Study: Medicaid block grants would save feds $150 billion

A Republican proposal to fund Medicaid through block grants could save the federal government more than $100 billion over five years, according to a new analysis released Monday.

The analysis from healthcare firm Avalere Health shows that if Medicaid were funded through block grants instead of through the open-ended commitment the program receives now, the federal government would save $150 billion by 2022.

Similarly, shifting to per capita caps, in which states would receive a set amount of money per beneficiary, would save $110 billion over five years.

“Medicaid block grants and per capita caps serve as vehicles to control federal spending on the program and put more of the decision-making on things like covered services and program eligibility in the hands of the states,” said Avalere president Dan Mendelson.Congressional Republicans argue that changing Medicaid’s funding mechanism would give states more control over their programs. Democrats say that beneficiaries would face slashed benefits under either proposal, while states would face more costs.

According to the study, only one state – North Dakota — would see increased funding under the block grant model.

The remaining states and Washington, D.C. would face a reduction in federal funding.

Through per capita funding, 26 states and D.C. would see decreases in federal funding while 24 would get an increase.

The proposals are also opposed by AARP.

“AARP opposes Medicaid block grants and per capita caps because we are concerned that such proposals will endanger the health, safety, and care of millions of individuals who depend on the essential services provided through Medicaid,” Joyce Rogers, AARP’s senior vice president for government affairs, wrote in a letter to lawmakers last week.

With Talk Of Medicaid Changes, Waiver Services May Be At Risk

by Michelle Diament | DisabilityScoop – February 2, 2017
A staffer at a New Jersey group home lifts a resident from her bed

A staffer at a New Jersey group home lifts a resident from her bed. Long-term services and supports for those with developmental disabilities could see big changes if Medicaid is converted to a block grant system, advocates say. (Tyson Trish/The Record/TNS)

The Trump administration is planning to fundamentally alter Medicaid, a move that could mean big changes to everything from health care to home and community-based services waivers for people with developmental disabilities.

President Donald Trump and his top advisors have indicated that they support moving to a block grant system for Medicaid. Though details are scant, such a shift may mean significantly less funding for Medicaid and greater control at the state level.

Currently, Medicaid programs are administered by the states, but they must meet certain federal requirements. In exchange, states receive matching grants from Uncle Sam, with no set cap.

Under a block grant system, however, states would likely get a finite amount of federal dollars for their Medicaid programs and more autonomy to set rules affecting everything from eligibility to coverage.

The prospect of such a dramatic shift has disability advocates bracing.

“We are very, very concerned,” said Marty Ford, senior executive officer for public policy at The Arc.

Individuals with developmental disabilities depend on Medicaid for everything from medical services to critical supports to help them live in the community.

Ford said that shifting to block grants could lead to eligibility changes, coverage cutbacks and longer waiting lists for Medicaid home and community-based services waivers, among other consequences.

“The reality is, this would be done to cut federal funding,” she said. “States generally do not have the ability to run a deficit under their constitutions so that puts more pressure on making cuts to the program.”

Republicans have yet to release any details about how exactly a block grant system might work. But Kellyanne Conway, Trump’s counselor, recently confirmed in an interview with NBC’s “Sunday Today” that block grants will be a key piece of the president’s effort to replace the Affordable Care Act.

Moving to a block grant approach would ensure that “those who are closest to the people in need will be administering it,” Conway said, adding that this change would “cut out the fraud, waste and abuse.”

Talk in Washington of such sweeping change to Medicaid is leaving providers of home and community-based services across the nation nervous, according to Gabrielle Sedor, chief operations officer at the American Network of Community Options and Resources, which represents more than 1,000 organizations providing services to people with disabilities.

“We’re hearing a lot of apprehension because (providers) don’t know what to expect and they don’t know what the administration intends,” Sedor said. “With intellectual and developmental disability services, it’s almost completely funded by Medicaid, so when you talk about changes, the impact is very direct.”

The prospect of drastically altering Medicaid comes as the program is strained, with waiting lists in most states for waivers and providers struggling with high staff turnover. A block grant approach would likely exacerbate those issues, advocates say.

“The bottom line is that Medicaid is already way underfunded,” said Julia Bascom, executive director of the Autistic Self Advocacy Network. “You see this already in states that have waiting lists and low wages for direct support professionals and the fact is that this is just going to get worse with block grants.”

Advocates said that they’re actively talking to lawmakers on Capitol Hill about the importance of Medicaid to people with developmental disabilities and they’re encouraging stakeholders to do the same. Such conversations are vital since some lawmakers don’t realize how Medicaid serves people with disabilities, instead thinking of it merely as a “poverty program,” Bascom said.

Travis Credit Union Provides Free Tax Preparation Services to Assist Solano County Residents at Multiple Sites

VACAVILLE, CA – Travis Credit Union today announced plans for this year’s Volunteer Income Tax Assistance (VITA) program. The VITA Program offers free tax help to low- to moderate-income people who cannot prepare their own tax returns.
This year, individuals and families earning up to $54,000 are eligible for the free services. Area residents can now visit Travis Credit Union’s Corporate Headquarters to get free tax preparation services by calling 211 to make an appointment in Solano County. For services in Richmond please call 800-494-5032. Appointments will take place from February through March 2017.
 
“From financial education to home ownership programs our goal is to put money back into the pockets of our working families and individuals,” said Barry Nelson, president and CEO of Travis Credit Union. “As a socially responsible corporate citizen, the VITA Program is one of a number of ways Travis Credit Union can support the communities we serve,” he added.
 
The credit union will initiate the free service by offering tax assistance by certified IRS volunteers, on Saturday, February 11, March 4, March 11, March 18, and March 25, 2017 from 9:00 a.m. to 1:00 p.m. at One Travis Way in Vacaville.
 
Weekday appointments are also available at our Dixon (1470 Ary Lane) and Richmond (3300-A Klose Way) branches, for four weeks on Tuesdays, Wednesdays, and Thursdays, from February 21 through March 16, 2017. These will also be by appointment from 10 a.m. – 1 p.m.
 
Call the appointment lines after January 16, 2017 to schedule your appointment and ask for a Travis Credit Union VITA tax appointment. A friendly representative will assist you in scheduling your appointment and send your information to us so that we know you’re coming.
 
Residents, who do not have an opportunity to file their tax returns on a Travis Credit Union sponsored date, may visit any VITA site from February 1 through April 15. All returns are filed electronically and taxpayers can expect to receive their refunds within seven to 10 days.
 
When visiting a VITA site, taxpayers should bring the following items:
 
Valid driver’s license or photo I.D.;
All W-2 forms; 1099 forms for 2016, if applicable;
Social Security cards for each family member; those who are filing jointly must bring their spouse;
Checking and savings account numbers (and routing numbers) for deposit of their refund directly to their account.
Tax Return from last year.
Household health coverage information 1095-A, B or C, Affordable Healthcare statements if purchased through Covered California
VITA volunteers will help taxpayers take full advantage of all tax credits for which they are eligible including the Earned Income Tax Credit (EITC) and the Child Tax Credit (CTC).
 
For more information about VITA or to locate additional sites, call the 211 helpline or visit Travis Credit Union’s website at www.traviscu.org.
https://www.traviscu.org/community/media-center/press-releases/1-17-2017-travis-cu-provides-free-tax-preparation/

Supreme Court likely to boost public schools’ responsibilities to children with disabilities

By David G. Savage

Supreme Court justices appeared ready Wednesday to clarify and strengthen the rights of the nation’s 6.7 million children with disabilities, perhaps by requiring public schools to offer a special education program that will ensure they can make significant progress.

The case of a Colorado boy with autism, Endrew F. vs. Douglas County School District, could have a far-reaching impact on millions of children and their parents as well as the budgets of school districts nationwide.
At issue is a long-standing federal law that says children with disabilities have a right to a “free appropriate public education.” Schools, courts and parents have been divided over what this promise means in practice.

Does it mean, for example, that a school must merely offer a minimal special program that may offer “some educational benefit” to the child, as a federal appeals court in Denver ruled? Or instead, do these children have a right to “make significant educational progress,” as lawyers for the outgoing Obama administration contend?

During Wednesday’s argument, the justices struggled with the lawyers and among themselves to find the right legal standard. At one point, Justice Samuel A. Alito Jr. drew knowing smiles from his colleagues when he complained of the “blizzard of words” being tossed around, most of which had no clear meaning.

However, most of the justices appeared to favor setting a slightly higher standard, one that should lead the child to make measured progress on academics or behavior. Chief Justice John G. Roberts Jr. said it would not be sufficient for schools to provide an expert for five minutes a day and claim they were providing the child “some benefit.”

But the chief justice and others said they were wary of setting an unrealistically strict standard that would require students to meet certain goals. They also voiced worries about costs and an explosion of lawsuits.

Parents who are dissatisfied with special educational programs may remove their children from public schools, enroll them in private schools and then sue to have the costs paid by the school districts. But to win a reimbursement, the parents must show that the public schools failed to provide the “appropriate” education promised by the federal Individuals With Disabilities Education Act.

A coalition of big-city school districts, including the Los Angeles Unified School District, warned the high court of the growing cost of private programs, which on average are more than four times as expensive as a public program. Los Angeles school officials said they spend $93 million a year on these private placements.

In the case before the court, the parents of Endrew F., an autistic child from Douglas County, Colo., enrolled him in public school through fourth grade. They worked with teachers to devise a special education program for him, but by fourth grade, his behavior was getting worse. He had repeated outbursts in class, banged his head on the floor and twice ran away from the school.

His parents moved him to a private school where he was “thriving,” according to the 10th Circuit Court of Appeals.

Nonetheless, the judges ruled the public school system need not reimburse the parents because it had provided their child with a minimally “adequate” educational program. “It is not the [school] district’s burden to pay for his placement [in the private school] when Drew was making some progress under its tutelage. That is all that is required,” wrote Judge Timothy Tymkovich, one of the 21 judges named as possible Supreme Court nominees by President-elect Donald Trump.

Stanford law professor Jeffrey Fisher, representing the parents, said the Supreme Court should reject the minimally adequate standard set by the 10th Circuit and instead say that children with disabilities have a right to make significant progress at school.

Lawyers from the U.S. solicitor general’s office joined in support of the parents. Irv Gornstein, a counselor in the office, said the law requires schools to provide a learning program “aimed at significant progress in light of the child’s circumstances.”

While this is not a guarantee of progress, they said, it is an approach that will require schools to aim high.

david.savage@latimes.com
Twitter: DavidGSavage

A special child may require a special parent – Napa Valley Register

She began the Napa Families of ASD page about two years ago after her son Charlie was diagnosed with autism spectrum disorder. Charlie, age 5, is a smart, smiling child who finds it easier to read a book than to interact with other children.

Chia and her husband, Jim Leiken, began to learn about special education and other resources through the local group ParentsCAN. She talked with another parent facing the same situation who had done more research than her and Charlie’s diagnosis began to seem less daunting.

“Then it became clear to me parents really had a lot of knowledge and passion and we all felt really isolated and alone,” Chia said.

Napa Families of ASD is a closed Facebook site where members can make connections. One recent post from a parent concerned haircuts.

Chia can relate, given Charlie can’t deal with going to a barber and having a flurry of scissor strokes sending shorn locks raining on his shoulders. She gives Charlie haircuts herself using electric scissors and a lot of patience. Another local parent cuts only a few locks of hair off her child each day.

Another post informs families of a “Sensitive Santa” event. This Santa avoids the loud “ho-ho-hos” and animated moves that might disconcert special needs children.

Another is from a mother with a child recently diagnosed with autism spectrum disorder.

“She was kind of shell-shocked and looking for guidance – ‘What should I think about this, what should I do?’ ” Chia said.

Children with autism spectrum disorder face a range of challenges, depending where they are on the spectrum. That leaves no one-size-fits-all handbook for parents.

“There’s a saying, ‘If you’ve met one kid on the spectrum, you’ve met one kid on the spectrum,’ ” Chia said.

American Canyon resident Teresa Silvagni is among those who use the Napa Families with ASD website and leaves posts there. She has a 6-year-old with autism spectrum disorder.

“We didn’t know who to contact, who to talk to,” she said. “It was a really nice resource to have.”

Chia has gone beyond starting the web page. She approached the Napa County Library about starting a “sensory friendly story time” for special-needs children.

Readers at the regular story times can grow too animated for Charlie and other special-needs children. The large library room allows them to wander off. The sensory friendly story time held the fourth Saturday of every month takes another approach.

“It’s a calmer story time,” Chia said.

Library Head of Children Services Ann Davis said Chia and another mother were proactive about the library starting the sensory-friendly story times.

“Candice is a mover and shaker and she’s very respectful,” Davis said. “She planted the seed and let us do it within our own time frame. Now it’s up-and-running and it will be a year in January.”

Target Will Offer Quiet Shopping Hours for Kids With Autism

In case you needed another reason to love Target: Stores are offering quiet shopping hours for kids on the autism spectrum and their parents, according to the Mighty.

On December 10, before the store even opens, from 6 a.m. to 8 a.m., parents can shop free of distractions. They’re going to dim the lights, turn off the music, and reduce the number of employees on the floor in order to create a sensory-free environment. These types of sensory stimulants might seem like no big deal, but for people on the autism spectrum they can be frustrating and even scary. Read more…

The Future of California’s Seniors: More Diverse, But More Disabled Too

The number of seniors in California is expected to more than double by 2060, from roughly 5 million to 12 million. A new report from the Legislative Analyst’s Office says this future senior population will be more racially diverse than seniors in the U.S. as a whole: the state’s elderly population is projected to become majority nonwhite as soon as 2030. Read more… 

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