By PHIL GALEWITZ, KAISER HEALTH NEWS
October 25, 2012

The House Republican plan to repeal President Barack Obama’s health law and turn Medicaid into a block grant program would save the federal government $1.7 trillion from 2013 to 2022, a 38-percent spending reduction,according to a report this week by the Urban Institute for the Kaiser Family Foundation.

It would also result in 31 million to 38 million fewer people getting  Medicaid coverage in 2022, according to the report. The entitlement program, which is jointly financed by the state and federal governments, now provides health coverage to about 62 million poor people, about half of whom are children.

THIS MIGHT HURT A LITTLE BIT

The block grant idea — paying a fixed sum to states — was formulated by Rep. Paul Ryan, Mitt Romney’s vice presidential running mate and chair of the House Budget committee, and passed by the Republican-controlled House of Representatives in 2011 and 2012. The strategy is part of the GOP plan to cut the nation’s $1 trillion federal deficit.

Romney backs a similar Medicaid block grant strategy that would cut $100 billion a year from Medicaid starting in 2013. Under Romney’s plan, federal payments to the states for Medicaid would grow at 1 percentage point a year above the Consumer Price Index. That would slow funding increases, but give states greater freedom in how they use the money, including the ability to cut eligibility or benefits to meet their budget needs. Today, the federal government sets minimum rules and guidelines and must approve any major changes to the program.

The Urban Institute analysis, which updates an analysis originally done in May 2011, said the House block grant plan would cut funding to hospitals by as much as $363.8 billion, and payments to nursing homes by $22.2 billion.

DISABLED FOLKS ARE LIABLE TO BE HURT THE MOST

Of the $1.7 trillion cut to Medicaid spending, $932 billion of the reductions come from repealing the Medicaid expansion in Obama’s health law and $810 billion is a result of spending cuts that are part of the block grant.

Under the health law, Medicaid would expand to cover as many as 17 million more people starting in 2014. States have the option to decide whether to expand eligibility, and several Republican-led states including Florida and Texas say they can’t afford the expansion.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

To read the article source, click here:
http://www.disabilityscoop.com/2012/10/25/study-republican-chop-medicaid/16733/

Another source of information:  http://www.theatlantic.com/business/archive/2012/08/is-medicaid-doomed-how-ryans-plan-would-affect-americas-very-poorest/261070

ON MEDICARE?  ON MEDI-CAL?  ON BOTH?

BIG CHANGES ARE COMING TO CLIENTS & CONSUMERS WHO RECEIVE HEALTHCARE AND SOCIAL SUPPORTS THROUGH MEDI-CAL ONLY OR MEDICARE & MEDI-CAL.

A new super agency, called the Administration for Community Living, was created in 2003 by combining three agencies under a single umbrella.  These are the Administration on Aging (AoA), the Office on Disability (OD) and the Administration on Developmental Disabilities (ADD).  There is a local manifestation of these three support networks in the forms of Passages, Independent Living Services of Northern California (ILSNC) and the State Council on Developmental Disabilities – Area Board 2

People who receive straight Medi-Cal or both Medicare & Medi-Cal, the so-called “dual eligibles,” will be switched from a “Fee-for-Service” method of payment to a “Managed Care” method by 2013-2014 in our area, according to plans from the California Departments of Health Care Services and Health & Human Services, in conjunction with the U. S. Health & Human Services.  To add to the confusion, military veterans, along with the dual eligibles and straight Medi-Cal clients will soon be directed to a new agency, called the Aging and Disability Resource Connection (ADRC).  All long-term support services requiring public funding will be referred to through a local ADRC.  Eventual plans call for an ADRC for all of California’s 58 counties.

In 2007, a contract was signed between ILSNC and Passages establishing an ADRC in a 5-county area served by Passages and ILSNC (Plumas, Butte, Colusa, Glenn and Tehama).  4 of our counties are served by a separate AoA based in Siskiyou County, serving Shasta, Modoc and Lassen counties as well, for which no ADRC exists.

These are momentous changes for our consumers and clients, who have been operating under a fee-for-service model whether utilizing Medicare or Medi-Cal for healthcare and attendant social supports.

How will people with disabilities and their families and caregivers going to be affected by the proposed changes?  How will the outcomes in the “Demonstration Project” in 8 counties affect healthcare and social supports in our service area?  Even among the professionals there are far more questions than answers.  Stay tuned for future developments as these initiatives are rolled out and the inevitable bumps in the road are smoothed out to create an operational network designed to provide a more efficient referral and service delivery process.

Additional information is available at:  http://www.communitychoices.info and http://www.hhs.gov/acl

DREADFUL CUTS MAY STILL COME AFTER NOVEMBER VOTE

CALIFORNIA HAS A BUDGET, ON TIME AND FULL OF HOPE(FUL ASSUMPTIONS)

Governor Jerry Brown signed the budget bill for 2012-13 into law on June 27.  What will be the effects on people with disabilities?  Here is our summary:

In-Home Supportive Services: Rejected Brown’s plan to cut caregiver hours by 7% across-the-board and eliminate domestic services in shared households while continuing current 3.6% cut in hours.  Shifts pay negotiations for workers from counties to a state board, which organized labor hopes will lead to higher and more uniform wages across the state.

Healthcare:  Eliminates Healthy Families program by moving clients to Medi-Cal.  Reduces payments to hospitals and nursing homes.  Approves the expansion of managed care for recipients of Medicare & Medi-Cal from original 4 counties to 8 counties.  What was once called a “pilot study” is now called a “demonstration project.”  This was a compromise with the Governor, who wanted authorization to expand this model to all 58 counties.  The 8 counties slated for implementation are: Los Angeles, Orange, San Diego, San Mateo, San Bernardino, Riverside, Alameda & Santa Clara.  These 8 counties comprise approximately 60% of the population for the entire state.

Additional information on the implementation of the “California Coordinated Care Initiative” can be found at: http://www.calduals.org

Venn Diagram of Dual Eligible

Obama Administration Announces New Steps to Fight Alzheimer’s Disease

The Obama Administration is making an additional $50 million available for cutting-edge Alzheimer’s research. The administration’s Fiscal Year 2013 budget will increase funding for Alzheimer’s research by $80 million, plus an additional $26 million for caregiver support, provider education and public awareness about the disease. This new funding will speed up the National Institutes of Health’s effort to develop new ways of helping people with Alzheimer’s disease and those at risk.

This information was recently added to Disability.gov. To learn more visit https://www.disability.gov/health/news_%26_events.

The Houston Chronicle (CFED)
By: Chris Tomlinson
February 5, 2012

Texans politicians (and our local Assemblymember, Dan Logue) like to tout the state’s economic growth, but more and more Texans are finding themselves teetering on the edge of poverty.

… a study by the Corporation for Enterprise Development has found that 27.7 percent of Texas households have no financial cushion in case of an emergency. If you exclude homes and automobiles from the calculation, a full 50 percent of Texans have no assets they could use to survive if they suddenly lost their income.

The findings match up with the latest U.S. Census data on Texas, which found that 17.9 percent of Texans — or 4.4 million people — live below the poverty line. That’s 2.6 percent higher than the national average and ranks Texas 40th in the nation.  When compared to the rest of the country, Texas ranks 41st in financial security.  Is Texas really a good model for California as we go forward out of the latest recession?

For the rest of the story, go to: http://blogs.cfed.org/cfed_news_clips/2012/02/many-texans-earn-low-pay-hold.html

Assemblymember Dan Logue explains "voodoo economics".

As reported in the Sacramento Bee, a federal judge on Thursday (1/19/12) continued to block the state from reducing in-home care to low-income disabled and elderly residents, a budget cut pursued last year by Gov. Jerry Brown and lawmakers.

The reduction would have slashed one-fifth of service hours for In-Home Supportive Services recipients to save the state $100 million over the next six months.

U.S. District Court Judge Claudia Wilken converted her temporary December order blocking the state into a preliminary injunction.

Last month, Wilken said the IHSS cut “raises serious questions” about whether the state had violated several federal laws, including those protecting people with disabilities.

The full story can be read at:

http://www.sacbee.com/2012/01/20/4201434/federal-judge-blocks-budget-cuts.html

Additional details are available in a press release from Disability Rights California

Services for disadvantaged citizens have already been cut to the bone.  Join us to protect vital services.  Your well-being depends on it.  Federal magistrate Wilkens has prevented a 20% cut in IHSS because that would force people from their homes into nursing homes.  Governor Brown wants to cut more next year.   Child care support for people looking to get off welfare is threatened.  Senior nutrition support is threatened. Join us.  We need you & you need us to protect your services.

Wednesday January 18, Noon on the South steps of the Capitol.  Transportation will be provided by ILSNC, 1161 East Ave.  Leave Chico at 9:30 sharp.

Click on this link to view the flyer.

01 18 12 Sac State of the 99% Flyer 1

The rally against unfair and inhumane state budget cuts to health & human services HAS BEEN POSTPONED UNTIL (most likely) JANUARY 18.  This new date will coincide with Governor Brown’s “State of the State” Speech, which we anticipate to be January 18.  WE WILL MAKE A DEFINITIVE ANNOUNCEMENT VERY SOON.  In the meantime, please call the office at 893-8527, #130 for additional information.  Please make plans to join us at the Capitol – together we can make a difference.  Rides will be available. 

WOLVES SIGHTED IN CALIFORNIA

Tis the season for celebration of various holidays throughout the world.  On Sunday, many of us will stop to celebrate Christmas.  We hope that this season finds you healthy and reasonably happy.  We offer for your enjoyment and edification this cartoon from Tom Meyer, which appeared in the Sacramento Bee on Dec. 20.

Wolves Return to California

Reprinted by kind permission of the artist (http://www.meyertoons.com)

Judge grants reprieve to 372,000 on cuts to in-home care

A federal judge has apparently granted at least a temporary reprieve to 372,000 elderly and disabled Californians who faced a 20 percent cut in their in-home care on Jan. 1.

U.S. District Judge Claudia Wilken of Oakland issued a temporary restraining order Thursday that prohibits the state from taking any immediate steps to carry out the reductions — in particular, from mailing out notices to all recipients, starting next week.  Wilken said a lawsuit by disability-rights groups and other advocates raised “serious questions” about whether the cuts would violate federal health and disability laws by forcing recipients into nursing homes.

That means it’s highly unlikely the reductions can take effect Jan. 1, said Stacey Leyton, one of the lawyers who filed the suit. She said the state’s attorneys had told Wilken they needed to send out the notices next week to start the clock running for cutbacks on New Year’s Day.

The judge has tentatively scheduled a hearing Dec. 15 on a request for a preliminary injunction that would block the cuts indefinitely. Even if she decides the state acted legally and denies the injunction, Leyton and other advocates said the cutbacks probably would be delayed by at least a few weeks. And Wilken’s ruling Thursday contained some strong language suggesting that she might well issue an injunction: She said the proposed reductions would put recipients “at imminent and serious risk of harm to their health and safety” and also risk “unnecessary and unwanted out-of-home placement, including institutionalization.” The state’s only concern is saving money, she said, while in-home care patients face “life-or-death consequences.”

The program, called In-Home Supportive Services, provides care to about 440,000 low-income Californians, including the blind and disabled and those over 65 who need help with daily tasks to live at home. The federal government pays about 60 percent of the cost.

Gov. Jerry Brown signed legislation in June that required the 20 percent cutback in services to 372,000 recipients in January if the state’s revenues fell short of projections, which they did. The law allows recipients to apply for an exemption if they can show they would be at serious risk of being forced into an institution. But lawyers for the recipients say the exemption uses the same flawed standards that Wilken rejected in 2009 when she blocked the state from eliminating in-home care to 36,000 people and cutting it back for another 97,000.  ….

Source:  San Francisco Chronicle Politics blog, December 1 2011

For detailed and up-to-date information on In-Home Supportive Services, please visit http://www.ihsscoalition.org