individual budget will flow first to the Support Coordinator who will inform the family so they can begin deciding what services will be provided in agreement with the needs identified in the person’s individual service plan, and they, the family will decide how much of the money goes to which providers that they choose. This turns the Developmental Disability system into a much more free American system where families are in charge of service and funding rather than the money going from the government to a provider and then the family having to go there to find out how much they got. I know this new way of doing business empowering families will make some providers nervous, but if you are a good provider you have nothing at all to worry about. They will still choose you.

Despite telling good providers that they can stop worrying about the money, worrying if families will choose them, some providers will still be worried. Again, good providers have nothing in the world to worry about. Mediocre providers probably do. Families will look out after their own son and daughter’s best interests and they will make sure that the taxpayer’s dollars they are using go to those providers that can do their son or daughter the most good.

We have conducted over 54 community forums and have spoken in person to more than 9000 families directly about these changes. And while an overwhelming number of persons with disabilities and their families love and will love these changes, as do most providers of services, there are some, some even good providers who are afraid they are going to lose funds to provide services. They must not be! In fact most providers will experience no change but receive the potential for increased funding, that is if the family chooses them to do all of their son or daughter’s services.

This is an exciting time for Georgians receiving these new individually funded waivers based on each person’s exact need, but not everybody wins.

Taxpayers win because their money is used to meet the exact needs of the individual person through individual allocation to meet that particular person’s exact needs. Families win because so many things that were not possible for their loved ones to be supported in the community during the day, in the evenings, and weekends are now possible in the new waivers. Providers win because good providers know what they are and will use the new funding to serve even more people. The only losers when the customer is in charge are mediocre providers that had the false security of a government contract for the money. Now it will be the families’ choice.

Safeguards are already in place to ensure that only DHR regional offices approved funds go to pre-authorized vendors of services. A lot of people have to say “yes” before the public funds are used but this time the first yes comes from the person and their family.

We will be fighting rumors and deliver on our promises to families who have fought so hard for these changes in Georgia. If you have something good to say or have a success story to tell, please share it with everyone. Nobody knows everything and we will make some mistakes in this month by month transition. We will stay in touch through our new website and as always by direct communication in your local communities. November 2008 through October 2009, the new Developmental Disability waiver transition months are truly great days for Georgians with developmental disabilities.

ACTION ALERT Help Stop Back Door Cuts to Medicaid Services

The outpatient regulation is now at the federal OMB for clearance and is expected to go into effect in the next several weeks unless a moratorium is included in the Tax Extender Bill in the House (see Friday's Action Alert on this issue).

The outpatient regulation, first published on September 28, 2007, has a real and very wide impact reducing funding to many clinics and hospitals. The rule treats visits to a clinic where many services are offered, including outpatient clinical services for people with disabilities, as if they are purely a visit to a doctor's office.

Hospitals will no longer receive reimbursement for outpatient services provided through Graduate Medical Education. They will see their disproportionate share payments reduced and flat rate hospitals will be very negatively impacted.

In the modern approach to medicine we want to encourage preventive services and services outside the emergency room setting yet this rule does just the opposite. It cuts funds to outpatient services. See Table below for some of the services that will be affected by this Regulation.

Service
Medicare Coverage
Impact of Outpatient Rule on Medicaid
Day Treatment
*Medicare does not pay for day programs for individuals with
developmental disabilities.
*Medicare does not pay for day treatment such as intensive
psychiatric rehabilitation.

No funding for day treatment programs for persons with psychiatric or developmental disabilities.

Comprehensive primary care and ancillary services.

*Medicare does not recognize clinics that provide comprehensive
primary care and ancillary services. Therefore it reimburses them as if they were visits to private physicians.

No funding for some clinic services, such as lab and radiology services.

Select Services
*Medicare does not pay at all for certain services such as
vision, psychiatric and dental services (but only dental care received as an exception under the proposed rule.)

No funding for clinics that specialize in mental health services or services for individuals with developmental disabilities.

ACTION NEEDED:

Call Speaker Pelosi, Majority Leader Hoyer, Majority Whip Clyburn and Members of the House Ways and Means Committee (see list below)- TODAY.
Ask them to include a moratorium on the Medicaid regulation IN THE TAX ENXTENDER BILL. Use the Capitol Switchboard to reach your Members at 202-224-3121.

FREE Seminar:

Please pass on ........ This is an important learning event, to PROTECT the future of your loved ones.
Planning for Families with Special Needs... Scroll down for topics covered.
* Network with folk from local support groups and agencies .Many resources available.Light refreshments will be served.

When:Tuesday, October 7th, 2008-6:30 p.m.

Where: Rosewood Ballroom
170 College Street
Macon, GA 31201

Who:Presented by Krista Dowling ,Financial Advisor -Smith Barney

PLEASE RSVP Krista.dowling@smithbarney.com
OR Tgoodridge@bibb.k12.ga.us, Nisaac@bibb.k12.ga.us

CO-HOSTED BY:
Bibb County Parent Mentors
Nalini Isaac & Terri Goodridge
Natalie Brown,Kinship Care Specialist
Middle Georgia RDC/Area Agency on Aging
484 Mulberry St 175-C Emery Highway
Suite 450 Macon, GA 31217
Macon, Ga 31208

SPEAKERS:
Krista Dowling
Financial Boone
Vice President-Wealth Management
(404) 266-6349

Seminar will cover:

Did you know that if you give a person with special needs more than $2,000 a year in his or her own name, that person may be disqualified for government benefits?

Fortunately, there are ways to protect those benefits. A Special Needs Trust is one of the key ways for your disabled loved one to receive an inheritance or gifts and still be eligible for Supplemental Security Income and Medicaid.
• Preventing the loss of government benefits, including Supplemental Security Income
• Providing additional income to facilitate a better quality of life
• The role of a trustee and how to select one
• Balancing the needs of other family members and beneficiaries

**Light refreshments will be served. Network with folk from local support groups and agencies. Many resources will be available.