Medicaid Waiver Would Increase Community-Based Services in New Jersey

New Jersey’s application for a Medicaid waiver would change the way federal money is administered for people with developmental disabilities, allowing many to stay out of institutions by receiving more community-based support services.
If approved, the state is proposing to spend $90 million a year on support that includes day programs for the disabled as an alternative to living in one of the state's seven developmental centers.

Supreme Court Holds Fate of Medicaid

WASHINGTON, D.C. -- Two cases before the Supreme Court have the potential to effectively do what Republican lawmakers have tried and failed: transform Medicaid into a block grant program for states with few enforceable federal rules about how they provide health coverage for the poor.
That outcome may not be the most likely scenario. But legal experts say no one can predict what the high court will do — particularly because many were surprised that the Supreme Court agreed to consider the Medicaid portion of the big multistate challenge to President Barack Obama’s health reform law in the first place.

Opinion: Kansas Shouldn't Shift Medicaid Program to Managed Care Too Quickly

TOPEKA, Kans. -- Health care providers and advocates — as well as state legislators — have ample reason to be nervous and cautious about major changes in the state’s Medicaid program.
The rising costs of the program make it a natural target for Kansas officials trying to trim the state budget or divert funds to other uses. Kansas isn’t the only state that is pursuing ways to cut its Medicaid costs — sometimes with mixed success.
Kansas already uses a private managed care provider for its HealthWave program, which serves children in low-income families. Gov. Sam Brownback now is proposing a plan that would include the elderly, disabled and mentally ill in managed care plans and to make the entire transition in one year’s time, by Jan. 1, 2013. Although other states are moving toward managed care plans administered by private insurance companies, making such a fast and complete shift is unusual. What works for children in low-income families may not work as well for elderly nursing home residents or people who need long-term assistance because of developmental disabilities.

Judge Issues Ruling in Idaho Medicaid Case

BOISE, Idaho — A judge says Idaho can't switch to just one provider for some types of Medicaid services for the developmentally disabled until the Centers for Medicare and Medicaid Services decides whether the practice complies with federal law.
The decision from U.S. District Judge B. Lynn Winmill was handed down Thursday — just one day before the state's contract with Community Partnerships of Idaho was to go into effect. The ruling keeps dozens of other residential habilitation companies across Idaho in business, at least for now.

Editorial: Fast Track Reform for Services

MINNEAPOLIS -- An object lesson for would-be reformers of state government's Big Hurt -- health care spending for the chronically ill and disabled -- was administered this year.
The lesson: Even when both partisan sides at the State Capitol agree on a goal for serving people better while spending less, achieving that goal isn't quick or easy. And cutting health care spending while working on systemic change can make the reform task more difficult -- and more urgent at the same time.

Brown Request to Cut Medicaid Puts White House In Difficult Position

From Healthwatch, The Hill's health care blog.

President Obama and congressional Democrats have been put in a tough spot by California Gov. Jerry Brown's (D) request to cut Medicaid spending 10 percent.
Brown says he needs to make the cuts to the state Medicaid program, known as Medi-Cal, to ease his state's severe budget woes. But advocates say cuts of that size would be devastating to California's most vulnerable residents.

Man Losing Aid That Lets Him Live at Home

DUFF, Tenn. -- For 17 years, Christopher Hughes' body held his mind prisoner.
Most of his teachers labeled Hughes "profoundly mentally retarded." The athetoid cerebral palsy that wracks his body with involuntary movements also prevents him from speaking words. Hughes, 34, cannot sit up unassisted. He cannot scratch an itch, bathe himself, eat, drink, go anywhere on his own, even across the room.

Still in Shadows with an Uncertain Future

Guest column from the Twin Cities Daily Planet by Tom Judd of Excelsior, who serves on the national board of The Arc, Tim Nelson, president of the board of The Arc Minnesota, and Steve Hayes, chair of the board of The Arc Greater Twin Cities. The Arc is the nation’s largest and oldest human rights organization for people with intellectual and developmental disabilities and their families.

Five decades ago, Minnesota and the nation began to develop an awareness of members in our society who had been long out of public view. President Kennedy talked openly about his sister with intellectual disabilities and called on the nation to bring all citizens with intellectual disabilities “out of the shadows.”
In Minnesota, advocates opened the doors of our state institutions, made us aware of the horrendous living conditions there, and then worked to create a world where people with intellectual and developmental disabilities could live in and contribute to their communities.
Since then, we’ve seen progress in some areas. Legal protections have been passed. In Minnesota, we‘ve worked hard to create services that keep people with disabilities in the community and keep families who have children with disabilities together.
Despite these gains, we are concerned that progress is grinding to a halt, if not reversing.

Rockefeller Vows to Fight for Medicaid

As Vice President Joe Biden and congressional lawmakers look for ways to trim federal spending as part of a deal to raise the federal debt ceiling, Democratic Sen. Jay Rockefeller has issued a clarion call on Capitol Hill to protect Medicaid, the shared federal-state health care program for the poor and disabled.
A former VISTA volunteer, Rockefeller served two terms as governor in West Virginia before being elected to the Senate in 1984. Because Medicaid beneficiaries tend to be less politically powerful than seniors on Medicare, Rockefeller fears that they may be less able to fend off spending cuts as Congress looks for ways to reduce the federal deficit.

The Right Way to Cut Medicaid Costs

Came across this on The Washington Post with Bloomberg blog on the economy by Ezra Klein.

The White House strongly objects to the notion that they’re going to sign onto a deficit deal that makes its main cuts in Medicaid. But they don’t deny, and in fact endorse the idea, that Medicaid will come in for some cuts. So I’ve spent much of the day asking various health-policy experts the same question: If you need to cut Medicaid, how would you do it?
One way to do it is to simply cut spending on the program. That’s the approach you see in the Republican budget. Currently, the federal government contributes to Medicaid based on need. That means spending goes up if there’s, say, a massive financial crisis that knocks millions out of work. But Republicans want the federal government to tie those contributions to a formula that’s unrelated to need, and in fact grows more slowly than health-care costs. And that would work. You can spend less by spending less. But it’d mean the program either needs to cut benefits for kids, the very poor, and the very old and disabled, or kick some of those people off Medicaid entirely. That is to say, it shifts costs rather than controlling them. And we need a better solution to Medicaid than simply “less of it

Florida Cuts Medicaid Funds to Agency

TAMPA, Fla. -- Florida health administrators are slashing hundreds of thousands in taxpayer dollars to a troubled Tampa Bay assisted living facility chain in a move that could jeopardize the homes’ ability to keep their doors open.
The action by the Agency for Health Care Administration leaders to stop Medicaid dollars to the homes comes two weeks after a caregiver at one of the facilities was arrested for rape, and one month after The Miami Herald profiled the homes in a series, “Neglected to Death,” which showed the state had allowed scores of problem homes to remain open — sometimes for years — despite a litany of abuses.
In a letter dated June 13, the state agency informed the owners of the Mapleway Communities ALF chain that, beginning in 30 days, they will no longer be able to bill for services under Medicaid, the state and federal insurance program for needy and disabled people. Medicaid pays for a variety of services for people with developmental disabilities at the homes.

States Brace for Medicaid Cuts

WASHINGTON — The Obama administration injected billions of dollars into Medicaid, the nation’s low-income health program, as the recession deepened two years ago. The money runs out at the end of this month, and benefits are being cut for millions of people, even though unemployment has increased.
From New Jersey to California, state officials are bracing for the end to more than $90 billion in federal largess specifically designated for Medicaid. To hold down costs, states are cutting Medicaid payments to doctors and hospitals, limiting benefits for Medicaid recipients, reducing the scope of covered services, requiring beneficiaries to pay larger co-payments and expanding the use of managed care.

Opinion: Maybe the Dumbest Cut of All

RALEIGH, N.C. -- The House budget that could be approved in the next two weeks would cut more than a billion dollars in health and human services spending over the next two years, more than $710 million of it from Medicaid. That's a bad idea for several reasons.
The deep reductions in Medicaid funding means fewer services for people who need them, lower reimbursements for the medical professionals who provide them, and a loss to the state of more than $2 billion in federal Medicaid funding, since the federal government matches state Medicaid expenditures 2 to 1.

Judge: Minnesota Autism Care 'Inconsistent'

ST. PAUL, Minn. -- A Ramsey County judge has ruled that Minnesota's Medicaid program has been "inconsistent" in paying for intensive autism treatment for some children while denying it to others.
But the ruling stops short of ordering the state to cover the treatment for a low-income child, identified as T.O., who is at the heart of the case.
The judge sent the issue back to an administrative law judge for further proceedings.
Amy Dawson, the lawyer representing T.O., had sued the state and HealthPartners for refusing to cover the child's bills for Applied Behavior Analysis (ABA) therapy. Dawson argued the state routinely paid those bills for more affluent families under a Medicaid program for disabled children, but refused it to low-income children like T.O., who was enrolled in a Medicaid managed-care program.

When Children with ASD Grow Up

Interesting column by Deirdre Imus, Founder and President of The Deirdre Imus Environmental Health CenterTM at Hackensack University Medical Center and Co-Founder and Co-Director of the Imus Cattle Ranch for Kids with Cancer. While she talks about the children with autism who will become adults . . . the question still remains about all the adults who have autism today and who may not have had the benefits of early intervention and other services.

April is Autism Awareness Month, and you may have already heard countless reports about the shocking fact that 1 in 110 – a full one percent – of American children have autism.
Because the majority of individuals with autism spectrum disorders (ASDs) are still under the age of 20, a great deal of attention has been focused on education.
But the problems facing individuals with autism does not end when they age out of school. In many ways they become even more demanding, difficult and costly.

Editorial: State Must Make Case for Facilities

The timing is impeccable: Just as national "Sunshine Week" is about to get under way, calling attention to the undeniable need to pry open the workings of government, the state has been ordered to turn over records of developmentally disabled residents at a local facility that long has been the subject of concern in the community.
For years, state officials have resisted efforts to obtain confidential records from two institutions for the developmentally disabled that legal advocates say will prove residents have languished there. And one of those facilities is the Wassaic campus of the Taconic Developmental Disabilities Service Organization.

Vermont Tops 50-State Ranking of Medicaid Services for People with Developmental Disabilities

Vermont provides the highest quality Medicaid services to individuals with intellectual and developmental disabilities, while Mississippi provides the worst, according to a United Cerebral Palsy analysis released Wednesday.
The states with the best services are Vermont, Arizona and Alaska. Meanwhile Texas, Arkansas and Mississippi round out the bottom of the list of the 50 states and the District of Columbia. (Find out where your state stands >>)
The full report titled “The Case for Inclusion 2009″ can be found by clicking here.