Moving forward, vol. 8, no. 7 (2003 February 21)

Volume 8, Issue 7

February 21, 2003

Two notable pieces of legislation dropped this week. Senate Bill 170, The Independence Plus Act, proposes that people who receive Medicaid waivers be provided the opportunity to select services and providers to enhance their choice and control of those services. HB 428 and HR 225 would offer special license plate to generate donations for Special Olympics Georgia. One-quarter of the funds raised would provide household establishment expenses for people with disabilities moving from congregate care facilities to the community.
Lawmakers are in recess so House Appropriations Committee members may work on the FY 2004 budget and the Senate can work on the amended FY 2003 budget. They return on February 26 at 1:00 p.m. for the 20th legislative day.
Legislation Tracker
HB 34: Education; students committing certain acts of physical violence; disciplinary tribunal Sponsor: Greene-Johnson, 60th Status: Filed
HB 38: Child support; amend provision; income deduction order Sponsor: Ehrhart 28th Status: Filed
HB 81: Teachers; rights for continued employment; restore Sponsors: Lucas 105th district, Cummings 19th, Hugley 113th, Greene 134th, Reece 11th, Jordan 83rd. Status: Education Committee favorably reported
HB 82: Fair Lending; redefine points and fees; exclude certain fees Sponsors: O'Neal 117th district, Richardson 26th, Massey 24th. Status: Read and referred to House Banks and Banking Committee
HB 130: Georgia Health Care Act Sponsors: Holmes 48th, Orrock 51st Status: Referred to Appropriations Committee
HB 142: Fair Lending Act; amend provisions Sponsors: Floyd 132nd, Shaw 143rd, Parrish 102nd, Royal 140th, Channell 77th, Skipper 116th Status: Passed the House; Senate read and referred to Banking and Financial Institutions Committee
HB 145: Health Maintenance Organizations; mental disorders; point-of-service options Sponsors: Gardner 42nd, Harbin 80th, Moraitakis 42nd, Henson 55th, Maddox 59th Status: Referred to Insurance Committee
HB 170: Fair Lending Act; repeal Sponsors: Franklin 17th, Joyce 2nd, Coan 67th, Burmeister 96th, Yates 85th, Amerson 9th Status: Referred to Banks and Banking Committee
HB 211: Assistance dogs; interfering with, assaulting, killing; penalties Sponsors: Rice 64th, Millar 52nd, Dix 70th, Sholar 141st, Jenkins 93rd Status: Referred to Special Judiciary Committee
HB 256: Industries for the Blind; manufactured products; purchase by state employess; exception Sponsors: Broome 141st, Sholar 141st, Skipper 116th, Westmoreland 86th, Drenner 57th, Lunsford 85th Status: Referred to House State Institutions and Property Committee
HB 295: Education; deaf students; certification of interpreters Sponsors: Butler 88th, Smith 76th, Thompson 69th, Burmeister 96th, Bordeaux 125th Status: Referred to Education Committee
HB 318: Adult Day Center Licensure Act; enact Sponsors: McClinton 59th, Howard 98th, Ashe 42nd, Mobley 58th, Sinkfield 50th, Maddox 59th Status: Referred to Human Relations and Aging Committee
HB 352: Licensing boards; complaints against licensee; certain notification

Sponsors: Harbin 80th, Campbell 39th, Powell 23rd, Boggs 145th Status: Read and referred to Governmental Affairs Committee
HB 357: Certain deaths; persons in compensated care; notify coroner Sponsor: Howard 98th Status: Read and referred to Human Relations and Aging Committee

HB 363: Electronic Textbooks; make available to local boards, schools, and students Sponsors: Fludd 48th, Greene-Johnson 60th, Marin 66th, Floyd 69th, Holmes 48th Status: Read and referred to Education Committee

HB 428: Intellectually Disabled Health and Fitness Program Fund; establish; special license plates Sponsors: Borders 142nd, O'Neal 117th, McBee 74th, Jenkins 93rd, Stephens 123rd Status: Read and referred to House Motor Vehicles Committee
HB 429: Workers' compensation; total and temporary partial disability; benefits Sponsors: Bordeaux 125th, Bannister 70th, Ralston 6th Status: Read and referred to Industrial Relations Committee

HR 225: Intellectually disabled health and fitness program; special plates Status: Appropriations Committee

SB 12: Criminal Offenses and Penalties for Abuse, Neglect, and Exploitation of Disabled Adults and Elder Persons Sponsor: Unterman 45th, Balfour 9th, Squires 5th Status: Passed the Senate; now in House Special Judiciary Committee

SB 17: Child support; computation of award, guidelines, income deduction orders Sponsor: Harp 16th Status: Read and referred to Judiciary Committee
SB 50: Health Insurers; Consumer Choice of Benefits Health Plan Act Sponsors: Seabaugh 28th, Golden 8th, Price 56th, Moody 27th, Mullis 53rd, Williams 19th Status: Referred to Insurance and Labor Committee

SB 53: GA Fair Lending Act; amend provisions Sponsors: Cheeks 23rd, Starr 44th, Crotts 17th Status: Passed the Senate, now moves to the House Banks and Banking Committee

SB 111: Death Investigations; patients receiving compensated care in facilties licensed by DHR Sponsors: Tanksley 32nd, Unterman 45th Status: Read and referred to Judiciary Committee

SB 170: Long-term care services; in-home and community based care; consumer choice and control; Independence Plus Act Sponsors: Jackson 50th, Dean 31st, Zamarripa 36th, Gillis 20th, Starr 44th, Thomas 2nd Status: Read and referred to Health and Human Services Committee
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View any bill in its entirety at http://www.legis.state.ga.us/legis/2003_04/leg/legislation.htm

Budget Overview

Suggested cuts for the Department of Human Resources are:

Proposed DHR Austerity Cuts for Fiscal Year 2004

Mental Health/Developmental Disabilities/Addictive Disease

State Dollars

Convert 75% of state-funded DD family support slots to Medicaid waiver slots

$586,767

Reduce Emory contract for Autism Resource Center

$100,000

Reduce state-level reserve for autism support (these are funds remaining from the closing of the Clayton Respite Home, and

do not reflect a loss in services.)

$35,924

Reduce room and board supplement for 1,362 consumers with

Developmental disabilities by 30% $2,039,731 Eliminate the Marcus Institute contract for fetal alcohol syndrome services

$108,520

Newly Proposed Cuts: Department of Community Health (DCH)

DCH is proposing premiums between $0-458/month for the Katie Beckett waiver program based on the parents' income. This will impact 5,417 children and families. To implement this proposal, DCH must obtain Federal approval. DCH also proposed a 10% provider rate cut for all Medicaid waiver programs.

Category

Total State Reduction

Community Care (CCSP)

3,216,146 DHR state

Independent Care

789,160 Medicaid

Mental Retardation Waiver

5,351,951 DHR state

Waivered Home Care

214,458 Medicaid

DSPS

86,731 DHR state

Therapeutic Residential Services

1,926,683 DHR state

SOURCE

312,200

MRWP (CHHS Waiver)

1,884,997 DHR state

FY 2003 Supplemental Budget This is a mid-year adjustment for 2003. Georgia's budget shortfall is over $600 million of

which $450 million is Medicaid. The proposed cuts in MHDDAD totals $8 million or 1.3% of their state budget. These

include:

State Dollars

Consolidation of Augusta Regional Hospital and Gracewood administration

(259,000)

Cut state MR service dollars and refinance with Social Service Block grant

(462,500)

One-time hiring freeze of state office and state hospital staff

(1.5 million)

Austerity Adjustments

($3.1 million)

Some Enhancements remain in the budget:

Transfer 11 children from nursing homes to community

$222, 692

Transition planning for people with DD or mental illness who want to move to community from institutions

$170,000

Start-up costs for 65 children moving from institutions to community

$585,000

FY 2004 Budget The big budget contains temporary tax increases for tobacco and alcohol totaling some $400 Million. It also calls for using the Rainy Day funds.

Enhancements: DCH

State Dollars

145 people to move from nursing home to community

$3.2 million

Assessment of people to move from nursing home to community

$75,000

15 people with serious mental illness will move from institutions to community and this reflects their primary care health

costs

$36,045

10 people off ICWP waiting list $220,369

Department of Human Resources (DHR): The overall Mental Health, Developmental Disability, and Addictive Disease FY 04

budget has been cut by $11 million state dollars. All cuts described in the following section are from existing state dollars. These

are not all the cuts to MHDDAD, just the ones which appear to directly impact DD.

Cuts: DHR

State Dollars

Consolidate administration at Augusta Regional and Gracewood

($813,417)

Reduce administration costs at CSBs

($2.6 million)

Cut MR state funds and replace with SSBG federal funds

($761,108)

Eliminate contract with Georgia Hearing Impaired

($50,000)

Austerity adjustments (budget cuts)

($5.46 million)

Pay raise from last year not annualized for 2004

($3.61

million)

Because so many people with DD are served in Community Mental Health Centers, which include all the CSB's, the additional

cut of $4.2 million will affect people with DD.

The only enhancements to DHR are for child welfare and Olmstead/Waiting Lists items. All enhancements are from projections for maximizing federal revenue through the ICF/MRs, ICFs and Skilled nursing facilities. The term used for this maximization process is upper payment limit (UPL). It is based on changing the federal reimbursement rates at the institutions so they can

capture 100% of their costs in the future. This is a short-term fix during a fiscal crisis, not a long-term solution. DHR is also researching whether flexibility in federal regulations will allow additional provider groups (other than nursing homes and hospitals) to participate in the UPL.

FY 04 Enhancements:DHR

State Dollars

Move 50 people from state hospitals to community

$2.6 million

Move 15 people with serious mental illness from institutions to the community

$432,898

Transition planning for moving the above 65 people

$170,000

Add 2 state office positions to certify and monitor services

$148,644



Serve 50 people with DD from the short term waiting list

who need services in addition to what they are already receiving

$949,031

Aging

There are also 84 people from nursing homes, who are being moved using the CCSP program at a projected cost of $421,523.

Current Waiting Lists For Services Over 3,300 people are waiting for help, including:
3,142 Georgians with Mental Retardation or Developmental Disabilities 249 people with severe physical disabilities

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