A Video and Vote from Senator Zarelli!

Please view the link below for a message and vote regarding IP’s (Independent Providers) who care for their family members in-home.

Thank you,

Kelly Church

It’s Reset Tuesday, and in today’s new video Sen. Joseph Zarelli raises questions about how state government compensates people who are “independent providers” of in-home care for family members and whether the cost of the program could be reduced by adopting the approach used to compensate foster parents.

Vigil-goers hold candles to the budget-cut wind

posted 05:47 PM 11/17

Some were in wheelchairs. Others held banners. In all about 100 activists showed up tonight for a candlelight vigil under the Capitol's stone-roofed north entrance, expressing worry that looming budget cuts are going to shred the state's safety net.

The state's anticipated budget shortfall for next year is $4.8 billion, and a Thursday morning revenue forecast could make the situation worse or better.

But already, Gov. Chris Gregoire has ordered across-the-board spending cuts to cover a $520 million deficit through June, and that alone will knock some 27,000 children off health-insurance subsidies and could end prescription drug coverage for up to 500,000 recipients of Medicaid after March.

Additional cuts of 10 percent or more are under review by state agencies as Gregoire prepares for a budget to be released before Christmas.

"Even though we are in a recession, and I know we have to do these cuts, it's going to hurt in the long run," said Kyle Matheson, who held a battery-powered candle. "We need to stop this hurt."

Matheson said he recently became unemployed and also serves on the board of People First of Washington, which advocates for people with disabilities. "I'm concerned about the Medicaid cuts, the pharmacy cuts, any type of cuts that are going to hurt anybody with developmental disabilities or mental health issues," he said.

Diana Stadden, policy and advocacy coordinator for the ARC of Washington advocacy group, said she has a 17-year-old son with autism and she worries about pharmacy cuts. As a parent of three children employed by a nonprofit, she said it will be difficult to pay for some of his medications.

Stadden's group was one of several that arranged the vigil, including AARP, PAS-Port for Change, Puget Sound Alliance for Retired Americans, SEIU Healthcare 775NW and the Washington State Senior Citizens Lobby.

Ingrid McDonald of AARP, Walt Bowen of the Senior Lobby and Sue Elliott of ARC met with Gov. Gregoire and other healthcare-issue stakeholders late in the afternoon to talk about the pending cuts. McDonald said there was a shared sense of despair about the budget in the short term but optimism longer term that is linked to federal health-care reform.

She said Gregoire pointed to the reform as a way to get out of the current financing mess and that Gregoire reported talking to federal Human Services Secretary Kathleen Sebelius about letting the state serve as a pilot for the new Centers for Innovation created by reform.

Dennis Mahar, leader of the Lewis-Mason-Thurston Area Agency on Aging said the state might be able to save money with a more coordinated use of Medicare and Medicaid spending.

He also expressed hope that lawmakers could find the guts to approve new revenues, summoning a two-thirds supermajority required by passage of Initiative 1053 on Nov. 2.

"I worry that our jails and emergency rooms will become our treatment centers," Mahar said.

Bowen said what is happening with budget cuts is the start of "dismantling" a long-term care system that took 30 years to build up and become cost-effective through supporting seniors in their homes instead of nursing facilities.

"I think the governor is … pained about the whole thing," Bowen said after the meeting with about 14 people and Gregoire about health care. "This is beyond anything she ever thought about in political life before … She was troubled by what is going to happen and tried to explain it. She's trying to figure out what to do about it."

The Governor’s Office confirmed Gregoire met with the parties but had no immediate comment. Mahar and McDonald cited elimination of hospice care aid for 2,600 low-income people and an end to prescription drugs for outpatient clients of the Medicaid system as major harmful outcomes of the budget crisis.

"I don't know how you do that,” Mahar said of the hospice cuts that are included in the Department of Social and Health Services share of 6.3 percent spending cuts. The cuts also will eliminate dental, vision and other care for low-income elderly and reduce hours available for homecare workers to assist the frail still living in their homes.

DSHS Secretary Susan Dreyfus said last week her agency also is cutting about $19 million more from its welfare spending, particularly in child-care subsidies for poor families transitioning to work, because caseloads have swollen and funding has not. That is in addition to more than $50 million in welfare cuts announced a few months ago.

Adam Glickman of the Service Employees International Union provided an analysis of the overall DSHS cuts that make up a large share of the $520 million in across-the-board cuts. The analysis showed administration and support services are being reduced by about 5.2 percent, while alcohol and substance abuse programs and developmental disabilities are cut by 10 percent. Economic services such as help for those on welfare are being cut 16.8 percent and long-term care is cut 15.7 percent, the analysis shows.

Inside of the long-term care area, SEIU's analysis shows home-care services are reduced by 15.5 percent and community residential services by 7.8 percent.

"It means some seniors and people with disability will lose homecare services entirely. Others will see their services drastically reduced, and thousands of vulnerable seniors will lose access to critical services like dental and vision coverage and prescription medications," Glickman said.

Glickman said SEIU and the coalition wants to put a human face on the cuts before the ugly budget fight gets under way in January in the Legislature. And McDonald said they want the public to know what really is at stake.

"There's not a clear path to it not being ugly," Glickman said.

Read more: http://www.theolympian.com/politicsblog/index.html#1443709#ixzz15eLnWb00

Stop the Cuts! DRW wants to hear your story.

November 17, 2010 The Governor’s budget eliminates Medicaid payment for all prescription drugs and all physical, occupational, and speech therapy services for people living in the community. This includes all prescription drugs - even medications essential for the treatment of diabetes, epilepsy, mental illness, heart disease, and other disabilities. We need to hear from you. These cuts must be stopped. If you have a story to tell about how the loss of medications or therapies will harm you, please contact Disability Rights Washington at: 1-800-562-2702 x 101. TTY callers please contact us between 8:30 a.m. and 5:00 p.m. at 1-800-905-0209. You can also e-mail us at: yourstory@dr-wa.org. Click here for more information.

Diana Stadden

The Arc of Washington State

Policy and Advocacy Coordinator

Cell (Call-Text-Email): 253.576.6351

Fax: 360.357.3279 attn: Diana

Email: Diana@arcwa.org

candlelight vigil on the Capitol Campus

You are invited to a candlelight vigil on the Capitol Campus to let the Governor know that the proposed cuts (below) are devastating! Be a part of a group to ask her to delay the cuts until the legislature has a chance to decide.

Date: Wednesday, November 17, 2010

Time: 4 - 6pm

Where: The side of the Legislative Building that faces the library/sundial.

Dress warm! Candles will be provided!

DDD & Medicaid Services Make Drastic Cuts!

The Governor recently announced that all agencies (except those protected by state or federal law) must make “across-the-board” budget cuts. These cuts will be extremely dangerous to people with developmental disabilities, costing the state more in the long run as people fill up emergency rooms or are forced to seek the only entitlement, an institutional placement, the only options left available. It will create safety issues and may even cause death.

Some of these cuts have already been implemented, some take effect January 1, 2011, others cannot be implemented without legislative approval when the state legislature is back in session on January 10, 2011. The cuts listed below have been sent to the Governor’s office by DSHS/Division of Developmental Disabilities and the Medicaid Purchasing Administration.

These cuts are happening because our state did not receive the amount of revenue they thought they would be collected. The Governor is required by the state constitution to have a balanced budget. These cuts are being made to make up for revenue not received.

Medicaid prescription drugs – Funding is eliminated for all outpatient pharmacy prescription drugs for adults. Only medications administered in a physician’s office or outpatient hospital settings will be covered. This takes effect March 1, 2011.

Medicaid Personal Care – Client receives personal care from a provider based on their assessment from the Division of Developmental Disabilities, allowing them to remain in their home. Cuts will be based on acuity (how high the need is). 6 to 14 hours per month will be cut from all clients beginning June 1, 2011.

Children’s Intensive In-home Behavior Supports – Provides in-home professional help for children with extremely challenging behavior challenges to avoid placing the child in an institution which would cost the state much more. This program is frozen, no new families will be enrolled. Effective Nov 1, 2010.

Individual and Family Services (IFS) – IFS is used mostly for respite, it is also used for therapies/co-pays and various other services. All families currently on IFS will lose service from Nov 2010 to July 2011.

Dental Services – All adult dental services except emergency services are eliminated. Adults will be able to go to a dentist or the emergency room for pain medication only, dental services will not provided. Effective Jan 1, 2011.

Vision, hearing & podiatry, physical, occupational & speech therapy services are all eliminated for adults. Effective Jan 1, 2011.

Residential Services – Rates to community residential providers will be cut 2%. It will be difficult for providers to attract and retain a stable workforce. Effective Jan 1, 2011.

Employment Services – Rates that counties pay employment providers will be reduced, causing service levels to clients will be reduced. Cuts to employment services means a loss of taxpayer revenue, no return on the State's special education investment and more demand on other support services. Effective Jan 1, 2011.

Transition Services – Clients graduating from high school in 2010 may lose their job that school transition staff helped them get or end up at home with no job, no return on the State's special education investment and more demand on other support services. Funding for 240 state-only clients that have not entered service will be eliminated. Effective October 2010.

Eliminate Case Managers (No Paid Services) – Clients with no services won’t have a case manager to provide community resources. Other clients won’t get timely assessments for services as some case manager positions currently open will not be filled. Effective Jan 1, 2011.

Temporary Layoff Days are extended to all DDD employees and two more layoff days are added. Effective Oct 1, 2010.

Residential Habilitation Centers – Reduce/restructure training programs & some services, close cottages, some staff layoffs. Effective Jan 1, 2011.

Diana Stadden

The Arc of Washington State

Policy and Advocacy Coordinator

Cell (Call-Text-Email): 253.576.6351

Fax: 360.357.3279 attn: Diana

Email: Diana@arcwa.org

2010 Initiatives – Their Effect on You

Referendum 52 – Healthy Schools for Washington
Many schools across Washington State have harmful toxins such as mold, asbestos and lead. Lead poisoning, particularly from old paint, is the most common environmental hazard that causes developmental problems. More than one in 25 American children have blood lead levels high enough to lower IQ or cause learning disabilities, violent behavior, attention-deficit disorder or hyperactivity.
Ref. 52 would use existing taxes to create 500 million dollars of bonding capacity to fix old, unsafe schools. Every school district in the state could get funding through competitive grants. Ref. 52 will also save taxpayers $130 million a year in reduced energy costs once buildings are updated and modernized and it will create 30,000 new construction jobs across our state. (www.HealthySchoolsForWA.org)
Initiative 1098 – Washingtonians for Education, Health Care & Tax Relief
A coalition of business, labor and community leaders, including Bill Gates, Sr., designed this initiative to provide badly needed funding prioritized for education and basic health services. I-1098 will raise $1 billion per year by taxing singles who make over $200,000 a year and couples making over $400,000 a year, only about 3% of our state’s population. The majority of other taxpayers will pay less by reducing the state property tax by 20% and increasing the small business tax credit from $420 a year to $4,800 a year. Small businesses are now required to pay B&O taxes even when they are losing money. I-1098 will eliminate this tax, making it easier for them to keep current employees and create even more jobs.
The income level cannot be changed to include more than those making the income listed above without a vote of the people. There would be regular audits and full public disclosure to ensure the funds are used for education and health services. Monthly reports on deposits, withdrawals and balances will be posted on the web. (www.YesOn1098.com)
Initiative 1100 and Initiative 1105 – Privatizing liquor stores
Currently, $330 million generated from taxes and the sale of liquor fund core public services for both state and local governments such as health care, law enforcement and education. I-1100 stops the state’s operation of liquor distribution by June 15, 2011, I-1105 stops it by November 15, 2011. Over 5 fiscal years, I-1100 is estimated to decrease state revenues between $76 million - $85 million while for that same time frame I-1105 is estimated to decrease state revenues between $486 million - $520 million. If state liquor stores are privatized, that also eliminates the state’s current avenue for selling lottery tickets, I-1100 would decrease lottery revenues $1,327,000 over 5 years and I-1105 would decrease lottery revenues $1,194,000. Washington State would have an estimated cost of $313,000 during the next biennium to make the changeover. (www.protectourcommunities.com) (http://ofm.wa.gov/initiatives/)
Initiative 1053
During the last legislative session the legislature suspended I-960 until the summer of 2011 in order to avoid an all cuts budget. I-1053 would reinstate I-960 and require a 2/3 vote of the legislature in order to raise taxes or create new taxes. If the legislature had not suspended I-960 during this bad recession it would have had to make severe cuts to public services. If I-1053 does pass, the legislature will have no choice but to cut more services in order to make up for the $3 billion shortfall the legislature is expected to face. This means cuts or elimination of state funded services such as Individual and Family Services as well as Medicaid coverage of dental, vision, therapies and other services. (www.sos.wa.gov/elections/initiatives/text/i1053.pdf)

Initiative 1082 – Privatizing the public worker’s compensation system
Our current public worker’s compensation system is regarded as a national model of efficiency. In I-1082 the insurance industry would like to privatize our worker’s compensation system. I-1082 would allow big insurance companies to prioritize profits over ensuring workers are able to fully recover before returning to work from a work related injury. These companies would look for low-risk, profitable businesses and leave the state with the high-risk businesses, and taxpayers would shoulder the cost.
I-1082 will hurt small businesses as they will not have the power of bigger businesses to get low rates. I-1082 also eliminates the worker’s contribution to the system, which would increase rates for businesses by at least 25% and mean lay-offs for many small businesses. AIG, which was a major player in the collapse of our financial system, is a major player in the private workers’ compensation market. (VOTENO1082.com)
Initiative 1107
In the 2010 legislative session, legislators worked to avoid an all cuts budget and to protect core public services by passing a small, temporary tax on soda pop, bottled water, candy and gum. Adding about 2 cents to a bottle of water or can of pop brings $352 million to our state over the next five years to help keep education, the Basic Health program and other services from being stripped. The legislature passed this tax only after having to cut $4 billion from Basic Health and nursing homes and suspending initiatives to reduce class sizes in education. I-1107 would repeal this small tax on items that are not essential to consumers. The tax does not affect food products, even though claims are being made to the contrary. It will actually increase B&O taxes for some businesses as well.

For additional information:
Washington Secretary of State


State of Washington Office of Financial Management


Washington State Budget and Policy Center

(put together by Washington State Arc)

Public Hearing on Affordable Housing

Public Hearings Re: 2011 Action Plan and Program Performance

Snohomish County will hold two public hearings to solicit citizens’ views on priority needs for the use of CDBG, HOME, and ESG federal grant funds for affordable housing and non-housing community development (ex. public services, public facilities, infrastructure, economic development) activities for the 2011 program year. The hearings will also report on and receive citizens’ views on program performance under the Snohomish County 2005-2009 Consolidated Plan. The County will also respond to proposals and answer questions.

The hearings will be held on:

Date: Monday, November 1, 2010

Times: First hearing will be held at 12 noon
Second hearing will be held at 6 p.m.

Location: Meeting Room 6A02
Snohomish County Robert J. Drewel (Admin East) Building
3000 Rockefeller Avenue
Everett, WA 98201

Persons unable to attend the hearings may submit written comments prior to the hearing date.


Best regards,

Sue Tracy, Senior Grants Analyst
Snohomish County Office of Housing, Homelessness,
& Community Development
Phone: (425) 388-3269
Fax: (425) 388-3504

ADSA Reorganization

Greetings:
Today I am pleased to announce the appointment of MaryAnne Lindeblad, Director of the Division of Health Care Services in the Medicaid Purchasing Administration, as the new Assistant Secretary for the Aging and Disability Services Administration effective November 1. MaryAnne brings a unique background, skill set, and experiences that will serve us well as we continue our efforts to build a strong system of care for our elders and persons living with developmental disabilities.
MaryAnne began her career with DSHS in 1977. Her first job was as a nursing care consultant in what is now ADSA. Lindeblad returned to DSHS as a division director in 2002. Prior to that, she served as assistant administrator at the Health Care Authority, where she managed the Public Employee Benefits Board’s programs for about 300,000 active and retired state employees. Earlier, she directed operations for Unified Physicians of Washington, a statewide physician-owned health plan, from 1994 to 1997. She has a master’s degree in public health from the University of Washington.
MaryAnne serves on the Medicaid Managed Care Technical Advisory Group, chairs the Long-Term and Chronic Care Committees of the National Academy for State Health Policy, serves on the Board of the Olympia Free Medical Clinic and the Family Support Center in Olympia, and is a member of the Advisory Board of the Evergreen State College Masters in Public Administration Program.
Under MaryAnne’s leadership, we will maintain our Department-wide commitment to assure that all people live safely, with dignity and fullness of life.
I know you join me in thanking Kathy Leitch for her service as Assistant Secretary of ADSA since 2000 and recognizing her many accomplishments for our state. She has worked tirelessly on behalf of our aging and developmental disability communities her entire career. She is one of a handful of national experts in the field of caring for our elders and people with physical and mental disabilities in their own homes and communities. We are recognized nationally for how far ahead of the nation we are in our home- and community-based system of care in both our long-term care and developmental disabilities systems. Kathy has been courageous and steadfast in her efforts in advocating at the state and national levels to protect vulnerable citizens from abuse, neglect and financial exploitation. She has positioned us well as we now move forward to reform our health care delivery system and further our efforts to increase the capacities of our systems that provide critical services for our elders and persons with physical and developmental disabilities.
In the future, Kathy will be working with MaryAnne on our initiatives to improve the quality of our adult family homes and modernize our adult protective services system. Kathy will also continue her work as we strive to build capacity and improve the quality of care and services we provide to people with developmental disabilities.
MaryAnne, as Director of the Division of Health Care Services in the Medicaid Purchasing Administration, has brought strong, innovative leadership in creating a state chronic care management program founded on targeting resources where they can achieve the best results and on helping consumers manage their own health. MaryAnne is a champion for the health home concept and other programs that focus on improving access to quality, integrated and affordable health care and services for low-income and vulnerable populations.
Last year, she was one of six Medicaid directors chosen nationally to participate in the inaugural class of a Medicaid Leadership Institute. The Institute, launched by the Robert Wood Johnson Foundation and chaired by former Wisconsin Governor and former U.S. Secretary of Health and Human Services Tommy Thompson, is aimed at building leadership in the Medicaid system and helping the state-federal programs serve as national models for high-quality, cost-effective health care.
I look forward to her continued leadership in making sure we maximize all of the many opportunities national health care reform will bring us to further improve the lives of our citizens.
I know that MaryAnne is looking forward to meeting you and all of our many partners as we continue our work together in the future. We are in historic and unprecedented times. Now more than ever we need to be working together to leverage every possible resource so that we continue to move forward as a state that is committed to our most vulnerable citizens.
MaryAnne will begin as Assistant Secretary of ADSA on November 1. Please join me in welcoming MaryAnne to ADSA. I am confident she will do an excellent job for our State.
Susan N. Dreyfus, Secretary
Department of Social and Health Services
October 15, 2010

Health Care Reform/ Social Security

The Capitol Insider for the Week of October 18, 2010

Major Events Last Week

Health Care Reform

A federal judge in Florida issued a ruling allowing a lawsuit to go forward challenging the constitutionality of the Affordable Care Act (ACA). The lawsuit was filed by 20 states, led by Florida, against the federal government to halt implementation of the new law. The ruling outlines which issues the states will be allowed to proceed with in the case. While Judge Roger Vinson dismissed several issues, he will allow the states to proceed on the following issues: whether the law's individual mandate requiring people to buy health insurance exceeds Congress's constitutional authority and whether the law's expansion of Medicaid eligibility to additional low-income people violates state sovereignty because it will require states to spend billions more on the program. Also last week, in a suit brought by private parties in Michigan, another federal judge upheld Congressional authority to establish the individual mandate to purchase health insurance. In Virginia, a similar lawsuit is scheduled to begin oral arguments today. The Arc and United Cerebral palsy (UCP) participated in an amicus brief supporting the ACA in the Virginia case. The judge in the Florida case refused to accept amicus briefs. These lawsuits could take years to be decided with certain cases making their way to the Supreme Court.

Social Security/ Cost of Living Adjustments (COLAs)

On October 15, the Social Security Administration (SSA) announced that monthly Social Security and Supplemental Security Income (SSI) benefits will not automatically increase in 2011 because there was no increase in the Consumer Price Index from the third quarter of 2008 (the last year a COLA was determined) to the third quarter of 2010. This will be the second consecutive year without an automatic COLA. In the SSI program, the maximum federal payment for an individual will remain at $674 per month. For couples, the maximum federal payment will remain at $1,011 per month. SSI resource limits will remain at $2,000 for individuals and $3,000 for couples.

SSA announced that it will also not increase the 2011 substantial gainful activity (SGA) level used to determine disability. Therefore, the SGA level for people with disabilities will remain at $1,000 per month in 2011, while the SGA level for people who are blind will remain at $1,640 per month. Similarly, while last year SSA increased the amount of earnings required to earn quarters of coverage, or work credits (used to determine whether an individual has contributed enough to the Social Security system to be eligible for disability, retirement, and survivor benefits), SSA has indicated that the earnings needed to earn a quarter of coverage will not increase for 2011. For more information, see:
http://www.socialsecurity.gov/pressoffice/pr/2011cola-pr.htm

Social Security /One-time payment

Following the SSA’s announcement of a second year without a COLA for Social Security and SSI beneficiaries, Democratic leadership of the House and Senate and the White House have announced support for legislation to enact a one-time payment of $250 for beneficiaries. For the typical retiree with a benefit of nearly $1,200 per month ($14,000 per year), the $250 payment amounts to about a 1.7 percent annual increase. Beneficiaries with disabilities, particularly those who receive SSI benefits, typically receive lower benefits than retirees; therefore a $250 payment would equate to an even higher percentage increase for them. Representative Earl Pomeroy (D-ND) introduced legislation in July to provide a one-time $250 payment, at a cost of $14 billion. House Speaker Nancy Pelosi (D-CA) and Senate Majority Leader Harry Reid (D-NV) have indicated their intentions to have the House and Senate, respectively, vote on legislation to provide the $250 payment when the Congress returns for a lame duck session after the November elections. White House Press Secretary Robert Gibbs noted that President Obama will renew his call for a $250 Economic Recovery Payment to seniors this year, as well as to veterans and people with disabilities. He also urged "Members of Congress on both sides of the aisle to support our seniors, veterans and others with disabilities who depend on these benefits".