NYSARC, in collaboration with the New York State Association of Community & Residential Agencies and the New York State Rehabilitation Association, recently hosted the fourth annual Community Integration Leadership Institute. The keynote speaker, Deborah Bachrach, former state Medicaid Director, discussed how the per capita caps in the American Health Care Act could result in the state losing $44 billion in federal funding. Since the per capita cap will be based on the 2016 Medicaid Budget, anything added in 2017, such as the increase in DSP wages the chapter fought for, will not be factored in.
The finalized budget for the State of Maryland contains many victories for The Arc Maryland including:
- A 3.5% waiver rate increase to cover the cost of compliance with the Minimum Wage Act of 2014;
- Funding for 789 individuals with I/DD aging out of the school system to receive employment and other day services;
- Waiver slots for the Crisis Resolution category, or the 101 individuals with the most urgent needs;
- Reducing the Family/Individual Support Capped Waiver and Community Support Capped Waiver Waiting lists by 400 each;
- The use of the Waiting List Equity Fund derived from the sale of state institutions and deinstitutionalizing to fund waivers for 36 individuals with priority given to those with the oldest caregivers;
- Community Services for 26 individuals with I/DD involved in the court system;
- $250,000 for inclusive higher education programs for students with I/DD;
- 100 new Autism Waiver slots; and
- A $3.7 million increase for pre-kindergarten education.
Thanks to the advocacy of The Arc Minnesota, the Minnesota Legislature passed and Governor Mark Dayton signed a Department of Health and Human Services funding bill that makes modest progress on several key priorities including:
- A 13% reduction in parental fees for participation in the TEFRA program.
- A 1% increase in the Medicaid spend-down, or about $10 per month
- $496,000 for statewide self-advocacy efforts;
- New services for those seeking competitive employment, pending approval by the Centers for Medicare and Medicaid Services; and
- A 1.5% increase for personal care attendants under the SEIU contract, however there was no across the board increase for DSPs.
The Arc New Jersey, as part of the Coalition for a DSP Living Wage, organized a group of more than 50 family members, self-advocates, providers, and DSPs to visit the State House and advocate for higher wages for DSPs. They met with at least 50 elected officials, including Senate President Steve Sweeney and members of both Budget Committees. For more information, visit the Coalition Facebook page.
The Arc Arizona has wrapped up its legislative session with many victories, including:
- HB 2208, which allows schools to offer inhalers to students when permitted by a physician, was signed by Governor Doug Ducey;
- SB 1030, which adds occupational therapy as a benefit under Medicaid, was included in the state budget;
- SB 1031, which creates a “Committee on Incompetent, Nonrestorable and Dangerous Defendants” to evaluate short and long term treatment and supervision that will include a person with expertise in developmental disabilities, was signed by Governor Ducey;
- SB 1102, which would have increased reimbursement rates for services provided through the Division of Developmental Disabilities was not heard in committee, however the state budget included increases to cover the cost of compliance with the state’s minimum wage increase;
- SB 1103, which would have provided funds for home and community based services provided through Area Agencies on Aging, was not heard in committee, but was included in the state budget;
- SB 1104, which increases funding for providers of services to the elderly and persons with disabilities, was not heard in committee, but was included in the state budget;
- SB 1317, which allows specially designed instruction aligned with an IEP to be delivered by general education teachers or other certified personnel and requires the State Board of Education to amend its rules to eliminate confusion on the instruction options for students with disabilities, was signed by Governor Ducey.
The Arc Wisconsin is advocating for a budget amendment to create a $5 million incentive fund to reward non-profit providers who improve compensation for DSPs. Because Wisconsin uses a managed care model, the state cannot directly increase rates for the purpose of increasing DSP wages. Incentive fund payments could be up to $1000 per full time employee and $500 per part time employee, depending on the number of applicants. Eligible providers must pay at least $10 per hour, contribute at least 70% of health insurance premiums, keep out-of-pocket health insurance costs below $4500, and contribute make an employer contribution of at least 3%; or pay at least $10 per hour and spend at least 65% of their general operating revenue on DSP salaries or benefits.
The Arc California is backing AB 279 and SB 499, which will increase Medicaid reimbursements rates for DSPs to cover local minimum wages that are higher than the state minimum wage. Providers in the San Francisco Bay area, Los Angeles County, Sacramento, and San Diego County do not receive adequate reimbursement to cover their cost in excess of the state minimum wage.
The Ohio House of Representatives has introduced a substitute to Governor John Kasich’s budget that includes many harmful changes to his proposed Medicaid budget including:
- No New Funding for Waivers;
- No Increase for ICF Rates;
- No Increase for Direct Support Wages;
- No Increase for Complex Care Add-On;
- No Increase to Rate for ICF Adults on Ventilators;
- No Increase for Families providing Shared Living;
- A prohibition on increasing the number of slots available under the Individual Options (IO) and Self Empowered Life Funding (SELF) Medicaid waivers;
- Prohibiting Medicaid rates from being increased for the purpose of encouraging providers to serve Medicaid recipients with complex care needs;
- Prohibiting the restructuring of Medicaid rates for the purpose of encouraging the shared living service setting; and
- Prohibits Medicaid rates from being increased for the purpose of increasing the wages of direct service staff.
The Arc Ohio is mobilizing their grassroots advocates to fight this harmful budget.
The Arc Pennsylvania lauds Governor Tom Wolf’s newly proposed budget as the best in a decade. Major improvements include:
- $26.2 million for a new waiver called the “Community Living waiver” with slots for 1,000 individuals with ID currently on the waiting list and 820 Person/Family Directed Support waivers for recent high school graduates;
- $195.9 million, a 14.7% increase, to provide home and community based services to more than 55,000 individuals and increase DSP wages;
- $4.9 million decrease for State Centers;
- $544,000 to transition 40 individuals out of state institutions and into the community as part of a litigation settlement;
- $25 million increase for special education; and
- $11.7 million for Preschool Early Intervention for 1,100 new children
In response to the budget, The Arc Pennsylvania’s Executive Director Maureen Cronin said: “Advocacy is frustrating work because we don’t always (well, almost never) see the impact right away, but times like this remind us that showing up makes a difference.”
As a result of advocacy by The Arc Arizona, the Arizona House budget includes funding to cover the costs of increasing the minimum wage for DSPs to comply with state-wide Proposition 206, which increases the state-wide minimum wage to $12/hour, and Flagstaff’s Proposition 414, which increases the city’s minimum wage to $15/hour. The Arc Arizona is mobilizing its advocates to ensure that language remains in the budget and becomes law.