ADSA FY 2011-13 Reduction Proposals

STATE OF WASHINGTON

DEPARTMENT OF SOCIAL AND HEALTH SERVICES

P.O. Box 45050, Olympia, Washington 98504-5050

October 7, 2010

TO: ADSA Staff and Stakeholders

FROM: Kathy Leitch, Assistant Secretary KL

Aging and Disability Services Administration

SUBJECT: ADSA FY 2011-13 Ten Percent Spending Reduction Proposals

My September 29th memo to you on current-year budget reductions promised information about what has been submitted by DSHS/ADSA for the Governor’s consideration as she prepares her budget proposal for the 2011-2013 biennium.

Unfortunately, the revenue picture is not significantly brighter for 2011-2013. Each agency was asked to submit options to reduce state spending by 10%. That target is not in addition to the 6.3% current-year across-the board reductions I outlined last week. As you will see, we carried some of those proposals forward through the biennium, did not carry others forward, and have identified several new options.

Previously I said the state will be bringing fewer resources into its partnerships than planned and service recipients and their families will need to assess their ability to do more, service providers will need to reassess and revise their business models, we will ask more of the federal government, and labor, local communities, and governments will need to help sort out their priorities and what role they can play in streamlining government. I also said that given the magnitude of these changes there inevitably will be some services that will no longer be provided.

While we have a bit more latitude to be strategic as we approach 2011-2013, those statements are still accurate and will frame our discussions as we move forward.

ADSA’s proposals would reduce its expenditure of state general funds as follows:

Long Term Care $ (272,404,000)

Developmental Disabilities $ (98,915,000)

Mental Health $ (68,512,000)

Alcohol and Substance Abuse $ (18,083,000)

Total $ (457,914,000)

The figures above include an increase of $169M in “other” revenues for ADSA programs (primarily through increased federal match and increased fees). An increase in “other” revenues allows a corresponding decrease in expenditure of state general funds. The balance of the reduction in state general fund spending comes from cuts in programs.

The program specific steps are outlined in the attached chart. Details for all DSHS programs, including ADSA’s, can be found at the DSHS Budget Page. Beginning this week, OFM will begin reviewing agency proposals and we will work throughout the fall to refine those ideas as the Governor’s budget is developed and then finalized in December.

As you can see from the attached chart the types of actions we can take fall into the same categories as before, except there are also several new ideas for 2012-2013 that will increase revenues from non-state sources. In summary:

· Most of the 6.3% current year reduction proposals are continued through the biennium, with the following major exceptions (by category):

o ADSA Reductions: Temporary layoffs for employees are not continued.

o Rate Changes: Boarding home rate reductions; reduction to AAA Case management rates; and DDD SOLA reductions are not continued.

o Service Reductions: Suspension of the Individual and Family Support program for families who support people with developmental disabilities; reduction in funding for the Senior Citizen Services Act; suspension of entry to the Children’s Intensive In-Home Behavioral Supports program; and the reduction to Youth Detoxification are not continued.

· There are several items that appear for the first time on the biennial list:

o Service Alternative: A proposal to purchase health care for direct care workers employed by homecare agencies at a lower cost through the BHP or other Health Care Authority health plan options (DDD and LTC).

o Service Investment: Additional funding for the Volunteer Services Program to increase the number of volunteer hours provided in support of vulnerable adults; incentive-funding for nursing homes to engage more fully in the home and community-based service system; and an additional investment in the Family Caregiver Support Program to slow entry of clients into the Medicaid system (LTC).

o Additional Revenues: Five new revenue proposals that would create a net reduction of $153.3M in state general fund expenditure:

§ A proposal to extend a revenue-generating public utility assessment on DDD community residential providers, licensed boarding and adult family homes and home care agencies (DDD and LTC).

§ A shift of current in-home service participants to the new Community First Options Program under Medicaid, which provides a higher federal match rate (DDD and LTC).

§ Implementation of a quality assurance fee on nursing homes (LTC).

§ A Vulnerable Adults Safety Improvement Package that improves the abuse response system and covers more facility oversight costs through increases in facility license fees (LTC).

§ An increase in fees for licensing, certification, and regulatory oversight of chemical dependency treatment programs and community mental health agencies (ASA and MH).

As always, I will continue to keep you informed as we move toward the upcoming legislative session.

Attachment

Message from the Governor

Dear Stakeholder:

You likely remember the headlines from a few weeks ago that announced the recession was over. Mathematically that may be accurate, but we know we still have a long way to go to rebuild our economy.

In the wake of reduced spending and hiring, there is still more to be done to balance our state budget. I want to take a moment to explain the need for across-the-board cuts, and what will happen next.

As the economy continues to sag and spending remains at a low level, state revenue continues to decline. At the same time, caseloads are increasing for public education and health care services. It is a cycle that is devastating to the people who rely on state services and difficult for state workers to endure. The supplemental budget passed this year left a $453 million ending fund balance, or surplus, in the state budget. However, the two revenue forecasts since May have been well below expectations. The state lost $203 million in the June forecast and $770 million in September. These reductions turned our $453 million surplus into a $520 million shortfall.

When a shortfall is projected, the law requires that I take action to balance the budget — either through spending reductions referred to as “across-the-board cuts,” or by calling a special session of the Legislature. Legislative leaders could not reach consensus on a special session. Thus, I had to direct agencies to reduce spending by 6.3% starting October 1. Agencies have submitted their reduction plans, which you can view at http://www.ofm.wa.gov/reductions/default.asp.

By law, across-the-board reductions leave no discretion to a governor. They apply to all branches of state government and to all agencies headed by elected officials that receive appropriations from the General Fund.

Though across-the-board cuts do not allow us to pick and choose the reductions we must make, we can use the supplemental budget to address some of the most compelling concerns these cuts raise, but the same level of cuts must be made. That supplemental budget will be presented to the Legislature, and legislators have the opportunity to take swift action when they return to Olympia.

Let me be clear: 1) cuts at this level in a fiscal year are a real challenge, and 2) balancing the budget through across-the-board reductions is difficult. The services we have to reduce are often the very ones we want to protect. These are hard times, and they are hard for me and for the state family I have known for the past 30 years of my career.

For me and my administration, this presents an unprecedented challenge in historic times. We have to do what we could never have imagined.

Simply put, we will emerge from this recession a much different state than when we started. We will still focus on the things we are proud of: protecting our most vulnerable citizens, keeping the public safe, stewarding our natural resources, educating our children, and creating the jobs of the future (lots of them!). But the way state government delivers on our promise will, by necessity, change. We are in that transformation now and I know it has created uncertainty and unfamiliarity.

When the Legislature returns, it will need to pass the supplemental budget and the added challenge of an operating budget that addresses a projected nearly $4.5 billion shortfall for the 2011–13 biennium. We all have a very tough job ahead of us. I welcome ideas from you, and citizens across the state, to transform our budget, prepare for the future and live up to our values.

Even in these hard times, I see hope. This is a time for us to work together and to support one another as we handle these difficult times. As partners, we will make our state an even better place to live and work.

Sincerely, Chris

The President Signs Rosa’s Law

The President Signs Rosa’s Law

E-Newsletter Issue Date: Monday, October 11, 2010

On Friday afternoon, President Barack Obama put his pen to work signing the Twenty-First Century Communications and Video Accessibility Act of 2010 into law, delivering brief remarks on the impact of the law on people with disabilities and celebrating Rosa’s Law. The law, which was enacted by the President on Tuesday, substitutes the term “intellectual disabilities” for “mental retardation” in many federal laws.

Self-advocates William Washington (The Arc’s national office receptionist), Jill Egle (Co-Executive Director, The Arc of Northern Virginia) and Jeremy Jacobson (son of The Arc’s Chief Development and Marketing Officer Trudy Jacobson) joined Paul Marchand, Director of the Disability Policy Collaboration to represent the intellectual and developmental disability community whose advocacy resulted in this bill.

Nine-year-old Rosa Marcellino, for whom the law was named was in attendance with her family and received a hug from the President. Also in attendance were the bill’s sponsors, key policy leaders and musician Stevie Wonder.

Rosa’s Law was passed by the Senate earlier this year and passed the House in September. Self-advocates and The Arc have led the effort to get the bill enacted as part of a nationwide effort to remove the stigma of the “r-word.” The majority of states have altered their terminology by replacing the term “mental retardation” with “intellectual disability” in state laws and in the names of state agencies that serve this population.

Changes in terminology are another stepping stone toward realizing a more inclusive society. The Arc was instrumental in the passage of Rosa’s Law by galvanizing support across the nation and through vigorous advocacy. “We have achieved another historic milestone in our movement. We understand that language plays a crucial role in how people with intellectual disabilities are perceived and treated in society. Changing how we talk about people with disabilities is a critical step in promoting and protecting their basic civil and human rights,” said Peter V. Berns, CEO of The Arc.

The Twenty-First Century Communications and Video Accessibility Act increases accessibility for people with sensory disabilities to modern communications, such as internet access over smart phones. The Arc also advocated strongly for this legislation and celebrates its enactment.

on behalf of DSHS Secretary Susan N. Dreyfus

This message is sent on behalf of DSHS Secretary Susan N. Dreyfus

October 5, 2010
Dear Stakeholders, Partners, Community Leaders and Colleagues:
As I said last week in my message and in our videoconference on Thursday, the 6.3 percent across-the-board spending reductions we announced would not be the end of budget reductions the Department will face in the short term. Given the revenue forecasts for the 2011-13 biennium, which begins July 1, 2011, the Governor’s Office of Financial Management has asked all Executive Cabinet agencies to submit additional reductions totaling 10 percent (Details are now posted on the DSHS Budget Web page).
Unlike the 6.3 percent, the 10 percent reductions we have developed for the next biennium are not going into effect now. We, along with other agencies, we will be working with OFM throughout the fall to refine the spending reduction options as the Governor’s 2011-13 biennial budget proposal is developed. The Governor’s budget proposal will be submitted to the Legislature in December for consideration during the 2011 legislative session, scheduled to begin January 10. The Legislature will adopt a budget for the 2011-13 biennium that we will begin to implement in July of 2011.
Beginning this week, OFM will start reviewing the spending reduction options submitted by all Cabinet agencies. This 10 percent reduction is not in addition to the 6.3 percent reductions. We carry forward into the biennial budget proposal many of the 6.3 percent reductions announced earlier this week, but the biennial budget process allows us to be more strategic in regard to our approach. It provides an opportunity to reinvest a portion of some of the reductions to help build stronger home- and community-based services. While these investments may be short-term in nature, these investments are intended to allow our community partners some flexibility and increased capacity to address expanded areas of social service needs in their communities.
We believe a thoughtful, strategic budget is one way we will bring to life our Framework for the Future. These reductions are not just about reducing, but about resetting in a sustainable way for our future. We must re-examine the work we do -- in light of the Governor’s eight budget development questions and our Department-wide efforts to:
strengthen and expand home- and-community-based service delivery systems
provide integrated case management services to high-need/high-cost individuals and families
and control General Funds-State expenditures while preserving services for our most vulnerable citizens.

I welcome your comments and questions at StakeholdersFeedback@dshs.wa.gov.
Thank you for the great work you do every day and your leadership.

Susan N. Dreyfus, Secretary
Department of Social and Health Services

Kelly Church
Parent/Family Coalition Co-Coordinator
425-258-2459 x 107
The Arc Of Snohomish County
kelly@arcsno.org

House Approves Bill Removing ‘Mental Retardation’ From Law

House Approves Bill Removing ‘Mental Retardation’ From Law
By Michelle Diament

http://www.disabilityscoop.com/author/michelle-diament/

September 23, 2010

The House of Representatives unanimously approved a bill Wednesday evening paving the way for the term “mental retardation” to be replaced with “intellectual disability” in many areas of federal law.

The legislation known as Rosa’s Law now goes to President Barack Obama who White House officials say intends to sign the measure.

Under the bill, the terms “mental retardation” and “mentally retarded” would be stripped from federal health, education and labor policy. “Intellectual disability” and “individual with an intellectual disability” would be inserted in their place.

The changes would occur as laws and documents come up for revision over the next several years. Since the alterations would be implemented gradually, the legislation is not expected to incur any cost.

“For far too long we have used hurtful words like ‘mental retardation’ or ‘MR’ in our federal statutes to refer to those living with intellectual disabilities,” said the bill’s sponsor Sen. Barbara Mikulski, D-Md., in a statement Wednesday. “Rosa’s Law will make a greatly-needed change that should have been made well before today — and it will encourage us to treat people the way they would like to be treated.”

The language swap would not alter the rights that individuals with disabilities have, but would merely bring the federal government more in line with a trend toward using the term “intellectual disability.” Already the term is used by most states and some federal agencies including the Centers for Disease Control and Prevention.

Rosa’s Law is named for Rosa Marcellino, a Maryland girl with Down syndrome.

Gov. Gregoire responds to budget ideas posted on website

Gov. Gregoire responds to budget ideas posted on website
For Immediate Release: August 26, 2010

OLYMPIA – Gov. Chris Gregoire today began posting video responses to the most popular budget suggestions offered recently on her budget ideas web site.

“As I said when we unveiled this web site, I want staff at the Office of Financial Management as well as members of the executive budget panel to review each and every idea,” Gregoire said. “I’ve been taking a look at them as well, and want those who have participated to know that we’re taking those ideas seriously.”

Visitors of the website submitted nearly 2,000 ideas, posted nearly 5,600 comments and cast 137,000 votes to weigh in on the suggestions.

Gregoire’s responses can be found on the state’s YouTube channel at http://www.youtube.com/user/washingtongovernment, as well as on the governor’s Facebook page at http://www.facebook.com/govgregoire. Responses will be posted periodically, with the first response posted this morning.

OFM will also begin providing written comments to many of the suggestions receiving the most votes. The feedback will be shared on the governor’s budget webpage at http://governor.wa.gov/priorities/budget/default.asp.

Facing a $3 billion deficit for the 2011-2013 biennium, Gregoire has initiated a process to transform Washington’s budget – which included soliciting ideas from Washingtonians. Along with the interactive website, more than 1,200 citizens attended a series of public hearings around the state to learn more about the budget process and share input and individual strategies.

Although the interactive website is now closed, the public can still share their ideas for transforming the budget through the governor’s website at http://governor.wa.gov/contact/default.asp.

County seeks advocates to protect vulnerable adults

There is a critical need for volunteer ombudsmen throughout Snohomish County to assist the elderly living in adult family homes, nursing homes and assisted living facilities.

As a certified volunteer long-term care ombudsman, individuals can make a difference by being an advocate, educator, investigator and problem solver. Volunteer ombudsmen come from all walks of life, various age groups and educational levels. The common thread is an interest in serving older adults and persons with disabilities.

Volunteers receive four days of free training to become certified ombudsmen. They are asked to volunteer four hours a week, attend monthly meetings and submit a monthly activity report. Expenses such as mileage are reimbursable.

The next four-day volunteer training will be held Sept. 21, 22, 28, 29.

The Snohomish County Long Term Care Ombudsman Program protects and promotes the interests, well-being and rights of vulnerable adults living in long-term care facilities. It is part of the Washington State Long Term Care Ombudsman program, a federally mandated program created by the Older Americans Act.

For more information and an application packet, contact Michal Glauner at 425-388-7393 or michal.glauner@snoco.org