August 18, 2005

NYSRA ReSource

For Perspective and Analysis

The Source of information for providers of community-based services for people of differing abilities.

Medicaid Update

Medicaid continues to be on the front burners of many entities at virtually every level of government. Discussion and developments are continuing in many areas. NYSRA continues to participate in many of these discussions and monitors this critically important matter.

Here are some things to highlight:

Pataki Names Medicaid Inspector General

Governor Pataki has named Kimberly O’Connor as the State’s new Medicaid Inspector General. O’Connor has worked for the Governor as chief counsel in the office of the Division of Criminal Justice Services. The new Medicaid IG is charged with working to overhaul the way the State identifies and deals with Medicaid fraud. In her new post, O’Connor is expected to take over some of the oversight of Medicaid practices from the State Department of Health. O’Connor is a former prosecutor from Schenectady County.

The Medicaid Commission was created under the Federal Advisory Committee Act, to advise the HHS Secretary on ways to modernize the Medicaid. The Commission is to submit two reports to the Secretary for his consideration and submission to Congress. By September 1, 2005, the Commission is to provide recommendations on options to achieve $10 billion in Medicaid savings.

Tell Congress to Protect the Rehabilitation Community

NYSRA members should act to inform their Congressional representatives that the rehabilitation community needs them to go to bat for us.

In the coming weeks, Congress will be drafting language that may include ways to save up to $10 billion from the Medicaid program over five years. Let your Members of Congress know how critical all rehabilitation services are to the health and independence of the Medicaid recipients you serve and how vital Medicaid funding is to the work that you do.

Members also should contact Governor Pataki’s office with the same message opposing the restructuring or redefinition of rehabilitation services under Medicaid.

Any members who may need assistance in contacting their representatives or the Governor’s office may contact NYSRA.

Specifically being considered is draft language that would prevent habilitation or maintenance programs from receiving federal Medicaid support under the rehabilitation benefit by requiring that rehabilitation services demonstrate “specific, measurable outcomes” that show restoration of function; make Medicaid the payer of last resort in terms of services by mandating that Medicaid not cover rehabilitation services if such services are provided by or are an “administrative function” of any other government program; and only allow Medicaid to cover rehabilitation services based on a provider fee schedule, versus the reasonable payment method currently used by many state Medicaid programs, particularly for services that are not strictly medical in nature.

NYSRA and its members absolutely support an efficient and effective Medicaid system, but cutting services and increasing costs to consumers are not sound methods to achieve those goals.

From the Consortium for Citizens with Disabilities (CCD), a coalition of national disability organizations, comes the following summary paragraph of excellent talking points to include in communications with Members of Congress and other elected officials:

Medicaid provides health care coverage for about 8 million Americans with disabilities, offering access to prescription drugs, long-term care, physical therapy, home health services, medical equipment, communication devices and much more. Although many people with disabilities receive services via private health insurance, many others are employed at jobs that don’t offer health benefits and “individual insurance policies for persons with less-than-perfect health are usually unaffordable or unavailable,” according to the Kaiser Family Foundation. Even for those who can get private coverage, plans likely do not cover all of the services a person with a disability needs. Medicaid is often the only avenue that allows a disabled person to remain independent.

Medicaid Matters Keeping Dialogue Open

The Medicaid Matters New York coalition of organizations has arranged to conduct phone meetings with two members of the Federal Department of Health and Human Services Medicaid Commission. The MMNY group will be meeting separately with Gwen Gillenwater, formerly of the National Council on Independent Living, and Dr. John Rugge, who represents the National Association of Community Health Centers.

MMNY also reports that it is meeting with HHS Region 2 Director Deborah Konopko in New York to discuss Medicaid waiver issues in New York.

Critical matters such as Medicaid restructuring are of continuing concern to NYSRA. We urge you to be a part of our internal policymaking and discussions on these matters by participating in our Divisions and taking advantage of training sessions offered through the Rehabilitation Research and Training Institute (RRTI).

News from State Agencies/NYSRA Advocacy

OMRDD Extends Deadline

OMRDD has let the DD trade association know that subsequent to our meeting on August 3, 2005, OMRDD re-evaluated its position to not accept any Health Insurance initiative surveys from providers after the June 20, 2005 deadline. Our primary concern was the impact that the decision to not accept the surveys would have on the direct care workers of the late submitting agencies

.

OMRDD has decided to extend the due date of the survey to September 1, 2005. Therefore, all surveys submitted on or before September 1, 2005 will be accepted and submitting agencies will be eligible as appropriate, for health insurance initiative monies.

OMRDD will be mailing a letter out to all providers who have not yet submitted the survey. If you have any questions, please call Joanne Howard at (518) 402-4330.

NYSRA Hosts Conference Call on OMH OISE

On Tuesday 8/16, NYSRA hosted a technical assistance call for NYSRA MH members to understand the newly announced 18 month transition plan from Office of Mental Health for Ongoing Integrated Supported Employment (OISE). OMH has developed a plan to administer the funding for these needed services. Their actions may involve any or all of the following actions:

-Removing excess capacity from a provider;

-Providing additional capacity to a provider who is identified for PROS conversion in the county PROS implementation plan that an agency submitted to OMH

-Transferring OISE capacity from a provider who is not identified for PROS conversion in your county’s current PROS plan and who expects to receive intensive slots from VESID to a provider who is identified fro PROS conversion.

NYSRA has a copy of the full letter. Any member wishing a copy should just send an email to Stacie Musculino at Stacie@nyrehab.org with your fax number (we only have a hard copy at this time) and she will gladly send it along to you!

NYS Office Of Mental Health Announces Assisted Outpatient
Treatment Quality Improvement Initiative

Sharon E. Carpinello, R.N., Ph.D., Commissioner of the New York State Office of Mental Health announced a quality improvement initiative focused on the Assisted Outpatient Treatment (AOT) program established under Kendra’s Law.

A team comprised of quality improvement experts, recipients of mental health services, family members, county representatives and other stakeholder groups will be announced in the fall 2005 and will be expected to meet at least quarterly to review data, issues and outcomes of AOT. Both individually and as a group, team members will search for opportunities for innovation as well as areas where improvements can be made.

“Under Governor Pataki’s leadership, the first five years of AOT demonstrated many positive outcomes,” said Commissioner Carpinello. “We have seen improved access to mental health services, coordination of service planning, accountability and collaboration between the mental health and court systems, and a reduction in hospitalizations and incarcerations. While these success stories make it clear that Kendra’s Law is working, we also want to take advantage of all opportunities for improvement. We want to further ensure that quality gaps are recognized and appropriately addressed, with input from interested stakeholders.”

Kendra’s Law created a statutory framework for court-ordered AOT to ensure that individuals with mental illness and a history of hospitalizations or violence participate in community-based services appropriate to their needs. The law was named in memory of Kendra Webdale, a young woman who died in January 1999 after being pushed in front of a New York City subway train by a man with a history of mental illness and hospitalizations. Webdal’s family is in full support of the initiative.

Did You Know?

US Census estimates 2 in every 7 families report having at least one member with a disability!

Federal Update

New Freedom Initiative Medicaid Demonstrations Act

Courtesy Marc Kilmer, ACCESS - On Friday, August 5, HHS Secretary Mike Leavitt sent to Capitol Hill a draft version of the New Freedom Initiative Medicaid Demonstrations Act of 2005. This bill would establish seven Medicaid demonstration programs similar to the ones discussed in the President’s budget this year:

Respite Caregivers for Adults — a ten-year demonstration project that would enable states to test the effectiveness of respite care in permitting some elderly and disabled Medicaid beneficiaries to remain in their homes and communities. These respite care givers would give temporary relief to family and other caregivers. It is hoped this would preclude the need to institutionalize some Medicaid beneficiaries. It would cost $449 million over ten years.

Respite for Caregivers of Children with Substantial Disabilities — a ten-year program similar to the program described above, but for children with disabilities. It would cost $118 over ten years.

Home and Community-based Alternative to Psychiatric Residential Treatment Facilities for Children — a ten-year demonstration program that would allow states to set up home and community-based alternatives to psychiatric residential treatment for children. The hope is that this would be more cost-effective than institutional care. It would cost $504 million over ten years.

Money Follows the Person Rebalancing Initiative — a five-year initiative for states to rebalance their long-term care systems to offer individuals residing in institutions more choice over whether to live in a community setting and reduce the reliance on institutions while increasing community-based options. In order to do this, the federal government would pay 100% of a state’s Medicaid costs for a Medicaid recipient in the first year that person moves from an institution to community-based care. It would cost $1.75 billion over five years.

Presumptive Eligibility for Certain Elderly and Disabled Person — this would give states the option of providing individuals with home and community-based services for up to ninety days while their eligibility for Medicaid is being determined. The federal government would pay for the first ninety days of community services regardless of whether or not the person is ultimately deemed Medicaid eligible.

Medicaid Eligibility of a Spouse of an Individual who performs Substantial Gainful Activity Despite Severe Medical Impairment — this would continue Medicaid eligibility for spouses of people with disabilities who return to work. It would cost $102 million over five years.

This bill will need to be introduced by a Senator or House member. It is unclear exactly who will do this once Congress returns from its recess in September. It is also unclear where money will be found to pay for these new initiatives. Most likely House and Senate leadership will demand that this new spending be offset by reductions in current Medicaid spending.

ACCSES will continue to monitor this bill and will update you when any action is taken on it.

One-Third of U.S. Troops From Iraq Have Mental Health Problems

A new Pentagon survey finds that 30 percent of U.S. troops returning from Iraq developed mental health problems within three or four months of coming home, the Army’s surgeon general said Thursday.

The mental disorders include anxiety, depression, nightmares, anger, and an inability to concentrate, the Associated Press reported. A smaller group has been diagnosed with post-traumatic stress disorder (PTSD), characterized by more severe forms of many of these same symptoms.

Earlier surveys have found 3 percent to 5 percent of Iraq veterans were diagnosed with a significant mental health issue immediately after they left the war zone, the AP reported. The Army only now has begun evaluating veterans three to six months after they leave combat.

Only about 5 percent of troops returning from combat actually have PTSD, though significantly more have problems adjusting, an Army spokesman told the wire service.

Statement of Solidarity on 15th Anniversary

of Americans with Disabilities Act

NYSRA has joined organizations from throughout the nation in a statement of solidarity on the anniversary of the Americans with Disabilities Act. Fifteen years ago, with bipartisan support in Congress and broad endorsements from the civil rights coalition, President George H. W. Bush signed into law the Americans with Disabilities Act (ADA), calling for the “shameful wall of exclusion” to come tumbling down. As we mark this significant anniversary, we celebrate improvements in access to polling places and the secret ballot, government services and programs, transportation, public places, communication and information technology. Parents pushing strollers, workers delivering packages, and travelers pulling roller bags have grown accustomed to curb cuts, ramps, and other accessibility features less common in 1990. Our country is more accessible today thanks to the ADA, and all Americans are better off.

Although substantial progress has been made, we are reminded every day of the significant remnants of the “shameful wall of exclusion” that continue to prevent this great country from realizing the full promise of the ADA.

Widespread social change cannot simply be legislated, and it will not occur without bold leadership from all sectors of American society. Public and private employers, in particular, must make a serious, concerted effort to recruit and advance qualified workers with disabilities within their labor force. Election officials must take the necessary actions to ensure that every adult is able to enter his or her polling place and cast a secret and independent vote. School administrators and university presidents must embrace their responsibility to deliver a world-class education to all their students. It is time for leaders across America—business owners, little league coaches, moms and dads, sheriffs and clergy—to reject exclusion, paternalism, and segregation and to take personal responsibility for removing barriers to full participation that still exist in every community in this country.

With the aim of making America work better for everyone, the following organizations pledge to build on the progress of the last 15 years and join together to promote the full participation and self-determination of the more than 50 million U.S. children and adults with disabilities. We believe that disability is a natural part of the human experience that in no way should limit the right of all people to make choices, pursue meaningful careers, live independently, and participate fully in all aspects of society. We encourage every American to join us in this cause.

State and Local Organizations - New York

Access to Independence of Cortland County, Inc
Action Toward Independence, Inc.
ADA Committee of New York State
AIM Independent Living Center
ARISE
Brain Injury Association, NYS
Catskill Center for Independence
Center for Independence of the Disabled in New York
Cerebral Palsy Associations of New York State
Civil Rights and Disability Law Project, Albany Law School
Consumer Directed Choices, Inc.
Disabled In Action
Disability Network of New York City
ICD
ilusa.com
Independent Living Center of the Hudson Valley, Inc.
ILUSA
Joint Public Affairs Committee for Older Adults (JPAC)
Legal Services of Central New York, Inc.
Long Island Center for Independent Living, Inc. (LICIL)
Mental Health Association in New York State, Inc.
Mental Patients Liberation Alliance
New York Association on Independent Living, Inc.
New York Association of Psychiatric Rehab Services
New York Association on Independent Living, Inc.
New York State Association of SHHH

New York State Rehabilitation Association
Niagara Frontier Center for Independent Living, Inc.
Northeast ADA & IT Center
NYSID (New York State Institute on Disability, Inc.)
Niagara Frontier Center for Independent Living, Inc.
Northeast ADA & IT Center

Regional Center for Independent Living (RCIL)
Rose F. Kennedy University Center for Excellence in Developmental Disabilities Education, Research and Service

Southern Tier Independence Center
Staten Island Center for Independent Living
Suffolk Independent Living Organization (SILO)
The Queens Chapter of SHHH at Lex
Westchester Disabled On the Move Inc.
Westchester Independent Living Center Inc.
Women’s WORLD

Social Service Applicants to get Faster Decisions!

Out of Washington last came the news that people seeking disability benefits from Social Security can expect to spend less time waiting for a decision under changes rolled out Tuesday on the anniversary of the Americans with Disabilities Act.

Social Security Commissioner Jo Anne Barnhart said people who are “clearly” disabled could be approved for benefits in as little as 20 days under the new procedures, which the agency expects to start putting into action next spring. The rest of the roughly 2 million people who seek disability benefits each year can expect to spend less time working through the process for appealing decisions when benefits are denied.

As you all know the Social Security disability insurance program pays cash assistance to people who cannot work for a year or more because of a disability. To qualify, an individual must have worked long enough, paid Social Security taxes and met the criteria for disability assistance. SSA reports that more than 11 million people, including some family members of disabled workers, receive benefits.

The key change appears to be new procedures to be implemented that will screen applicants for cases of clear disability that can be quickly approved for benefits by a special unit. Then for any other applicants, it appears that the changes will replace a step that sent cases back to a state agency for review or in essence a “rubber stamp” since hardly ever did a state agency deny a claim.

The intent is to have a federal review meaning that applicants receive a more meaningful reconsideration of their claims more quickly. The new process also establishes a unit of medical and vocational experts available to those evaluating disability applications at all stages of the process. The new procedures are further expedited by their connection to an electronic system that alleviates the need for Social Security officials to mail paper files around the country, Barnhart said that process should shrink about 25 percent.

The Social Security Administration plans to publish proposed regulations for public comment and then issue final regulations by the end of the year. Full implementation however will take a couple years yet before it is practice throughout the country.

Announcements/Opportunities

HUD reopens Section 811 Supportive Housing

for Persons with Disabilities Program

HUD understands that many applicants may have had difficulty submitting their applications. Therefore, HUD has reopened the Section 811 Program with a new application submission date of September 6, 2005. This is an electronic application and all applicants must
register at Grants.gov Web site at http://www.grants.gov. For additional information contact Frank Tolliver, HUD Project Manager at 202-708-3000 or visit http://www.hud.gov/offices/adm/grants/nofa05/reopenings.cfm

Research Project on Dementia and Down Syndrome

The Center on Intellectual Disabilities at the University at Albany is conducting a research grant through the National Institute on Disability Rehabilitation Research (NIDRR). The Preparing Community Agencies For Dementia (PCAD) project looking for caregivers (community agencies and families) of persons with Down Syndrome to assess caregiving issues and their impact on the amount and nature of care that people receive as they age. This research is confidential and will be used to make recommendations to NIDRR on funding to meet caregiver needs. For more information, or to enroll a participant contact DiAnn Baxley at the University of Albany at 518-442-3791 or at dbaxley@albany.edu

World Institute on Disability - Did You Know?

World Institute on Disability (WID) is a non-profit public policy center dedicated to the promotion of independence and full inclusion in society of people with disabilities. WID’s Access to Assets (ATA) program provides training and technical assistance to asset building and disability organizations seeking to improve the inclusion of people with disabilities in poverty reduction programs. In addition, ATA provides information and referral services to individuals with disabilities and conducts federal and state policy analysis on related issues.

NEW! Toll-Free Technical Assistance Hotline: 1-866-723-1201

Do you have questions about asset building strategies or serving people with disabilities? Please contact:

Megan O’Neil

World Institute on Disability

Access to Assets Project Coordinator

megan@wid.org

EQUITY is a publication of World Institute on Disability’s Access to Assets Program and is supported by the Asset Accumulation and Tax Policy Project. The Asset Accumulation and Tax Policy Project (AATPP.) To subscribe or unsubscribe to EQUITY, please send an email to equity@wid.org. EQUITY is disseminated in plain text in an effort to be as accessible as possible to a variety of audiences.

Some good background information from WID EQUITY on Family Self-Sufficiency (FSS) under HUD. Listed are resources with appropriate links to more information about this HUD program.

TIP OF THE MONTH:

Family Self-Sufficiency: Disability Service Providers and Housing Authorities Collaborating to Build Assets for People with Disabilities

www.wid.org/publications?page=equity&sub=200508&topic=tm

Jeff Lubell supplies a mutually beneficial proposal for disability organizations providing employment services to form partnerships with public housing authorities offering HUD’s Family Self-Sufficiency programs.

I have a disability and want to own my own home. What programs are out there to help?

www.wid.org/publications?page=equity&sub=200508&topic=responds

EQUITY e-newsletter: Summer 2005

Disability and Asset Building Communities Working Together

www.wid.org/equity

In the Summer EQUITY:

HUD’S Family Self-Sufficiency (FSS) Program:

Saving for Economic Independence

www.wid.org/publications/?page=equity

FEATURE ARTICLE:

Family Self-Sufficiency: A Key Asset-Building Opportunity for People with Disabilities

www.wid.org/publications/?page=equity&sub=200508&topic=fa

Jeff Lubell, FSS Partnerships, provides an overview of the HUD Family Self-Sufficiency Program, which offers the chance for people with disabilities to obtain employment services and access a unique savings account to build assets and become economically self-sufficient.

WID’S Family Self-Sufficiency Fact Sheet

www.wid.org/publications/?page=equity&sub=200508&topic=ss

The World Institute on Disability’s Access to Assets program has developed a Question & Answer fact sheet on the Family Self-Sufficiency program, specifically addressing issues most relevant for people with disabilities.

*New HUD Publication “ Discrimination Against Persons with Disabilities”

July 25, 2005

www.huduser.org/publications/hsgspec/dds.html#2

Visions of the Future: Scott Batchelar

www.wid.org/publications/?page=equity&sub=200508&topic=profile

Scott Batchelar wants to use his artistic talent as a photographer to help change people’s perceptions about people with disabilities. With the help of the Housing Authority of Portland, OR and their Family Self-Sufficiency program- GOALS- Scott is turning a passion into profit.

VESID State Plan Town Meetings Announcement

The New York State Office of Vocational and Educational Services for Individuals with Disabilities (VESID) will hold seven public meetings and a virtual public meeting. As part of the State Plan development, VESID will seek public comment on connecting individuals with disabilities to employment services and resources that lead to employment. Discussion will focus on career development, individualized planning of employment goals and use of community resources. VESID staff will facilitate the discussion and collect public comment on the State Plan.

In addition to the public meetings, individual recommendations can be submitted in writing to VESID, VR Policy and Partnerships Unit-Room 1603 (OCP), NYS Education Department, Albany, NY 12234. Electronic submission can be sent to VRpolicy@mail.nysed.gov or through the Virtual Public Meeting, http://discus.nysed.gov/cgi-bin/discus-mando/discus.cgi (available on September 12, 2005).

September 12, 2005 through November 11, 2005

Virtual Public Meeting

http://discus.nysed.gov/cgi-bin/discus-mando/discus.cgi

24-hour access

September 14, 2005

State Rehab Council (SRC)

Best Western Sovereign Hotel, Albany

3:00pm–4:30pm

September 22, 2005

NY Association of Psychiatric Rehabilitation Services

Nevele Grande Resort, Ellenville

11:15am–12:30pm

September 23, 2005

NY Association on Independent Living Council (NYAIL)

Holiday Inn Express, Latham

2:00pm–3:30pm

September 26, 2005

New York State Rehabilitation Association (NYSRA)

The Desmond, Albany

4:00pm–5:30pm

October 18, 2005

Long Island Transition

Eastern Suffolk BOCES, Holbrook

6:00pm–8:00pm

October 25, 2005

New York ADA Symposium

Oncenter Complex Convention Center, Syracuse

3:30pm-5:00pm

November 2, 2005

NY Work Exchange

90 Broad Street, New York City

2:30pm–4:00pm

The 2006 Paul G. Hearne/AAPD Leadership Awards

Up to two people with disabilities, who are emerging as leaders in their respective fields, will each receive $10,000 to help them continue their progress as leaders. They will also have an opportunity to meet and network with national disability leaders at the AAPD Leadership Gala in Washington, DC on March 8, 2006. U.S. residents with any type of disability are eligible to apply.

For this award an emerging leader is defined as someone who has demonstrated leadership qualities in his/her personal and/or professional life, and who is just starting to be recognized at a local, regional or national level. Winners of The 2006 Paul G. Hearne/AAPD Leadership Awards must demonstrate all of the following:

• Leadership achievements that show a positive impact on the broad community of people with disabilities or within their area of disability interest. Connections they have made between individuals with disabilities and others in their communities.

• A positive vision for the disability community and a continuing commitment to their leadership activities.

• The demonstrated ability to collaborate with other leaders, to follow when necessary, and to cultivate new leaders within their organizations and communities.

• Potential to contribute at a national level.

To learn more and obtain an application, please visit the AAPD website: www.aapd.com.

SUBMISSION DEADLINE: Friday, September 9, 2005 (5:00pm, eastern)

‘Impact Fund’ Launched to Help Nonprofits Manage Volunteers

The UPS Foundation (NYSE: UPS) and two leading U.S. companies are joining to launch formally a unique grant-making fund to help non-profit organizations manage volunteers more effectively.

In development for the past year, “IMPACT: A Fund for Change Through Volunteerism,” will combine financial resources from The UPS Foundation, The Home Depot and Capital One Financial. Grants will be made to both national and local organizations to support projec