Advocacy Update on Cutbacks to Pennsylvania Medical Assistance Transportation Program

During the most recent PA Transportation Alliance conference call the representatives from PennDOT were discussing this subject.

Throughout the state the transportation providers who handle MATP trips are also PwD (Persons with Disabilities) providers. The 18% cut back is real. Some counties and therefore providers will run out of funding for MATP between February and April.

PennDOT has told those providers that they cannot "automatically" shift people to PwD for trips that would have been MATP funded. However, they have asked providers for an estimate of what PwD funds would be necessary to cover the short fall under MATP. This tells me that they understand the dilemma they face when MATP consumers who also would be qualified for PwD begin to get certified and ask for trips formerly funded by MATP.

The Alliance is writing a letter to PennDOT asking for PwD budget information for the last three years to see if there is a trend of surpluses. They are also considering a position on the MATP vs. PwD trips. I was asked to draft that and here is what I submitted.

"It is our understanding and position that the two main attributes of the PwD program as it was implemented could be described as follows.

As long as a potential rider had a disability as defined by the ADA they were qualified for a trip under the PwD program as long as they completed the PwD application process with the provider. In addition, they were eligible for any trip purpose under the PwD program that could not be paid for from another funding source.

With this in mind and in consideration that some providers will run out of MATP funding during the fiscal year, it is our understanding and position that a rider who is qualified for PwD should be able to have medical trips paid for from the PwD program that were formerly provided under MATP if a provider no longer has MATP funds.

It would be our advice to people with disabilities who currently use MATP for medical trips to qualify themselves for the PwD program as soon as possible in order to avoid any interruptions in their medical care when MATP funds no longer exist for their transportation provider."

I think it behooves TRIPIL to let our MATP consumers know it would be in their best interest to apply for PwD if they have not already done so. Many of them may have not used PwD at all. They may have just used transportation providers for MATP.

Pennsylvania Department of Public Welfare and Secretary Alexander Named in Class Action Lawsuit

Harrisburg, PA (December 1, 2011) – Disability Rights Network of Pennsylvania today filed a class action lawsuit against the Pennsylvania Department of Public Welfare and its Secretary, Gary Alexander, for violating Title XIX of the Social Security Act, the Americans with Disabilities Act, and the Rehabilitation Act. The lawsuit is on behalf of Rebecca Leonard, Matthew Leonard, Elisa Anslow and other individuals who have autism, brain injury, and other disabilities and who receive services funded through the OBRA Waiver. In October, the Department of Public Welfare (DPW) announced plans to eliminate and/or severely restrict vital services that allow these individuals to safely live and work in their communities. The cuts are set to go into effect January 1, 2012.

“These cuts are destabilizing a group of individuals that need, and had in fact achieved, stability to lead independent and integrated lives where they can work, attend college, live in their own homes, support local businesses, and volunteer in their communities,” says Kelly Darr, Legal Director at Disability Rights Network of Pennsylvania. “Providers are sending termination notices and families and individuals are panicking, because DPW’s ill-advised decisions do not provide for any appropriate replacement services. This is a giant and expensive step backward.”

Rebecca and Matthew Leonard, 40 and 44 years of age respectively, are diagnosed with severe autism. Their parents, both in their mid 70s, are party to the complaint. “Our two children have been living in the community for 10 years with ongoing support services. They are employed part time, pay taxes, use local banks and are learning to manage their resources,” says Joe Leonard. “Without adequate supports, our children and others risk institutionalization or psychiatric hospitalization that will greatly increase the costs to taxpayers and cost our children their homes, their jobs and their lives in the community.”

According to the complaint, “Without Community Integration Services and Behavior Therapy or appropriate and available alternatives that can meet their needs, Plaintiffs and other similarly situated individuals will regress, losing the community living skills that they have worked to attain and some will deteriorate behaviorally. Some may be required to accept services, if available, in more segregated settings than are appropriate to meet their needs. Some may no longer be able to live in their own homes, forcing family members -- many of whom are aging, ill, or have other responsibilities -- to care for them.”

Disability Rights Network of Pennsylvania is asking the court certify the case as a class action, declare that Defendants' actions violate federal law, and issue appropriate injunctive relief to stop the cuts from going into effect on January 1.

Kate Blaker's Holiday Speech

Happy celebration every one.
Most of you know me. But for those who are new I am Kate Blaker and have held several positions here. At the present, I work with the Nursing Home Transition program. I also assist consumers to advocate for maintaining their services.
Recently, our elected officials have appointed staff to policy making roles that have made decisions that negatively impacted Home and Community Based Services. That means that the people who chose to live in the community rather than an institutionalized setting have had their services changed in one way another.

I belong to PA ADAPT and we have visited officials to call for a positive and caring response. On Tuesday, people from the area and along with other advocates from across the state traveled to Harrisburg to support state providers in a rally held at the capitol. We distributed a flyer to explain our concerns.

• Approved services plans in a timely manner and save money! Our homes not nursing homes!! People overwhelming wish to live at home instead of costly institutions.

• People are dying waiting for services in the community and in nursing homes. Give us the Community First option NOW to allow people with disabilities to choose independence and not a life in an institution.NO MORE WAITING LIST!

• Pennsylvanians need a real Olmstead Act now and PA ADAPT want to help you write it!

• Stop going backward and continue to rebalance our long term care system.

• All people with disabilities need home and community based services and these services should be based on functional needs. People with autism and cognitive disabilities should not lose access to home and community based services.

• Bring back the Community Living Advisory Council; disabled people are experts on what they need in the community. We demand a seat at the table.

You all have heard that call to serve your country: Uncle Sam Needs You!
Well I have a better one: You Need You!

RAISE YOUR VOICE!

Dear Consumers,

It is important that you know about a trend of delays and indecisions in the Office of Long Term Living (OLTL) in Harrisburg that could affect TRIPIL’s ability to serve you in the near future.

It is also important that you know that this trend may affect your ability to remain in your chosen home and to receive home and community based services.

All of the delays and indecisions involve the process of approving the budgets that serve you and every other person under the OLTL Home and Community Based Services Waiver programs.

By delaying budget approvals for each person like you, money that OLTL would normally send to TRIPIL to pay your attendants and to pay for your service coordination and support staff is not being sent to TRIPIL.

Being in the situation of paying for services without being paid back, TRIPIL’s financial resources will not last forever, and its efforts may not be successful unless you are concerned enough or angry enough to help.

TRIPIL, as a leader in independent living advocacy, is committed to your independence and is committed to using all of its resources to reverse the trend of delays and to serve you as long as possible.

But we need your help.

Call or write your local state representative and state senator and tell them this:

"The Office of Long Term Living is threatening my independence. I receive home and community based services under a waiver program. OLTL is delaying approval of my budget and funding that allows me to stay in my home in my community. Without these funds I could be forced into a nursing facility and costing Pennsylvania more money and losing my right to be free. I want something done."

If you have questions or need assistance in contacting your legislators, please contact John Lorence at 724-223-5115.

Thank you.

• Are mothers (over the age of 18) diagnosed with a mental illness (Major Depression, Schizophrenia Spectrum Disorder or Mood Disorder)

• Currently have primary/shared custody and are serving as the caretaker for at least one child (natural, adopted, or stepchild) under the age of   18

• Have access to a computer and the Internet

• Would consider using the Internet for support and information

• Are United States Residents

• Are fluent in English

Participants will be compensated up to $100 for their participation in this study.

If you want to participate or would like more information, please email us at the following address: [3]momsupport@temple.edu.

HELP SPREAD THE WORD!

Please help us reach interested mothers by disseminating and sharing this alert via your listserv or in your next newsletter. Also please let us know if you have additional suggestions that will help us reach mothers with a psychiatric disability who may be interested in participating. Contact Katy Kaplan at 215-204-6779 or email her at katy.kaplan@temple.edu.

No Waiting List for Washington County Access Program

The Washington County Redevelopment Authority is using the current funds available to serve EVERYONE!!! on the current waiting list for the Access Program.

Now that the waiting list is going to be served, the Redevelopment Authority needs to build a new waiting list. Funds are available for them to request/renew the Access Program but they need a waiting list.

All it takes is time and a stamp to apply.

Information on all programs from the Redevelopment Authority are available at www.racw.net, click on programs or call 724-228-6875

Here is some information on the access program

Access Program

The Redevelopment Authority has made funds available to provide low and moderate income residents with permanent, physical disabilities increased accessibility in their current homes.

Basic Eligibility Requirements:

Low and moderate income homeowners and tenants with permanent, physical disabilities residing in Washington County who need physical modifications to their homes may apply for this program.

Income eligibility - annual income must not exceed 80% of the Median Family income for the Pittsburgh MSA as determined by HUD and adjusted based on household size. Note: Income limits may change periodically.

-Family of 1 - $35,850

-Family of 2 - $41,000

-Family of 3 - $46,100

-Family of 4 - $51,200

-Family of 5 - $55,300

-Family of 6 - $59,400

*Property taxes are current

*No municipal, state, or federal liens

*Not in foreclosure in bankruptcy

*Verification of permanent, physical disability

*Other eligibility criteria must be met for participation. This includes requirements not listed above but included in the Guidelines.

Once we receive your pre-application, we will send you a letter stating that we have received your pre-application and that it has been placed on a waiting list. When funding becomes available, we will contact you to begin processing your application.

Ensuring Consumer Access to Complex Rehab Technology Requirements for Maximizing Outcomes

Complex Rehab Technology (CRT) products are defined as medically necessary, individually configured devices that require evaluation, configuration, fitting, adjustment or programming.
Examples of CRT include individually configured manual wheelchair systems, power wheelchair systems, adaptive seating systems, alternative positioning systems and other mobility devices. These products and services are designed to meet the specific and unique medical, physical, and functional needs of an individual with a primary diagnosis resulting from a congenital disorder, progressive or degenerative neuromuscular disease, or from certain types of injury or trauma.

CRT is essential for the health and well‐being of people with disabilities who require the equipment and services and for their caregivers. The proper access to and provision of CRT products and services is critical for the independence, well‐being, and ability of people with disabilities to live, attend school, work, worship and participate in their communities. To ensure there is appropriate access,
the following requirements must be incorporated into all applicable policies and practices:

• Consumers require a choice of appropriate quality equipment and services and the opportunity for input during the evaluation, selection, and procurement processes.
• Consumers require access to a thorough evaluation by qualified clinicians and suppliers.
• Consumers require transparency in the funding process and associated decisions, including an option for the consumer to provide supplementary funding above available allowable payment amounts.
• Consumers require adequate customization, integration, fitting, adjustment, and training along with appropriate post‐delivery maintenance and timely repair.
• Consumers require that clinicians and suppliers be held accountable to appropriate quality and service standards.
• Consumers require responsiveness from clinicians, suppliers, manufacturers, and payers along with timely complaint resolution and consumer recourse.
• Consumers require that physicians, case managers, social workers, discharge planners, and other referral sources be provided a clear and concise process for making a referral for prescribed CRT.
• Consumers require that physicians, other prescribing medical professionals, clinicians and suppliers be provided a clearly defined set of coverage and payment policies with reasonable, consistent, and explicit documentation requirements regarding medical necessity.
• Consumers require that policies recognize the services and support systems necessary to evaluate, research, simulate, assemble, fit, educate and maintain the prescribed CRT.
• Consumers require that payers establish adequate payment schedules that are appropriate given the product and service costs involved.
• Consumers require replacement of prescribed CRT when the cost of repair exceeds 50% of the cost of replacement, regardless of the length of time it is in use.
• Consumers require that payers allow the option for suppliers to obtain prior funding approval for uncertain coverage situations.

In recognition of these stated requirements, the undersigned CRT stakeholders and supporters request that federal, state and local policymakers and agencies incorporate these into all related coverage, payment, and quality standards policies to ensure appropriate access to prescribed CRT products and services for people with disabilities.

My Medicaid Matters Action Alert