ADAPT's Call to Action for Home and Community in America

Common People Holding Our Government Accountable for Enforcing Our Rights

Sunday, March 28, 2010

Illinois Battles Managed Care Situation

Illinois lawmakers want to introduce managed care as a cost savings solution. Disability advocates are up in arms. Check out this blog post by Springfield advocate Tyler McHaley:

...The impetus behind this entire post, though, was Access Living's March 19 public forum on managed care, entitled "Managed Care, Managed Lives." Jennifer Thomas, the Personal Assistant Coordinator for Access, put together the event and did a masterful job. She and Tom Wilson, Access' Personal Assistant and Health Care Reform Team Leader, facilitated the forum as well as discussions on a myriad of topics, including the Division of Rehabilitation Services' Home Services Program (HSP), education, the managed care pilot program developed by the Department of Health Care and Family Services (HFS), and the Governor's proposed state budget in its totality.

There was a good crowd of, approximately, 50 people there to take part in the forum. Many who came to the meeting knew the state had many problems with its budget and its ability to manage money, but I suspect they did not realize how deeply the roots of those problems burrowed their way into every layer of the state's fiscal foundation, especially relating to social services. The job of those of us addressing the group that day was to inform and educate grassroots advocates about the problems facing those services particularly geared toward people with disabilities. This was not an easy task, as this is a difficult topic to discuss with people charged to implement policies with which we disagree. If those familiar with the problems as well as the proposed solutions have trouble giving informed answers to relatively simple questions, how is the average citizen supposed to understand all the nuances of pension reform, surcharge taxes for education only, and cuts to social service programs, which are cleverly disguised as "savings?"

For more, see:

Saturday, March 27, 2010

Illinois Cuts $90 Million in Community Services and Supports for Mental Health

March 27, 2010

About 70,000 adults and children in Illinois would lose access to state-funded mental health services and another 4,000 would be displaced from community-based housing under Gov. Quinn's proposed budget, advocates for the mentally ill warned Friday.

More than $90 million in proposed cuts to the Department of Human Services would also leave the state without the infrastructure needed to start moving psychiatric patients from nursing homes to community housing, as agreed to in a recent legal settlement, mental health advocates say.

For more, see,CST-NWS-mental27x.article.

Tuesday, March 16, 2010

No Matter What You Call it…It’s Still a Cap!

From Anita Cameron:

Disabled Activists Travel to Albany to Protest Proposed Budget Cap on Personal Care

38 activists from the Center for Disability Rights joined over 50 other people with disabilities from around the state, converging on Albany on Wednesday, March 10, 2010, to protest Governor Paterson’s proposed budget caps on personal care for people needing more than 12 hours of care per day.

Upon arrival, we broke up into teams of 10 – 15 people and visited the office of every member of the state legislature. Decked out in bright orange t-shirts and baseball caps that read, “No Matter What You Call it…It’s Still a Cap”, we were very noticeable as we scoured the Legislative Office Building. Armed with fliers and baseball caps, our members spoke to staffers and sometimes, the legislators, themselves, putting a human face on the issue by telling how these caps on personal care will send us into costly institutions. At the end of each visit, the legislator, or their staff were presented with a beautiful pledge sheet that they were asked to sign. It stated that the legislator would pledge to reject the Governor’s budget cuts to personal care. While most expressed support, three legislators – Senator Bonacic, Senator Huntley, and Assembly Member Towns signed the pledge on the spot. The rest will need follow up back home in their districts.

Each office was also left a bright orange baseball cap with our message on it, so that they would not forget why we were there.

After our visits, we gathered for our traditional lunch from McDonald’s, then headed upstairs to the Senate Chambers, where state senators were preparing to enter into a session to address the budget. The time had come for the senators to get a real lesson on how the caps would affect our community!

Activists formed a gauntlet down the hall and the entrance leading to the Senate Chambers. Huge banners mysteriously appeared, made from shower curtains reading, “Personal Care Is a Civil Right”, “Care, NOT Caps”, “Don’t CAP My Freedom”, among others. At the end of the hall was a banner cut to resemble a jail, with the words, “Nursing Facility” at the top. This banner would figure prominently in what happened next.

Loud chanting that reverberated throughout the entire floor greeted senators and their staffers as they entered the chambers. “No Cuts, No Caps!’ we chanted as we handed out fliers and baseball caps. “No Matter What You Call it…It’s Still a Cap!” filled the ears of the senators as they began their session. At times, an announcement would ring out, “Let us show you what we mean”, and people with disabilities would line up before three individuals with placards with the acronym for three different programs that the state is suggesting that they go to once their services are capped. These programs, Long Term Home Health Care Program (LTHHCP, also known as Lombardi), Managed Long Term Care plans (MLTC), and Nursing Home Transition and Diversion waiver (NHTD) have built-in hourly caps or, due to administrative constraints, are inappropriate for those needing more than twelve hours of care per day.

As each advocate went before the person with the placards and asked for service, they were told, “Sorry, you’re capped” or “Denied!” and sent to the next person with a placard until they were directed to the nursing facility “jail” at the end of the line. After several rounds of this theatre, a gentleman in a business suit (he looked like a legislator, but was actually the Executive Director of Action Toward Independence in Middletown) approached the nursing facility “jail”, signed our Pledge, signifying that the legislature had rejected the budget cap on personal care, and freed the captive activists.

Toward the end of the day, after the senators had been in session for some time, the Sergeant-at-Arms came out to ask that we stop the chanting or he would have to have us removed. He said that we could continue to pass out fliers and hats, so we agreed to his request. In an interesting turn of events, word reached us that some of the senators were asking if we had any more of our caps to hand out. It appeared that at least some of them had gotten our message: No Matter What You Call it…It’s Still a Cap!

Monday, March 15, 2010

Advocates Stake White Crosses For Those Who Have Died Waiting For Services

(Lawrence Journal-World)
March 10, 2010

TOPEKA, KANSAS-- [Excerpt] Advocates for Kansans with disabilities on Tuesday stood at the entrance of the parking garage at the Capitol handing out information to legislators about budget cuts to social services.

The advocates, some dressed as the Grim Reaper, had set up white crosses to represent Kansans who they believe have died while on a waiting list for state services.

“We’re sending a message to legislators that people are in crisis,” said Greg Jones, an advocate from Parsons.

More than 1,800 people with physical disabilities are on a waiting list for home- and community-based services. The program is designed to help keep people out of more expensive nursing home care and provide a more independent quality of life.

The State Independent Living Council said 58 people have died while on the waiting list.

Entire article:
Advocates for disabled urging Legislature to restore cuts

Group urges disability funding (Topeka Capital-Journal)

Kansas priorities: Liquor industry first, disabled citizens last (Kansas City Star)

Monday, March 8, 2010

Activist Reports From New York State

New York State Budget Cuts Town Hall

Today, Gov. Paterson from New York held a Town Hall meeting in Brooklyn which I attended. Despite the room being filled with folks with many questions, I was able to get recognized by the moderator. As a response to the fiscal problems in New York State, the Department of Health is proposing a cap on community-based services which will have the effect of pushing people into nursing homes. I explained to the governor that 11 years ago I attended the arguments to the Olmstead case before the US Supreme Court and that this was really a matter of civil rights or people with disabilities.

Below is a link to the video of the entire event. If someone can download the entire clip you can extract my question and his response, which occurs approximately 70% into the event.
T.K. Small

Tennesseans Sue State Over Budget Cuts
2 sue over health cuts
They want state to pay for home treatment
By Clay Carey • THE TENNESSEAN • March 5, 2010

Two Tennessee men with severe disabilities have sued the state's TennCare program over cuts in home health care that could force them into nursing homes.

Justin Cochran, 27, and Glen Barnhill, 49, say in the federal lawsuit that the state violated the Americans with Disabilities act by cutting off their access to home-based nursing.

Both men are seeking a court order requiring the state to pay for them to get treatment at home, not in a nursing home.

This year, TennCare is launching a new program called CHOICES designed to give people the opportunity to get long-term care in their homes rather than in a nursing home. But to qualify, the cost of home care can't be more than the cost of a nursing home, TennCare spokeswoman Kelly Gunderson said.


Advocacy group warns that TennCare cuts would lead to more hospitalizations

TennCare cuts won't be quite so deep after break from feds

According to their lawsuit, filed last week in U.S. District Court, the state contends it is less costly to provide Cochran and Barnhill daily, around-the-clock care in nursing homes, so TennCare would not cover the cost of their in-home care.

"For both of them, it would be an extraordinary loss of independence," said Katie Evans, an attorney representing Cochran and Barnhill. She said both men are able to live in their homes, with the help of caregivers.

"It would be extremely damaging to their mental health as well as their physical health if they were to be forced into a nursing home," Evans said.

Gunderson and a spokeswoman for the Tennessee Attorney General's office, which represents the state in court, declined to comment on the lawsuit Tuesday.

Cochran, who lives in a Knoxville apartment, has exhausted his administrative appeals, the lawsuit says. Five years ago he suffered a spinal injury that left him partially quadriplegic and dependant upon a ventilator.

Barnhill, who was left partially quadriplegic after a shooting in 1994, is awaiting an administrative hearing. He is getting treatment at Vanderbilt University Medical Center. Before his hospitalization, he lived independently, with help from caregivers paid by TennCare.

According to court documents, Barnhill told a clinical psychologist that he had a bad experience in a nursing home before, and he fears he would die if he were to be placed in a nursing home again.

Contact Clay Carey at 615-726-5933 or

Take Five! ADAPT Steps It Up! Contact CongressWOMEN!

As we Defend Our Freedom at the state level and call on the administration to enforce our rights established by the Supreme Court's Olmstead decision, we can't let Congress off the hook. After all, Congress has the power to end the institutional bias by passing the Community Choice Act (S683/HR1670). So how are we going to step it up? We're going to take on FIVE of them at a time, together!

Right now, we have 121 co-sponsors in the House (at least until Eric Massa's resignation takes effect) and 25 co-sponsors in the Senate. About one-quarter of each house has signed on as a co-sponsor of the CCA!

The number of people signing on slowed down a bit while we focused on health care reform legislation, so we are changing our approach. Instead of asking everyone to contact their local Representatives or Senators, ADAPT's Community Choice Workgroup is identifying FIVE specific members of Congress that we will ask everyone across the country to work on. We will do electronic action alerts that allow us to fax and email the DC office, encourage local people to call the office, and coordinate visits in the DC offices.

It's really important that we all reach out to local folks as well. Our elected officials do pay closer attention to the people who elect them. After doing an alert, everyone should try to identify people and groups we know are in the Representative's district (or at least close). These may be family, friends, or that friend from high school long ago that you now have a reason to call or email.

When we release new targets, we will offer talking points that can be used.

It can be really frustrating if you think you're the only one making calls and contacts. You don't know what other people have been told. When a staff person says, no one else has asked about this, you don't know what to say. ADAPT, as part of the Coalition for Community Integration, has set up a website,> , where we can post information about our legislative advocacy and visits. This will allow everyone to share specific information about their work. Also members of the Coalition are regularly in Washington, DC and set up appointments in the DC offices. The DC advocates can take the information you have shared online to those appointments and report back to you online about what they heard.

Take Five's First Round: IT'S TIME TO FREE OUR SISTERS!

In recognition that we are starting this effort on International Women's Day, we have identified five Congresswomen who we want to sign on as co-sponsors of the Community Choice Act (S683/HR1670). All have been previous co-sponsors of the legislation, but haven't signed on yet.

Judy Biggert, IL-13: Her district includes the cities of Naperville, Downers Grove, and Bolingbrook.

Nita Lowey, NY-18: Her district is in southeastern corner of New York State, just north of the Bronx, and includes parts of Westchester and Rockland Counties.

Carolyn McCarthy, NY-4: Her district is located in central Long Island in west-central Nassau County and includes Mineola, the Five Towns, East Rockaway, Rockville Centre, Oceanside, Garden City, Hempstead, Uniondale, East Meadow, Roosevelt, Franklin Square, Valley Stream, and Elmont.

Gwen Moore, WI-4: The Congresswoman is the first woman to represent the district which is based in Milwaukee and also includes South Milwaukee, Cudahy and St. Francis, and part of West Allis.

Loretta Sanchez, CA-47: California's 47th congressional district covers the cities of Garden Grove and Santa Ana and parts of Fullerton and Anaheim, in Orange County. The 47th congressional district is one of the few districts in California that does not have an overwhelming majority of voters favoring one party.


START by doing this electronic Action Alert:>

After you do the alert, forward it out to other folks, particularly people and organizations from the districts these Congresswomen represent. Consider sending it out to women's groups! FREE OUR SISTERS!

Some Talking Points: The Institutional Bias is a women's issue!

According to the most recent data on the CMS website, 68.4% of nursing facility residents are women.

Women typically live longer than men and, if married, tend to outlive their husbands. As they grow older, women are more likely than men to live alone, without a spouse or other family member to provide assistance. In fact, by the time a woman reaches the age of 75, the chances that she is living with a spouse have dropped below one in three.

Women are more likely to need assistance than men of the same age. Among people age 75 or older, women are 60 percent more likely than men to need help with one or more activities of daily living, such as eating, bathing, dressing, or getting around inside the home. One in nine women age 75 or older, and one in five age 85 or older, needs assistance with daily activities.

Women are 60 percent more likely than men to go into a nursing facility at some point in their lives.

According to a 2003 National Alliance for Caregiving/AARP survey, six out of ten informal caregivers were women. Among caregivers providing high levels of care, the proportion of women was even greater.

The 2003 survey reported that the "typical" caregiver is a 46-year-old woman, who has some college education, works, and spends more than 20 hours per week providing care to her mother.

More than 60 percent of female caregivers who were employed had to make sacrifices at work to accommodate caregiving, including going in late or leaving early, working fewer hours, turning down a promotion, losing some benefits, taking a leave of absence, or choosing early retirement or giving up working entirely.

Sunday, March 7, 2010

Obama Administration Joins Suit Against In-Home Care Cuts
The Obama administration has filed an amicus brief supporting a lawsuit against a state plan to cut or reduce subsidized in-home care to 130,000 seniors and disabled people in California.

Attorneys with the U.S. Justice Department's civil rights division filed the brief Tuesday in the U.S. Court of Appeal for the Ninth District.

An injunction in a lower federal court stopped the state with going forward with its plan pending the outcome of a suit filed by Disabled Rights California, the National Senior Citizens Law Center and others.

The Schwarzenegger administration appealed, saying officials had a right to reform the In-Home Supportive Services program.

The changes were intended to save the state budget $82.1 million this fiscal year by cutting services to certain people based on an index measuring their mental and physical abilities.

Disabled-rights attorneys argued that the index's purpose is to determine what kind of care the disabled require, not whether they could function in their homes without help. Cutting some people off based on scores, they said, would put people's health and safety at risk and could lead to putting them in an institution.

The U.S. Justice Department brief says: "The United States has a direct and substantial interest in this appeal, which involves the proper interpretation and application of Title II of the Americans with Disabilities Act."

The act, it says, "prohibits discrimination against individuals with disabilities in the provision of public services."
In-home care is financed by federal, state and county dollars with some contributions from individuals who get care.

DOF Gains Momentum in Texas: ADAPT Nation Wants Community Choice

For Immediate Release:
March 8, 2010
For Information Contact:
Jennifer McPhail (512) 627-5869
Danny Saenz (512) 971-5311

ADAPT's Defending Our Freedom Campaign Gains Momentum in Austin, Texas:
Local Communities Follow National Lead and Call for Community Choice

Austin, TX---Texas Independence Day Resolutions in support of the Community Choice Act and the "most integrated setting" mandate contained in the ADA were proposed on March 2 in several precinct caucuses. Introduction of these resolutions is especially important as they come on the heels of the passage of a Democratic National Committee resolution in support of community services.

"Barbara Jordan once gave a keynote address at the Democratic National Convention," said Jennifer McPhail, ADAPT organizer from Austin, Texas. "In that address she said of the Democratic Party, "We believe in equality for all and privileges for none. This is a belief-- this is a belief that each American, regardless of background, has equal standing in the public forum -- all of us. Because we believe this idea so firmly, we are an inclusive rather than an exclusive party. Let everybody come." So, the passage of these resolutions will make Barbara Jordan's declaration a reality for all of us who use community services in Travis County," emphasized McPhail.

Danny Saenz, another Austin organizer for ADAPT, added "I was inspired by President Obama's acceptance speech, particularly when he said, "I say to the people of America, to Democrats and Republicans and Independents across this great land: "Enough!" Well, I too, say enough - enough of the institutional bias! Pass the Community Choice Act now!"

The resolutions in support of the Community Choice Act and affirming the ADA's most integrated setting provision will be considered by members of the Travis County Delegation on March 20, 2010. If the resolutions are passed by the Travis County Delegation, they move on to the Texas Democratic Party Convention June 25-26, 2010. Local communities and political organizations across the country are encouraged to follow Austin's lead. For more information on the Defending Our Freedom campaign go to

42 Governors Ask Congress for Extension on Medicaid Funds

Out of Connecticut:

Congress urged to extend Medicaid
Published: Sunday, March 7, 2010

Social services providers, researchers and state legislators Friday urged Congress to pass a pending jobs bill that would extend the provision of federal funds supporting Medicaid.

Gov. M. Jodi Rell and 41 other governors have already sent a letter to Congress requesting an extension, and various groups held a teleconference Friday echoing those sentiments.

Ron Cretaro, executive director of the Connecticut Association of Nonprofits of Hartford, said his organization represents more than 500 nonprofits in the state.

More than 300 of them hold human services contracts with government agencies, which makes those agreements vulnerable to state budget cuts.

James Horan, executive director of the Connecticut Association of Human Services in Hartford, said failing to extend federal Medicaid assistance would hurt both low-income families and the state economy.

For more, see:

Saturday, March 6, 2010

Illinois Budget Crisis Forces Jails to Serve as Mental Health Facilities

Budget crisis keeps inmates from needed mental help

By Edith Brady-Lunny
Posted: Friday, March 5, 2010 7:00 am

BLOOMINGTON -- A 20-year-old man was deemed unfit to stand trial on aggravated battery charges on Jan. 22, a finding that should have triggered his transfer to Springfield's McFarland Mental Health Center for services that would restore him to fitness.

But he and three other inmates found similarly unfit remain in the McLean County jail, the victims of a state budget crisis that has reduced services at the state mental health facility.

McLean County Sheriff Mike Emery said the four men are among a dozen inmates currently requiring special housing arrangements due to mental health issues. The jail, said Emery, "is serving as a small mental health clinic."

For more, see

No Medicaid Cuts in Oklahoma...For Now

Gov. Brad Henry OKs bills to put budget deal into action
Funds to prevent trooper furloughs, reverse medicaid provider rate cuts
Published: March 6, 2010

Gov. Brad Henry quietly signed bills Friday that complete a budget agreement that takes care of a nearly $300 million projected deficit at the end of this fiscal year. The bills’ approval provides emergency funds to head off trooper furloughs and reverse recently announced Medicaid provider rate cuts of 3.5 percent.

Bills signed Friday by the governor included emergency funding for several agencies:

• Corrections: $7.2 million
• Public safety: $3 million
• Public schools: $54.4 million
• Higher education: $25.6 million
• Health Care Authority: $33 million
• House Bill 1017 Education Fund: $50 million
• Rehabilitative Services Department: $1.2 million
• Central Services Department: $700,000 (to replace boilers in the Will Rogers and Sequoyah office buildings)

The governor signed 20 bills that implement the agreement through appropriations and funding transfers.

The budget agreement calls for spending $223.5 million of the state’s savings account — the Rainy Day Fund — and using $181 million of about $696 million in available federal stimulus funds to close out the 2010 fiscal year, which ends June 30.

Read more:

Looking for the Money: Severe Cuts to Medicaid in Idaho

Idaho lawmakers approve budget cuts for Medicaid
Brian Murphy - Idaho Statesman
Published: 03/04/10

Richard Armstrong, Director of the Idaho Department of Health and Welfare, speaks with reporters following the JFAC budget setting Thursday morning at the Idaho Legislature. Armstrong has some concerns with the language in the budget, which includes a severe cut to Medicaid.

Idaho legislative budget writers approved a Medicaid budget Thursday morning that forces the Department of Health and Welfare to finding savings of more than $47 million in the program and gives Gov. Butch Otter the authority to modify state statutes to keep the program in check.

The entire Medicaid budget is $1.55 billion dollars, with $298 million coming from the General Fund. More than $1.5 billion of the budget comes from the federal government.

Lawmakers expect $25 million to come from the Hospital Assessment Act, a bill that has yet to be introduced this session. Hospitals will pay the state in order to continue to keep its federal match.

That still leaves more than $22 million in savings for the department to find.

For more, see

State Budget Cuts and How They Lead to Managed Care: Update from Illinois

An update on the managed care struggle in Illinois, from advocate Tyler McHaley:

Kill Bill, Vol. III

An interesting thing happened on the way to the Medicaid Reform Committee hearing yesterday. I was prepared to testify on behalf of HB 5113, a bill sponsored by Representative Mary Flowers, which would prohibit any state agency, including HFS, DHS, and the Department of Aging from using managed care providers or HMOs to pay for medical care for people receiving Social Security or benefits under other federal waivers. That may sound complicated, but it really is intended to kill the entire managed care pilot project proposed recently by HFS.

It was only after I realized I was at the wrong hearing room that I ran into Representative Chapa LaVIa. It was a fortuitous meeting, as she then told me the current state of her bill, HB 5086, which was heard in the Medicaid Reform Committee last week. Though it passed with only the requirement of some amendments being attached, she informed me the bill was going nowhere. She said the people in the Governor's Office had told her they were not going to work with her legislation. She felt her bill was likely dead even with passage from the committee. Therefore, she told me that she and, presumably, her cosponsors were rallying behind Representative Flowers' bill. Moreover, she wanted disability rights advocates to stand behind that bill as well. Her reasoning was simple inasmuch as she thought that if her idea for a task force to oversee the pilot project was a nonstarter, it was best to ensure the pilot project never had a chance to take root.

For more, see

Thursday, March 4, 2010

More from California

Mar 04, 2010

The San Francisco Chronicle: "A federal appeals court barred California on Wednesday from lowering Medi-Cal payments to doctors and hospitals by 5 percent and from cutting in-home care workers' wages by nearly 20 percent, saying the state's budget crisis doesn't justify violating federal laws that protect the poor and disabled. In four rulings, the Ninth U.S. Circuit Court of Appeals in San Francisco rejected attempts by Gov. Arnold Schwarzenegger and the Legislature to reduce the state's deficit by paying less to the health professionals who treat 6.6 million low-income Californians, and to hundreds of thousands of workers who care for some of the neediest."

The appellate court said federal law requires "states to maintain poor residents' equal access to basic health care, and forbids cuts intended solely to save money" (Egelko, 3/4).

The Associated Press/Mercury News: State officials said they would appeal the decision. "'We strongly disagree with the court's decision, which interferes with the state's ability to manage its finances and reduce its spending to match its revenue,' Schwarzenegger spokeswoman Rachel Arrezola said. 'We are confident that the U.S. Supreme Court will overrule the 9th circuit's ruling.' Wednesday's decision does not affect California's $20 billion deficit because finance officials did not count on the savings in the governor's January budget, said H.D. Palmer, Schwarzenegger's finance spokesman" (Lin, 3/3).

The Sacramento Bee: "The Ninth Circuit agreed with lower court decisions that granted preliminary injunctions against the cuts because California did not comply with the federal Medicaid Act. The cuts were contained in budget agreements over the past two years. The court decisions not only have blocked past budget cuts, but they could also preclude the state from pursuing similar ways of solving its current $19.9 billion budget deficit. … The court previously determined that under the Medicaid Act the state Department of Health Care Services must set rates 'that bear a reasonable relationship to efficient and economical hospitals' costs of providing quality services, unless the Department shows some justification for rates that substantially deviate from such costs.'" (Yamamura, 3/3)

The Bee, in an earlier story:"A state appellate court ruled Tuesday that Gov. Arnold Schwarzenegger's line-item vetoes last year reducing funding for several programs were constitutional, rejecting a challenge from various social service advocates, unions and Democratic legislative leaders. In a 3-0 decision, Justice J. Anthony Kline wrote that the challenge failed to show that Schwarzenegger had overstepped his executive authority in further reducing expenditures during last July's budget revision. The case, St. John's Well Child and Family Center v. Schwarzenegger, called into question seven line-item vetoes worth $288 million, cutting programs ranging from the Office of AIDS to Healthy Families" (Yamamura, 3/2).

Texas Man Obtains Injunction Against State Budget Cuts

Texas Man With Special Needs Obtains Injunction Allowing In-Home Care to Continue
Last Updated: 2/22/2010
A U.S. district court grants a Texas Medicaid recipient with severe developmental disabilities' request for a a permanent injunction barring the state from terminating his community-based waiver services after experts testified that placing him in a state home would kill him. Knowles v. Horn (N.D. Tex., No. 3:08-CV-1492-K, Feb. 10, 2010).
Ryan Knowles, a 26-year-old man with severe developmental disabilities, received round-the-clock care in his home under a Texas Medicaid waiver program administered by the Department of Aging and Disability Services (DADS). Because the cost of Mr. Knowles's care exceeded his individual cost limit under the waiver program, DADS attempted to place him in a state school. The U.S. District Court for the Northern District of Texas granted a temporary injunction preventing the state from cutting off his benefits and moving him to a school.
In the meantime, the state passed a rider to the DADS budget allowing DADS to continue funding a Medicaid waiver recipient's costly in-home care if there is no other living arrangement that would protect the recipient's health and safety. DADS refused to reevaluate Mr. Knowles, claiming that he could be treated in a state school. Mr. Knowles moved for a permanent injunction. In support of his motion, Mr. Knowles presented evidence that DADS gave the supposedly appropriate state school a rating of 22 out of 100, and he also introduced testimony from his treating physicians that Mr. Knowles would die if he were moved to the state school.
The same U.S. district court grants Mr. Knowles's motion, finding that "no harm could be more irreparable, and no remedy at law can adequately address the harm" Mr. Knowles faces if institutionalized. "Thus, despite Defendants' legitimate concerns over fiscal restraint, the balance of harms tilts decidedly toward Plaintiff."
For the full text of this decision, go to:

Maine Restores $37 Million in Community Based Services Funds

Revised Maine budget unveiled, some cuts restored


Maine Gov. John Baldacci presented a state budget rewrite Wednesday that reflects a slightly improved economy and restores some services he previously proposed cutting, most notably in social services and schools.

The restorations reflect $51 million in upgraded revenue projections and nearly $28 million in additional Medicaid funding from the federal government. Thanks to those funding boosts, Maine's revenue shortfall was lowered last week from $438 million to $360 million less than halfway through the two-year budget cycle.

Baldacci, who outlined his proposals at a news briefing in his office, did not rule out further changes in the weeks left before lawmakers adjourn, saying the economy -- which drives the state budget -- remains unpredictable.

"Despite today's good news, we know the economy is fragile and our economy is far from certain," the governor said.

The largest piece of the funding restoration -- $37 million -- is targeted for services including support for nursing homes, assisted living facilities, services for the disabled, home-based care and mental health crisis intervention. The restored funding represents more than half of the human services cuts that had been proposed by the governor in December.

For more, see

California Court Says No to Reduced Home Care Worker Wages

Court rules against Calif. social, medical cuts
By JUDY LIN Associated Press Writer
Posted: 03/03/2010 04:32:04 PM PST
Updated: 03/03/2010 06:09:16 PM PST

SACRAMENTO, Calif.—Gov. Arnold Schwarzenegger and state lawmakers will have to find more ways to trim spending after an appeals court on Wednesday shot down two budget cuts made in recent years.

In separate cases before the 9th U.S. Circuit Court of Appeals, two judges ruled against the state's plans to cut spending in certain social and health care programs.

One was to reduce the state's contribution to the wages of home care workers by $2 an hour, from a maximum of $12.10 an hour to $10.10. The other was to cut Medicaid payments by 5 percent to pharmacists, hospitals and adult day care providers.

Finance Department officials estimated the state could be saving $79 million in the current fiscal year through June from reduced home care worker wages. At the same time, the state could be saving another $117 million from reduced Medicaid provider payments. California calls its Medicaid program, Medi-Cal.

Union representatives and home care workers said Wednesday's rulings help protect the state's most vulnerable. The groups argued that the state made cuts without studying the impact on the quality of care.

For more, see

South Carolina, Oklahoma, Arkansas Medicaid Cuts

From Kaiser Daily Health News (sent by Marsha Katz)

South Carolina, Oklahoma and Arkansas Grapple With Medicaid Cuts To Help Balance Budget

[Mar 03, 2010]

States consider major cuts to Medicaid services and reimbursement rates to help fill gaps in the budget.

The Associated Press: "Lawmakers are considering cutting all services for nearly 26,000 people with disabilities as South Carolina tries to plug a $560 million budget hole. Parents say the proposed cuts to day care programs and other services would force them to give up much-needed jobs to stay home and care for their young and adult children." But "[l]awmakers say they have little choice. They are trying to close a shortfall in next year's budget in a heavily Republican state where tax increases are not considered a viable option" (Davenport, 3/3).

McKnight's Long-Term Care News: "Starting April 1, the Oklahoma Health Care Authority is reducing Medicaid reimbursements to nursing homes by 3.25%. While the reduction is expected to save the Medicaid agency $5 million, it also will result in the loss of $15 million in federal matching dollars, according to a Tulsa World report. Long-term care and other healthcare providers that serve Medicaid patients will face the same payment cut" (3/1).

Arkansas News: "Suggestions received by the state on how to reduce future Medicaid costs by up to $400 million are being placed on the Internet for public viewing, and the state Medicaid director said today he hopes to finalize a recommendation to the governor this spring. Everything from cuts to Medicaid providers to charging Medicaid recipients additional co-payments is being considered, said Gene Gessow, director of the Division of Medical Services for the state Department of Human Services" (Moritz, 3/2).