Brown Budget Plan & Loss of MCO Tax

When Gov. Jerry Brown (D) unveils his fiscal year 2016-2017 budget proposal on Thursday, one of the big unknowns may be answered —- what he plans to do about the pending loss of the MCO tax and the $1.1 billion hole it leaves in the budget.The managed care organization tax is due to expire June 30, 2016. The state imposed a 3.9% tax on revenue generated by health plans through Medi-Cal managed care and received federal matching funds for the MCO tax. The state then reimbursed the MCOs.

Editorial: Wake Up California!

It’s shameful that California’s elected leaders have let 2015 go by without taking care of our most vulnerable fellow citizens. We must not allow that to happen again in 2016.

Those with developmental disabilities deserved an increase in funding for the services they receive through the state. They, through the Lanterman Coalition, pleaded for an immediate 10 percent funding hike this year to end the slide in services, followed by a restructuring of the funding system to make it sustainable.

The money was and is there. State coffers are awash in revenue. But state leaders are ignoring the need.

California Service System Without Funding Increase in More than Decade

“Guess where I am right now?” my son Matthew asked giddily in a recent phone call, “I’m on a bike ride with Larry Davis!” If you are the parent of a child with a developmental disability like me, you know how this kind of phone call affects you. (I’m tearing up right now just thinking of it.)

Matthew met Larry 5 years ago when he was in a day program in Santa Cruz–The Laurel Street Center–and Larry was his “Service Provider.” Going to the day program was a tough adjustment for Matthew, but it was his connection with Larry that made things work. Fortunately, their friendship continued after Larry left the program, and I am so grateful. Larry is one of the many people who have supported Matthew over the years, but it wasn’t until recently that I understood a major reason why agencies have a difficult time retaining such talent.And we must do something about it.

California Medicaid Providers Win Battle

SACRAMENTO — A federal judge on Friday barred California from reducing payments for certain Medicaid services for developmentally disabled Californians.
Medicaid providers will not have to comply with a policy forcing them to bill for only half a day when they work for less than 65 percent of the workday.

Californians Gain More Protection

An additional layer of protection for individuals with developmental disabilities has been added to the Lanterman Developmental Disabilities Services Act, a 1969 California law that guarantees equal access to services and rights for persons with developmental disabilities.

AB 1687, also known as the Persons with Developmental Disabilities Bill of Rights, went into effect Jan. 1 and adds a fundamental right to the Lanterman Act: a prompt investigation. It applies to any alleged abuse perpetrated against persons with autism, epilepsy, cerebral palsy, and various other developmental disabilities.

Managed Care Pilot Meets Resistance

California’s initial efforts to move almost 500,000 low-income seniors and disabled people automatically into managed care has been rife with problems in its first six months, leading to widespread confusion, frustration and resistance.

Many beneficiaries have received stacks of paperwork they don’t understand. Some have been mistakenly shifted to the new insurance coverage or are unaware they were enrolled. And a third of those targeted for enrollment through Nov. 1 opted out, indicating they will stick with their traditional coverage.

Blue Shield to Cover ABA! What's the Catch?

From Laura Shumaker of the SFGate.com

I was encouraged when I read the following press release, last Friday:
SACRAMENTO -- Senate President pro Tempore Darrell Steinberg said he's pleased with what may be significant progress in the fair insurance coverage of therapy for people with autism, after the Department of Managed Health Care revealed a new insurance settlement agreement with one of the state's largest HMOs during a hearing of the Senate Select Committee on Autism and Related Disorders.
During Wednesday's hearing, DMHC revealed a settlement agreement with Blue Shield of California regarding insurance coverage for Applied Behavioral Analysis (ABA) in the treatment of autism and related disorders. DMHC also indicated it is in similar negotiations with Blue Cross and Kaiser Permanente. Those three health plans represent an estimated 95 percent of the 22 million Californians covered by HMOs, according to testimony at the hearing.
Good news! Great news as a matter of fact. There must be a catch.

Police Searching for Missing Autistic Teen

Our hearts go out to the Garza family during this stressful time.


SAN JOSE, Calif. -- San Jose police are seeking help in finding a 13-year-old autistic boy who was last seen going to sleep in his parents' home early this morning.

The parents of Jesus Garza woke up this morning at about 6:30 a.m. and found that their son was not inside the family's home in the 300 block of North 8th Street, according to San Jose police.

Jesus is autistic and has the mental capacity of a 6- or 7-year-old child, according to police. His speech is slow and deliberate and might be difficult to understand.

California Budget Slashes Services

SACRAMENTO, Calif. -- Poor people will receive less medical care and welfare, disabled people will see fewer services, state parks will close and public university students will pay more in California under the budget that takes effect Friday.

Family Raising 3 Son with Autism

VISALIA, Calif. -- On Austin Collins' 17th birthday, he sat at the kitchen counter and fiddled happily with the brand-new CD-player radio his mother, Lori Collins, gave him.
"See what I did here?" Lori said as she holds up the bright yellow string that connects the device to Austin's stool. "This way, he has to keep it down here in the kitchen. He can't carry it up to his room and destroy it. Even though he loves it, he'll end up destroying it."
This is just one of many tricks Lori has devised to streamline everyday life for her unusual family, who live in Visalia. Having three children with low-functioning autism is a challenge, but it is one that 36-year-old Lori Collins was seemingly engineered to handle.

Horticulture-Based Day Program Provides Opportunity for Adults with Disabilities

FARMERSVILLE, Calif. -- Tammy Beach reaches deep into a lavender bush at Herbs and More in Farmersville. She grabs a handful of fragrant lavender in one hand and cuts the stems 4 inches below the buds with her other hand.
The public is invited to cut their own bunches of the aromatic herb during the second annual you-pick lavender festival Saturday and June 11 at Herbs and More, 226 E. Front St. in Farmersville. Herbs and More grows four varieties of highly aromatic lavender: hidcote, munstead, grosso and provence.
The horticulture-based day program for adults with developmental disabilities focuses on each client's ability to participate, said co-owner Kathy Lewis.

Opinion: Cutting Funds for Supported Employment Programs Poses a Higher Cost

Compelling argument by Cameron Haste, chief operations officer of Bay Federal Credit Union and a HOPE Services board member, in the San Jose Mercury News.

In this challenging time, state funds need to provide an effective return on investment. Cuts to the Department of Developmental Services (DDS) continue to threaten job placement programs that get individuals with developmental disabilities employed -- and when these cuts occur, we increase these individuals' reliance on state funding.
In a study released by Kent State University in March 2010, researchers demonstrated the cost-efficiency of supporting employment for people with severe disabilities.
Another study published in the Tash Journal showed that hiring these individuals returned an average monthly net benefit to taxpayers of $251 (or an annual net benefit of $3,016 per supported employee) and generated a benefit-cost ratio of $1.46 for every dollar spent.

High School Student's Inner Circle

BRENTWOOD, Calif. -- Equipped with an ample supply of M&Ms in pastel shades and polka-dot ribbon, Emily Simino and a couple of friends are turning miniature glass jars into party favors for a mutual companion's birthday.
The Brentwood 15-year-old maintains a running conversation with Brandon Gruber, who snips off strands of ribbon and affixes them along the edge of the lids at her direction.
"Cut it right there," Emily says. "Perfect. Do you have a little glue?"
Gruber carefully applies a few drops.
"Yeah, you really are good with a glue gun," Emily says.
That both Brandon, 15, and fellow favor maker 23-year-old Brittany Cassen have Down syndrome makes no difference to the Heritage High School sophomore, who counts them among her closest friends in a social network that includes dozens with similar disabilities.

Opinion: When Prison May Be Best Option

SAN FRANCISCO -- I'm beginning to hope my son will be sent to prison - perhaps Death Row.
Rob stands accused of no crime. And I am not an unloving mother. Let me explain: Rob has a developmental disability, and California is balancing its budget by gutting the services that keep him alive.
The situation is dire enough that I must wonder: Once Rob's services are cut, will Death Row be a safer place for him?
I know that every program is getting cut. But the single largest budget cut just signed into law by the governor - $568.6 million - is for services for people with developmental disabilities.

California Group Home OK'd; Appeal Likely

REDWOOD CITY, Calif. -- Fans of the controversial "Big Wave" development erupted in cheers, hugs and tears Tuesday as the San Mateo County Board of Supervisors approved land-use permits for a Coastside office complex and living facility for adults with developmental disabilities.
Project applicant Scott Holmes was dry-eyed, however. Opponents of the project, who appealed the project to the Board of Supervisors, have promised to appeal Tuesday's decision to the California Coastal Commission on the grounds that the proposal -- which includes eight office buildings and housing for 50 developmentally disabled adults, along with 20 caretakers -- is just too big for its location in a vacant field next to Half Moon Bay Airport.
There's also the fact that the project is located entirely within a tsunami evacuation zone, adding a darkly ironic twist to the project's nickname.

California Group Claims Autism Treatment Is Denied Illegally

California regulators are violating mental health and other laws by allowing health insurers to deny effective treatment for children with autism, consumer advocates contend.
In a lawsuit, Consumer Watchdog, a Santa Monica group that monitors insurance practices, is asking a judge to order the Department of Managed Health Care to require insurers to provide autistic members with the services their physicians have ordered.
The battle over autism treatment is at least a decade old. In 1999, in response to widespread outrage over insurers' refusal to cover such needs, the state Legislature adopted the Mental Health Parity Act.
The law requires insurers to cover care for mental and behavioral problems at the same level as they do for physical illnesses.