The Medicaid Cry(sis)

Like states around the country, Texas is suffering from a huge budget crisis. To fix this mess, legislators are looking to reduce the two largest line items on the government budget, Education and Health & Human Services.

HHS, which is funded by both state and federal coffers, has several components. The one which most directly affects people with disabilities is Medicaid. As many people with intellectual and developmental disabilities are unable to hold a traditional job, with traditional health benefits, Medicaid is critical for meeting their health care costs. In addition, this true “life support” also provides necessary attendants, job and life skills training, as well as the mechanism to live independently in the neighborhood of their choice.

This support is not cheap. Within Medicaid, 15% of the participants are people with disabilities, yet they make up 40% of the total spending. As non-government entities, such as business and the faith-based organizations, have chosen to abdicate care for people with disabilities to the government, this lifeline is understandably critical. in lieu of no alternative, it must be maintained.

People and families with disabilities have unique experiences to which most common families have little exposure. True dependence on another person for the basic needs of life creates fear in the individual, but an astounding level of stress for the caregiver. For each person with a severe disability, there are at least 4 other “traditional” people whose lives are directly affected.

Issues facing families with disabilities go far beyond the common concerns of picking kids up from school, worrying about which soccer squad they make, or even concerns about losing a job or making the monthly mortgage. Even in the most extreme cases of job and home loss, people with traditional skills can often scale down their consumption to fit their new circumstances, as the skills they have can usually transfer to a new profession. For people with severe intellectual disabilities, there is no room to “scale down”, as the only option to independence is seclusion in an antiquated state institution.

When trimming budgets, elected leaders often use a blunt sword instead of a precision scalpel. Wholesale reductions in Medicaid result in service providers going out of business, job training programs disappearing, and people forced to leave their homes and move to state institutions. In an ironic twist, the cost of institutionalization is actually three times higher per person than the cost of community support due to the excessive overhead the state creates.

Everyone needs a voice, and at some point in their lives, everyone needs help from a friend. To people with intellectual and developmental disabilities, The Arc of Dallas is that helping friend who provides a strong voice for people in North Texas.

--Clay Boatright

President, The Arc of Texas

‘Texas Tsunami’ will blow away services

Without a doubt 2011 will be uniquely challenging for people with intellectual and developmental disabilities in Texas. To overcome those challenges we need to prepare, engage, and more importantly, support one another. Here’s why.

A tsunami will hit Texas on September 1, 2011. Early reports indicate that anywhere from 13,000 to over 50,000 people will have their lives destroyed immediately. In addition, up to another 100,000 people will lose their jobs, quit, or significantly reduce their work hours as a result of this devastation. Thousands of marriages will crumble as the financial, physical and psychological stress becomes unbearable. Child abuse will skyrocket and some of the tsunami victims may become institutionalized.

Leadership to deal with this disaster will be nonexistent. Elected officials will blame the state budget and federal government, while offering no solution. Though a few pastors may say a prayer for those harmed, most will act as though nothing has happened even as members of their flocks search desperately for help. The general public will be relieved that the storm did not hit them.

The tragedy described above is very real. Services for people with disabilities are on the chopping block as state agencies submit their budgets for the next legislative session. Currently there are over 100,000 Texans on decade‐long waiting lists for services. Meanwhile, the state is developing plans to remove those services from many who had waited so long. Waiting years for someone to help their neighbor is wrong. Eliminating that help when a life depends on it is an abomination.

In rural Texas, a Native American was told for 35 years that there was no one, no service, and no money to help her. Only after her aging mother collapsed in their home did she receive emergency assistance. Today she enjoys the blessing of an independent life, a life which will be jeopardized when she loses her support. Expecting a now 75 year old mother to resume care for her adult daughter is beyond comprehension.

In Houston, a 7th generation Texan receives help from the state for her most basic needs, thus enabling her mother to hold a job and care for her own elderly parents. With no one else to help them, the loss of support will require the mother to quit her job in order to care for her daughter. In one fell swoop, this will reduce the quality of life for three generations.

A restaurant in Austin has a loyal employee with intellectual disabilities who lives in his own apartment nearby. Removing state support will cause him to lose his home and independence, and may force him to move to an institution away from his family and friends where his talents will go unheralded.

Near Dallas, a family of five receives help after school for their twins with severe autism. Each twin requires one‐on‐one attention at all times, as their disability can cause behaviors which are physically painful to others. Losing that assistance may force their father and sole provider to take a lower paying job in order to help his family during the day. This will greatly reduce their ability to pay taxes, support the economy, and contribute to their church. That family is mine.

The Texas legislature is now meeting and making decisions that will affect the lives of thousands of people who have no other place to turn. To our elected leaders the request is simple…please, do no harm.
‐‐‐‐‐‐‐‐‐

Clay Boatright is President of The Arc of Texas and past president of The Arc of Dallas. He and his family live in Plano.

Teacher of the Year!

The Arc of Dallas was happy to honor Denise Dudley, of Rockwall ISD, as the 2010 Teacher of the Year! Check out this great article by the Dallas Morning News.

Sherry Wacasey, Executive Director of The Arc of Dallas, surprised Denise with her award.

There were so many great educators nominated! The Arc of Dallas would like to say a special Thank You to each of them. You truly make a difference.

Touch 20 Launched!

Touch 20 people this Holiday Season!
The Idea has been around for a long time. When you need help, reach out to those you know care. Sign up for The Arc's Touch 20 email campaign and help support the people who need it most by emailing 20 friends and asking for $20. It's easy! Raise the most in the "Family Team", "Individual", and "Arc L.I.F.E. Class" categories to win great prizes!

How do I sign up?

1. Go to www.arcdallas.kintera.org/touch20
2. Click "Register Here"
3. Select "Team" or "Individual" registration
4. Fill in contact information and select a username and password
   (you will then be sent to your fundraising "Headquarters")
5. Once in your "Headquarters", click on "My Webpage" to customize your webpage with our ready-made template or upload your own photos and edit text to make it more personal!
6. Now, let your friends and family know! Click on the "Email" tab to send up to 30 personalized emails at once. Use our sample, or create your own!
7. When someone donates you get an email, that's it!

Win these great prizes!

• Family Team
  1st Place - 42" Flatscreen TV
  2nd Place - Blu-ray player
  
• Individual
  1st Place - 26" Flatscreen TV
  2nd Place - Kindle
  
• Arc L.I.F.E. Class
  1st Place - Outing of Choice (up to $400)
  *Every class that reaches their $5,000 goal wins a Pizza Party!

If you have any questions please let us know! Contact Robert Eilers, reilers@arcdallas.org or call 214-634-9810. Thank you for helping us help the community this Holiday Season.

Happy Holidays from everyone at The Arc!

The Arc Ranks Among Biggest Charities

Taken from The Arc of the United States e-newsletter:

On November 17, Forbes published their annual listing of the 200 largest charities in the U.S. In terms of Total Revenue, The Arc comes in at #8 just after Goodwill Industries and United Way and above The American National Red Cross. Easter Seals, at #20, is the only charity serving a similar constituency who comes even close.

Wow! This information proves how strong and vital our incredible network of chapters is to our community - and to our nation!

EXPO - South

The Arc of Dallas was thrilled to work with Region 10 and multiple school districts (see below) to make resource available for people with disabilities and their families at the Live the Dream EXPO - South. Attendees were able to visit with a wide array of exhibitors and gather important information in speaker sessions. Here are a few pictures from the event!

School Districts included: Cedar Hill ISD, Dallas ISD, DeSoto ISD, Duncanville ISD, Grand Prairie ISD and Midlothian ISD.

Thank you to everyone who made this great event possible, and a special thanks to Duncanville ISD for hosting it. We look forward to next year!

SAVE THE DATE:

Live the Dream EXPO - North

January 29, 2011

Garland Special Events Center

Please contact us HERE for more information.

Notice to DART Passengers

(from a DART handout)

"Level Boarding Starts and High Blocks Close on Saturday, November 6.

Following two-and-a-half years of construction and station closures, Level Boarding will be implemented at all DART Rail stations on Saturday, November 6, 2010.

Boarding ramps or "high blocks," which have served persons with disabilities and mobility challenges since the rail system opened in 1996, will be removed from service, as these passengers begin utilizing the center doors in each train's low-floor center section.

Each low floor center section is equipped with two clearly marked areas designated to accommodate wheelchairs. Other passenger will be expected to yield these spaces to customers with special needs, as they do now at the front seats of the train. Near each space is a blue call button to alert the train operator when a person in one of these spaces requests a stop.

For the benefit of people who are blind or with visual impairments, trains at Green Line Stations, the new Lake Highlands Blue Line station and Union Station will stop with the low-floor doors nearest the Ticket Vending Machines at the center of the platform. At downtown Dallas stations, accessible entrances will be at the outbound end of the platform, and at the outlying Red and Blue line stations, they will be aligned with the 8" high mini-platforms or "humps" that have been constructed during the past few months.

Additional information on training of persons who are blink of visually challenged is available from the Dallas Field Office of the Texas Department of Assistive and Rehabilitative Services(DARS), Division for Blind Services (DBS), 214-378-2600."

Moving from SSI to SSDI When a Parent Retires

From Colleen Horton, Program Officer, Hogg Foundation for Mental Health, The University of Texas at Austin, Rosemary Alexander, TxP2P Staff, and Debbie Luzzo, TxP2P Parent and Realtor.

I have received a number of calls over the past year from families who have been told that their adult child is no longer eligible for Medicaid when they go from receiving SSI to SSDI. SSI is the Supplemental Security Income for folks with disabilities with low income. Many individuals with disabilities access Medicaid through their SSI eligibility. As parents begin to retire, their "adult child with a disability" often becomes eligible for Social Security Disability Income (SSDI) which typically has a higher monthly stipend than SSI. When they lose SSI (can’t receive both SSI and SSDI) they are sometimes told that their family member is no longer eligible for Medicaid because their income is now too high. The fear of losing Medicaid eligibility can cause a family significant stress as there is a two-year wait to receive Medicare services (health coverage available through SSDI).

This is not true. There is a provision in federal law referred to as the "Pickle Amendment" – named after our own Congressman Jake Pickle. This amendment states that if an individual’s monthly income is over the SSI limit simply because they went from receiving the SSI stipend to the higher SSDI stipend, they maintain their eligibility for Medicaid. This is extremely important to know because, as stated earlier, the Medicare coverage under SSDI has a two year waiting period. Read two stories HERE of two parents’ experiences with this important process.

Nominate an educator for a $1,500 gift!

The Mary Claire Phipps Award for Excellence in Education, given annually by The Arc of Dallas, recognizes an education professional who exhibits exceptional dedication to making a difference in the lives of students with intellectual disabilities. The award is $1,500, with a matching gift going to the classroom.

Download the nomination form by clicking HERE.

Announcing a new EXPO!

The Arc of Dallas is excited to partner with seven school districts to bring the first ever EXPO-SOUTH. We are happy to offer this resource fair to families, caregivers and professionals in a new location.

The EXPO will take place on November 6th, from 1:00 - 4:00 pm at Duncanville High School.

Over 80 exhibitors are expected at this event, which includes fun activities for kids and informative sessions and panel discussions!

The following topics will be covered in sessions:

1:15-2:00 pm
“Social Security Income”
Bryan Trevino

2:15-3:00 pm

“Life Planning: Guardianship & Special Needs Trust”
TJ Kroehle

3:15-4:00 pm

“State Assesment & Graduation Requirements”
Rosemary Manges, Cindy Pierce

*Want to be an exhibitor? Contact pr@arcdallas.org.

Last Call for FINDS Survey

The Arc has developed a national initiative to tap into the knowledge and perspectives of individuals and families within the intellectual and developmental disabilities (I/DD) community. This effort, which launched in July, will be coming to a close on October 31st, 2010.

The purpose of this survey is to capture the perceptions of individuals with intellectual and developmental disabilities of all ages,and their families, on issues concerning disability support needs across the life spectrum. Responses will be used to help inform disability organizations, services, policy, and public perceptions on issues related to disability supports that you or your family member has now, needs or is anticipated to need in the future. Your answers will remain completely anonymous and confidential.

Please take a moment to complete this survey. The Arc of Dallas fully supports this initative to bring improved services to our community!

To access the survey, click HERE.

We thank you for your input!.

Action Alert: Write Letters to Governor's Staff by October 15, 2010

The Arc of Texas collected 30 letters over the past three days!

We need more letters—take a few minutes to write your letter today!
Your letters will be read by key legislative staff and members—those who are directly responsible for drafting the state’s budget for the next two years (Fiscal Years 2012-2013).
As of today, state agencies have submitted proposed budgets (“Legislative Appropriations Requests”) to the state’s leadership. Those proposed budgets help key members write the next state budget for 2012-2013.

The Arc of Texas is especially concerned with the proposed budget submitted by the Texas Department of Aging and Disability Services (DADS) because it does not include funds to serve 13,368 individuals who are currently receiving Medicaid Waiver services or expected to receive Medicaid Waiver services by the end of FY11. [DADS is not at fault; they were simply following budget writing instructions from leadership offices.] However, the Legislature must fund DADS Exceptional Items #1, 2 and 3 (“wish list” items outside the proposed budget) in order to MAINTAIN CURRENT SERVICES. If these items are not funded, over 13,000 are at risk of losing the precious community based services and supports they receive through the Medicaid Waiver Programs. The next section in this alert provides pointers on writing your letter.

If you are a self advocate or would like to assist self-advocates in writing their own letter, Texas Advocates prepared a form letter you might find helpful. Click here: Letter .

Write Letters to Governor’s Staff by October 15, 2010

DADS Legislative Appropriations Request— the agency baseline request DOES NOT include funds to serve 13,368 individuals who are currently receiving Medicaid Waiver Program and other community-based services or expected to receive services by the end of FY11.

OUR MESSAGE:
“Maintain current DADS services!! Fund DADS Exceptional Items 1, 2 AND 3! Any cuts to DADS services would be DEVASTATING to individuals and families.”

Information to include in your letter:

• Your name and address
  
• Your affiliation with The Arc of Texas (i.e. “I have been a volunteer with The Arc of Texas for 25 years…”)
  
• How long you or your loved one was on the waiting list.
  
• What life was like for you/your loved one during the waiting period (details are important here!)
  
• What program you/your loved one currently receives.
  
• How the program services and supports make your/your loved one’s life more meaningful (details are important here!)
  
• Describe what you/your loved one would have to endure if services were cut after having waited so long; how devastating would it be to you/your loved one (i.e. it would be devastating AND I would go into a more expensive institution, lose my job, lose my home, lose my marriage)

Address your letter to Katherine Yoder (Katherine.Yoder@governor.state.tx.us). In addition, send a copy of your letter to Amy Mizcles at amizcles@thearcoftexas.org.

Call for Advocates!

Update: Restraint and Seclusion

Senator Christopher Dodd (D-CT) introduced The Keeping All Kids Safe Act, S 3895, an updated version of his earlier bill (S. 2860). Senator Richard Burr (R-NC) is a co-sponsor of S. 3895. The updated version of the bill would allow school districts to include restraint and seclusion in individual education programs (IEPs) only if students had a two-year history of dangerous behaviors that could result in serious bodily injury and a functional behavioral assessment and behavioral intervention plan were developed and implemented by professionals. The bill would prohibit all chemical and mechanical restraints and restraints that restrict breathing. The bill was referred to the Senate’s Health, Education, Labor and Pensions Committee.

How Do We Discus This Calmly?

I have been with The Arc for around a quarter of a century and I don’t remember every going into a State of Texas Legislative session without repeating the mantra of “more funding for more and better services.” What else could we say when families and individuals were looking at 10 year-long waiting lists and minimal levels of services and supports.

Well, this year with billions of dollars in short-falls we are hearing of the very real possibility of service cuts and a stops to most efforts for waiting lists reductions. Remember that programs such as Home and Community Based Waivers (HCS) and CLASS are not entitlement programs such as State Supported Living Centers (State Schools) and Medicaid. In other words the State is not compelled or required to provide the service just because a person is eligible.

The Arc will do its best to keep everyone informed as the budget process proceeds. But if you want to become part of the solution please email your contact information to info@arcdallas.org with “Advocacy” in the subject line. The people with disabilities who we care about need “action” not “ah shucks”. They need a core group who will respond to action alerts with calls, letters, visits or email.

To read another perspective on the situation, please click HERE.

DART New Service Model "FAQ"

Thank you David Sheppard (Manager, Paratransit Customer Relations) for sending us this updated information! Please post any questions or comments.

Q. What is the new service delivery model?
A. The new service delivery model has three parts: next day ADA service, subsidized service, and coordinated service. The next day ADA service is the service that is being provided now. Subsidized service is something that we plan to have in the future where riders can choose a more flexible and spontaneous service by paying a little more than the $3 base fare. Coordinated service is also something that will happen in the future where DART will coordinate our services with other agencies, such as health and human service providers.

Q. Why is DART privatizing its Paratransit services?
A. DART has always used a contractor to provide drivers and maintenance. The only change with the new model is that the scheduling and dispatching functions will also be done by the contractor.

Q. How does the new service model differ from what DART Paratransit is doing now?
A. Instead of one vehicle type, DART will be using a variety of vehicles, to include vans, sedans, and taxis.

Q. Will the new service model completely do away with vans?
A. No. There will still be fully accessible vans for all customers who need them.

Q. How will I schedule trips using the new model?
A. Trips will be scheduled just like they are now, by calling the same number, 214.515.7272.

Q. Will I be picked up by a taxi?
A. Possibly, if your travel needs can be accommodated by a taxi.

Q. How can I be assured that this new pool of transportation providers will be courteous, friendly, and operate safe vehicles?
A. The drivers will be fully trained and expected to provide excellence in customer service, safety, and sensitivity. Any drivers who do not provide excellent customer service will be removed from our program.

Q. Is the one-way fare expected to increase with this new model?
A. No. Currently, there is no discussion of a fare increase for this new model.

Q. When are these changes expected to occur?
A. The new service is anticipated to go into effect October 1, 2011.

Q. Is there an opportunity for me to learn more about the new service model?
A. Yes. The new service model will be explained in detail at DART’s Americans with Disabilities Act Community Meetings. The next meeting is scheduled to occur at the Richardson Civic Center on Saturday, October 16, at 10:00 a.m. During the meeting, DART staff members will explain in further detail the many benefits of this new service model. We will also be discussing the new service delivery model at our meetings in January, March, May, July, and September, 2011.

Q. How will the new model benefit me?
A. We expect our riders to experience a higher quality and more personalized service. We expect ride times to be shorter, and on-time performance to be higher. We also expect that riders will have greater flexibility and more spontaneity in making trip reservations.

Please note: Effective Friday, October 1, 2010, our department name will change from Paratransit Services to Mobility Management Services.

End to Discriminatory Insurance Practices?

September 23, 2010, is a critical date in expanding health care to young Americans and ending harmful and discriminatory insurance practices.

Highlights of the changes taking effect include:

• Health insurance plans can no longer refuse insurance to youth under age 19 who have health conditions.
• Employers who offer dependent care coverage must continue to offer it to dependents up to age 26.
• Harmful limits placed on how much an insurance company will pay over a lifetime for an individual are removed.
  

These changes are part of the Affordable Care Act, which prohibits discrimination against people with disabilities, expands access to long-term services and supports and makes a number of other changes to our health care system. Learn more about these changes and how they may impact you—read the latest National Policy Matters or visit HealthCare.gov.

Major Changes in Store for DART’s Paratransit

During the two decades that DART has been providing paratransit services for riders who cannot access the fixed route system, there have been lots of changes, tweaks, grumblings and successes. But now DART planners are looking at an entirely different approach to providing the service.

DART currently is offering a “supply driven” model. DART decides how many vehicles and drivers are needed with an eye on what it can afford. The “supply” of rides is determined by budget, estimated hours and availability of vehicles. That then dictates how many hours of rides are offered.

The new plan under consideration is “customer driven”. DART will hire a transportation management company who will coordinate ride request with independent transportation providers with whom they have contracts. It would work something like this; a certified paratransit rider calls the reservation number and requests a ride much as it is currently done. The transportation management’s software searches through the independent providers for a match. A rider could be matched with someone who also accepts work form an established taxi company for example.

DART is quick to point out that this will be nothing like the brief and troubled attempt several years ago to work with cab companies. We will address the differences in a later communication.

There are obvious financial advantages for DART in the new plan, but there are huge potential benefits for riders as well as it will dramatically increase the pool of potential drivers. As the need for rides increases then the management company will increase the number of trip requests to as many independent transportation providers as are needed to satisfy customer demand.

Just think, in a few years we might not be just looking at “same day” reservations, but trip request within a few hours of the time a ride is needed. This change in how DART delivers paratransit services is still in the early planning stages and nothing is definite at this point. One thing that DART will always retain is customer service and eligibility determination.

The Arc of Dallas will keep posting updates as the planning unfolds.

Students

Schools had been in session for two or three weeks when The Arc got a call from the mother of a five-year old student. Her son was being evaluated by his school to confirm his diagnosis of autism. She was calling seeking help because her five-year old son has already been suspended and sent home twice since the beginning of school! How is this possible?

“Special education students [sic] in Texas public schools are nearly twice as likely to be suspended as students in the general education population, according to recent Texas Education Agency testimony,” reports The Texas Tribune’s Kate Ergenbright.

TEA found that for every 100 students receiving special education supports, there were 55.8 in-school suspensions and 25.1 out of school-of-school suspensions.

The mom of one student who was sent home five times last year feels, “Teachers don’t know how to deal with special education kids, so it gets to a level where they will explode because they are tired of dealing with this kid.”

If over taxed professionals is part of the problem then consider that this year legislators are looking at billions of dollars less to provide services. This coupled with the astonishing finding that the number of students with autism in public schools grew 404 percent from 1999 to 2009, a statistic Committee Chair Florence Shapiro, R-Plano, called “mind-boggling.”

Caregivers must understand not only students’ rights, but effective suggestions and techniques to offer the IEP team. The sections on discipline and behaviors in It’s a New IDEA from The Arc of Texas and Advocacy, Inc. is packed with good information for students, families and education professionals.

Have you had a troubling experience with your student being inappropriately disciplined or do you have a terrific success story? Please tell us about it. It always seems as if the most effective ideas come from sharing with others.

HCS demystified

The Arc of Dallas' board president, Clay Boatright, gets asked for guidance from a lot of other parents. He has commented many times that if he finds the state's intellectual and developmental disabilities systems and processes maddeningly confusing, just think how lost the new caregivers must feel!

The Arc is always on the lookout for helpful information that will at least partially demystify how to get supports for people with disabilities. Clay found a winner when he read "Enrollment Process" written by Advantage Community Services President David Rogers. David enthusiastically gave his permission for us to share the site with readers. It is a simple step-by-step look at Home and Community Based Services (HCS).

One important thing to keep in mind however, is that the case management function will move from Advantage Community Services, and all of the other Texas HCS providers, to the local authorities on June 1, 2010, so no doubt some of the steps will change. For most of our area that will mean working through: Metrocare Services, LifePath Systems, Tarrant County MHMR or Lakes regional MHMR.

A lot of transitional activities are going on now. Visit DADS (Department of Aging and Disability Services) to learn more.

Goodbye 'R' Word...

A quick word about language. It is pretty clear now that the "R" word is headed for the history books, but what is taking its place? It looks as if the phrase of choice is "intellectual and developmental disabilities" or "IDD". A solid justification and explanation can be found on The Arc of the United States website.

Texas Advocate Gets a Response

One of our Texas Advocates member, Suzie, wrote Senator Corona about the "R" word and received a response. Way to go Suzie!

Click here:

Announcing: Disabilities At Work Internet Talk Radio

Disabilities At Work Radio spotlights businesses that go ‘beyond compliance’ in finding and hiring qualified people with disabilities, or who support people with disabilities through philanthropy or in other ways. The show features corporate VIPs, successful service providers, educators, people with disabilities who have interesting stories, authors, researchers, government officials, elected representatives, and celebrities who have reasons to be involved.

Debuting on April 14, 2010, on the VoiceAmerica Business Channel, the show will air every Wednesday at Noon EST. Look for weekly emails about show topics and speakers.

Click HERE to read more.