Senator Jack Hill's analysis of the Quality Assessment Fees

Medicaid currently relies on around $90M from a 5.5% CMO “Quality Assessment Fee” that provides funds to the Medicaid population. These fees are used to “draw down” enhanced federal funds and do not have a negative impact on the CMOs. The Federal Agency with Medicaid responsibility has ruled that states like Georgia cannot assess a fee on one Medicaid provider without assessing the same fee on all health care providers. You can’t treat a Medicaid provider differently from other providers like insurance companies. So Georgia is faced with a choice which must be made and implemented by October 1, 2009. Either stop taxing the care management companies and create a $90M hole in the 2010 budget or start assessing insurance companies the same amount. Governor Perdue has proposed to lower the assessment fee from 5.5% to 1.6% but to apply the fee to insurance companies and to the net revenue of hospitals. In other words, all health care providers will be subject to this fee. The total produced by the fee would continue the $90M presently collected as well as plug a Medicaid shortfall created by the prior use of one-time reserve funds. This amount is $204.9M. The total of $217M would also pay for increased Medicaid demand and fund $60M towards a Trauma fund for hospitals. The Hospital piece of the funding, $259M has been met with strong objections by hospitals around the state. Rural hospitals particularly say they would be hard hit and that the fee has the potential to put some out of business. This is one of the crucial issues before this General Assembly. The Governor’s proposal does not appear to have widespread legislative support.

Senate Bill 1: Waste Reduction Act

The “Waste Reduction Act,” introduced by Senator David Shafer, would implement a system of zero-based budgeting for state government. Georgia currently prepares its budget on a “continuation” basis, which assumes that all current spending will be carried forward. His legislation would require that one-fourth of the budget be zero based each year, so that over a four year term, the entire budget is scrutinized by the General Assembly.

Go to www.aaddvocacy.org for legislative resources

2009 Money Follows the Person Conference

This conference, scheduled for March 2-4, 2009 in Baltimore, MD, will address subjects such as community inclusion for persons living with disabilities, innovative ways to increase housing capacity, Medicaid rebalancing, self direction and quality management systems. The Money Follows the Person (MFP) program is designed to help states move individuals enrolled in Medicaid from institutions back to the community, where they will keep their Medicaid coverage.

For more information, go to CMS website on Money Follows the Person

DisabilityInfo.gov provides quick and easy access to comprehensive information about disability programs, services, laws and benefits. You can begin your search by visiting any of the nine subject areas at the top of this page. To find disability resources in your state just click on the Find State and Local Resources map located in each of these subject areas.

Some of the many topics you will find information about on DisabilityInfo.gov include:

Americans with Disabilities Act (ADA)
Autism and other Developmental Disabilities
Fair Housing Rights
Social Security Disability Benefits
Vocational Rehabilitation

University Centers for Excellence in Developmental Disabilities Education, Research and Service
The Administration on Developmental Disabilities (ADD) funds University Centers for Excellence in Developmental Disabilities Education, Research and Service (UCEDDs) in every state and territory. UCEDD programs are designed to increase the independence, productivity and community integration of individuals with developmental disabilities. For a complete list of Centers visit ADD's Web site or the Association of University Centers on Disabilities.

Atlanta Journal Constitution letter to the editor

Thank you to Joni Pelta for writing this letter and sharing with us that it was printed.

READERS WRITE
By Joni Pelta, Robert W. Keeler, A. Jean Richardson

For the Journal-Constitution

Wednesday, January 28, 2009

Perdue needs to get hooked on special-needs kids

Every January brings the same rituals to Georgia. There’s a cold snap and a hard freeze. The Legislature resumes work under the Gold Dome. Special-needs parents and supporters must lobby hard to get funding for their loved ones’ programs.

I realize this year that state sales tax and other revenues are down as the economy stagnates. If the pie that all government programs feed from has shrunk, all worthy groups have to work even harder to grab their meager crumbs. That I can accept.

What rankles this parent of a special-needs child is that while Gov. Sonny Perdue and his staff nibble yearly to cut the crumbs of funding from special-needs programs, somehow there is $23 million for Perdue’s Go Fish project in Perry. Fishing is a fun, worthy hobby. However, why is building fishing facilities a bigger priority than those with special needs? Why is there never enough money to get the more than 6,700 people with special needs off the state waiting list and receive the services they need to become active, contributing members of society?

JONI PELTA

Atlanta

What do you think? Go to www.unlockthewaitinglists.com to learn more.

Abilities Celebration at the Georgia Aquarium!

Be a part of the first Abilities Celebration at Georgia Aquarium! Visit the Georgia Aquarium from Feb. 4-7, 2009, as we celebrate the diversity of human accomplishments and abilities. During this four day event, Georgia Aquarium will showcase the talent and creativity of special guest performers and speakers with various backgrounds and abilities. Join the Georgia Aquarium in increasing awareness of human abilities through these special performances, speakers and more!

Click here for more information and the schedule of events.

6,812 Georgians with Developmental Disabilities Wait for Help

This story came out last thursday on Savannah's WSAV-TV.

To see the video clip that went with this online story, click here.

I want to thank the Arc of Effingham's Nina Dasher for her help in making this story happen at the last minute. To learn more about the Arc of Georgia's efforts, click here. Also thank you to all those families on the waiting list who had very important stories to tell as well that I called throughout the afternoon. Note that they got the number of waiting wrong - they were using numbers from December - it is now 6,812 for people with DD and 138 for people with physical disabilities. For a list of cuts, go to the Unlock website.

State lawmakers continue looking for ways to cut two billion dollars in spending, as Georgia faces a historic budget shortfall.

The Governor’s proposed budget includes cutting $428 million to lower property taxes, $350 million dollars in cuts to education, plus cuts to transportation, prisons, and healthcare.

One area facing critical cuts is special needs service programs for the developmentally disabled, specifically developmental disability waivers. The waivers help families with providing special services and care—like mental health benefits, wheelchair ramps, and at-home caretakers— for their loved ones.

Jennifer Lanier, 37, lives with disabilities most of us can’t imagine. “Mental health status, and disability status… I had back surgery, and I suffer with schizophrenia… a developmental disability also,“ says Jennifer. Jennifer lives with a family friend but spends most of her time confined indoors.

“Either go to doctor’s appointments, or stay at home and put puzzles together,“ she says. Jennifer has qualified for a developmental disability waiver from the state that would help her in a number of ways. “Transportation, that’s a big thing I have a big problem with, because you have to call 3 days in advance to get the Medicaid van,“ she explains.

But advocate Nina Dasher says Jennifer is one of 6,700 hundred Georgians and their families on a waiting list for this assistance.“When you have a developmental disability, your functioning is that of a child most of the time, and that takes constant care for a lifetime,“ says Dasher, who herself cares for an 18 year-old granddaughter with developmental disabilities.

Dasher says Governor Perdue’s current budget includes no money for the program.

“It’ll be at least 18 months before anybody else with a developmental disability will get on that waiver, and as the population that has the waivers when they die, that money is not being left in the budget,“ she says.Joyce Arnsdorff says she’s happy to open her home to Jennifer but wishes the government could do more to help.

“It’s like they say, ‘Well, you know you need to be taken care of, so we’re going to take care of you, but we’re not going to do as much as you need,‘“ she says.

Advocates for Georgians with developmental disabilities have started a campaign called Unlock the Waiting Lists to try to reduce the number of people waiting for these services.

To see the video clip that went with this online story, click here.

Last week's Legislative Round Up

Last week, in a joint session of House and Senate Appropriations committees, legislators questioned agency heads about their budgets. The Departments of Human Resources and Community Health presented their FY09 and FY10 state budget proposals. For a list of budget cuts that will impact people with disabilities, go to the Unlock the Waiting Lists Action Alert page. There will be no new community supports for people with disabilities waiting in community for help for at least 18 months if the House and Senate accept this budget proposal.

The Department of Human Resources has proposed FY2009 budget cuts to the Governor that will leave our most vulnerable families and individuals even more at risk. While there supports for 150 DD services and 100 persons with physical disabilities to transition from institutions to the community, there are no disability supports for the over 6,900 people current on Georgia’s waiting list. We are afraid that with no new supports for these community waiting lists, we will be cutting Georgia's ability to support our most vulnerable.

We are asking Governor Perdue and our legislators to not cut funds for existing disability supports or contracts, rate increases, or developmental disability waiver slots in the Department of Human Resources or Community Health Budgets. Please help to protect these much needed supports for people with disabilities by encouraging Georgia’s General Assembly to look for revenue solutions to serve our most vulnerable citizens during these hard economic times.

Lawmakers also heard troubling state tax revenue forecasts. Economist Kenneth Heaghney projected that even if Georgia cuts its budget by $2 B (about 10%), tax revenues will still produce $600 M less than is needed in FY 2011 (beginning July 2010). He believes such shortfalls will continue for at least three years and says officials could have to decide whether to cut further or raise revenues. Georgia Budget and Policy Institute experts point to structural deficiencies in the taxation system they say must be addressed. See The Georgia Budget and Policy Insitute.

The federal stimulus package could bring Georgia $5.6 Billion. President Obama’s American Recovery and Reinvestment Plan could bring some near-term relief, and experts say it could create 143,000 jobs here. Now being marked up in the U.S. Senate Finance Committee, the plan includes such measures as tax cuts, spending on infrastructure projects, unemployment insurance, fiscal relief for Medicaid, and help with COBRA coverage for people losing jobs. The President wants a bill by mid-February, although it is drawing opposition in some quarters, including from some of Georgia’s delegation.

The General Assembly reconvenes today, January 26th. The House opens at 10:00 a.m. and the Senate begins at 1:00 p.m.

Legislator's Responses

Throughout this year's session, I will post legislator's responses to your emails and letters. Keep checking back here to see what they are saying about our issue.Here is a fantastic letter from one of Georgia's Partner in Policymaking graduates (Note that Jackie put "I live in your district" in her email's subject line):

Dear Rep. Walker,

Subject: Re: I live within District 107
RE: Unlock the Waiting List
I live within your district and have also had the privilege of hearing you speak at a Town Hall meeting that was held at Gwinnett County School's Instructional Support Building. Our 13 year old daughter, is currently on the waiting list for a MRWP (Mental Retardation Waiver Program) and has been waiting for a little over 2 years. She has autism and is totally nonverbal. She has severe learning disabilities and requires lots of care and support. Since she turned 13, her behaviors have become more challenging. Our family is in need of support on how to guide her and help her.

Since she has the mental capacity of someone much younger, we are not able to leave her alone. It requires that I be at home to see her off to school and meet her bus in the afternoon. Needless to say, I am not able to work fulltime and that further inhibits us from being able to afford needed services. She requires help with her personal care and all other activities, even going to bed. My husband works many hours to support us and I am She's primary caretaker. We do not get to spend any time together as a couple and our son is also asked to make sacrifices no child should have to make. I dread to think of
what single parents are doing to survive and take proper care of their child with disabilities.

Please do not cut support to families like ours, who are in desperate need of help. Ask them to do all they can to find funds to offer support for those who are on the waiting lists for waivers.

If you have any questions or wish to contact me, I can be reached at [phone number]

Thank you,
Jackie McNair

Len Walker wrote back:

From: Len Walker
To: "Jackie McNair"
Subject: Re: I live within District 107
Date: Thu, 22 Jan 2009 19:13:02 +0000

Jackie,
Thank you for this reminder. This, as you know, is an issue of enormous
importance. I will certainly do all I can.
Sincerely,
Len Walker
Sent via BlackBerry by AT&T

The Governor's Budget Address

Governor Perdue delivered his State of the State Address yesterday. Included in this address was his budget proposals for amended budget for Fiscal Year 2009 and his full budget for Fiscal Year 2010.

His speech can be found at on his website. Some highlights include:

The Governor thanked the legislature for working with his administration to help replenish the Rainy Day Fund, which now stands at $1.2 billion. In these budgets, Governor Perdue recommended using the maximum amount available for appropriation from the reserves, appropriating $187 million for the education midyear adjustment, $50 million in 2009 and $408 million in 2010. In 2009, a number of one-time strategies unavailable in 2010 will be implemented to balance the budget. Therefore, Governor Perdue recommended the largest portion of available reserve funds be committed to the 2010 budget.

Governor Perdue also outlined a proposal to restructure the Department of Human Resources. Currently, $3.8 billion is spent within DHR every year. The plan calls for the creation of a new Department of Behavioral Health which will include all mental health and addictive disease programs. The bill also establishes a Department of Health, a combination of the public health and oversight programs in DHR and the current functions of DHR. Remaining social services, such as Developmental Disabilities, Aging, DFCS and Child Support, will come together under a reconstituted Department of Human Services.

Governor Perdue will also introduce legislation to ask those who receive Medicaid payments to help fund the system. This proposal takes advantage of the fact that every dollar used toward Medicaid purposes draws down almost two additional dollars from the federal government. The budget will reflect, and an accompanying bill will propose, a 1.6 percent fee on hospitals and health insurance plans to, not only fill the hole in Medicaid, but also to do what the healthcare community has asked of Governor Perdue’s administration. This proposal will significantly raise Medicaid rates, particularly for hospitals; and in conjunction with the SuperSpeeder legislation, provide $60 million for trauma to sustain and expand the state’s trauma hospitals, EMS and trauma physician infrastructure.

Video of the Governor's Speech can be found here.

To see an update on the budget, go to http://www.unlockthewaitinglists.com/

NOTES FROM THE SENATE BY SENATOR JACK HILL

It is no secret that the major issue this legislative session will be the budget and dealing with the revenue shortfall. As legislators and the governor grapple with cutting agency budgets, it is important to remember that, unlike the federal government, Georgia must produce a balanced budget. This means that the state can only spend as much as it actually receives. Therefore, there is a finite pool of money that will be divided between all of the state’s agencies. There are a number of major issues that will be debated as the governor and legislature work their way through the 2009 Amended and 2010 General Budgets. Here is a brief explanation of some of the bigger issues:

Homeowners Tax Relief Grant

The Homeowners Tax Relief Grant (HTRG) is a grant provided by the state to counties in order to offset a portion of homeowners’ property taxes. HTRG is implemented by exempting the first $8,000 of a home’s assessed value from property taxes and shows up on the front of the tax bill as a reduction. In FY09, the legislature appropriated $428 million for HTRG. The Governor under his authority acted to suspend the distribution of these funds in July. If HTRG is granted, then budget writers will have to find that $428 million from cuts or reserves. If HTRG is not granted to homeowners, either counties or homeowners will foot the bill.

Managed Care Provider Fees

The state has three Care Management Organizations (CMOs) that service the state’s Medicaid population. Georgia charges CMOs a 5.5% fee on the revenues they earn and uses revenues from these fees as matching funds for federal funds for Medicaid and Peachcare. In October, federal law will change and require that the state either charge the same fees to commercial CMOs (insurance companies) or to none of the CMOs. If the state is not going to charge this fee at all, it will be a loss of at least $90 million to the budget. The Governor has proposed a plan that would impose a 1.6% fee on CMOs and commercial insurance providers. In addition, the Governor’s plan would charge the same 1.6% fee on hospitals’ net revenues. The Governor’s proposal would cover some of the deficits facing Medicaid programs as well as cover a way for the state to pay more to providers and even provide a source for funding trauma care. This proposal, of course, is controversial and opposed by insurance companies and hospitals.

Whose Budget To Cut?

This summer, the governor announced a reduction in the revenue estimate for the 2009 Budget and with the concurrence of Legislative leaders, pooled together one time funds and a 6% budget cut across the state budget (2% in education, 5% in Medicaid funds) to meet an anticipated $1.6 billion shortfall.

With December’s revenue report, the shortfall is expected to reach $2.1 billion or so for the present budget year. So the most immediate problem will be how to fill that additional hole. That is of course where the HTRG issue comes into play. The additional funds needed are in addition to the $428 million in suspended HTRG funds that legislators want to fund as well. The announcement of the use of $525 million in Reserve funds form the State Employees Health Insurance fund will make up part of the shortfall. Of course this means the Legislature cannot now use these funds to pay out the HTRG.

For the 2010 General Budget, if the revenue estimate reflects the new lower figure we are expecting, additional, higher cuts are likely. Remember when you remove Education and the Medicaid / Peachcare part of the overall budget amount to be cut, that is over one half of what will be a $17 billion budget. Education will have a 3% cut, probably and Medicaid is again a 5% cut at this point. An 8-10% cut in the balance of the budget is not out of the realm or possibility.

This is almost certain to be a session to either long remember or soon forget…

**Notification of New “Transparency in Government” Website** Open Georgia is a gateway for obtaining information and key documents about how the State of Georgia spends tax dollars and other revenues to provide services to Georgians. The information maintained on this site comes from various state agencies and is updated annually.
http://www.open.georgia.gov/

Contact Information:
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

PLEASE watch this video clip concentrating on ABILITIES

Animal School Movie

This is a MUST SEE for anyone connected to Special Education. Please forward to teachers and families.

Sent by a Parent Mentor.

"The reality is that we miss so much when we only concentrate on a child’s inabilities rather than how we can motivate them to use their abilities each day. I hope this will focus you for the week."

Governor Perdue Announces December Revenue Figures

Governor Sonny Perdue announced today that net revenue collections for the month of December 2008 (FY09) totaled $1,489,148,000 compared to $1,634,866,000 for December 2007 (FY08), a decrease of $145,718,000 or 8.9 percent.

The percentage decrease year-to-date for FY09 compared to FY08 is 2.7 percent.

Click here for the full report.

Wrightslaw Special Education Law & Advocacy Boot Camp with Peter Wright, Esq. and Pamela Darr Wright

Location: Weeki Wachee (Spring Hill Area), FL
Date: Friday and Saturday, January 16 - 17, 2009

This two-day Special Education Law & Advocacy Boot Camp, a Wrightslaw training program with Pete Wright and Pam Wright, is being sponsored by the Special Students of Hernando Support Group and Hernando County School Board Exceptional Student Education Department.

The program will be held at:

GlenLakes Golf and Country Club
9000 GlenLakes Blvd.
Weeki Wachee, FL 34613

Program Description

Participants will learn about changes in IDEA 2004 including:

* New requirements for initial evaluations, reevaluations & parental consent
* New requirements for IEPs, IEP goals, IEP teams, IEP meetings
* New eligibility issues for students with specific learning disabilities
* New procedural requirements and timelines, including the “Due Process Complaint Notice” and “Resolution (IEP) Session.”

Participants will learn about requirements in No Child Left Behind including:

* Reading and research based instruction
* Highly qualified teachers
* Parental rights and options
* High stakes testing

Participants will also learn how to:

* Use tests and measurements to measure progress
* Write SMART IEPs
* Use tactics and strategies for effective advocacy

Click here for more information and to register.

Register for the TASH 2009 WEB CONFERENCE SERIES

Asset Building for People with Disabilities
"Poverty does not have to be synonymous with disability"

Webinars: January 21 & 28, February 11 & 18, March 4 & 11

We live in a country that values ownership and wealth, but millions of people with disabilities are trapped into a life of poverty. There is a growing awareness that economic self-sufficiency does not follow from simply getting a job. Instead, people are often trapped in poverty due to a lack of information, prevalence of incorrect information, or limited access to bureaucratic advocacy. Even worse, society has grown to accept poverty as an expected consequence of disability. The disability community and disability policy makers have recently begun to discuss asset development and are exploring what needs to change in order to help persons with disabilities overcome poverty.

TASH Web Conference sessions offer informative and interactive presentations from many leading experts in the disability community.This series will provide a foundation for the concepts supporting asset development for individuals with disabilities. We will explore what is currently happening around the country, and possibilities for the future.

Click here for more information and to register for the webinars.

Opening - Advocacy Events Coordinator

AADD is current hiring a part time Advocacy Events Coordinator. Please contact Rita Young at rita@aadd.org to apply. This position would be 20-25 hours per week and based in the AADD offices in Midtown Atlanta.

PURPOSE
• Coordinate events within the Division of Public Policy
• Provide clerical and secretarial support
• Support the mission, vision, and goals of AADD

ESSENTIAL DUTIES/RESPONSIBILITIES
•Provides event support, onsite support, and evaluation.
•Arranges travel and lodging for staff, program participates and/or speakers.
•Plans, coordinates and attends a series of two three-day training seminars. Provides assistance and information as needed to participants during and between sessions. Prepares agenda for each session, which includes arrangements for speakers and presenters.
•Negotiates fees and charges for presenters, speakers, transportation, personal assistance and other childcare.
•Develops and prepares homework assignments and evaluation forms for each session.
•Oversees support staff in the collection of evaluation forms and compilation of information.
•Maintains all program documents.
•Assists with recruitment of future participants of leadership programs.
•Updates participant database with current contact information and activities
•Coordinates at least two learning trips for leadership program participants.

QUALIFICATIONS
Education and Experience

•High School Diploma or GED
•Secretarial certification; or equivalent experience
•Three years secretarial experience

Skills
•Excellent general computer software skills (MSWindows, MSOutlook, MS Frontpage, MS PowerPoint, MSWord, and MSExcel). Knowledge of web publishing preferred.
•Excellent grammatical, spelling, writing, editing, organizational and communications skills
•Ability to use personal computer, typewriter, facsimile machine, labeling machine, folding machine, postage machine and other common office equipment

Governor Announces Launch of Open Georgia: Transparency in Government Website

Governor Sonny Perdue announced Monday the launch of the Open Georgia: Transparency in Government website. The website can be found at open.georgia.gov. The site allows Georgians online access to agency expenditures on professional services, employee salaries and travel, state financial reports and program reviews from the two previous fiscal years.

“The Open Georgia website makes state government more transparent to its customer, the taxpayer,” Governor Perdue said. “By being willing to further open the halls of government to the public, we give citizens more confidence that their tax dollars are being spent wisely.”

There are numerous ways to search for salary and vendor information. Users can search by name, title, description and agency. The site allows Georgians to view professional service vendors doing business with the state and view how much they were paid during the two previous fiscal years. Once the information is accessed, it can be exported into Microsoft Excel or Adobe pdf formats. Users with questions about the site are able to call the state’s main information phone number, 1-800-GEORGIA, to be directed to the appropriate agency contact.

The Open Georgia site is the result of Senate Bill 300, the Transparency in Government Act, sponsored by Senator Chip Rogers and Senator Chip Pearson. The bill, which was signed by Governor Perdue on May 12, 2008, called for the site to be operational in January 2009.

“This is a great day for Georgia taxpayers,” Senator Rogers said. “We have taken a major step towards fully open and easily accessible accounting of how every state tax dollar is spent. The very best way to prevent wasteful government spending is to let those paying the bills see exactly where their money is going.”

The website is maintained by the Georgia Department of Audits and Accounts. In 2010, it will be expanded to include grant and contract payments to vendors by state agencies.