Stateside Report: April 12, 2021

Rights & Access

Georgia – (The Union-Recorder, 03/30/21) The Georgia General Assembly has unanimously supported “Gracie’s Law”, a bill that will protect organ access to Georgians with disabilities. The bill opens a pathway through local courts for families who believe a medical provider discriminated against their loved one with a disability in access to organ transplants.  The bill is named for two-year-old Gracie Joy Nobles who was born with Down Syndrome and a heart defect. Gracie’s mother Erin called the bill “lifesaving”. The Senate also added additional language to the bill that would require a medical provider to get permission from a minor’s parents before putting a “do not resuscitate” order on the patient’s records, also known as “Simon’s Law”.  Georgia is in good company with at least nine other states that are moving similar legislation this year alone.  Gracie’s mother was quoted, “We’re not fighting for our children to get priority on the list.  We’re fighting that our children can get on the list.”

New Jersey – (ROI-NJ.com, 04/08/21) Rutgers University has opened a building to better serve students with autism through vocational and recreational programs. The Rutgers Center for Adult Autism Services (RCAAS) is a first-of-its kind in higher education and cost $9.5 million financed through philanthropic funds. “The state-of-the-art building includes vocational, social and life skills teaching areas, individual and group training rooms, a professional kitchen, recreational and common spaces, offices and meeting rooms. The center more than doubles the capacity of programs to provide employment, job training, psychological assessment and other services to Rutgers students and adults with autism.”  Christopher Manente, executive director for RCAAS said, “There is no other university program as comprehensive and ambitious in terms of focusing on the success of adults on the spectrum in a multifaceted way.  We hope this community center will serve as a model for other institutions.”

West Virginia – (Curtesy of ANCOR’s subscription to Fiscal Note, 03/30/21) The West Virginia Legislature passed HB 2290 initiating a State Employment First Policy to facilitate integrated employment of disabled persons, and to establish a taskforce to develop the policy.  The findings directed that legislature, “to create a state initiative to promote competitive, integrated, and customized employment opportunities for disabled citizens using publicly funded services regardless of the individual’s level of disability. The state Employment First Policy initiative is intended to promote the expectation that individuals with intellectual, developmental, and other disabilities are valued members of the workforce, and can often meet the same employment standards, responsibilities, and expectations as other working-age adults when provided the proper education, reasonable accommodations, and supports.”

Medicaid, Medicaid expansion, MLTSS

Michigan & Wisconsin, (PEW Stateline, 04/07/21) The Biden administration has rescinded the authority for Michigan and Wisconsin to require Medicaid beneficiaries to work in order to maintain eligibility for benefits.  Under President Trump, CMS gave similar authority to twelve states which was met with significant push-back from advocates and attorneys alike.  In 2019, federal judges halted the initiative in district courts in Arkansas, Kentucky, and New Hampshire. Other states that received clearance to implement similar programs have not enforced the requirements because of the federal court’s rulings. Meanwhile, Arkansas is asking the U.S. Supreme Court to reverse the lower court’s ruling, but the court could decide the issue is “moot” now because of the administration’s objections.  In CMS’ letter to Michigan and Wisconsin, they said the work requirements “were not consistent with the objectives of Medicaid to provide medical care to the nation’s most vulnerable and low-income populations, particularly during a pandemic when job losses have been high.”

Ohio – (Springfield News-Sun, 04/09/21) Ohio has selected six insurance companies to manage the more than $20 billion Medicaid program.  The new bids were awarded as the state is overhauling how the program operates.  By rebidding the contracts, the state will update the conditions for the payers to receive and spend Medicaid funds and it gives the state the opportunity to select which insures it trusts to meet their goals. 

Oklahoma – (Oklahoma News 4, 04/08/21) In an effort to sideline Gov. Stitt’s managed Medicaid program, one local lawmaker has introduced a bill that would create an “internal managed care system” for Medicaid rather than outsourcing to a third party. Rep. Marcus McEntire’s bill would have the Oklahoma Health Care Authority reform to manage Medicaid with the goal of controlling costs and improving health outcomes.  However, the Oklahoma Health Care Authority is aligned with the Governor’s plan.  In a statement, Kevin Corbett, CEO of the Health Care Authority said their view is that the “…superior alternative is to join with third-party managed care organizations” (the Governor’s plan is calling for four entities).  Corbett went on to say, “It has a significant amount of risk because of standing up and building a new organization internally certainly has a cost element to it.”  In a statement by Stitt the governor said, “It is irresponsible to use hundreds of millions of taxpayer dollars to require a state agency to create a program that already exists and is successfully implemented in 40 other states.”

State Budget

Colorado – (CPR News, 04/07/21) After months of negotiations and public hearings, the Colorado Joint Budget Committee introduced its agreed-upon plan for the next fiscal year to the full Senate.  The $12 billion budget represents an 11% increase over current spending, is described as “historic”, and takes steps to shrink the waiting list for services for people with developmental disabilities.  State Senator Bob Rankin said the proposal “…creates 520 slots. That’s good news. We think we have as many as 3,000 people waiting for services. So, it’s a great start.”

Illinois – (Chicago Sun Times, 04/02/21) As Illinois is ranked 47^th among states for their funding of community-based services, has a waiting list for services of approximately 18,000 people, and as a federal judge found the state in violation of their 2011 consent decree mandating dramatic increases to pay for needed services, a new campaign has been launched by community-based non-profit organizations asking legislators to fully fund a new rate structure.  Advocates say this will allow them to provide “consistent, quality care” for those they serve. ANCOR member and CEO of the Illinois Association of Rehabilitation Facilities, Josh Evans, said his members “feel an obligation to make the legislature and the public aware of their funding needs, especially as the state begins to carve up any expected federal COVID-19 relief money”.  The proposal is the result of two years of planning. A key cost driver in the plan comes from a call to set the state’s wage-rate (what the state pays to fund employee wages) for employees in residential programs at 150% of the state’s minimum wage (currently at $11.00 per hour) with a 15% increase for those in the Chicago area.  In Evan’s statement he said, “…his members appreciate Gov. J.B. Pritzker’s administration’s efforts to provide more money in recent years, but it has barely allowed them to keep pace with the new minimum-wage requirements”.  Pritzker’s budget for next year included a $77 million increase to partially fund some of the study’s recommendations. But Evans said, “…it would take $329 million to do the job right plus $100 million over each of the next four years.”