A Slice of Pie is an ongoing publication keeping our readers informed about important public policy issues. It is the mission of the Policy Information Exchange to educate and inform Pennsylvanians with disabilities, their families and advocates, and the general public, regarding public policy issues and to further the exchange of policy information between the Pennsylvania Developmental Disabilities Council and federal, state, and local policy makers. The Policy Information Exchange is funded in part by the Pennsylvania Developmental Disabilities Council.
The final budget was signed on the night of June 30, shortly before the new fiscal year began on July 1. To view the bill (HB 1485, now Act 1A of 2011), go tohttp://www.legis.state.pa.us/cfdocs/billinfo/billinfo.cfm?syear=2011&sind=0&body=H&type=B&BN=1485.
HB 960, now Act 22 of 2011, passed as part of the budget process. It amends the Public Welfare Code to give the Secretary of Public Welfare the power to change rules and regulations on benefits, eligibility, fees/co-pays, rates etc. without legislative
or public oversight. This expedited review process is intended to allow DPW to make changes in order to get down to the reduced funding level in the final budget deal.
Here, by Department, is a summary of how some programs of interest to the disability community fared in the budget which was passed:
Office of Developmental Programs (ODP)
- Intellectual Disability—Intermediate Care Facilities: While there is a 30% increase in state funds, the loss of federal funds results in a net decrease of less than 1%.
- Base Funds Intellectual Disabilities: There is a net increase of 3.8%.
- Waivers Intellectual Disabilities: The Governor’s budget would have cut $27 million in funding for residential room and board expenses. The final budget restores $22 million of that $27 million. The final budget also added a cut of $13 million for savings to be gained from waste, fraud and abuse. The final budget is a 1.3% increase over 2010-11. The appropriated funds are expected to be sufficient to meet the goals included in the Governor’s budget to:
- continue current program, meet changing needs, and annualize services for people brought into service during 2010-11
- transfer 7 people from the MH system
- serve 35 people who are living in state hospitals with diagnoses of mental illness and intellectual disabilities; and
- bring 50 people out of state centers.
- There is no waiting list initiative.
- The final budget amounts to a 9% cut in total funds. The budget includes the following language, “For services to persons with autism spectrum disorders, including oversight, supportive services and provider training.”
- Early Intervention (birth to age 3): The budget increases state funds over 2010-11, but including federal funds, this amounts to a 2% decrease from 2010-11.
- Mental Health services funding is almost the same as 2010-11.
- Behavioral Health Services is reduced by 10% from 2010-11.
- State funds for Services to Persons with Disabilities (CSPPPD), which includes the Independence, OBRA and CommCare waivers, increased by $20 million. However, the decrease in federal funds results in a net decrease of 8%.
- For Attendant Care (which includes both the Attendant Care Waiver and state-onlyAct 150), both state and federal funds have been decreased, amounting to a 16% reduction.
- The Long Term Care line item had included nursing homes, LIFE and the Aging Waiver. The final budget leaves nursing homes in the Long Term Care line item, but separates out the home and community based services. While the overall nursing home/long term care budget seems to be reduced, the General Assembly restored the Governor’s proposed 2% rate cut at a cost of $21.9 million. They did so by delaying a payment to nursing homes which saved approximately $77 million.
- The Aging Waiver is included in a new line item called “Home and Community Based Services.” Combining state, federal and tobacco funds, that line item is increased from 2010-11. The amount available is supposed to be enough to annualize people currently served.
- The LIFE program is in a new line item called “Long Term Care—Managed Care” and funded at the Governor’s recommended level which is a 25% increase.
- MA Transportation is reduced more than 17%.
- The Human Services Development Fund (HSDF) received $23.5 million in 2010-11. The Governor proposed eliminating it. The final budget restores $15 million for HSDF.
- This budget does not attempt to create a new department. Instead, the Office of Long Term Living remains connected to both DPW and Aging with funding included in the DPW budget.
- The Governor’s budget included level funding for Drug and Alcohol and no funds for the new Department. The House Republican budget takes $1 million from Drug and Alcohol program funds and moves it to a line item titled, “Transition forDepartment of Drug and Alcohol Programs.”
- A number of programs, including New Born Hearing Screening and Epilepsy Support Services, would be eliminated. (Same as Governor’s proposal.)
- The line item for Services for Children with Special Needs has been partially restored in HB 1485.
- Funding for Accessible Housing is combined with funding for New Communities in a new line item called, “Keystone Communities.” House Republicans propose reducing the combined line item.
- OVR is level funded. (Same as Governor’s proposal.)
- The Governor proposed funding Supported Employment at the 2010-11 level; the House Republican budget would reduce it further.
- Centers for Independent Living (CILs) would be funded at the same level as the current 2010-11 year. (Same as Governor’s proposal.)
- Assistive Technology would have been reduced by 24% under the Governor’s proposal. The House Republicans would restore part of the funding reduction, so that they would receive 10% less than 2010-11.
- Special education is level funded in state funds. But factoring in lost federal funds, it’s a 10% decrease.
- Early Intervention (ages 3-5). There is a 1% increase. Funding to continue the program and new funding for additional children is included.
- Charter Schools for the Deaf and Blind and Approved Private Schools are level funded.
- A $4.7 million line item of state funding for Intermediate Units is eliminated
Bills of Interest
Below we summarize some bills of interest to the disability community. For more information about these or any other state bills, go to:www.legis.state.pa.us/cfdocs/legis/home/session.cfm . At the top of the page is a box labeled, “Find Legislation By”, choose “Bill #”, then enter the bill number and click on “Go”.
SB 200. Introduced by Senator Patrick Browne (R-Lehigh). It establishes standards for managing concussions and traumatic brain injuries to student athletes. The bill passed the Senate on June 22, 2011. It was sent to the House where it was voted out of the House Education Committee and given first consideration by the full House. It’s been laid on table. See also HB 200 introduced by Representative Tim Briggs (D-Montgomery.)
SB 458. Introduced by Senator Andrew Dinniman (D-Chester). The bill would amend the Mental Health and Mental Retardation Act to change the term “mental retardation” to “intellectual disability.” It was passed by the Senate on June 22, 2011 and sent to the House. It’s currently in the House Human Services Committee.
SB 862. Introduced by Jay Senator Costa (D- Allegheny). The bill provides for pooled trusts for people with disabilities. It was introduced and sent to the Senate Judiciary Committee on March 28, 2011. [Note: This is a corrected bill number from the Spring 2011 Slice of PIE.]
HB 704. Introduced by Representative Bernie O’Neill (R-Bucks). The bill provides for thespecial education funding formula. It was voted out of the House Education Committee and sent to the Appropriations Committee. See also, SB 1115. Introduced by Senator Patrick Browne (R-Lehigh) which was referred to the Senate Education Committee on June 16, 2011. And SB 1154. Introduced by Senator Robert Tomlinson (R-Bucks), referred to the Senate Education Committee on June 17.
HB 1564. Introduced by Representative Thomas Murt (R-Montgomery). This bill would establish a bill of rights for people with intellectual and developmental disabilities. It cites Olmstead and calls for a plan to address the waiting list. It was introduced and referred to the House Human Services Committee on May 23, 2011.
HB 1720. Introduced by Representative Tim Hennessey (R-Chester). The bill provides for a procedure for determining who has authority in guardianship proceedings by providing for uniform authority in adult guardianship and protective proceedings. It was introduced and referred to the House Aging and Older Adult Services Committee on June 24, 2011.
HB 1755. Introduced by Representative Chelsea Wagner (D-Allegheny). This bill would tighten the rules on disability plates and placards. Among other things, it would require photos on placards and require recertification every five years. HB 1755 was introduced and referred to the House Transportation Committee on June 29, 2011
On July 11, the PA Department of Public Welfare (DPW) Division of Medical Assistance Transportation (MATP) issued a memorandum that, effective August 1, 2011, all trips to psychiatric rehabilitation services will not be paid by MATP because the service is not in-the Medicaid State Plan. Affected counties and managed care plans will enter into local agreements with transportation providers to continue transportation services, but will have to find funds other than Medicaid dollars.
The Office of Long Term Living (OLTL) has issued two new Bulletins which can be viewed at: http://services.dpw.state.pa.us/olddpw/bulletinsearch.aspx
- Revised Pennsylvania Preadmission Screening Resident Review Evaluation (PA-PASRR-EV) Form was issued on July 6, 2011 and was effective June 1, 2011. The Bulletin revises the PA-PASRR-EV form dated September, 2007, and applies to all agencies that perform the PA-PASRR-EV (Level II) for individuals either prior to or after admission to a Medical Assistance enrolled nursing facility.
- Rescission of OLTL Bulletin 10-07 (05-11-03, 51-11-03, 52-11-03, 55-11-03, 59-11-03). The Bulletin withdraws a prior Bulletin relating to dual enrollment for services funded through OLTL home and community-based programs and services funded through the Office of Developmental Programs. This means that people should not be denied OLTL home and community-based waivers or other OLTL services on the basis that they are also receiving ODP base-funded services. For more information, contact the Office of Long-Term Living, Bureau of Individual Support at 717-787-8091.
ACT 150 Transition Policy
- Dental exams and prophylaxis (preventive treatment) are limited to 1 per 180 days, per recipient;
- Elimination of crowns, endodontic and periodontal services; and
- Coverage of dentures limited to one upper arch or partial and one lower arch or partial, or one full set of dentures per lifetime.
- The consumer has a serious illness or health condition and his or her life would be in danger, or health would get much worse, without the dental service; or
- The consumer would need more expensive services if the exception was not granted; or
- It would be against federal law for the Department to deny the exception to the consumer.
He was employed by AmeriHealth Mercy in network development and has more than 20 years of experience in managing the business relationships between Keystone Mercy Health Plan and the hospital physician network. Gordon replaces Izanne Leonard-Haak who has accepted a position in the private sector.
2012 Federal Budget
On the August 2nd deadline, Congress passed and President Obama signed a bill that raised the debt ceiling so that the US can continue to borrow money to pay the nation’s bills. Many in Congress made reduction of the national debt a condition of their vote; the bill that passed does include substantial spending cuts but not to Medicaid, Medicare or Social Security. It also includes a “supercommittee,” made up of both parties and both chambers, charged with making additional debt-reduction recommendations on November 23, 2011 for a Congressional vote. If they don’t agree on enough savings by December 23, 2011 some automatic cuts up to $1.2 trillion take effect. This includes a 2% reduction to Medicare aimed at slowing its growth. For information by the Center for Budget and Policy on the impact of the agreement, go to www.cbpp.org.
In an August 5, 2011 letter to state Medicaid Directors, the Centers for Medicare and Medicaid Services (CMS) provides guidance on the “maintenance of effort” (MOE) provisions in the Affordable Care Act. For example, the letter explains, “While the MOE provisions of the Affordable Care Act require that States maintain eligibility standards, methodologies and procedures, the MOE provisions do not affect a State’s ability to manage waiver costs by modifying waiver benefits, rates or introducing new waiver service-specific medical necessity criteria or utilization controls which do not affect individuals’ eligibility for Medicaid. For example, a State may change the criteria for receipt of a particular service that would not impact an individual’s overall Medicaid eligibility, but would instead impact their ability to receive a specific service.” ADAPT, a self-advocacy group, has criticized the letter “For publicly supporting community-based services for people with disabilities while quietly advising states on options to curtail such programs.” To read the letter, go towww.cms.gov/smdl/downloads/SMD11-009.pdf.
Vermont offers the best Medicaid services for people with intellectual and developmental disabilities, while Mississippi provides the worst, according to United Cerebral Palsy’s 2011 report “The Case for Inclusion”http://medicaid.ucp.org/pdf/Case_For_Inclusion_Report_2011.pdf
PA ranks 15th, up from 29th in 2007. PA’s improvement is attributed to a “large increase in the number of people served (from less than 30,000 to 50,000), a substantial shift in the number of people in community settings with seven residents or less (up from 85 percent to 94 percent), a drop in population in large settings to 1,359 from 1,865 in 2009 and the closure of one state institution and a 60 percent reduction in its waiting lists.” Since the 2010 The Case for Inclusion report, a total of six state institutions around the country were closed, and more than 2,000 people were moved from these large facilities into community settings. Soon, Alabama will join Alaska, D.C., Hawaii, Maine, Michigan, New Hampshire, New Mexico, Rhode Island, Vermont and West Virginia in having no state institutions. To read the report, go to
In recognition of the 12th anniversary of the Supreme Court’s Olmstead decision, the US Department of Justice (DOJ) issued a Statement on Enforcement of the Integration Mandate of the Americans with Disabilities Act and Olmstead. The DOJ said that in the years since the decision, the goal to provide individuals with disabilities opportunities to live their lives like individuals without disabilities – has yet to be fully realized. For information contact the DOJ ADA Information Line, 800-514-0301 (voice), 800-514-0383 (TTY). The statement, which includes information on filing a complaint, is at www.ada.gov/olmstead/q&a_olmstead.htm.
The Technical Assistance Collaborative, Inc. (TAC), in conjunction with the Consortium for People with Disabilities, has released a report, Priced Out 2010. They found that in 2010, as a national average, a person receiving SSI needed to pay 112 percent of their monthly income to rent a modest one-bedroom unit, leaving no income for food, clothes or other necessities. Smaller studio/efficiency rental units cost 99 percent of SSI income. There are 218 markets across 42 states where rents for modestly priced units exceed 100 percent of monthly SSI. Further, there are 30 housing markets where rents were equal to, or in excess of 150 percent of SSI. In six states, rents across the entire state exceeded 100 percent of monthly SSI. In the dozen years since the first Priced Out study, the housing affordability gap for people with disabilities has almost doubled. The report is available atwww.aucd.org/docs/policy/PricedOut2010.pdf.
The advocacy group formerly known as the MH/MR Coalition has become two separate coalitions, the Behavioral Health Coalition (BH Coalition) and the Intellectual Disability and Autism Coalition (IDA Coalition). The new names reflect updated terminology and common issues. Coalition members will bring the two coalitions together periodically to share information and to pursue common interests and advocacy. For information about the IDA Coalition, contact the current Chair, Ilene Shane at the Disability Rights Network of Pennsylvania at 800-692-7443, or IShane@drnpa.org, and for information about the BH Coalition contact the current Chair, Sue Walther at the Mental Health Association in PA at 717-346-0549 or firstname.lastname@example.org.
Starting July 29, 2011, The Commonwealth changed its email addresses for state workers to (name)@pa.gov from the previous (name)@state.pa.us. The old addresses will still work so that communication is not interrupted.
The website, iAdvocate, was developed at the Syracuse University School of Education to help parents of students with disabilities work collaboratively with a school team to improve their children’s education and to provide inclusive and meaningful educational environments for students with disabilities. To view the site, go to:http://iadvocate.syr.edu.
On their web site, the State Civil Service Commission has a PowerPoint presentation that explains the Civil Service employment process in general and services available to applicants with disabilities in particular. To access this presentation, go towww.portal.state.pa.us/portal/server.pt/community/general_information/14274/applicants_with_disabilities/590786.
The Self-Employment & Small Business Ownership section on Disability.gov has information about programs and services that can help with writing a business plan and small business loans.
To receive updates on disability issues from the White House, email email@example.com.
The Office of Developmental Programs (ODP) has added three new reports to the ODP Consulting System website. IM4Q is one of the quality measures for programs that serve people with intellectual disabilities. Individuals and/or their family, friends or guardians are interviewed about their satisfaction with parts of their lives. The new reports are the 2009-10 IM4Q State Center report, the IM4Q Statewide Summary 2010 Icon report that includes pictures to show the results, and the IM4Q Statewide Summary 2010 Chart. To view the reports, go to:www.odpconsulting.net/index.php?option=com_docman&task=cat_view&gid=291&Itemid=73.
The AARP Public Policy Institute has published a report, “Valuing the Invaluable: 2011 Update – The Growing Contributions and Costs of Family Caregiving.” The report uses current data to update national and individual state estimates of the economic value of family caregiving. In 2009, about 42.1 million family caregivers in the U.S. provided care to an adult with limitations in daily activities at any given point in time, and about 61.6 million provided care at some time during the year. The estimated economic value of their unpaid contributions was approximately $450 billion in 2009, up from an estimated $375 billion in 2007. The report also details the costs and consequences of providing family care and provides policy recommendations to better support caregiving families.
The U.S. Department of Justice (DOJ) posted a technical assistance document on its website about service animals and the requirements of the Americans with Disabilities Act (ADA). DOJ revised its ADA regulations in September 2010 and clarified that under the ADA, dogs trained to work for an individual with a disability meet the requirements for service animal. The guidelines include a discussion of the limited circumstances under which miniature horses may be considered service animals. To read the document, go to www.ada.gov/service_animals_2010.htm.
In 2011, the Center for Women Policy Studies started an online series of papers on women and girls with disabilities. The 2011 Barbara Faye Waxman Fiduccia Papers present the perspectives of women with disabilities on topics such as access to health care, reproductive rights and health, violence against women and girls, women and AIDS, employment and economic development and participation in government at every level. For more information, go to: www.centerwomenpolicy.org/programs/waxmanfiduccia/2011OnlineSeriesBarbaraWaxmanFiduccia.asp.
The Pennsylvania Emergency Management Agency has a website on emergency preparedness. There’s a link addressing emergency preparedness for people with disabilities. Go to www.readypa.org and click on People with Disabilities under “Preparedness for those with special needs.”
The Disability Advocacy Support Hub (DASH), a project of the Disability Right Network of PA funded by the PA Developmental Disabilities Council, has announced its fall trainings. The morning topic is Advocacy with the Media and the afternoon topic is Advocacy with School Districts. The free training sessions are scheduled as follows:
Pittsburgh – September 12 @ Three Rivers Center for Independent Living
Erie – September 13 @ Community Resources for Independence
Lancaster – September 26 @ Disability Empowerment Center
Philadelphia – October 3 @ Abilities for Equality
Reading – October 6 @ Abilities in Motion
Forty Fort – October 13 @ Luzerne County Annex Building (next to airport)
Seating is limited and reservations are required. Please make requests for accommodations or alternative formats by August 30, 2011. To register, or for more information, contact DASH toll free at 800-692-7443, x312 (877-375-7139 tty) or email Lan Do at firstname.lastname@example.org.
This year’s session of Competence and Confidence: Partners in Policymaking for Families of Children in Early Intervention (C2P2EI) will start in October 2011 and end in April 2012. It will be held in the Pittsburgh area. C2P2EI provides family member participants with up-to-date information, leadership development training, resources and skills about the local, state and national issues that affect children with disabilities. Interested family members throughout Pennsylvania who have an infant, toddler or pre-school age child who has special needs are eligible to apply. Family members must commit to attend all four 2-day training sessions, which will consist of four sessions. Applications can be requested by writing to the Institute on Disabilities, Temple University, 1755 N. 13th Street, Student Center, Room 411S, Philadelphia, PA 19122, by visiting the website at www.disabilities.temple.edu or by telephone or e-mail to Diane Perry, Family Inclusion Coordinator at 215-204-3031, 215-204-1356 (TTY) or email@example.com.
The Building Bridges Conference will be held on September 20-21 at the Holiday Inn Harrisburg/Hershey, Grantville, PA. This conference is designed for people who are part of the Aging Network and the Intellectual Disabilities System and is co-sponsored by the Department of Aging and the Department of Public Welfare. For information contact the Long Term Living Training Institute at 717-541-4214 or go to www.ltltrainingpa.org/events/index.cfm?ekeyid=821.
The Arc’s National Convention will be held from Sept 17-19 in Denver Colorado. The theme is “Achieving New Heights.” For more information, go to
The Alliance For Full Participation Summit 2.0 “Real Jobs – Its Everyone’s Business” will be held Nov 17-19 at the Gaylord National Harbor outside of Washington DC. For more information or to register, go towww.allianceforfullparticipation.org/summit-2011.
The PA Association of Rehabilitation Facilities will hold its annual conference, “Innovation and Integration: What’s New and What’s Next in Rehabilitation,” on September 20-23 at the Nittany Lion Inn in State College, PA. For information, contact PARF at 717-657-7608, or go to www.parf.org.
The PA Community Providers Association will hold their annual conference, “Hats Off,” on October 11-14 at Seven Springs Mountain Resort in Champion, PA. For information, contact PCPA at 717-364-3280, or go towww.paproviders.org.
A statewide, cross-disability conference looking at the challenges faced by immigrants and culturally diverse individuals with disabilities in Pennsylvania will be held on Wednesday, October 5, 2011. The conference, “Empowering the ‘Forgotten Ones’ Through Systems Change,” will be held at Temple University Center (South) 1755 N. 13th Street (Between Cecil B. Moore Avenue and W. Montgomery) Philadelphia, PA 19122. For more information, contact the conference coordinator, Diversity Dynamics, LLC, at 201-653-0047.