Category Archives: Region 2

Join GAP, LCPD, UDDC, and DLC in Requesting Respite

 

WHY UTAH NEEDS A FAMILY RESPITE PROGRAM FOR THOSE
IMPACTED BY DISABILITY

Four advocacy organizations (Grassroots Advocacy Partnership,  Legislative Coalition for People with Disabilities, Utah Developmental Disabilities Council, and Disability Law Center) have come together to request an appropriation of $350,000 to provide critical support to families on the Division of Services for People with Disabilities (DSPD) waiting list through a Family Respite Program (FRP).

There are 1,878* families waiting for services throughout Utah. The FRP will help some of these families with respite services they need.

⫸ Respite care is relief for those who are caring for family members with disabilities. Respite can prevent the need for more intensive services that the family would not otherwise choose. Respite programs provide planned short-term and time-limited breaks for families and other unpaid caregivers of children and adults with disabilities. Respite helps keep the family unit together. The FRP will allow families to hire caregivers to provide direct care in their home. For example, a caregiver may be hired for a few hours a week, giving the family caregiver an opportunity to focus on other siblings.
⫸ Respite care is the MOST requested DSPD service because it gives families a break from the constant stress of caregiving and helps prevent further crisis. These individuals are already determined Medicaid eligible and qualified for much more costly services.
⫸ The FRP is a Utah designed program and is intended to serve a limited number of families without additional federal oversight. FRP supports the collection and analyses of data on the program’s effectiveness and possibly a limited services-type waiver.
⫸ Funding the FRP at $350,000 will begin to serve families with the most critical needs-families near or in crisis today.
⫸ The value of respite cannot be overstated. It provides the family caregiver with dependable care options while the caregiver engages in self-care and tends to other family responsibilities. Respite also can be a source of prevention for potential abuse and neglect. Uninterrupted and persistent stress among family caregivers has been shown to contribute to negative health outcomes, increased use of medications, and increases in depression.(1) Furthermore, the U.S. Centers for Disease Control and Prevention suggest respite care as a means for keeping balance in the family (see www.cdc.gov Caregiving Tips for Families of People With Disabilities).

WHAT WE NEED FROM YOU:

Please join us in asking your legislators to support this appropriations request. Contact your state senator and representative. Tell them you are a member of GAP and that you support the appropriation for a Family Respite Program. Send emails to your family and friends and ask for their support. Share this information with other disability organizations. A printable copy of the fact sheet is available here.

(1)As just two of many research findings about the value of respite, see the Virginia Department for Aging and Rehabilitative Services. virginia.gov; and the Administration for Children and Families at U.S. Department of Health and Human Services.

*As of January 22, 2013

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Read the Latest GAP Newsletter

Click on the link to view the latest GAP newsletter. It contains information on advocating from a distance, how to give public testimony, video of Jacob Hansen testifying, and the respite appropriations request that GAP is supporting.

GAP Newsletter, Legislative Session Week 2

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Fact Sheet on the Medicaid Expansion in Utah

Fact Sheet:   Medicaid Expansion in Utah – A potential windfall of $659 million per year for each of the next six years.

In 2010 Congress enacted the Affordable Care Act.  One part of this legislation mandated that all States expand their Medicaid to all persons whose incomes are under 138% of the federal poverty level, which is less than $15,415 per year for a single person and less than $31,809 for a family of four.  In June 2012, the U.S. Supreme Court held that Medicaid Expansion could not be a mandate, making Medicaid Expansion optional for States. 

This Fact Sheet explains why Medicaid Expansion will be a major source of new federal funds and a significant driver of Utah’s economy. That is why it is vitally in Utah’s economic interest to opt to provide for Medicaid Expansion.

Medicaid Expansion represents new federal dollars available to Utah.  These otherwise unavailable federal dollars will create jobs, provide new state tax revenue and stimulate the state economy. Hospitals, nursing homes, managed care organizations, medical supply firms, and physicians will directly benefit. Medicaid Expansion funds will create a major ripple effect throughout Utah’s economy, spurring job creation and benefitting both the public and private sectors. 

  1. In Utah, there are about 145,000 people whose incomes are under 138% of the federal poverty level but who are not currently eligible for Medicaid for other reasons.[1] These people will be Medicaid eligible after Utah’s “Medicaid Expansion.” 
  2. The Centers for Medicare and Medicaid Services (“CMS”), the federal agency that administers Medicaid, has reminded States that “while States have flexibility to start or stop the expansion, the applicable federal match rates [for the Medicaid Expansion] … are tied by law [Congress] to specific calendar years…; States will receive

100 percent [federal financial assistance] … in 2014, 2015 and 2016;

95 percent in 2017,

94 percent in 2018,

93 percent in 2019, and

90 percent by 2020, remaining at that level thereafter.”[2]

3.This means the federal government will pay for all the Medicaid costs for the 145,000 people under 138% of the federal poverty level in Utah between 2014 and 2016 — the entire 100% of their Medicaid.  Yes, it will be an enormous influx of federal funds with no Utah match.  Between 2017 through 2019, the federal reimbursement will decrease a little, but never fall below 90 percent.

4.   Contrast these federal reimbursements for Medicaid Expansion with what the federal government presently matches Utah for the 248,200 people who already receive Medicaid.[3] The present federal reimbursement rate is only 71% and Utah pays the remaining 29%,[4] as compared to the 90 – 100% federal reimbursement rate for Medicaid Expansion!

5.   What if Congress in a few years changes its mind or changes these percentages?  Is Utah stuck with the expansion?  CMS was asked “if a State accepts the [federal] expansion [funds], can a state later drop out of the expansion program?” CMS responded “Yes. A State may choose whether and when to expand [coverage], and if a state covers the expansion group, it may decide later to drop the coverage.”[5] 

6.   Is it administratively difficult or time-consuming for a State to enter the Medicaid Expansion program? As with other parts of a Medicaid State plan, it’s easy for States to sign up.  A State need only notify CMS that it has amended its Medicaid State Plan to include persons whose incomes are under 138% of the federal poverty level. This is a very simple process which can be done on-line or by letter. Similarly, “if a state later chooses to discontinue coverage …, it would submit another state plan amendment to CMS” notifying CMS it no longer will cover the group under 138% of the federal poverty level.[6] 

7.   Let’s take a six year view for Utah. From 2014 through 2019, the federal dollars for the Medicaid Expansion will come to about $4.129 billion. [7] Those federal dollars will cost Utah $174 million over the six years as a match.  [8]

8.   That’s a 23.70 to 1 federal to state match! Is there any business in Utah which would not put up one dollar to receive 23.70 dollars? It’s hard to imagine a business that would refuse such a rate of return, especially if the business could always drop out of the Medicaid Expansion without any penalty or loss.

9.   It has been estimated that this $659 million in new federal funds between 2014 and 2019 will only increase by 3.7% what Utah would have spent if it had not participated in this Medicaid Expansion.[9] Why would Utah NOT expand?

10.   Over the next six years that is a net gain of $3.955 billion dollars.  An average federal gain of $659 million per year for Utah!!![10]  If you are interested in economic development and can kick in $659 million per year into the State for anything, whether highway construction, foster care and adoption assistance, or Medicaid, that $659 million is going to help the State.

11.   If Utah does not enroll the 145,000 low-income people in Medicaid Expansion, the State will actually lose federal reimbursements it had previously received. When the Affordable Care Act was passed, Congress assumed every State would expand coverage to families whose incomes are less than 138% of the federal poverty level. Congress also reduced special hospital payments that had been providing a disproportionate share of reimbursements for hospital services to the lowest income residents.  Congress significantly reduced these special reimbursements because it assumed that the hospitals would be reimbursed under the regular Medicaid program for serving the Medicaid Expansion population.

12.   Therefore, if Utah does not agree to Medicaid Expansion, the State and hospitals will lose about $18.4 million in federal reimbursements per year[11] without receiving in its place the stream of reimbursements that Medicaid Expansion would have provided! That means jobs, as well as health care services.  Over the same six years, this loss of special hospital payments will amount to about $110.4 million.  Any way one cuts it, this loss is far more than what Utah would spend if it agreed to the Medicaid Expansion. 

13.   It makes simple business sense to accept the $4.129 billion in Medicaid Expansion, because Utah and its hospitals will lose $110.4 million over the six years regardless.  Why not come up with $174 million in state funds spread over 6 years to finance Medicaid Expansion which will then ensure and provide for the tremendous financial benefits to the hospitals?

14.   One could also look at potential increases in revenue for the health care industry.  For example, if Utah participates in the Medicaid Expansion, this will generate about $228,167,650 per year in new hospital revenues.[12] That means new jobs at all economic levels. 

15.   Besides hospitals, other health-related industries will similarly benefit, including        pharmaceutical and managed care companies because there will be 145,000 new Medicaid recipients to use their services. 

 Medicaid Expansion is a win-win: it increases both health care access and the amount of federal funds put into Utah’s economy.

Fact Sheet prepared by Stephen F. Gold, Esq., 215-627-7100, ext 227. For more information, citations, and data, contact stevegoldada1@gmail.com.


[1] http://www.urban.org/UploadedPDF/412607-Opting-Out-of-the-Medicaid-Expansion-Under-the-ACA.pdf

[2] http://cciio.cms.gov/resources/files/exchanges-faqs-12-10-2012.pdf at 11.

[3] http:// www.statehealthfacts.org /profile.jsp  

[4] http://aspe.hhs.gov/health/fmap12.shtml

[5] http://cciio.cms.gov/resources/files/exchanges-faqs-12-10-2012.pdf at 11.

[6] Id.

[7] http://www.kff.org/healthreform/upload/medicaid-coverage-and-spending-in-health-reform-national-and-state-by-state-results-for-adults-at-or-below-133-fpl.pdf  Table 1 at 10, column 5.

[8] Id. at column 4.

[9] Id. at column 9.

[10] This was computed by subtracting the six year State match of $174 million from the federal match of $4.129 billion and then dividing by six.

[11] This represents the total Medicaid Inpatient Hospital –Disproportionate Share Hospital (DSH) payments in 2010 multiplied by the federal match in # 4 above. 

[12]  This amount is derived by computing Utah’s average current Medicaid recipient’s Medicaid hospital costs and multiplying that by the number of people who will be enrolled in Utah’s Medicaid Expansion.   

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Meetings at the Capitol Feb 5th and 7th

Fellow Advocates,

The Session has started!  I wanted to let you all know of two important dates next week.  Tuesday, February 5th DSPD and USOR will be giving testimony to the Social Services Appropriations Committee.  We are looking for folks who have a story to tell about how either of these programs have benefited your life or how they COULD benefit your life if you are on the waiting list to receive services.  The meeting is at 8:00 a.m. at the Capitol.  I know this is not a very convenient hour but it is so important to get people to this meeting and get a few individuals that would be willing to share their story with the committee.  If you would be able to come on the 5th and need transportation please contact me as soon as possible.

Another important day is Thursday, February 7th.  Roads to Independence is taking a bus to the Capitol and will arrive around 11:00 a.m.  We will provide lunch for you at the cafeteria.  We will try to attend a committee meeting and then talk with legislators that we request visits from.  We will be staying for the reception put on by the Legislative Coalition for People with Disabilities (LCPD), which goes from 4:00 to 6:00 in the rotunda.  This is a chance for us to visit one on one with legislators.  Don’t forget to email or call your legislators letting them know you are attending the reception and are hoping to visit with them!

 Again, please let me know if you will be able to come and if you want to ride the bus.  It is very important to RSVP so we can plan accordingly. 802 612-3215

I appreciate each of you and the efforts you make.  I know that the efforts we make during the Session have a positive impact and bring results for families and individuals with disabilities.  Let’s make this Session a great one!

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Utah Symphony – Utah Opera Education – Events for Individuals with Special Needs

January 24, 2013
7:00 pmto10:00 pm

The Utah Symphony | Utah Opera offers an annual concert for children of all ages with special needs and their families. We present this concert because we know that many families cannot attend cultural events together because their special needs child acts in distracting ways. We feature our Opera Resident Artists with the Utah Symphony on the Capitol Theater Stage in a special concert where everyone understands the difficulty of keeping these family members quiet in their seats. This concert is FREE but registration is required.

WEB--special-needs-concert-

 

 

 

 

 

 

 

 

Utah Symphony – Utah Opera Education – Events for Individuals with Special Needs.

 

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LCPD Legislative Reception February 7, 2013

February 7, 2013
4:00 pmto5:45 pm

Please join us at the LCPD Legislative Reception. This is a wonderful opportunity to meet your elected officials. Call them prior to let them know you will be attending. Invite your local People First chapter to attend with you.

For a printable flyer, please click here.

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Logan Area Meet Your Elected Offical Event

January 17, 2013
6:30 pmto8:00 pm

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Upcoming Events – Families of Autism and Asperger’s Standing Together

January 23, 2013
7:00 pmto9:00 pm

Join F.A.A.S.T. for their January event, featuring Brett Hortin Financial Services on January 23, 2013 at 7:00pm. This event will include information comprehensive life care planning for children with special needs. It is being held at the Weber County Library. Click on the link below for further details.

Upcoming Events – Families of Autism and Asperger’s Standing Together.

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Community Social Club Winter Get Together

Date: January 2, 2013

Place: DSPD at 1290 East 1450 South in Clearfield

Time: 4:00 to 5:30

Come play board games and eat pizza!  Pizza is provided. You can bring something to share (salad, veggies, dessert, soda)  or a $2.00 donation.

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GAP Newsletter — Pre Session

GAP’s most recent newsletter contains a link to Governor Herbert’s budget, lists of committee members for the upcoming Utah State Legislature, links to websites where you can contribute for victims of the Newtown shootings, and statements from NAMI and the autism community regarding the tragedy. There is also a link where you can sign up to join our mailing list.

GAP Newsletter — Pre Session.

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