http://www.lgtinc.org en-us http://www.lgtinc.org N/A contact@lgtinc.org Fri, 30 Jul 2010 09:51:21 EDT 20 http://www.lgtinc.org/articles/246/1/Therapy-and-Good-Morning-America-Update June 29, 2007   Dearest Advocates:   Even though the Governor vetoed HB 549, I have some great news!  Effective July, 2007, The Dept of Community Health is changing the procedures for prior authorizations for therapy............   If you would like to see all the updates, please go to the following website and look at page 11+ regarding PAs: https://www.ghp.georgia.gov/wps/output/en_US/public/Provider/MedicaidManuals/CIS_v7_2007-07.pdf    The one concern we have is that the manual states "up to" 180 days.  I know the Trialliance is working on this issue and trying to get clarification from DCH at this time. Reminder: We currently have to submit therapy PAs for more than 8 units / month (approx. 2 visits/month) EVERY 3 months and this would increase to every 6 months!   Once again, I do think us continuing to educate everyone on what the "real" issues are, helps the process. No, we did not get everything we want (including increasing the number of units our children can receive prior to having to get the PA) BUT at least this is a step in the right direction.   Thanks again to everyone that got involved to making a difference this legislative session. More work needs to continue BUT we are making progress!    ===================================   UPDATE:  Today on ABC Good Morning America.................Apparently- Eight-year-old Mikeriya Ainsley (the girl that was in the news segment) HAS BEEN REINSTATED HER THERAPY!  I hope you can see the power of the media and helping everyone see the "real" issues our children face in receiving the services they NEED!   PLEASE continue to post your comments on ABC's website regarding the segment Good Morning America aired on Tuesday entitled "Rocky Transition From Public Medicaid to Private HMO's"…………  Here is the web link:   http://abcnews.go.com/GMA/OnCall/comments?type=story&id=3314626&GMA=true   Just in case you missed the news story: http://abcnews.go.com/GMA/OnCall/story?id=3314626&page=1   UNITED... WE WILL MAKE A DIFFERENCE.   Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how Heidi can help you maximize your child's potential, please go to www.heidijmoore.com "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore. To see how you can advocate for your child go to www.kidshealthcarega.org. Heidi J. Moore Fri, 29 Jun 2007 00:00:00 EDT http://www.lgtinc.org/articles/245/1/UPDATE%3A-Good-Morning-America--CMO%26%2339%3Bs-in-GA-and-Wall-Street-Journal-Article June 27, 2007   Dearest Advocates:   I wanted to give you an update from yesterday's advocacy email.  Thanks to so many of you that forwarded to me additional information that could be sent out to everyone!   If you would like to post your comments on ABC's website regarding the segment Good Morning America aired yesterday entitled "Rocky Transition From Public Medicaid to Private HMO's"…………  Here is the web link:   http://abcnews.go.com/GMA/OnCall/comments?type=story&id=3314626&GMA=true   Let's keep up the pressure on getting something done about the system. Even if you are not affected by the CMO system, please remember that Aged, Blind and Disability populations were almost put into CMO's this legislative session but due to our advocacy efforts was taken out!   We all need to be good stewards of tax-payers $$$- and that's not happening with the CMO program.  Only through communicating what the real issues are and educating those around us………are we going to receive the necessary change needed in the Medicaid system! Please help and get involved!   In addition- for those that did not get a copy of the Wall Street Journals article, it can be found by going to: http://biz.yahoo.com/wallstreet/070625/sb118254994081445264_id.html?.v=1   If you have comments regarding the WSJ's article, they can be sent to the reporter, John Hechinger at john.hechinger@wsj.com    UNITED… WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi ============================================ June 26, 2007   Dearest Advocates:   Today on Good Morning America-ABC National News, they did a story titled "Rocky Transition From Public Medicaid to Private HMO's".  As many of you are aware, this has been a very difficult time for families and providers in the Georgia Medicaid system.  Please take a moment to see the segment at:   http://abcnews.go.com/GMA/OnCall/story?id=3314626&page=1   Also- if you could email ABC news letting them know about your personal struggles with the Medicaid system, that would be great. The more knowledgeable the general public becomes regarding the issues surrounding the Medicaid system…..The Better!  We need to do our part in educating those that don't understand the system (including our legislators and the Governor).  ABC News specifically talked about Georgia's Medicaid system.  I agree we need to be good stewards of taxpayers $$$, but we also have to take care of those that can't take care of themselves!!!!! Including our precious children with disabilities.  ; ; ; ;   Please let our voices be heard….."UNITED… WE WILL MAKE A DIFFERENCE!"   Comments can be submitted to ABC via the following web link (only 500 characters so be brief and to the point): http://abc.go.com/site/contactus.html?cat=Good%20Morning%20America     Education and building awareness of the issues is the key to success in making change in the overall Medicaid system! We as parents and providers must continue to help others understand the need for necessary services.  I do believe our children must be viewed as an INVESTMENT and NOT a Liability in Georgia!   ---------------------------------------------------------------------------------- In addition- the Wall Street Journal had an article on the front page of their newspaper yesterday titled "'Mainstreaming' Trend Tests Classroom Goals". Unfortunately, I was not able to pull the entire story from their website (you have to be a subscriber).  Here is the link for fyi:   http://online.wsj.com/article/SB118254994081445264-search.html?KEYWORDS=inclusion+education&COLLECTION=wsjie/6month   ------------------------------------------------------------------------------------- I hope everyone is having a great summer.   I will be issuing additional information regarding the proposed changes to the Georgia Babies Can't Wait Program and how you can get involved very shortly. Stay Tuned……….   Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how Heidi can help you maximize your child's potential, please go to www.heidijmoore.com "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore. To see how you can advocate for your child go to www.kidshealthcarega.org. Heidi J. Moore Wed, 27 Jun 2007 00:00:00 EDT http://www.lgtinc.org/articles/244/1/HB-549-Media-Attention-to-the-Issue%21 June 8, 2007   Dearest Advocates:   Below is a newspaper article today in the Gwinnett Daily Post written by Dave Williams regarding the HB 549 that was VETOED by the Governor 1 ½  weeks ago.  As many of you are aware, this is a very frustrating time for both families and providers since the implementation of a more difficult prior authorization process for therapy in September 2006.   This bill would have allowed for prior authorizations (PA) to occur every 6 months and not 3 months, as well as, increase the number of units of therapy from 8 units to 16 units / month before needing a PA. There is a reason why our children need therapy……We already have to go thru a ton of paperwork just to "prove" that we qualify for Medicaid for our children and now they say we have to "prove" it every 3 months for therapy!  This is a waste of taxpayers $$$. Hiring more therapists to "review" the cases instead of paying for the therapy for our children to begin with……is crazy!  In addition, our children do not make the type of progress warranted to be reviewed every 3 months like other "general" Medicaid populations.  There are many ways to access Medicaid and there are different criteria for those populations. Mr. Trail's comments below do not make sense.  I'm sorry…I usually do not give this much of my personal views on issues, but I strongly disagree with the VETO and the reasoning behind it!   Here is the actual link to the newspaper article: http://www.gwinnettdailypost.com/index.php?s=&url_channel_id=32&url_article_id=28865&url_subchannel_id=&change_well_id=2   PLEASE take a moment and thank Dave William (dave.williams@gwinnettdailypost.com) for continuing to educate the State on what is truly happening to our children. This same article can also be read in the Albany Herald Newspaper http://www.albanyherald.com/front.html#chil .   We are continuing to work on this issue and will hopefully have more information in the near future on what we all can do to make a difference! Therapy is an INVESTMENT for our children!   Hang in there. UNITED… WE WILL MAKE A DIFFERENCE!   Happy Reading. Heidi   gwinnettdailypost.com   Parents frustrated with veto of therapy bill 06/08/2007 -   By Dave WilliamsStaff Writerdave.williams@gwinnettdailypost.comATLANTA - Advocates for children with disabilities are seeing first-hand just how powerful one governor is compared to 236 state legislators.As a bill easing restrictions on therapy visits traveled through the General Assembly this year, the 180-member House and 56-member Senate supported it unanimously three times. And the fourth vote on the legislation, in the Senate, was 47-2. Yet, House Bill 549 was among the casualties last week when Gov. Sonny Perdue vetoed 41 bills in one day. Absent an unlikely attempt by lawmakers to override the governor when they reconvene in January, the measure is dead. "That's the frustration of this," said Heidi Moore of Alpharetta, a leading advocate for children with disabilities and mother to a 7-year-old boy with Down syndrome. "The House and Senate saw the need for this. ... Either (Perdue) doesn't understand this bill or it gets down to numbers again."Moore and other parents began pushing for a legislative remedy to their complaints about therapy services covered under a Medicaid waiver program after the state instituted a policy last September requiring families to seek prior approval every three months.The bill, sponsored by House Speaker Pro Tempore Mark Burkhalter, R-Alpharetta, would have extended prior approval for  therapy visits to six months.It also would have required the state to cover children for 16 units of physical, speech or occupational therapy per month, up from eight units under the state policy. Four units equals one hour of therapy.But Perdue, in his veto message, said those changes would have run afoul of the federal agency that oversees Medicaid. "(The bill) would restrict the state's ability to conduct appropriate prior authorization review as required by federal regulations," the governor wrote.Mark Trail, Medicaid director for the Georgia Department of Community Health, said the state sent a copy of the bill to the federal Centers for Medicare and Medicaid Services and was told the CMS would not approve it.Specifically, Trail said the agency objected to a provision allowing children with "chronic" disabilities to seek prior authorizations every six months but forcing kids with "acute" conditions to adhere to a shorter time frame."That sets a standard in law that would be unacceptable to the federal government," he said. Perdue's veto message instructed the DCH to continue looking for ways to streamline the paperwork therapists and parents have to fill out to process prior authorizations.Trail said the agency already has put in place some changes, including consolidating two of the required forms into a single document and improving the Web site families use to submit prior approval requests.He said the DCH also has hired 21 therapists to review requests, additional staffing that is expected to speed up the process."We have a very high percentage of approvals now, which says to us that the providers know how to submit the forms," he said. Moore said as long as the process remains cumbersome, more and more therapists will stop taking Medicaid patients."We lost a therapist because of it," she said. "Our speech therapist told us she just can't deal with the paperwork."The ultimate fear, Moore said, is that so many therapists will pull out of the program that families won't be able to get therapy services they can afford. In the long term, that would mean more disabled children growing up to become a huge burden on taxpayers, she said."Therapy is an investment in our children," Moore said. "You either pay pennies now or dollars later."   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how Heidi can help you maximize your child's potential, please go to www.heidijmoore.com "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore. To see how you can advocate for your child go to www.kidshealthcarega.org. Heidi J. Moore Wed, 27 Jun 2007 00:00:00 EDT http://www.lgtinc.org/articles/243/1/Governor-Veto%26%2339%3Bs-HB-549 May 31, 2007   Dearest Advocates:   As many of you may have already been aware- Governor Perdue VETOED HB 549 (regarding the therapy process, prior authorizations,etc).  This is VERY disappointing since I know many of you took time out of your busy day to write/call the Governor's office last week in support of this bill.  We will continue to advocate for a change in the system…………………Medicaid needs to streamline the paperwork and make it easier for our therapist to provide the necessary services our children need!   Below is the explanation the Governor gave regarding his veto.  I do not necessarily agree with his statement but I wanted you to see first hand what he said:   HB 549         HB 549 seeks to amend prior authorization requirements for recipients of Medicaid funded services.  The proposed changes inadvertently conflict with federal mandates on Medicaid services.  Specifically, HB 549 would restrict the States ability to conduct appropriate prior authorization review as required by federal regulations (CFR 433.15(b)(7)).  Federal regulators have also indicated an objection to the establishment of different standards for recipients based on a general categorization of their condition rather than based on an individuals specific medical needs and likely rehabilitation and recovery (CFR 440.240).  For these reasons, federal approval of the changes mandated by HB 549 is not expected.  The timeliness of these services, particularly to this constituency is important.  I am, therefore, directing the Department of Community Healt h to continue its efforts to provide for a more streamlined preauthorization process so as not to unduly burden the practitioners and patients this bill seeks to assist.    Please remember….United… WE WILL MAKE A DIFFERENCE.   We may have lost the battle..... but WE WILL WIN the WAR!   Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how Heidi can help you maximize your child's potential, please go to www.heidijmoore.com "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore. To see how you can advocate for your child go to www.kidshealthcarega.org. Heidi J. Moore Wed, 27 Jun 2007 00:00:00 EDT http://www.lgtinc.org/articles/242/1/URGENT%3A-HB-549-NEEDS-YOUR-SUPPORT.-PLEASE-CALL-THE-GOVERNOR-TODAY%21 May 22, 2007   Dearest Advocates:   URGENT   I have been told that the Governor now needs to hear from families and providers on why House Bill 549 is important to us and our children.    PLEASE CALL the Governor Perdue's office this week at 404-656-1776, or Fax:404-657-7332 or  e-mail him at sperdue@gov.state.ga.us . We would prefer you call or send a fax if possible. The deadline for the Governor to sign this bill is May 30, 2007.   A lot of work has went into supporting HB 549 with providers, parents and legislators and we want to make sure that this bill goes into law. I've been told that Dept. of Community Health has been in meetings with the Governor's staff this week trying to convince them why the Governor should veto this important bill.   OUR CHILDREN NEED YOUR SUPPORT!   Just to remind everyone.......Basically, House Bill 549 will help alleviate many of the issues with the prior approval process for therapy in the Medicaid system.  It streamlines the paperwork, defines medical necessity, changes the prior approval process to every six months instead of 3 and allows 16 units of therapy per discipline before the prior approval process kicks in.     THIS IS AN IMPORTANT BILL THAT CAN HELP ALL OUR CHILDREN WITH THERAPY……Now and in the future!   PLEASE CALL TODAY!     YOUR CHILD's THERAPY MAY DEPEND ON IT!   Thanks in advance for your support in this urgent issue.   Sincerely,   Heidi --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore Heidi J. Moore Tue, 22 May 2007 00:00:00 EDT http://www.lgtinc.org/articles/241/1/SB-10--Governor-Signing-Tomorrow-and-other-info May 17, 2007   Dearest Advocates:   I wanted you to be aware of this announcement that was just released today:   We have just been notified that the Governor will sign SB 10 tomorrow--Friday-- at 9:30 a.m. in his office at the Capitol.  You are welcome to come.  It is an open event.  The ceremony itself will probably take no longer than 15 minutes.  But the law will go into effect on his signature.  If anyone is planning on attending, please let me or my office know.  If there is a large enough crowd of families, we can ask that the ceremony be moved from the office to the steps to accommodate more people.   SB 10 is the beginning of a significant shift in the way we provide public education.  The benefits of this bill will be seen for many years to come.   Melanie Davis Stockwell Chief of Staff and General Counsel Senator Eric Johnson, President Pro Tempore Georgia State Senate Atlanta, GA 30334 404-656-5109 404-657-9727 (FAX) melanie.stockwell@senate.ga.gov ==============================================   In addition: I received this information from Stuart Bennett who is the Chief Deputy State Superintendent for Policy and External Affairs:   Since the passage of Senate Bill 10 on April 22, we have received a number of inquiries from interested schools and parents. For that reason, we have launched a very preliminary Georgia Special Needs Scholarship Program website. Once the bill becomes law, this new website will serve as the one-stop shop for the Georgia Special Needs Scholarship Program.  Over the coming weeks and months, the Department will add critical program information as soon as it becomes available, so we ask that you check the website frequently. Until then, we ask that all interested parents and private schools use this website to file an "Interest to Participate" form.  The information provided through these two forms will help the Department as it moves forward to implement this new state program for the 2007-2008 school year. The website ur l is: http://public.doe.k12.ga.us/sb10.aspx ===================================================== Also- Will be making an additional announcement for needed advocacy for Babies Can't Wait Program very soon. Stay tuned. Have a great day, Heidi --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore Heidi J. Moore Tue, 22 May 2007 00:00:00 EDT http://www.lgtinc.org/articles/240/1/Disability-Updates-and-Information May 14, 2007   Dearest Advocates:   I wanted you to be aware of a few items of interest:   1. SB 10 Update. This is the bill that would allow families to receive school vouchers if the children is currently in the public school system, has a diagnosis and and IEP.  More information can be found by going to the following website: www.doe.k12.ga.us/sb10.aspx   2. Proposed Babies Can't Wait advocacy. It has been brought to my attention that there is being proposed some radical changes to the Babies Can't Wait program in Georgia. I am working with some key individuals to get the facts, and prepare an advocacy strategy to make a change to help this program for our children. My concerns are that BCW needs coordination and how we do that as a State will be a top priority on how effective this program really is for the children 0-3 yrs old and those not even born yet that need this service.    Further information will be issued shortly on how you can get involved and make a change to this program. Keep you posted.   3. Medicaid Identity Concerns. Anyone that has Medicaid should have received a letter from ACS Georgia Health Partnership (subconstractor to Medicaid) regarding a CD that was lost that may have contained personal information on it (including: Medicaid eligibility data: name, address, social security number, date of birth, etc).  This is VERY serious.  Additional information can be found by going to the following website: http://www.ftc.gov/bcp/edu/microsites/idtheft/    I strongly recommend you request an annual credit report for your child.  www.annualcreditreport.com or you can call ACS at 1-800-213-3969 for further questions.   4. Many of you may have received a letter from DCH regarding a new program called "Georgia Medicaid Management Program-GAMMP" that will be run by APS Healthcare (as subcontractor to Medicaid). The program is supposed to offer you a nurse who will work with you to provide education on your overall health for your child and look for "ways" you can feel better every day.   I have gotten clarification of the program: A.. This program is VOLUNTARY to your family. B.  You do not need to fill out the survey if you do not want too. C. If you choose not to enroll in this Medicaid program, nothing will happen. D. All Medicaid consumers were issued this letter (including MRWP and Katie Beckett Waivers) that are not under a Care Management Organization (CMO) or a Disease Management Program.   That's all I know for now.....I hope you find this information helpful.  Happy Belated Mother's Day to all you Mom's out there!!!   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore Heidi J. Moore Tue, 22 May 2007 00:00:00 EDT http://www.lgtinc.org/articles/236/1/Advocacy-%26-Medicaid-Information-from-Heidi-Moore May 1, 2007   Dearest Advocates:   A few weeks ago I gave a presentation to the Down Syndrome Association of Atlanta that I thought might be helpful to you.  The presentation has years worth of information in it thanks to many people that have worked with me on my advocacy efforts and trying to better understand the system  in order to help my family and thousands of others.    Please remember: I am just an informed parent and not an attorney. If you need legal advice, please contact an attorney. This information should be used for general information only!    In addition, starting the first of the year, I started a consulting business to help families with the Katie Beckett/Deeming Waiver and MRWP application process (as well as education and other advocacy issues for their child)  based on all the experience I have learned in the last 4 yrs of advocating for families and working with DCH/DHR and other non-profit organizations.  If you are interested in this service, please let me know.      In addition this year,  I started working part-time for B&B Care Services, Inc as their Community Relations Manager. For those that don't know- B&B Care Services, they help to provide services to families under the Mental Retardation Waiver Program (MRWP),Independent Care Waiver Program, Community Care Services Program and the SOURCE Program throughout the State of Georgia. Please let me know if you have any questions regarding this company and how I can help you with getting those services via B&B Care Services, Inc.   I must warn you....this is a very long email and you may want to print it out for future reference.   Hope you find this information helpful!   In addition, if you would like to see my previous advocacy email postings, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore?Page=9   United... We WILL Make a Difference! Sincerely, Heidi ============================================ Medicaid Waivers and AdvocacyYour Child Needs YOU! Heidi J. Moore   Parent Advocate for Children and Adults with Disabilities   Proud Mother to Jacob- 7 yrs old with Down syndrome and Jared - 5 yrs old   The material contained in this presentation is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or qualified legal representative.   Agenda •Medicaid - Waivers and Supports. •Tips and Traps. •Networking and Building Alliances. •Advocacy •General Information - Things you should know!   Medicaid  Medicaid is a federal entitlement program of medical assistance for people of low-income who are: •Age 65 and older; •Blind or have other disabilities; •Children; •Pregnant women; •and families with children.   Medicaid Basics •Funding for Medicaid comes from both state and federal dollars. •Each state's Medicaid program is unique. (must be in compliance with federal guidelines.) Medicaid Eligibility •Individual must meet both "categorical" and "financial" requirements. •In Georgia, the following categories of people are eligible for Medicaid: •Parents and children, •Pregnant women and infants, •Children through age 18, and •The aged, blind and disabled   •In Georgia, SSI recipients are  automatically eligible for Medicaid.   What is the Katie Beckett / Deeming Waiver ? •Category for Medicaid eligibility based on the Tax Equity & Fiscal Responsibility Act (TEFRA) 1982. •State's are allowed to make Medicaid available to a child with a disability if: -18yrs old or younger, AND -Meet federal criteria for childhood disability, AND -Meet institutional Level of Care, AND -Can safely be served at home, AND -Cost does not exceed the applicable institutional cost.   What is the KB Waiver criteria based on? •Federal Regulations established general requirements in 42CFR 435.225. -Requires institutional level of care: nursing home, hospital, or intermediate care facility- mental retardation.   1. Intermediate Care Facility - Mental Retardation - 442CFR440.150 & 42CFR483.440 •Requires 24 hour supervision AND active treatment. 2. Hospital Level of Care - 42CFR440.10 •Georgia uses Interqual. 3. Nursing Home LOC - 42CFR440.155 •DHR Rules 290-5-8 & OCGA 31-7-1(1)(b). •Requires 24 hour nursing care.   Background on Katie Beckett-Deeming Waiver for Georgia •KB Waiver was created to waive income limits of parents to establish eligibility for Medicaid in 1982. •This is an optional Medicaid Program for Georgia. •In 2001, the only national study ever conducted concluded that 20 states enrolled approximately 25,000 children in Medicaid through the KB waiver option. Georgia was the second highest ranked State for KB waivers. •Increase in KB Waiver denials since May 2005. No specific disability has been targeted. •Over 6,200 families had the KB waiver before the new guidelines were implemented on 11/15/04. Over 2,400 children have been denied since that time.   How is the Level of Care determined for the KB Waiver? •Initial application made to DFCS. -Clinical detail is sent to and reviewed by Georgia Medical Care Foundation. -If Level of Care is satisfied, DFCS does cost neutrality assessment. •Georgia Medical Care Foundation does clinical review. -A certified Prospective Review Organization. -Co-Medical Directors and nurse reviewers.   What is the Appeal process for KB Waiver? •An  initial administrative appeal can be requested from GMCF. You have 30 calendar days to supply additional information. •A 2nd appeal can be made by requesting a hearing directly from the DCH. (Fair hearing in front of a judge) •As of 1/17/07, DCH is currently conducting fair hearings for January 2006 requests! DCH has limited any patient liability to 3 months, should the hearing not turn out in the parents favor.   Appealing…..Tips & Traps •Tips for Appealing: -In the original denial letter, the parents have 30 Calendar days to appeal. -Resubmit any Medicaid documents that you feel you may have not filled out properly based on the new eligibility criteria. -Prepare a 24 hour Care Plan going into detail about your child's day. Explain everything you do as a parent that goes beyond a "typical" child's duties as a parent. -Have all your doctors, therapists and any other professional that works with  you child submit a letter explaining why your child needs the waiver. -Contact your local State Senator and Representative and send copies of e-mails to the Governor. -Detailed information on the procedural aspects of a fair hearing and instructional video on representing yourself in a hearing without an attorney can be found at: www.osah.ga.gov/   Tips and Traps •Review the eligibility criteria by going to www.communityhealth.state.ga.us or http://dch.georgia.gov/00/channel_title/0,2094,31446711_31946814,00.html   •All applications have new forms which include the following: -Pediatric DMA6(A). -Care Plan (DMA 706). -Cost-Effectiveness Form (DMA 704 which replaced the Deeming waiver Physicians Referral Form). -3rd Party Liability Health Insurance Info. Questionnaire (DMA 285).   Tips and Traps •Fill out all forms out as a "Provider" NOT as a "Parent". •Always send everything to GA Healthcare Partners / DCH by certified mail / return receipt. •#1 Reason for denials is an administrative denial (lack of paperwork and incomplete package). •Submit ALL the forms and supporting documentation in one application. •Put together a Table and Contents and tab each document. •Question #7 on DMA6(A) "Does guardian think the applicant should be institutionalized? Yes or No".  •Don't date the DMA6(A) until submitting the entire application package. (Form only good for 30 days!) •Include a picture of your child. Make it personal!   Home and Community Based Service Waivers •Section 1915c of the Social Security Act allows the federal government to "waive" (ignore) certain Medicaid rules to enable states to cover home and community-based services as an alternative to institutionalization. •These are called Home and Community Based Service Waivers.   Service Waivers "Waive" Medicaid policies that require institutionalization of an individual before non-medical services can be provided.   •This allows states to offer programs that provide additional services to Medicaid eligible individuals in their home and/or community.               Georgia's Service Waiver Programs •CCSP (Community Care Services Program) •ICWP (Independent Care Waiver Program) •CHSS (Community Habilitation Support Services) •MRWP (Mental Retardation Waiver Program)   Community Care Services ProgramThe Community Care Services Waiver (CCSP) is for the elderly with disabling conditions and people with severe physical disabilities who need in-home support services.             To apply:  CCSP Intake Unit (Atlanta Regional Commission)  (404) 463-3244 www.agewiseconnection.com             Eligibility: Must have a functional impairment. • Require nursing home level of care • Medicaid eligible • Any age             May include cost share which is determined by individual's monthly income Resource limit.  Individual may have up to $2,000 in resources.              Provides Adult Day Health • Personal Support Services • Out of Home respite care • Home delivered meals • Home delivered services, e.g. nursing, PT, OT, ST • Alternative Living Services • Emergency response services   Independent Care Waiver Program The ICWP is for adults between ages 21 and 64, with physical disabilities or traumatic brain injury.   •Individuals must be able to direct their own care. Must be at risk of nursing home or hospital placement.   •Services include: case management, companion services, including homemaker services, personal support services, environmental modification, skilled nursing, specialized medical equipment and supplies, personal emergency response systems,  counseling, occupational therapy, adult day services, respite care,  physical therapy, and speech therapy.   Community Habilitation Support Services   §        This waiver program was created to serve individuals in institutional settings to facilitate their move back into the community. §        Individuals are not being added to this program. §        Individuals must be Medicaid eligible; have mental retardation since birth or before age 18, or another developmental disability since birth or before age 22, which requires services similar to those needed by people with mental retardation. §        Services are residential supports, day habilitation and supported employment.     Mental Retardation Waiver ProgramThe MRWP provides a wide array of community based services to individuals with developmental disabilities.   To be eligible for an MRWP, an individual must: •be Medicaid eligible; •Have mental retardation or another developmental disability which requires services similar to those needed by people with mental retardation; •Be at risk for going into an institution for people with mental retardation if unable to get the services you need in the community. The MRWP is available to all ages.   MRWP Services •Natural Support Enhancements •Respite Care •Specialized Services •Medical Equipment •Personal Support •Day Support •Day Habilitation •Supported Employment •Home Modifications •Support Coordination •Residential Training and Supervision   Support Coordination •Support coordination is a separate State contract- it does not use an individual's waiver money. •Support Coordination is for those on the Short Term Planning List and for those enrolled in the program. •The regional office contracts for support coordination.   MRWP +The largest service waiver program in Georgia.             +The largest waiting list for services (over 6,000 people statewide)   +Georgia has had this waiver since 1989.   MHDDAD Regional Offices Region 1: (706) 802-5272 or toll-free 1-800-646-7221.   Region 2: (706) 792-7733 or toll-free 1-866-380-4835.   Region 3: (770) 414-3052. Clayton, Cherokee, Cobb, DeKalb, Douglas, Fayette, Fulton, Gwinnett, Henry and Rockdale   Region 4: (229) 225-5099.   Region 5: (912) 303-1670 or toll-free 1-800-348-3503.   NOW Waiver will likely replace MRWP on 7/07 •Behavioral support up to $2,460 max a year •Community access •Community Guide services up to $ 2000 max a year •Community living support •Community residential •Dental services for adults up to $ 500 a year •Environmental accessibility adaptations up to $ 10,000 lifetime •Financial support services •Natural support training and individual directed goods and services •Professional therapeutic services up to $ 1800 a year •Respite •Specialized medical equipment and supplies •Support coordination •Transportation up to $ 2800 a year •Vehicle adaptation up to $ 6,240 max lifetime cap   Medicaid Covered Services •GAPP (Georgia Pediatric Program) •SOURCE (Service Options Using Resources in Community Environments)   The above are services (not waivers) covered under Medicaid.   Things to Know…. For those who already have a waiver •Individuals who have a Medicaid waiver are entitled to ALL the necessary services provided in that waiver program. •Waivers can be used anywhere in the state of Georgia but cannot be transferred out-of-state.   For those who are waiting for a waiver. •Parents and family members need to advocate for services.    Networking & Building Alliances •Contact Governor's Council on Developmental Disabilities (GCDD) via e-mail (vmsuber@dhr.state.ga.us) regarding being placed on their "Moving Forward" e-mail update during the legislative session. •Contact your State Senator and Representative's by going to www.vote-smart.org and inputting your zip code.  They need to hear from you about your situation and how it impacts your family. •Contact Governor Perdue:  Georgia.Governor@gov.state.ga.us .   Networking & Building Alliances •Stress when talking to your legislators that the majority of the our families are hardworking, middle class, tax paying, voting citizens that have never asked from anything from the State until they had a child with a disability.   •Atlanta Alliance on Developmental Disabilities (AADD) is also involved in advocating for the disability waiting list. http://www.unlockthewaitinglists.com/   •Work with the media to get the message out and to help educate the general population of our concerns and abilities of our children (given the right resources)!   Networking   •Get Involved! Advocating is the key to success in getting the services we need for our children. Send on e-mail to : heidijmoore@comcast.net if you would like to be placed on my advocacy distribution list. (over 2,500+ members)   •My goal: Make the issues easy to understand and explain to advocates what they can do to influence change in this State.   •Additional information can be found at: -www.kidshealthcarega.org -http://www.lgtinc.org/authors/41/Heidi-J.-Moore   •Effective February 2007, Heidi now provides fee based consultation services for the Medicaid application process for the Katie Beckett Waiver and MRWP and other advocacy issues including education, healthcare and general information.  Please contact her for additional information.   More Helpful Website Information •GCDD guide to waivers :   http://www.openminds.com/indres/111306gawaivers.pdf •Summary of GA Medicaid waivers  :  http://www.unlockthewaitinglists.com/pdf/summaryofwaivers.pdf •Medicaid's Main ICF-MR page:          http://www.cms.hhs.gov/medicaid/icfmr/default.asp •Parent to Parent of GA KB Waiver Information: http://www.parenttoparentofga.org/roadmap/insurance/insurancedeemingcover.htm •Unlock The Waiting Lists website : •http://www.unlockthewaitinglists.com/  •ICF-MR level care and "persons with related conditions":             http://www.healthlaw.org/library.cfm?fa=download&resourceID=61843&appView=folder&print •Great site to find current lawsuits in other states re: disabilities: http://www.healthlaw.org/ •When you see a code w/  "CFR" go here to look it up.  Most healthcare is in title 42.  Medicaid's definitions are listed here.             http://www.gpoaccess.gov/cfr/retrieve.html •An appeals decision re: 24 active care vs. 24 supervision.  This is the court's breakdown of the fed regs and how they interpreted them.           http://www.state.in.us/judiciary/opinions/previous/archive/02280101.nhv.html •Autism Handbook http://www.usd.edu/cd/autism/Autism%20Handbook.pdf                                                                          Update : Strengthening Families of Children with Disabilities (SFCD)- KB Waiver Foundation. •In April 2006, the legislature approved $7.6 million to go towards families that have been denied from the KB waiver. •A foundation was formed to manage this process. (Community Foundation of Greater Atlanta-CFGA) •Eligibility: Families that were denied the Katie Beckett Waiver from Oct 2005 - to date. •One time prepaid debit card will be paid in the amount of $2,600/child expires March 31, 2007. •Funds are being set aside to address the long-term needs of medically fragile children and their families •Currently, DHR is finalizing the Advisory Committee members. •Contacts: Lita Ugarte- Program Officer- CGGA (404) 688-5525 and Brian Dowd with DHR bddowd@dhr.ga.gov 404-657-3592..   Advocacy Issues Therapy Issues- -Starting Sept. 1, 2006, Prior Authorizations are needed for more than 8 units/month for ST, PT, OT. -Starting Nov. 1, 2006, CHOA no longer accepts outpatients for therapy. -HB 549 - Defines "Medically Necessary Services" and being prescribed by Physician not defined by DCH. Also changes process and need for prior authorizations. Currently awaiting Governor's signature!   Other Advocacy Issues:   •Administrative Service Organization (ASO) coming in 2007 for all disability waivers. •SB 10 Voucher program for children with IEP's. Waiting Governor's signature. •Get involved and monitor your child's Medicaid card. -www.ghp.georgia.gov and request a password from GA Health Partnership to be able to track Medicaid charges to your child's account. -This is very important in order to verify and report problems. You can report a complaint via the website as well. -Only through education, accountability and communication are we going to be able to make a difference in the process.   Be Prepared, Advocate, and Win…… YOUR Child Depends on YOU! --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 01 May 2007 00:00:00 EDT http://www.lgtinc.org/articles/235/1/Media-Coverage-of-HB-549 April 29, 2007   Dearest Advocates:   I just wanted to send you a quick email letting you know about some media attention we have received regarding HB 549 which changes the way our therapy is approved via the prior authorization process. As you are aware, the House and Senate approved the Bill and we are awaiting the Governor's signature. There is NO need at this time to contact the Governor's office. I will let you know if any additional advocacy efforts are needed in the future regarding this matter.     Please take a moment to thank reporter, Dave Williams, dave.williams@gwinnettdailypost.com with the Gwinnett Daily Post for his continued coverage of issues that matter that help continue to educate our State on the needs of our children.    To see the actual article, please go to the following website: http://www.gwinnettdailypost.com/index.php?s=&url_channel_id=32&url_subchannel_id=&url_article_id=27299&change_well_id=2.   Thanks again for everyone's hard work in making this happen. I hope you are seeing that our advocacy efforts are working.....OUR legislators are listening and making a difference for our children.   Sincerely, Heidi gwinnettdailypost.com   Families of disabled children hail therapy bill 04/26/2007 - By Dave WilliamsStaff Writerdave.williams@gwinnettdailypost.comATLANTA - Advocates for children with disabilities were upset with tighter restrictions the state imposed last year on Medicaid coverage for therapy visits.So they mounted a public campaign against the changes, including a rally at the Capitol on the Saturday before Election Day. The result is legislation the General Assembly passed during the hectic final day of this year's session making it easier for children with diseases such as Down syndrome and autism to get needed therapy. "This is the first legislative session where we stood up and got action," said Heidi Moore of Alpharetta, a longtime advocate for children with disabilities, who has a 7-year-old son with Down syndrome. "The legislators listened to the families and responded." The bill won final passage last Friday night with an hour left in the 2007 legislative session and is on Gov. Sonny Perdue's desk for his signature.Under the legislation, families seeking physical, speech and/or occupational therapy for their children through a Medicaid waiver program would only have to apply for prior approval every six months. A policy change imposed by the state Department of Community Health last September made families go through the prior approval process every three months.Children also would be covered for 16 units of therapy per month, up from eight units under the current policy. Four units equals one hour of therapy. "That allows children who are getting therapy for an hour a week not to have to submit for prior authorization," Moore said. Also, the legislation directs the DCH to reduce the amount of paperwork families and therapists have to fill out to comply with the program's requirements. "It's silly that we require therapists and doctors to fill out nine pieces of paperwork to say, 'Yes, this child has Down syndrome,' " said House Speaker Pro Tempore Mark Burkhalter, R-Alpharetta, who introduced the bill."We're spending 10 to 15 hours a week on paperwork," added Ellen Roberts, a speech  language pathologist at Children & Adult Therapy Services in Monroe. Moore said the paperwork has become so burdensome that some therapists have stopped accepting Medicaid, reducing families' access to therapy services."It's been a nightmare," she said. "It's one thing to get approval for therapy. It's another to find a therapist to provide the service." Mark Trail, Medicaid director for the DCH, said the agency already has put in place some changes to streamline the process.He said two of the required forms have been combined into a single document. Also, families now can attach requests for prior authorization onto the program's Web site rather than having to fax it in, he said."We're not interested in making more paperwork than is necessary," Trail said. "But it has to be enough to determine if the care is actually m edically necessary."Burkhalter's bill was amended when it reached the Senate to extend the bill's requirements to the care management organizations that oversee therapy services for disabled children who are covered by the regular Medicaid program and not through the waiver. Families enrolled in Medicaid through the CMOs under an initiative the state launched last year have made the same complaints about delays in prior approvals and limited therapy visits.   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore Heidi J. Moore Tue, 01 May 2007 00:00:00 EDT http://www.lgtinc.org/articles/234/1/Advocacy-THANK-YOU-%21 April 22, 2007   Dearest Advocates:   I just wanted to say a big THANK YOU to everyone that participated in making this a very successful legislative session this year for individuals with disabilities.   Here is a short list of just some of the issues that have been addressed this legislative session due to our efforts in advocating for change:   1. The Aged, Blind and Disabled populations were being proposed to be placed in a "Managed Care" model.  This has been REMOVED from the budget being submitted to the Governor for signature!   THIS IS BIG NEWS.  The last thing we need for this vulnerable population is be placed in a managed care model that does not work and just adds additional layers of management without benefit to those individuals that need the care. (Again, thank you so much for those 25 people that came out to the Capitol on Monday morning to help in this effort, as well as, those that made the necessary phone calls and emails to the legislators).  We need to continue to make sure our voices are heard on this issue i n the future!   2. House Bill 549 was approved in the House and Senate and is now at the Governor's office for signature.  Basically, House Bill 549 will help alleviate many of the issues with the prior approval process for therapy in the Medicaid system.  It streamlines the paperwork, defines medical necessity, changes the prior approval process to every six months instead of three and allows 16 units of therapy per discipline before the prior approval process kicks in.  There were some changes in the original language but overall this is a step in the right directions.   I do want to clarify that there is mention of a Care Managed Organization (CMO) in the final version of this bill. This DOES NOT mean that those families with disability waivers will be in care management. They just placed this language in there for those that have Peachcare that are under the CMO's.    Many thanks to everyone that flooded key legislators phone lines on Friday morning in support of this bill!  Our voices were heard loud and clear!    3. SB 10- Basically, this is the bill that would allow families to be able to use vouchers for their children's education. I have not been as involved with this bill since others have taken the lead of advocacy for this.  This Bill is now at the Governor's desk for signature as well.   I hope you can see that our voices are being heard.  I hope that in the future more people get involved.  Keep up the great work.    Our children's Healthcare/Education and Future depend on our advocacy efforts of today.   UNITED… WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore Heidi J. Moore Tue, 01 May 2007 00:00:00 EDT http://www.lgtinc.org/articles/233/1/Champions-for-Children-Initiative---Input-needed April 21, 2007   Dearest Advocates:   Received this information that I thought you might be interested in.....FYI- this is part of the $7.6 million that was allocated last legislative session for those families that were denied the Katie Beckett Waiver under the new eligibility requirements that were implemented in November 2004.   Thanks, Heidi ==================================== The Community Foundation for Greater Atlanta is pleased to provide an update on its partnership with the State of Georgia and the Department of Human Resources (DHR) to develop a statewide service delivery system for medically fragile children and their families. Established in the fall 2006, Champions for Children with Exceptional Needs Initiative (formerly Supporting Healthy Families Initiative) will map the existing services for medically fragile children and their families, identify where there are gaps, and develop recommendations to meet those gaps with an appropriate nonprofit or network of nonprofits across Georgia. This work is being guided by an Advisory Committee comprised of a diverse group of stakeholders. The Georgia Health Policy Center (GHPC) has been hired to conduct the research and outreach activities. As an important stakeholder, The Community Foundation would like to update you on the Initiative's progress:   ·         Ongoing literature review on best practices for states delivering health services to medically fragile children. GHPC has not only researched best practices, but also reviewed how programs are structured. ·         Completed an analysis of CY 2005 Medicaid claims of children who received services through the Katie Beckett Waiver Program, including utilization and Medicaid payments. The analysis revealed that families use funds mostly to cover therapeutic services, prescriptions, and medical equipment, although families also used funds to cover home care and outpatient hospital services. ·         Conducted focus groups with family members of medically fragile children. The focus groups included families no longer eligible for the Katie Beckett Waiver Program and families still eligible for the Katie Beckett Waiver Program. ·         Ongoing key informant interviews with providers and leaders of nonprofit organizations, including representatives from organizations serving medically fragile children and representatives from the medical community (doctors, nurses, and therapists). In individual settings, participants have shared in-depth knowledge of the needs of medically fragile children and their families, systems (medical and nonprofit) that work to address their needs, and thoughts on how the funds set aside by the Legislature could be used.  In the next two weeks will conduct two half-day Community Forums to gain feedback on results of the data gathering and outreach activities. The first Forum will be held in metro Atlanta on April 28 and the second Forum in the Savannah area on May 5. These forums will be open to the public and will provide all stakeholders an opportunity to give us additional feedback. The attached announcement contains details on the two Community Forums. Please forward t his email and the attached announcement to all parents, advocates, service providers (nonprofit, medical, etc.) and any other stakeholders you feel would be interested in attending the Forums. We will continue to update you as Champions makes progress toward meeting its goal. If you have any questions, please feel free to contact us by email at champions@atlcf.org.  Champions for Children with Exceptional Needs Lita Ugarte, Program Officer Kristina Morris, Program Associate The Community Foundation for Greater Atlanta (404) 688-5525 http://www.atlcf.org ===========================================   Champions for Children with Exceptional Needs Community Forums     Champions is an initiative designed to bring together people and resources to create a comprehensive statewide support system to address the medical, social and emotional needs of Georgia's medically fragile children and their families.   By attending a forum, you can: Hear results gathered from outreach activities to parents and service providers (focus groups and key informant interviews)   Give feedback on the results of data gathering and outreach activities   Participate in small group working sessions to prioritize and develop appropriate service options       Dates and Locations Saturday, April 28th (Atlanta forum) North Atlanta High School 2875 Northside Drive, NW Atlanta, GA 30305   Saturday, May 5th (Savannah forum) Nancy N. and J.C. Lewis Cancer & Research Pavilion at St. Joseph's/Candler 225 Candler Drive, Suite 203 Savannah, GA 31405   Check-in and light continental breakfast: 8:30AM-9:00AM Community Forum: 9:00AM-12:00PM     To register for the Forums send an email to champions@atlcf.org by 12:00PM on Friday, April 27 for Atlanta and 5:00PM on Thursday, May 3 for Savannah. Please specify if you will attend the Forum in Atlanta or Savannah.     --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore Heidi J. Moore Tue, 01 May 2007 00:00:00 EDT http://www.lgtinc.org/articles/232/1/Pierce-Ruck%7B47%7DLeanne-Manning-Needs-Our-Prayers-and-Support April 20, 2007   Dearest Advocates:   I don't know if many of you know about the Ruck Family......their precious Pierce has been in and out of the hospital since this fall when he was diagnosed with leukemia (Pierce is 3yrs old w/ Down syndrome). Pierce is currently fighting for his life in ICU at Egleston Hospital right now.  Pierce's Father, Bill, has been very involved in advocating for children with disabilities in the past and needs our support. (For those that attended the Healthcare for Kids Rally- He was the father that spoke and talked about us jumping thru "hoops" with a hula hoop on stage! He made us all laugh!)   When I spoke to Bill yesterday he said.....what they need more than anything is prayers for Pierce right now.  In addition, if everyone could donate blood to the American Red Cross that would be helpful. Even though Pierce will probably not get your specific blood, donating helps the cause (and other children) and it helps Pierce in the long run. Pierce is expected to continue to be at the hospital until June and he also has a younger brother, Evin (who is 1 yr old). As you can imagine, this has been a very difficult time for the family!   Below is the link for the care page for Pierce if you are interested in finding out more.  If you have any service that could help the family as well, the best way to contact them is via this website link.   I usually don't send out alerts regarding specific children but Pierce needs all of us to lift him up in prayer right now.....Please Pray for Pierce Today!   ============================================ In addition: Great article in the AJC yesterday: http://www.ajc.com/search/content/living/stories/2007/04/17/0418lvreal.html   Please take a moment to thank the reporter, Gracie Bonds Staples gstaples@ajc.com for this very uplifting story. Education is a key component in helping society see the potential of our children.......Articles like this helps others see that all our children have dreams and goals in life!  ================================================= Also- I just got word today that Leanne Manning's (Leanne was my right hand women in helping me plan the Healthcare for Kids Rally in November.) grandparents were both killed in an automobile accident yesterday.  Our thoughts and prayers are with that family with losing two members of the family. They were married for 73 yrs! Please send prayers to Leanne's family as well at this difficult time.   Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. For previous advocacy email's, please go to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore   -------------- Forwarded Message: -------------- From: "" To: heidijmoore@comcast.net, Subject: Invitation to Pierce Ruck's CarePage Date: Wed, 18 Apr 2007 14:59:01 +0000 Apr 18, 2007 09:58 AM You've been invited to visit Pierce's CarePage. A personalized Web page, called a CarePage, has been created for Pierce so you can easily receive the latest news, view photos and share messages of support.CarePage Name: PierceRuck Please forward this e-mail to anyone who would be a meaningful part of Pierce's support group. About CarePages   CarePages are free, easy-to-use Web pages that help family and friends communicate when a loved one is facing illness. As a CarePage member, you have the opportunity to be there for a family like never before. Rather than wondering or worrying, you will be informed when updates are posted to the site, and you can read and leave messages for the family on the message board anytime. CarePages are available to anyone, free, at http://www.carepages.com/?extrefid=tlcinvite2 This message is an invitation that was sent by a friend or family member of Pierce's. This message is not part of a mailing list, nor will youre-mail address be given to anyone without your explicit permission. For more information on CarePages.com's privacy pledge, please see http://http://www.carepages.com/privacy_pledge.jsp Heidi J. Moore Thu, 19 Apr 2007 00:00:00 EDT http://www.lgtinc.org/articles/230/1/URGENT--HB-549--Therapy-Needs-YOUR-Support-TODAY%21 April 18, 2007   Dearest Advocates:   URGENT- I realize I have issued out a number of advocacy emails in the last few days but this is crunch time in the legislator. We either have our voices heard NOW or NEVER!   PLEASE read below this important advocacy alert that needs your attention TODAY regarding advocating for your child's therapy in Georgia!   House Bill 549 has passed through the House of Representatives and went through the Senate Appropriations Committee.  TODAY- April 18, 2007 at 5:00 the Rules committee votes on this bill and we need all advocates to contact the members of the rules committee to ask them to support this bill. If it passes on Wed. then it will go to the senate floor on Thursday.    Basically, House Bill 549 will help alleviate many of the issues with the prior approval process for therapy in the Medicaid system.  It streamlines the paperwork, defines medical necessity, changes the prior approval process to every six months instead of three and allows 16 units of therapy per discipline before the prior approval process kicks in.     THIS IS BIG NEWS AND CAN HELP ALL OUR CHILDREN WITH THERAPY……Now and in the future!   PLEASE CALL TODAY THE FOLLOWING Senators letting them know of your support of HB 549:   Don Balfour-Chairman 404-656-0095 Dan Moody 404-463-8055 Eric Johnson 404-656-5109 Tommy Williams 404-656-0089 Jack Hill 404-656-5038 Renee Unterman 404-463-1368 David Adelman 404-463-1376 Gloria Butler 404-656-0075 George Hooks 404-656-0065 Ross Tolleson 404-656-0081 David Shafer 404-651-7738 Chip Pearson 404-656-9221   In addition, please contact your own Senator (www.vote-smart.org  and inputting your zip code).   YOUR CHILD's THERAPY MAY DEPEND ON IT!   In addition, please thank Senator Dan Moody for being willing to sponsor the Bill in the Senate at the last minute! Also- Thanks to Donna for working on helping make this possible Bill a reality for our children!   Thanks in advance for your support in this urgent issue.     Sincerely,   Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 18 Apr 2007 00:00:00 EDT http://www.lgtinc.org/articles/229/1/URGENT%3A-Managed-Care--Continued-Advocacy-Needed-By-YOU%21 April 16, 2007   Dearest Advocates:   Please find below additional information regarding our advocacy efforts. MANY thanks to those 25 families/kids/providers/concerned citizens (and even a grandma!) that took time out of their busy schedules to come down to the Capitol today to show a unified voice on this issue.......The Aged, Blind and Disabled populations can NOT be in another managed care model!   The Senate listened and took this proposal OUT of their version of the 2008 Budget!   BUT our advocacy efforts must continue........PLEASE take a moment and call and/or email the below legislators (ESPECIALLY if you are in their District. It means more when you live in their district!!!!!) and the Governor letting them know that managed care does not work in this population of individuals and why.    Please make your stories personal and how it could impact your family. Also thank the Senators for taking it out of their version of the budget and help the our House of Representatives understand better so they will support that final decision with the 08 Budget!   To help you with your phone calls and emails, below are some of the facts to the situation..........   Facts:   Many of our families already have a managed healthcare network! With the Katie Beckett Waiver children alone, 71% of those waivers use Medicaid as SECONDARY INSURANCE and have primary healthcare insurance.  Why would we need to be in ANOTHER managed care situation?   For the other Waivers (including MRWP, SOURCE, ICWP, CCSP, etc) - They are already in a managed care model.     There needs to be a lot more thought and input into this option before adding into the budget at the last minute.  No study data is available at this time. We don't even know how many individuals this could impact!     This plan was not discussed in any public meetings and was NOT recommended by the Appropriation Health Subcommittee and Dept. of Community Health (DCH)!  DCH Commissioner Medows says the plan is premature because the State has less than a year's experience with the current managed care (CMO) model in place.   DCH would have to get a 1115 Waiver from the Federal Medicaid office even if this is approved by the Georgia legislator (which takes time).   Given the complexity and needs of this vulnerable population, many who have private health insurance and hold Medicaid as secondary insurance, the cost of coordinating care would be a financial burden to Medicaid and could actually end up costing the State more taxpayer dollars! Bottom line: Managed care is NOT a good service delivery model for the Age, Blind and Disabled populations and could actually cost the state taxpayers more money.  We need more time to evaluate the options before this radical approach is taken. Please remove this line item from the 2008 Budget! Thanks in advance for your support.   UNITED... WE WILL MAKE A DIFFERENCE!   Our advocacy efforts are paying off...keep up the GREAT WORK!   Sincerely, Heidi  ==================================================== THIS STATEMENT ISSUED BY:  Laura O. Moore Founder and CEO Dream House for Medically Fragile Children, Inc. laura.moore@dreamhouseforkids.net 770-717-7410 Leanne D. Manning Project & Advocacy Coordinator leanne.manning@dreamhouseforkids.org 678-462-7789 Heidi J. Moore heidijmoore@comcast.net 678-357-8200 YOUR VOICE WAS HEARD!!! Dream House Call to Action Update United…We are making a difference!!! Our state leaders heard from you today, your phone calls and emails made the difference and the Senate did not approve the last minute amendment that would implement a managed care program for the Aged, Blind and Disabled Medicaid population in the Atlanta region, which is said to become effective January 1, 2008. We have one more thing to do… The House and Senate Committees will now need to work out their differences on this issue, So we still need to call and email our legislatures, Especially tomorrow, Tuesday, April 17!  Please voice your concern about this rush of putting the aged, disabled and blind into care management.  We would like to have the study data used to validate how many aged, blind and disabled people this change would affect made public and given time to review that data; to learn about how much money this change would actually save or cost, both long and short term; and to be able to participate in timely public response before this change is implemented into legislation. We do not want the state budget balanced upon the health and lives  of children or elderly folks, disabled, or blind people. But what can I do that  will make a difference? 1.      Please call and email your state legislature on Tuesday!! You can find your State Senator and Representative by going to www.vote-smart.org and typing in your zipcode. 2.      Please call Governor Sonny Purdue's office at 404-656-1776, or FAX: 404-657-7332 or email: sperdue@gov.state.ga.us. 3. Contact Lt. Gov. Casey Cagle's office at 404-656-5109 or email him at: http://ltgov.georgia.gov/00/article/0,2086,2199618_2208307_11792200,00.html   4. Contact Senator Jack Hill at 404-656-5038 or jack.hill@senate.ga.gov 5. Contact Senator Tommie Williams at 404-656-0089 or tommie.williams@senate.ga.gov or tommie@tommiewilliams.com 6. Contact Senator Eric Johnson at 404-656-5109 or  eric.johnson@senate.ga.gov or ejohnson56@comcast.net  7. Representative Ben Harbin at 404-463-2247 or  ben.harbin@house.ga.gov 8. Rep. Jerry Keen 404-656-5052 jlkeen@bellsouth.net 9. Rep. Mark Burkhalter 404-656-5072 or  mark.burkhalter@house.ga.gov Dream House for Medically Fragile Children, Inc. provides education, skills training, and assistance with healthcare equipment acquisition and resource referrals, so that kinship, foster, and adoptive families can care for medically fragile children in their own 'dream home'. ###   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 18 Apr 2007 00:00:00 EDT http://www.lgtinc.org/articles/228/1/URGENT%3A-Please-Forward%3A-Call-to-Action-for-Monday--April-16-at-10%3A30am April 14, 2007   Dearest Advocates:   URGENT! Please see below a call to action regarding the latest proposal to place the Aged, Blind and Disabled populations to a managed care program.  I realize that this is late notice. Things are moving VERY quickly but we all need to get involved now!    We are asking anyone that can to come to the Capitol this Monday, April 16th at 10:30am and hand deliver your message to the necessary Senators.  The plan at this point is to meet at the front stairs of the Capitol on Washington Street side (where we had our Healthcare for Kids Rally in November) and organize from there. If you have any questions about this call to action, please contact Leanne Manning  at leanne.manning@dreamhouseforkids.org.   If you can't participate on Monday, please make your phone calls and emails!  Senators that need to hear from us including the following:   1. Jack Hill, Chair of Appropriations jack.hill@senate.ga.gov, 404-656-5038   2. Greg Goggans, Vice Chair, appropriations, Health  drgg@alltel.net  or greg.goggans@senate.ga.gov  404-463-5263   3. Tommy Williams, Appropriations, tommie.williams@senate.ga.gov or tommie@tommiewilliams.com 404-656-0089   4. Casey Cagle, Lt. Governor, go to the following website to contact him: http://ltgov.georgia.gov/00/article/0,2086,2199618_2208307_11792200,00.html   or 404- 656-5030   5. Eric Johnson, Senate 1, President Pro-Tem, eric.johnson@senate.ga.gov or ejohnson56@comcast.net 404-656-5109   6. Also please contact your individual State Senator for your own district by going to www.vote-smart.org and typing in your zip code.      7. AND Contact Governor Perdue at sperdue@gov.state.ga.us, or 404-656-1776, Fax:404-657-7332.   Thanks in advance for your support in this matter.   YOUR child's Medicaid may depend on it!  Sincerely, Heidi    --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative.   -------------- Forwarded Message: -------------- From: "Leanne Manning" Subject: Please Forward: Call to Action for Monday! Date: Sat, 14 Apr 2007 14:38:19 +0000 THIS STATEMENT ISSUED BY:  Laura O. Moore Founder and CEO Dream House for Medically Fragile Children, Inc. laura.moore@dreamhouseforkids.net 770-717-7410 Leanne D. Manning Project & Advocacy Coordinator leanne.manning@dreamhouseforkids.org Heidi J. Moore heidijmoore@comcast.net 678-357-8200 Dream House Call to Action! But what can I do that  will make a difference? Meet us on the Capitol this Monday, April 16 at 10:30am! Our state leaders need to hear from you personally:  Write a letter to our state leaders with your concerns, and let's personally deliver our message! Don't balance the budget upon the health of children or elderly folks, disabled, or blind people. It is very concerning that the House Budget includes a last minute amendment that would implement a managed care program for the Aged, Blind and Disabled Medicaid population in the Atlanta region, which is said to become effective January 1, 2008. There needs to be a lot more thought and input into this option before adding into the budget at the last minute, resulting in: ·       No study data to validate how many aged, blind and disabled people this change would affect. ·       No study data to show how much money this change would actually save. ·       No chance for timely public response; and no options for those affected to learn of the impact of this decision and act in timely response. This last minute item surprised DCH, Medicaid, providers, patients, our top state leaders, and the taxpayers of Georgia, this legislation would implement managed care for the most disabled populations in our state, a model of care that has not proven to be successful across the country.  Instead, the current system which is based on disease management is the most effective for the patient and the payer.  Current state employee health coverage does not provide the same services that PeachCare offers, yet state workers who earn within the income bracket for Peach Care are not allowed to apply for Peach Care. State employees, if they meet the same criteria as non-state employees, should have health care benefits equivalent to those of Peach Care.  How can this be paid for? ·       Not by cutting Peach Care benefits; ·       Not by taking the most disabled and placing them in "managed care" which has a proven failure record for individuals that face complicated or multi-diagnosis'; Don't balance the budget upon the health of children or elderly folks, disabled, or blind people! What kind of message is conveyed by lowering the standards of health care in Georgia? What will happen to people in nursing homes? Would managed care interfere with the implementation of the MRWP/NOW waiver? How will the impact of reduced health care services affect and increase the burden placed upon schools for already overstrained special education services? If a decision is made to 'dump' the most complicated of patients on top of a system that is already ineffective and losing doctors and providers, what kind of care are any of our most vulnerable citizens going to get? Would this change really save 30-40 million dollars by putting elderly, disabled and blind people, individuals in Medicaid waivers like Katie Beckett, Children's Medical Services, into managed care?  Or, would the real cost be the lives and health wasted by lack of coordinated care? Given the complexity and needs of this vulnerable population, many who have private health insurance and hold Medicaid as secondary insurance, the cost of coordinating care would prove to be a financial burden to Medicaid. Problems with the current 'care maintenance' system have resulted in many providers opting out of Medicaid.  These families need home and community based services, requiring a robust provider network with appropriate compensation for their services. Dept. of Community Health and the House and Senate Budget offices have a lot of concerns about the ability to implement this change, and they would need an 1115 waiver to do this.  We have been advised to contact the Senate with these concerns.  The budget will go to the Senate floor by Tuesday, and then it will go to conference committee to work out the differences. Bottom line: Managed care is NOT a good service delivery model for the Age, Blind and Disabled populations and can actually cost the state taxpayers more money.  We need more time to evaluate the options before this radical approach is taken. But what can I do that  will make a difference? Meet us on the Capitol this Monday, April 16 at 10:30am! Our state leaders need to hear from you personally:  Write a letter to our state leaders with your concerns, and let's personally deliver our message! Dream House for Medically Fragile Children, Inc. provides education, skills training, and assistance with healthcare equipment acquisition and resource referrals, so that kinship, foster, and adoptive families can care for medically fragile children in their own 'dream home'. ### Heidi J. Moore Wed, 18 Apr 2007 00:00:00 EDT http://www.lgtinc.org/articles/227/1/Urgent%3A-Advocacy-Needed.-Contact-your-Legislators-TODAY%21 April 13, 2007   Dearest Advocates:   URGENT ALERT! Please Read and write and call TODAY…….   A surprising item showed up in the Fiscal Year 2008 budget when it was passed out of House Appropriations on Thursday, April 12.  It is in the Department of Community Health Budget, and the item reads as follows:  "The Department of Community Health shall implement a managed care program for the Aged, Blind and Disabled Medicaid population in the Atlanta region, effective January 1, 2008."  ($30,000,000)    This means that legislators expect that they can save 30 million dollars by putting this population (individuals in waivers, Katie Beckett, Children's Medical Services) into managed care.  They need an 1115 waiver to do this.  Dept. of Community Health and the House and Senate Budget offices have a lot of concerns about the ability to implement this change.  We have been advised to contact the Senate with these concerns.  The budget will go to the Senate floor Tuesday, and then it will go to conference committee to work out the differences.    What you can do to make a difference by Tuesday -April 17, 2007:   Please Contact the Senate leadership:   1. Jack Hill, Chair of Appropriations jack.hill@senate.ga.gov, 404-656-5038   2. Greg Goggans, Vice Chair, appropriations, Health  drgg@alltel.net  or greg.goggans@senate.ga.gov  404-463-5263   3. Tommy Williams, Appropriations, tommie.williams@senate.ga.gov or tommie@tommiewilliams.com 404-656-0089   4. Casey Cagle, Lt. Governor, go to the following website to contact him: http://ltgov.georgia.gov/00/article/0,2086,2199618_2208307_11792200,00.html   or 404- 656-5030   5. Eric Johnson, Senate 1, President Pro-Tem, eric.johnson@senate.ga.gov or ejohnson56@comcast.net 404-656-5109   6. Also please contact your individual State Senator for your own district by going to www.vote-smart.org and typing in your zip code.      Talking Points:   Many of our families are already in a healthcare network already! With the Katie Beckett Waiver children alone, 72% of those waivers use Medicaid as SECONDARY INSURANCE and already have Primary Healthcare insurance.  Why would we need to be in ANOTHER managed care situation? Managed care will probably NOT save money for individuals that have primary healthcare insurance and use their own provider networks and may end of COSTING MEDICAID MORE MONEY if coordination is not done properly. For the other Waivers (including MRWP, etc)- We are already in a managed care situation.  Our families need home and community based service which managed care companies do NOT do well. We do not want managed care to interfere with the implementation of the MRWP/NOW waiver. There needs to be a lot more thought and input into this option before putting into the budget at the last minute.   BOTTOMLINE: Managed care is NOT a good service delivery option for individuals with disabilities!   I recommend that you first call them. If you feel uncomfortable with that, send them individual emails on this matter.  Please try to not send in a distribution list (it is not as likely to be read).   Also- make your phone call/message or email personal. Explain how this personally impacts your family.   As many of you are aware, the managed care program (CMO- Care Management Organization) has had a ton of difficulties in the general Medicaid population in the last year since implementation and continues to work thru it's issues……Why would we want to be a part of this program given the complexity and needs of our children and many of us already have primarily healthcare insurance with Medicaid as secondary?   The State of Georgia needs to fiscally responsible for our tax dollars and this is NOT going to achieve that. WE ALL NEED TO HELP EDUCATE OUR LEGISLATORS ABOUT THE TRUTH AND NOT WHAT IS BEING LOBBIED BY THE HEALTHCARE INDUSTRY!   I have not been writing as many emails lately due to my health and my son's but I feel that this was too important for all of you to know what is really going on and be apart of the education and change in Georgia.   This is VERY serious…….Please take a moment and contact the above Senators…..YOUR child's Medicaid may depend on it!   Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 18 Apr 2007 00:00:00 EDT http://www.lgtinc.org/articles/226/1/Articles-from-Effingham-Herald-Newspaper April 8, 2007   Dearest Advocates:   Thought you might be interested in the below articles in the Effingham Herald Newspaper. As I stated before, we need to see more articles in the media on what the real issues are and the need for additional supports for our children and adults with disabilities to succeed in life and in the community they live!   Here is the link for the third part of the series:   http://www.effinghamherald.net/display.php?id=9937   Please take a moment to thank Ralna Pearson rpearson@effinghamherald.net the reporter that wrote a three part series on the movement of moving individuals with disabilities from the institutions and into homes in the community.   Also- Many thanks to Lynnette Bragg for opening her heart and life into the media to help them better understand the needs of individuals with disabilities. Her advocacy efforts over the years is amazing and she continues to not only help her son, but thousands of others.  Lynnette started B&B Care Services in 1999. B&B provides supports for the elderly and individuals with disabilities in their homes and community. Currently, B&B is one of two Medicaid service providers that accept MRWP waiver in the Metro Atlanta area.    I personally believe in this company and what it wants to become for our children in the future.  FYI.....In late January, I accepted a part time position as Community Relations Manager to help in the growth, development and support of families in the Metro Atlanta area for B&B Care Services.   Happy Reading! Heidi --------------------------------------------------------------------- Here is the Second part of the series (that is no longer on the Effingham Heralds's website):   At home, at last   By Ralna Pearson This is the second in a series that will  examine the movement to move mentally challenged individuals  out of institutions and into homes in the community.  Lying in his recliner with a big smile on his face and  watching "Wheel of Fortune," Scott Bragg is as content as can  be."He's truly the king of his own castle, said his  mother, Lynette Bragg.His days begin with breakfast  and he'll tell you what that will be. Then he progresses into  a television marathon that mainly centers on the CBS network. It's "Good Morning America" then "Regis & Kelly" in the  morning, followed by the "Price is Right," WTOCs News at  Noon" and soap operas his caregivers got him into.In  the afternoons, it's the evening news, "Jeopardy" and the  aforementioned big wheel game show. "Used to be and  so metimes now he'll guess 'em and we couldn't figure out how  he could do it till we realized they were reruns," Bragg  laughed.He has the channel turned to see his other  favorite show, "Judge Mathis," because of all the drama that  takes place on it."He likes the excitement," said his  caregiver, Jerri Sutton. "It gets monotonous around  here; we change it to the good stuff."His grandfather  and caregiver Homer Wells added, "He likes a fuss."At  3 years old, Scott, now 32, was diagnosed with mental  retardation. "We always knew he was never like other  children," his mother said.He also suffers from autism  and five seizure disorders. Throughout his life, he has broken  several bones, so he does not walk.Bragg, a registered  nurse and advocate for those with disabilities, was confronted  with the challenge of caring for a child with n eeds her rural  Georgia community did not provide services for."We  know intense therapies can make a difference early on, where  Scott did not have the benefit of early on," she said.  However, she did have the support of a loving family  to help with Scott's care. Her parents, Shirley and Homer  Wells, kept him during the week while she and her husband had  him on the weekends."He would kinda swap back and  forth," Bragg said.Group home a new  homeIn 1984 Bragg and her father experienced some  health problems, and she was forced to place Scott in a group  home near Atlanta until they got better.For one year  while at the home, Scott would come home for 10 days and spend  three weeks at the home. His family called him every  night.While there, Scott attended school. He also  picked up some lessons outside of the curriculum. < BR>"One  thing he learned at the group home is how to fight," shared  Bragg.He returned home fighting and screaming. His  family had to re-teach him how to use his words  instead.Yet the most powerful thing he brought back  was unforgiveness.For four years, Scott did not show  any affection toward his mom, refusing even to sit beside her  because he blamed her for placing him in the  facility.Bragg said that if she and her family had  been able to get in-home support for Scott, they would not  have had to place him in the group home.Today,  however, all is well. Scott lives in his own home  right beside his parents' house. He requires care 24 hours a  day, which his grandfather provides in part. The renowned  research plant pathologist retired so that he could care for  Scott full-time.In addition, Scott has a caregiver w ho  comes every day to help care for him who is paid through  Medicaid's Mental Retardation Waiver Program. And the Braggs  provide some of his care directly or through private  care.Truly king of the castleAt  his home one afternoon Scott demonstrated that he really is  the king of his castle."If he ain't happy, ain't  nobody happy," noted Sutton, who has been caring for Scott for  six years. "What does Miss Jerri do?" Bragg asked her  son."Sleep," he innocently replied in a deep, husky  voice as everyone burst out in laughter."He's telling the  truth," Sutton answered back with a smile. Scott's  family has been active in caring for him all his life, but his  biggest cheerleader was his late younger brother,  Matthew."He was his brother's strongest advocate,"  shared Bragg.Despite being eight years younger,  Matth ew taught his brother how to talk, play and have  relationships. He even encouraged his parents to open B&B  Care Services, Inc. to help provide needed services to Scott  and others with special needs.They started the company  in 1999 and today it is in 111 Georgia counties. It provides  supports to the elderly and those with disabilities in their  homes. And if they lack a home environment, the company helps  them find one. In February 2001 two days before his  18th birthday, Matthew was killed right down the road from his  home in a car accident. Three months later, Bragg's mother  died."Scott had a double whammy there with losing both  of them within a short span of time," Bragg said. "He lost his  two strongest advocates there and the rest of us had to kick  it up a notch ... or two or three notches."Matthew's  death also spurred the Bra g gs into ad vocacy work for disabled  Georgians."We had gotten comfortable in knowing that  Matthew would make sure that Scott was cared for," Bragg said.  "And the day that (Matthew's death) happened, we realized that  we had to jack up our efforts in helping Georgia provide a  system that would support Scott."Providing for  his futureIn addition to the care they provide  now to their son, Bragg and her husband also have planned for  when Scott no longer has them to rely upon.Within the  same week Matthew was killed they met with attorneys and  established a supplemental needs trust for Scott, which allows  money and property to be placed in a trust. The Braggs  have named seven individuals to implement it. They will help  Scott make decisions about where he lives, who provides his  supports and how the resources will be used to con ti nu e his&nbs p; lifestyle, according to Bragg. Some of the trustees  are family, while others are friends. They are educators,  financial officers, nurses and social workers.Anyone  can establish a supplemental needs trust for their loved one.  Bragg strongly encourages families to consider doing  so. Likewise, she advises families to make sure their disabled  relative has a legal guardian with their best interest at  heart and not the state.She is Scott's legal guardian  and in the event of her passing, her husband or grandfather  will petition the court for guardianship to make sure that a  loved one maintains guardianship."It's very important  to protect people," Bragg advised. In the meantime,  Scott spends his days happily and freely thanks to the  sacrifices and hard work his family has put forth to make that  possible.--Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 18 Apr 2007 00:00:00 EDT http://www.lgtinc.org/articles/225/1/Urgent%3A-Therapy-Advocacy-Needed-by-You%21 March 9, 2007   Dearest Advocates:   As many of you are aware, there have been significant changes to the therapy "process" to get approval for our children's therapy in the last 6 months. Due to the changes in DCH's approval process and making our therapist submit prior authorizations every 3 months, access to therapy has become VERY difficult!  Please take a moment and get involved.    Our legislators need to hear from us and why the process is "FAILING" our children and the services they need! Please see below an email that was sent to via the Trialliance (an advocacy group put together by the various PT, OT and ST associations).    Please help influence change! United... WE WILL MAKE A DIFFERENCE! Have a great weekend. Heidi ===========================================   Members of the Trialliance and our lobbyists have been working with Representative Burkhalter (R-Duluth) on legislation to establish requirements for basic therapy services. Rep. Burkhalter authored HB 549 which will establish requirements for basic therapy services for children with disabilities. In the bill "basic therapy services" is defined as "occupational therapy, speech therapy, physical therapy or other services provided in the frequency specified pursuant to EPSDT Program to an eligible Medicaid or PeachCare for Kids beneficiary 21 years of age or younger and which are prescribed and designated as medically necessary by a physician or other healthcare provider working within the scope of his or her legal authority." The term "medically necessary services" is defined as "services which are deemed necessary by a physician or other healthcare provider to correct or ameliorate defects and physical and mental illnesses and conditions." The Bill sta tes that "all persons who are 21 years or younger who are eligible for services under the EPSDT Program shall receive basic therapy services without prior approval in accordance with the provisions of this article." The initiative also establishes specific requirements regarding administrative prior approval for services and appeals. Moreover, the Bill addresses the issue of modification to the State plan for Medical Assistance concerning the rate of payment to providers of medical assistance services.   In the Bill, the Department of Community Health would be directed to implement a modification of the State Plan or any of the affected rules or regulations to provide a rate of payment to providers that is sufficient to "enlist enough providers so that services are available to Medicaid or PeachCare for Kids beneficiaries.to the extent that services are available to the general public" no later than June 1, 2007. If passed, this would become effective upon approval of the Governor. Trialliance members and families of the children we are treating need to contact members of the Health and Human Services Subcommittee now and ask them to support HB 549 authored by Representative Burkhalter. To contact the members of this committee go to the following website: (Enter into your browser) http://www.legis.state.ga.us/legis/2007_08/house/Committees/healthHuman/h ealth.htm During your phone call or in your letter, please let legislators know about the difficulties families are having obtaining therapy services for children with disabilities through the CMOs and Medicaid. It is urgent that we start a strong grassroots advocacy effort to support this bill and its passage. Please contact your legislators and encourage others within your areas to do the same. They are very interested in hearing from families so PLEASE urge families to act today to have a say in services for their child. (Heidi's Comments: In addition to contacting the above Healthcare Committee on this issue, please also send an email to your State Senator and Representative (To find them: www.vote-smart.org and input your zip code). Also- make your email/phone call personal. Explain how the DCH changes have impacted your child's ability to receive therapy! If they do n't hear from us, they don't know there is a problem. Parents need to support what the therapists are saying......The process is broken and needs to be fixed ASAP) ================================================   In addition, I have added a lot of individuals to my distribution list in the last few months.  If you have missed any of my previous e-mails, you can find them at http://www.lgtinc.org/authors/41/Heidi-J.-Moore?Page=8 . Page down to see the most recent advocacy emails.  Thank you. --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 09 Mar 2007 00:00:00 EST http://www.lgtinc.org/articles/224/1/NMML-Sports-Complex-Update--Advocacy-Needed March 8, 2007   Dearest Advocates:   As many of you know, I sent out an email a few days ago expressing concerns about Alpharetta City Council's continued partnership/support with North Metro Miracle League (NMML) and the construction of the Sports Court at North Park.   First of all, I want to personally thank all the families and friends that attended the City Council meeting on Monday and sent e-mails of support.  We packed the court room (estimates are over 100+)!  The Mayor even commented on receiving over 300+ at the meeting!  I think this shows the communities concern with the issues.  It was obvious from that Council meeting that more needs to be done to "help" educate our elected officials on the needs of individuals with disabilities and their families and the support of the entire community!   The city continues to talk in vague terms about a "process" that needs to be completed (citizens survey, assessment,etc) to prepare a "master plan".  Unfortunately, NMML (and the City thru Block Grants) has $47,000 to possibly lose due to the lack of support in a timely matter to support the final construction phase of the Sports Complex.    Facts:   The partnership between NMML and the city is a win/win situation. Good business decisions. In past, the City invested 10% (via Community Development Block Grants) of the cost of the Sports Complex and now is worth over $2.0 million (rate of return on investment of 900%)!  The Sports Complex has added value to the City and allowed all its citizens to benefit from this facility to date. Sports Court Delay……  If the City does not make timely decisions now, NMML will loose this opportunity for Alpharetta to have a Sports Court that everyone can benefit from? I agree that a needs assessment is a good tool because it will show how many families support additional programming opportunities for the disability community. But, unfortunately we don't have the time to wait.  Even the Alpharetta Youth Softball Association (AYSA) is in support of this proposal and sees the benefit. Our families need sports programming options. NMML goal is to provide programming that offers a variety of more appropriate challenges for children and adults with disabilities. Baseball is not a "one size fits all" answer to the multitude of challenges the NMML athletes face.  We are very appreciative of the work so far but we need to do more.  A choice of sports programming will allow parents and coaches to find the right match between a person's disability and an adapted sports program that will maximize the improvement in that persons physical, social and coping skills. The multi-use Sports Court may be used by children and adults of all ability levels but it will specifically fill the need for the disability community that is currently drastically underserved.   Action Items Needed By YOU:   A. Please take a moment if you have not already done so and send an email to Alpharetta City Council with the following message points:   + Appreciation of the City partnering with NMML and continuing that relationships in the future. It's a win/win!   +Question the Council on: What are the timeframes for completing the citizen's survey and needs assessment? (The Council still has not given us any timeframes of the process and only talked in the general terms. We need answers!)   + Overall- need for more sports programming opportunities in the community for individuals with disabilities.   + Please make your e-mail/ phone calls are personal. Explain the impact this has on your family.   The following is a link to contact information for the Alpharetta City Council and Mayor: http://www.alpharetta.ga.us/index.php?p=29.   Please copy John (jettjock@mindspring.com) (ED for NMML) or myself (heidijmoore@comcast.net) on your emails.   B.  If you are an Alpharetta Resident, please participate in the Citizens Survey when you receive it in the mail.  I received mine yesterday. Specifically, Question D9: "Do you or any member your family have a disability? And Question D10: "Do you think Alpharetta meets the needs of people with disabilities?"  THEY NEED TO HEAR FROM US!!!!   In addition, Revue and News Newspaper had an article in today's newspaper entitled "Miracle League told to wait -City Council sticks to process before giving OK to Sport Court for disabled residents". To view that article go to:   http://www.northfulton.com/1editorialbody.lasso?-token.folder=2007-03-01&-token.story=154705.112113&-token.subpub=   Also send an email to the reporter, Bob Pepalis, bob@northfulton.com thanking him for the coverage of the situation and why it is so important to the disability community.  The article did not totally represent the facts to the situation and NMML plans on writing a letter to help clarify the true issues.      (Heidi's Comments:......NMML has been communicating well with the Council on this issue, unfortunately, the Council has not done a good job communicating within itself! )   There was also an article on Page 2 of the Alpharetta Neighbor yesterday. Unfortunately, it is not on there website www.neighbornewspapers.com.  The reporter, Amber Summers did a great job explaining the concerns of the community on this issue. Please take a moment and thank them for their coverage of the situation: nfulton@neighbornewspapers.com.   Even if you don't live in Alpharetta, NMML works with families all over the Metro Atlanta area and needs your help.  Thanks in advance for your help in this matter. UNITED…. WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi   For more information on NMML go to: www.nmml.net . It truly is a wonderful organization that has helped an entire community with the acceptance of individuals with disabilities and seeing our children for their abilities NOT disabilities!   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 09 Mar 2007 00:00:00 EST http://www.lgtinc.org/articles/223/1/Advocacy-and-Information March 6, 2007   Dearest Advocates:   Thought you might be interested in the below information. Only with getting involved attending events, filling out survey's, communicating our concerns…………….are we going to continue to have our voices heard for our children!  YOU are your child's #1 advocate.  Hope you find this information useful.  Sincerely, Heidi =====================================================    The following is a message from David Tolleson with the City of Roswell:   Special Populations Awareness Month in Roswell: Advocacy Opportunity:  7:30 PM, Monday, March 19th, in front of Roswell's City Council.  At that time, the Mayor will be proclaiming that April will again be Special Populations Awareness Month.  There will be a brief video presentation about the Inclusion Task Force's past successes in Roswell, including information about how far we still need to go.  We're asking to double the budget of our ADA Task Force this year and the presence of many families helps us make progress slowly, but surely.  There will be a reception with sn ack-type foods after the presentation, probably around 7:45. Due to the March date, the Task Force suggested wearing something green as a sign of solidarity (shirt/scarf/whatever).   (Heidi Comments: I realize this is a school night but it always helps for the City to see the faces of the children.  You don't have to be a resident of Roswell to show your support at this event.  The timing of this event is critical since they are going into budget season. )    Educational Seminar for Special Needs Families   SPECIAL NEEDS CONFERENCE -- Kennesaw, GA - - On Saturday, March 31 from 10:00 a.m. - 12:30 p.m. at NorthStar Church in Acworth/ Kennesaw, Ga. This educational event is designed for parents and families of special needs children, as well as anyone interested in learning more about Autistic Spectrum Disorders (ADHD, ADD, Aspergers Syndrome, Autism, Pervasive Developmental Disorder, Non Verbal Learning Disorder and more). The conference will feature an expert physician panel, including: Amy Thornhill Pakula, MD - Dr. Pakula is a Neurodevelopmental Pediatrician and Director of Developmental Pediatric Clinics at the Marcus Institute. She specializes in early identification of, intervention for, developmental and behavioral problems in children during infancy and the pre-school years. Cobb County Schools Parent Mentors - The parent mentors can help educate on what the school system has to offer special needs children. Stephanie Pretti, OTR/L - Ms. Pretti, Occupational Therapist, Children's Healthcare of Atlanta Rehabilitation Services.  Deborah Matthews McCormick, MS., NCC, LPC - Mrs. McCormick is a licensed counselor with experience in helping both children and their families. The panel will discuss the diagnosis, treatment (pharmacologic and non-pharmacologic), education and expected outcomes for children and will conduct a question and answer segment with parents and families. Online reservations are available at northstarchurch.org.  Paper registration forms may be printed online. Please contact Jeff Hardin at 678-427-5380 or Tricia Levy at 404-245-2870 for more details. There is no cost for the seminar, and childcare is available by reservation only.  NorthStar Church is located at 3413 Blue Springs Road, Kennesaw, GA 30144.  Office phone is (770) 420-9808.  Directions to NorthStar Church's campus and offices can be found at www.northstarchurch.org/directions.shtml. ================================================= The following is a message from Stephanie Moss, Part C Coordinator, Babies Can't Wait.   We need to hear from you!  The Babies Can't Wait program, Georgia's early intervention system for infants and toddlers (birth to three) with disabilities and their families, needs your input to help improve our services for Georgia's children and families.     As part of this process we are conducting an online survey of our stakeholders, including families, service providers, our own staff, and our community partners, both public and private.   Our time frame is extremely tight.  The online survey will be available only Monday, March 5, 2007 through Friday, March 16, 2007 http://s urveybcw.caresolutions.com   Because of your work on the front lines, your input and assistance is critical.  We are asking you to participate in the survey yourself as well as help get the word out and encourage others in your community - families, service providers, LICCs, school officials, child advocates, etc. - to participate.  Attached is a flyer you can email,  copy and distribute.     Please be assured that all survey responses will remain anonymous - an independent consulting firm will collect and analyze the data and provide the BCW with summary reports. Thank you in advance for your participation and your help in getting others to participate!   (Heidi's Comments: Even if your child is out of the BCW program, please take a moment to fill out this survey. BCW needs to hear from EVERYONE in order to continue to provide services to families from birth to 3 yrs old.)   ================================================= The following is a message from Susanna Mitchell with the Governor's Council on Developmental Disabilities:   Please visit http://www.surveymonkey.com/s.asp?u=181193386114 to complete a brief survey on Disability Day at the Capitol 2007.  The survey will be available until Friday, March 9.    Thank you everyone who already completed the survey.  We appreciate your feedback!   ===================================================   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 06 Mar 2007 00:00:00 EST http://www.lgtinc.org/articles/222/1/Advocacy-Needed-By-YOU%21 March 2, 2007   Dearest Advocates:   Earlier this week I sent an email out regarding the need for family participation at an upcoming Alpharetta City Council meeting.  I wanted to clarify the reason why we are asking to speak to the Council……   Our goal is to help educate the Council on the needs of its residents/community/tax-payers/businesses and to continue to support the partnership the City has with North Metro Miracle League (NMML). This is also includes the completion of the Sport Court in our existing Sports Complex.   The Council needs to understand us and listen to our concerns and SEE the critical mass of people being concerned about the issue.....Individuals with disabilities need access to programming in the community!   PLEASE take this opportunity to show your support and attend this meeting (see specifics below).  We plan on having the following list of speakers that represent various segments of the disability population.   Tina D'versa - Chairperson for NMML - Overview why we are here. Heidi Moore - Parent / Resident- younger children. Cindy Smith - Parent / Resident - older children. TBD - Youth Volunteers "Buddies" Maureen Wales - Adaptive PE teacher and programming. Al Nash - President of N. Fulton Chamber of Commerce Mark Johnson - Resident - wrap-up   If you can't attend this important meeting , send a e-mail message to the Mayor and City Council.  Tell them what the NMML and a completed Adapted Sports Complex means to you, your family and/or group and our community.  Following is a link to contact information http://www.alpharetta.ga.us/index.php?p=29. Please copy John (jettjock@mindspring.com)  or myself (heidijmoore@comcast.net) on your emails.   Hope to see you there. Sincerely, Heidi   ================================================   February 26, 2007   Dearest Advocates:   PLEASE READ   Unfortunately due to some political issues, funding for a Sports Court for children and adults with disabilities is at risk AND WE NEED YOUR HELP! Even if you don't live in north metro Atlanta, this should be everyone's concern.   Proper funding for programs for children and adults with disabilities is necessary.   North Metro Miracle League (www.nmml.net) is a fantastic organization that has been instrumental in helping our children participate in sports in North Atlanta (as well as many other programs not involving sports).  They have been able to secure federal funding for a Sports Court but due to some political issues from the Alpharetta City Council (ACC).NMML may not be able to build this complex.  ACC is not convinced that the land utilization for this complex is best for North Park.   This is about more than just a Sports Court, it is about an opportunity to politely educate ACC for the need of  access to adaptive programming for children and adults with disabilities in Georgia.  If ACC is not going to provide services to the community, they should support the efforts of NMML (like they have done in the past). Private / Public partnerships are wonderful ways to develop the necessary programs needed for our children. It is a win/win situation.   Alpharetta City Council needs to see our families/concerned tax payers understand, care and want fair funding opportunities and programming for our children!   Please Attend!   Details:   Alpharetta City Council Meeting Monday, March 5 at 7:30 pm Alpharetta City Hall 2 South Main Street, Alpharetta, GA 30004 (parking is to the south of city hall building) 678-297-6000   Families and Children are welcome. (Bring your friends and neighbors. We need critical mass)   Please RSVP John McLaughlin (NMML Executive Director) at jettjock@mindspring.com or 770-777-7044 of your attendance ASAP.   Thanks for support in this very important matter. See you there!   Sincerely,   Heidi     --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 06 Mar 2007 00:00:00 EST http://www.lgtinc.org/articles/221/1/Katie-Becket-Waiver---Foundation-Needs-YOUR-INPUT February 27, 2007   Dearest Advocates:   The State of Georgia is looking for our input regarding the $7.6 million that was set aside last legislative session for families that have been impacted/denied the Katie Beckett Waiver.  If you would like to participate and help set the direction on where is money is to be spent, please try to attend one of the below group discussions.    Please contact Community Foundation of Greater Atlanta (they are managing the program on behalf of Dept. of Human Resources and Dept. of Community Health) regarding any questions to the below email that they provided. This is good news….they are looking for OUR input!     Heidi   ==================================================== We need your assistance in identifying parents with children currently on the Katie Beckett waiver program who would be willing to attend one of two focus groups to discuss the needs of their children. The Georgia Health Policy Center will be conducting the focus groups to better understand the needs of children with special needs. As you know, last year the Georgia Legislature set aside $7.6 million to assist medically fragile children and their families, including those impacted by the changes in eligibility for the Katie Beckett Deeming Waiver Program. In addition to providing transitional funds to families no longer eligible for Katie Beckett, funds were set aside to address the long-term needs of medically fragile children and their families. We are asking parents to share their experiences and provide guidance on how to most wisely use the funds set aside.     The focus group discussions are being held on:   ·         Monday, March 12 from 6:30 to 8:30 p.m. in Athens (Hall County) ·         Monday, March 19 from 6:30 to 8:30 p.m. in Decatur (DeKalb County)   Participants will be provided with a light meal and given a stipend of $50.00 to help defray any costs associated with attending the meeting. The focus group conversations will be recorded but all comments will confidential and no comments will be associated with any individual in the report that will be prepared.    Spaces are limited, so if you would like to attend, please respond by either calling Daphne Renolds at 404-651-1464 or emailing her at dtrghdoff@bellsouth.net. She will provide you with further details regarding the exact location of the meeting.   Again, we are looking for parents of children currently enrolled in the Katie Beckett Deeming Waiver program.   Thank you for your interest. Lita Ugarte Program Officer- The Community Foundation for Greater Atlanta 50 Hurt Plaza Suite 449 Atlanta, GA 30303 (404) 688-5525, (404) 688-3060 fax lugarte@atlcf.org http://www.atlcf.org   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 06 Mar 2007 00:00:00 EST http://www.lgtinc.org/articles/220/1/Newsweek-Magazine-and-AJC-Articles January 26, 2007   Dearest Advocates:   There are a number of articles that I thought you might be interested in:   Newsweek Magazine:   Newsweek Magazine had an article this week on the new guidelines issued by the American College of Obstetricians and Gynecologists (ACOG) on the recommendation that all pregnant women, regardless of age, be offered genetic counseling and testing for Down syndrome.  Unfortunately, 85 percent of pregnancies in which Down syndrome is diagnosed end in abortion.    As you can imagine, this is a very controversial issue……On a personal note: I think my son, Jacob, is a true blessing in this world (note: I found out at 20 weeks of pregnancy that Jacob was diagnosed with Down syndrome, a severe heart condition and excess water on the brain and may not live thru pregnancy). My husband and I truly believe that God gave us our precious Jacob for a reason and that we were "chosen".  I can honestly say that Jacob (only 7 yrs old) has had more of a positive impact in this world than most people do in a lifetime.  I do think society would be a better place if more people had love, compassion and determination like my son.    Here is the web link to the article:   http://www.msnbc.msn.com/id/16720750/site/newsweek/   If you would like to write to the reporter, George F. Will, he can be reached at webeditors@newsweek.com (also copy Letters to the Editor letters@newsweek.com ).   =============================================================   Also in today's Atlanta Journal- Constitution Newspaper the following articles:   Vouchers for special-needs students proposed By KEVIN DUFFY   http://www.ajc.com/news/content/metro/legis07/stories/2007/01/25/0126metlegvoucher.html   State's mental hospitals under reviewDHR chief responds to newspaper articlesBy ANDY MILLER jamiller@ajc.com and ALAN JUDD   http://www.ajc.com/health/content/health/stories/2007/01/25/0126meshmenta.html   And another previous article about the situation in AJC: http://www.ajc.com/health/content/health/stories/2007/01/04/0107meshabout.html   Happy Reading! Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/219/1/GCDD-Wants-Your-Opinion-on-Senate-Bill-10%21 January 24, 2007   Dearest Advocates: Please find below a survey GCDD wants our input on regarding SB 10 ASAP.  Please take this important opportunity to voice your opinion in this matter this week. Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative.   -------------- Forwarded Message: -------------- From: "Governor's Council on Developmental Disabilities (GCDD)" To: heidijmoore@comcast.net Subject: GCDD Wants Your Opinion on Senate Bill 10! Date: Tue, 23 Jan 2007 23:59:41 +0000   Make A Difference! The GCDD is interested in your thoughts, ideas and concerns about Senate Bill 10: Georgia Special Needs Scholarship Act Act now to Make A Difference! Visit www.gcdd.org to post your comment on Georgia Special Needs Scholarship Act. Post Your Comment! Visit the Issues Chat Room on the Governor's Council on Developmental Disabilities' website to share your opinion: http://www.gcdd.org The Council will use your comments to develop its position on this legislation and will share your comments with legislators.Full text of SB 10 and fact sheet also posted at www.gcdd.org  Click here to share your comment with GCDD! Thank you for making a difference! email: eejacobson@dhr.state.ga.us web: http://www.gcdd.org Forward email This email was sent to heidijmoore@comcast.net, by eejacobson@dhr.state.ga.us Update Profile/Email Address | Instant removal with SafeUnsubscribe™ | Privacy Policy. Powered by Governor's Council on Developmental Disabilities | 2 Peachtree St. NW | 26th Floor, Suite 230 | Atlanta | GA | 30303 Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/218/1/Advocacy-Updates%3A-SB-10%2C-Unlock%2C-and-KB-Waiver-Presentation January 22, 2007   Dearest Advocates:   Additional advocacy information for your use………   Senate Bill 10:   The new proposed Georgia legislative amendment offers children with special needs $7,000 to be used for private school. The proposal, however, requires that the child currently be enrolled in public school to receive the $7,000 for the following year.   You can find Senate Bill 10 by going to following website: http://www.legis.ga.gov/legis/2007_08/fulltext/sb10.htm   Here is some additional information from Florida and what there are doing regarding a similar program to allow families flexibility:   In Florida, the amount of a McKay Scholarship for a student varies depending on the amount and type of services provided by the school district while the student was enrolled in a public school.   The amount and type of services is largely based on the type and severity of the student's disability.  This amount can range from $5,000 - $20,000, per school year.   Chad L. Aldis Scholarship Programs Director Office of Independent Education and Parental Choice   More information: SB 10 Facts (As Prefiled) The Georgia Special Needs Scholarships will provide a scholarship to go to parents of students with disabilities to be used at an eligible private school. The amount is the state and federal amounts for services that the child would earn in a regular public school or the amount of private school tuition, whichever is less. The scholarship is not limited to any particular disability, but is available for any child who is identified by a public school has having a disability which qualifies for special education. The definition of disability for purposes of the scholarship is the same as under federal law. The student must have spent the prior school year in attendance at a Georgia public school and have an Individualized Education Program (IEP). The parent has to be accepted into a private school and has to accept full financial responsibility, included transportation to and from the private school. An eligible private school is one in Georgia where students have direct contact with teachers (no virtual schools) and must demonstrate fiscal soundness and be academically accountable to the parents. DOE will approve the private schools. Home schools are not eligible to enroll scholarship student, nor are residential treatment facilities. Acceptance of scholarship students will not impose additional regulation on the private school. The DOE will make four equal payments during the academic year. The payments will be made in individual warrants made payable to the students parents. To access the scholarship the parents must endorse the warrant for deposit into the private schools account.  The Georgia Special Needs Scholarship is modeled after a program in Florida. The average amount of the scholarship in Florida is $6,117. Specific Georgia numbers are still being gathered, but it will probably be fairly close to this. In Florida, 15, 910 students received the scholarships in 2004-2005 (out of approximately 370,000 who are eligible. 703 private schools participated in the program.  In Florida the scholarship does not impact any one particular disability any more than the others. The distribution of disabilities using the scholarship mirrors the distribution of disabilities in the public schools. The Florida program was evaluated by the Manhattan Institute in 2003. That study found that almost 93% of scholarship participants were satisfied or very satisfied with their scholarship school; only 32% were satisfied with their public schools. Class sizes dropped from an average of 25 students per class in public school to 12.8 students per class in schools participating in the Scholarship. 47% of students said they were bothered often and 25% were physically assaulted because of their disability in public schools, compared to 5% bothered often and 6% assaulted in scholarship schools. Over 90% of students who left the scholarship school and returned to public school say the program should continue to be available to families who want to participate. I have not been as involved with this proposed legislation but it does look like it gives our families some flexibility they did not have in the past.  If you have any comments regarding SB 10, please call or e-mail Senator Johnson at eric.johnson@senate.ga.gov and the Senate Education Committee listed at the below website link:   http://www.legis.state.ga.us/legis/2007_08/senate/education.php     Unlock the Waiting Lists! Need your Help!   In addition, we need everyone to support the additional 2,000 MRWP waiver slots for this fiscal year (currently the Governor is proposing a reduction to 1,500 slots and not DHR's recommended 2,000).  Please go the following website to find out more information and how you can help: http://www.unlockthewaitinglists.com/actionalert.html================================================   Katie Beckett Waiver Presentation at FOCUS.   Also- Wanted everyone to know that I will presenting on the Katie Beckett Waiver at the upcoming FOCUS educational conference on February 10. I will also be discussing other advocacy issues as well.  For more information, please go to the following website:http://www.focus-ga.org/   Hope you find this information helpful.   Sincerely, Heidi     --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/217/1/Peachcare-advocacy%2C-IDEA-survey-and-fun-opportunity-for-kids%21 January 10, 2007   Dearest Advocates:   Wanted you to be aware of some additional advocacy opportunities, as well as, a wonderful event. Please note that we must all get involved in order to support Peachcare for children. All children need access to healthcare in GA! See details from others below: ============================================ PEPP (Parents Educating Parents and Professionals) launched a survey to collect feedback and comment on the IDEA and important issues regarding the influence in development of the final State Regulations. The survey helps parents and professionals of the field to become aware of important issues that have come up for change or further definition. Educate yourself today and become aware of these issues and possible changes that will affect you and your child today! Please take a look at this easy to access survey at http://www.surveymonkey.com/s.asp?u=632012778076 or visit our website home page for a direct link to the online survey. Surveys in hard copy can also be requested for hand distribution to your communities. ================================================ Peachcare Advocacy ALERT- Need your help! We are forwarding this alert from Healthy Mothers Healthy Babies askingyou to contact members of the U.S. House and Senate immediately aboutfunding for PeachCare.  Georgia children need your help now.  Please seethe alert below which contains an explanation and contact informationfor Georgia's delegation.  (The alert is attached if you have difficultyreading the notice embedded in this e-mail.)   Also, Voices for Georgia's Children is coordinating a sign-on letter toCongress regarding the PeachCare issue.  The letter is attached.  Ifyour organization wishes to sign the letter, please notify MoniqueFolston at Voices by 6:00 p.m. on Wednesday, January 10th of how youwant to be listed.  MFols ton@georgiavoices.org   or 404-521-0311. HMHB Legislative AlertFEDERAL FUNDING FOR PEACHCARE AT RISKGeorgia's PeachCare for Kids program is facing a $131 million shortfallin federal funds. If the shortfall is not addressed, PeachCare for Kidswill run out of funding by March 2007 and the 270,000 children in theprogram plus future enrollees will lose their health care coverage.PeachCare for Kids is the Georgia version of the national StateChildren's Health Insurance Plan (S-CHIP).You can help! We all need to contact members of the GeorgiaCongressional delegation and ask them to address this issue now, duringthe first days of the 110th Congress.PeachCare for Kids provides health c a re coverage to 270,000 children.The program ranks fifth in the nation in the number of childrenenrolled, but due to the current funding formula, Georgia receives lessfunds per child than some states that have enrolled fewer children. Inaddition to the threat of this funding shortfall, our state is beingunfairly penalized for doing a good job of enrolling children in theprogram. WHAT YOU NEED TO DO:Contact both U.S. Senators and your U.S.Representative today.Ask them to:*    Work for reauthorization of S-CHIP.*    Make sure Georgia receives the funding we need to continuePeachCare for Kids.*    Work to fix the S-CHIP funding formula so that states like Georgiathat have done a good job of enrolling children in the program are notpenalized.Contact information for both of Georgia's U.S. Senators and the 13 U.S.Representatives is listed below. You need to contact both Se n atorIsakson and Senator Chambliss, and your U.S. Representative. If you arenot sure which Congressional district you live in, you can go to www.vote-smart.org . The panel on the leftside of the page asks for your nine-digit zip code and instructions fordetermining the nine-digit zip code are included. Your congressionaldistrict will be listed following the names of the two U.S. Senators. Please call, fax or email today!Senator Saxby Chambliss416 Russell Senate Office BuildingWashington, DC  20510Phone: 202-224-3521Fax: 202-224-0103Email: Saxby_chambliss@chambliss.sena te .gov Representative Lynn Westmoreland - District 81213 Longworth House Office Building Washington, DC 20515 Phone: 202-225-5901 Fax: 202-225-2515Email: lynn.westmoreland@mail.house.gov Senator Johnny Isakson               ; ; ;                    120 Russell Senate Office BuildingWashington, DC  20510Phone: 202-224-3643Fax: 202-228-0724Email: http://isakson.senate.gov/contact.cfm Representative Charlie Norwood - District 92452 Rayburn BuildingWashington, DC 20515Phone: (202) 225-4101Fax: (202) 226-0776Email: rep.charlie.norwood@mail.house.gov Representative Jack Kingston - District 12368 Rayburn HOB Washington, DC 20515 Phone: (202) 225-5831 Fax: (202) 226-2269 Email: Jack.Kingston@mail.house.gov &l t; BR>Representative Nathan Deal - District 102133 Rayburn House Office BuildingWashington, DC 20515-1009Phone: (202) 225-5211Fax: 202-225-8272Email: congressmandeal@mail.house.gov Representative Sanford Bishop - District 22429 Rayburn House Office BuildingWashington, DC  20515Pho ne: 202-225-3631Fax: 202-225-2203Email: http://bishop.house.gov/display.cfm?content_id=229 Representative Phil Gingrey - District 11119 Cannon House Office Building Washington, DC 20515 Phone: 202-225-2931 Fax: 202-225-2944 Email: gingrey.ga@mail.house.gov Representative Jim Marshall - District 3515 Cannon House Office BuildingWashington, DC  20515-1003Phone: 202-225-6531Fax: 202-225-3013Email: jim.marshall@mail.house.gov < BR>Representative John Barrow - District 12226 Cannon House Office BuildingWashington, DC 20515Phone: 202-225-2823Fax: 202-225-3377Email: http://barrow.house.gov/contactemail.asp   Representative "Hank" Johnson - District 41133 Longworth HOBWashington, DC 20515-1004Phone: (202) 225-1605Representative David Scott - Distric t 13417 Cannon House Office BuildingWashington, DC 20515Phone (202) 225 - 2939Toll free: 1-877-762-8762Fax: (202) 225 - 4628Email: david.scott@mail.house.gov Representative John Lewis - District 5343 Cannon House Office BuildingWashington, DC  20515Phone: 202-225-3801< BR>Fa x: 202-225 -0351Email: http://www.house.gov/johnlewis/contact.html Representative Tom Price - District 6506 Cannon House Office BuildingWashington, DC  20515Phone: 202-225-4501Fax: 202-225-4656Email: tom.price@mail.house.gov Representative John Linder - District 71026 Longworth House Office BuildingWashington, DC  20515-1007Phone: 202-225-4272Fax: 202-225-4696Email: http://linder.house.gov/index.cfm?FuseAction=Contact.Home Please excuse duplicate e-mails.  You may be on more than one list.Linda Smith Lowe1137 Morela nd Place, S EAtlanta, GA  30316404.274.1746; 404.622.5079 faxsmithlowe@earthlink.net ==================================================   The Kool Kidz Can Imagine Triathlon If You Imagine It, You Can Do It   For Kidz of All Abilities, ages 5 to 21   Sunday, January 21, 2007 10:00 am Mountain View Pool 2650 Gordy Parkway Marietta, GA 30066  25 yard swim (flotation device permitted, adult stand by permitted) Run, walk, propel, power around perimeter of pool one time (assistive devices of all types permitted)* Bike around perimeter of pool one time (adaptive bikes of all types permitted)* Weather permitting, the run and bike portions may be conducted outside   $20 Registration until 1/14/07; $25 late and day of registration Awards and t-shirts will be given to all participants For more information, contact Lauren Shoda, program coordinator lshoda@koolkidzfoundation.org or 770.517.1585 ­­­Return registration form and check for $20/$25 To: Kool Kidz Foundation PO Box 680936 Marietta, GA 30068-0016   Name________________________________Date of Birth____________________   Address________________________City__________________Zip_____________   Email Address_____________________Primary Phone Contact_______________   T Shirt size (circle one): Youth small  med  large        Adult small  med  large         Assistive devices you will be using  in event:______________________________   Hope you find this information helpful. Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 7 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/216/1/Media-and-Advocacy-Updates January 8, 2007   Dearest Advocates:   There is a wonderful article in the Townlaker Newspaper this month regarding Adrienne O'Prey and the success she has had with getting the employment and resources she needs to build success!  This just shows you how given the right resources and support allows our children to succeed in life! Unfortunately, Adrienne is still on the long term waiting list for the MRWP waiver.  She and many others needs your support this next legislative session to "Unlock the Waiting Lists" and get more funding for adults like Adrienne. Enjoy this inspirational article!   http://www.townelaker.com/townelaker/2007/01/2007-1-864.php   I've said this before and will say it again.......we need to continue to educate our community and legislators on what the real issues are and seeing the success of our children! ====================================== In addition- this article was in the Sunday Athens Banner-Herald newspaper today regarding healthcare:   http://onlineathens.com/stories/010707/genassembly_20070107047.shtml   Looks like healthcare will continue to be a topic of discussion during this legislative session.  Keep up your communication with your legislators on your concerns with healthcare for our children! ============================================= Also- please take time to attend the upcoming Dept. of Education Input Sessions for State Special Education Rules on January 9th in Suwanee, GA-at the Gwinnett County Instructional Support Center (437 Old Peachtree Road) from 10-1 and 4-7.    A full list of times and dates and the proposed draft of state education rules can be found at: http://www.gadoe.org/pea_communications.aspx?ViewMode=1&obj=1328   Hope you find this information helpful. Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/215/1/National-Postive-Media-Coverage-%26-Other-Information January 4, 2007   Dearest Advocates:   Happy New Year! I wanted you to be aware of a wonderful story in People Magazine this week about a true hero that lives right here in Georgia- Laura Moore.  If you recall, Laura spoke at our Healthcare for Kids Rally in November.    We also got confirmation that ABC World News Tonight with Charlie Gibson (used to be Peter Jennings) will air the Dream House Story at 7:00pm THIS Friday night!!   Please see the below email regarding the People Magazine article and take a moment to thank reporter Tom Fields-Meyer for his story  ( tom_fields-meyer@peoplemag.com ). We need to continue to educate everyone the importance of getting involved to make change for our children. Education is the key to changing the world and Laura is an excellent example of this!    In addition, it's with a sad heart that I have to let everyone know that Judy Hammett lost her precious daughter, Kiley, before Christmas. Judy and her husband are another amazing couple that have dedicated their lives to helping with foster caring and adopting medically fragile children.  (see memorial service information below).  Judy also spoke at our Rally.  If you recall, she is the grandmother that started another life of foster caring and adopting these precious angels.  Kiley will always be remembered in our hearts! (note: Judy is also in the People Magazine article as well)   In addition, the legislative session starts on January 8th at the Capitol. Please continue to build your personal relationships with your legislators....It does make a difference!   I'll be having additional advocacy updates later this month.  Due to medical issues with my son, I have not been able to be as involved with advocacy in the last month.  I know you all understand.   I have been asked a lot of questions regarding the Katie Beckett Waiver recently. No- there has not been any changes to the process.....that I'm aware of at this time.  Please understand if I don't respond to you directly (I'm still receiving over 250+/week over Christmas).   Talk to you soon, Sincerely, Heidi   ========================= Hi Everyone:   Wanted to let all of you know that Kiley's memorial service will be held at 10:30 am on Saturday, January 13, 2007 at Stone Mountain First United Methodist Church,  5312 W.Mountain Street, Stone Mountain.  This is the stone church in the area of the Stone Mountain Village.    For those of you who have asked:  Her color was pink.   We hope you can be with us to honor Kiley at her service.    Thank you all for the many prayers and all the support you have given us during this sad time.   It is still hard for me to believe she is gone.    On another note:  We heard today we are in People Magazine...page 119.   The issue that came out this weekend.   God Bless each of you and we hope to see you on the 13th.   We love you all,   Judy, Ken, and the Angels (1 in Heaven).   ==================================================== Call to Action:  Email Response to People Magazine for a GREAT story about Dream House Time Sensitive: Details Below  Please forward to everyone you know!! In a time when kids' healthcare issues are hanging in the balance, Dream House has been successful in changing the lives of and creating programs for the care of Georgia's medically fragile children!  Please read the heartwarming and compelling story of Laura Moore (Founder CEO of Dream House) and her newly adopted daughter, Katie in this week's People Magazine: Jan. 8 issue with "Half Their Size" on the cover. Dream House equips families and communities with resources and training for the care of medically fragile children. Their education programs will go statewide in 2007. The Resource Center being built in Conyers, Ga will provide more transitional homes for children as well as facilities for hands-on training and respite for families. In a significant and unique collaborative of private, state and future federal funding, Dream House programs fill the gap for the care of medically fragile children. In upcoming years plans are to take Dream House's programs to other states, touching thousands of kids and families, as well as providing a real solution to an existing multi-million dollar healthcare bill on taxpayers. At the heart of the program are kids like Laura's newly adopted 8 year-old daughter Katie, who survived two back to back five organ transplants and now has a home, a family and a future. Kids like Katie inspire us to try harder, hope longer and work tirelessly because it's the right thing to do; so that these children can be loved and cared for the way they should be... Please take the time to write a brief email to the writer of the article in People Magazine, thanking him for the wonderful coverage on Dream House!  Please ask him for more stories about Dream House, and let him know how much we appreciate his article!   Please copy and paste Tom's email address and your note to: tom_fields-meyer@peoplemag.com Thank you so much; You make the difference,  Leanne D. Manning  Mom of two awesome girls who don't give up:  Emory, who has Turner Syndrome; and Michel, who has Autism/Asperger Syndrome. --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/214/1/Information-Update-and-Advocacy December 21, 2006 Dearest Advocates:   It has been brought to my attention that DCH/DFCS is using a Form # 285 for new and re-applications for the Katie Beckett Waiver.  This form has been in existence since January 2006 but has not been implemented across all DFCS offices until now.  (Many thanks to Vickie for letting me know about this change).    I did ask DCH what the purpose of the form was and why we needed to fill out this additional information when most of the information is already on the Form 222 and HIPP form...This was their response for FYI..... "Medicaid applicants and recipients are required to provide information regarding third party resources available. This information is captured on a 285 form. Rights to Third Party Resources must be assigned to the Division of Medical Assistance (DMA). Medicaid is partially funded by the Federal Government and by law Medicaid is the payor of last resort. Therefore, if a member has another coverage, that plan should first process the claim as primary and Medicaid will process the claim as the secondary payer. If  Medicaid paid a claim as primary when we should've paid as secondary then State Medicaid departments are required by law to recoup the funds. The recoupment data is sent to CMS quarterly.  Attached is a copy of the 285 form for your review." I hope you find this information helpful.    As always, I can't stress enough how important it is to continue to build relationships with your state legislators. They will be going back into session on January 8th. To find out who your elected officials are, go to www.vote-smart.org and input your zipcode.  We are continuing to evaluate and work with our elected officials on the best approach for advocating this legislative session to make the necessary changes to the Medicaid healthcare system. Will keep you posted.   In addition, please take time to attend the upcoming Dept. of Education Input Sessions for State Special Education Rules in the coming month.  A full list of times and dates and the proposed draft of state education rules can be found at:http://www.gadoe.org/pea_communications.aspx?ViewMode=1&obj=1328   Happy Holidays to everyone. Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/213/1/CBS-46-Coverage-of-Healthcare-Issues-for-a-child November 21, 2006   Dearest Advocates:   Yesterday, CBS 46 aired a story on the difficulties one family is having receiving the necessary healthcare services for their son.  Please take a moment and thank the reporter, Cynne Simpson (cynne.simpson@cbs46.com) for her in depth report and the call to action! I also want to thank the Mink Family for being willing to tell their story on camera. Education and building awareness of the issues is the key to success in making change!   The state of Georgia MUST make healthcare a priority for children!   Here is the link (just in case  you did not see it): Brain Damaged Boy on Life Support     A Marietta family is crying out to the state to save their son. 9-year-old Peyton Mink suffers from brain damage and requires 24 hour care. But it's care the state is now threatening to cut. CBS 46's Cynne Simpson has more. You'll need a version of Windows Media Player 7 or higher to view the video. If you need to download it, go to http://www.microsoft.com/windows/mediaplayer/en/default.asp. The video player is supported by Microsoft IE 5.0 and above. Happy Thanksgiving, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/212/1/AJC-Article-%26quot%3BWhen-Parents-die%2C-disabled-adults-need-help%26quot%3B November 20, 2006   Dearest Advocates:   There was a wonderful article in the AJC newspaper today on the front page regarding the issue of when parents die and their children with disabilities are of need of care.  This is a real issue that needs to be addressed. Please take a moment and thank Gayle White at gwhite@ajc.com for her article and continuing to keep the community informed about real issues and the need to Unlock the Waiting Lists of our children in Georgia to receive the services they desperately need. The article also had some great resource information as well.   Here is the actual link to the AJC newspaper article:   http://www.ajc.com/search/content/meshsiblings1120a.html   Have a Happy Thanksgiving. Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) For more information about how you can get involved regarding advocating for children, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 30 Jan 2007 00:00:00 EST http://www.lgtinc.org/articles/206/1/Healthcare-For-Kids-Rally-Update-and-Advocacy%21 November 6, 2006   Dearest Advocates:   Rally Update:  On Saturday, we had our Healthcare for Kids Rally at the State Capitol.  The Rally was fantastic! Very informative, entertaining and inspirational!  We had a respectable turn out of people (estimates are at 700+ participates) given the time of the day and low temperatures.  We truly appreciate those that attended and wanted to make healthcare a priority in our state!    Unfortunately, we could have sent a stronger message if more people would have attended. What's more important than your child's healthcare?  WE as parents CAN NOT rely on others to advocate for our children or the State will win this battle.    I also want to publicly thank all the Rally committee members for their devoted energy and time making this one of the most professionally run and educational grassroots Rallies this state has EVER seen.    We did receive a lot of media attention over the last three weeks regarding our Rally in radio, TV and newspaper!  We are continuing to educate our State on what the "real" issues are the impacts to those decisions!   In addition, we did have the following legislators attend our Rally: Lt. Governor Mark Taylor, Senator Steve Thompson, Senator Steve Henson, Senator David Adelman, Rep. Sean Jerguson, Rep. Nan Orrock, and Former Governor Roy Barnes   ACTION ITEMS:   1. VOTE on Tuesday November 7th! The Georgia Disability Vote Project 2006 handed out voter guides at our Rally. But you can also view them on the web at www.gdvp.org for more information regarding candidates' responses to disability issues from our elected officials!   2. Continue to check our website at www.kidshealthcarega.org for further updates on what you can do help make a difference in healthcare for kids. Additional postings in the next few days will include the following information that was given out at the Rally: Facts on Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) and a Babies Can't Wait informational flyer. In addition, we will have photos from the Rally on the website in the next few days!   More Media Coverage of Rally:   1. Atlanta Journal-Constitution Newspaper- Saturday, November 4th article: http://www.ajc.com/search/content/meshmedicaid1104a.html   The article in the AJC on Saturday, once again shows us that we need to do a better job of educating not only our elected officials on what are the "facts" but also the media.  In the article it stated that the September 1st prior authorization changes were for 8 therapy sessions per month NOT 8 units per month. This is not correct information.  8 units is approximately 2 visits per month. This is off by a factor of 4!   I can understand why our elected officials don't understand our issue when this information is misreported. I do plan on sending an e-mail to the AJC helping them know what the "true facts" are in this matter and the impact it has on our families, providers and taxpayers!   Sunday, November 5th - two pictures in Metro Section of the Rally.   2. Atlanta Parent Magazine- November issue. They had two articles in their magazine regarding healthcare issues. Page 38 article titled: "Advocating for Change- Parents Inspired to Action by Their Children's Challenges".  Page 44 article titled: "Parents Rally for Changes to Healthcare System".  (A list of locations where the magazine can be found is at : http://www.atlantaparent.com/findatlparent.html )   Please send Liz White the Editor of Atlanta Parent Magazine a quick e-mail thanking them for their continued support of this important issue…healthcare for kids! Her email address is: lwhite@atlantaparent.com   3. TV CBS 46 did cover the Rally as well last night on their 11:00pm news.   Overall, we are very pleased with the amount of media attention we received and the dedication our families, providers and concerned citizens of Georgia regarding this issue, BUT, I can not stress enough……………..WE MUST WORK TOGETHER.   PLEASE do not rely on others to advocate for your child. We need to work together in order to resolve this issue.  I hope in the future more families will get involved and stand up for what is right in this state. Healthcare must be a priority.   Before the legislative session begins (January 2007), I highly recommend you start to develop relationships with your State Senator and State Representative for your area (go to www.vote-smart.org to find out your legislators by putting in your zip code).  We need to start discussing our concerns with our legislators prior to the start of the legislative session.   I will have further updates regarding advocacy efforts in the next few weeks. At this time, I need to slow down and take more time out for my family. Please do not get upset if you do not receive a response in a very timely matter at this time. I am only a volunteer parent trying to make a difference in our childrens lives. I hope you understand.    United…WE WILL MAKE A DIFFERENCE!   Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) Additional information regarding the Healthcare for Kids Rally, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 17 Nov 2006 00:00:00 EST http://www.lgtinc.org/articles/205/1/Healthcare-for-Kids-Rally-Update%21%21%21%21%21 November 2, 2006   Dearest Advocates:   Healthcare for Kids Rally Update   Rally Day is Here!     As many of you know........I have been very involved in the organization of the Healthcare for Kids Rally that is going to take place this Saturday, November 4, 2006 at 9:30am at Georgia State Capitol.     Please make every effort to attend this largest grassroots advocacy effort our state has ever seen.  We need to show our strength in numbers and put faces to the situation!      For more information regarding the Rally and helpful tips the day of the event, please visit us at www.kidshealthcarega.org.     Therapy Survey Results are In!     In addition to Rally preparation- our group recently conducted a therapy survey in which over 140 therapists from 57 GA counties participated.  Bottom line: the new prior authorization procedure for therapy services (implemented on September 1st) HAS had a HUGE impact on the services our children are receiving and the providers that service them!     The survey clearly shows that cuts in services and increases in bureaucratic paperwork are having a detrimental impact on the children. Georgia taxpayers need to know that their tax dollars are being wasted on paper pushing and not being spent on the very people for whom these programs are intended to help......our children.  We now have the "data" to prove that there is a REAL PROBLEM in the system that needs to be fixed ASAP!     We will be posting the press release regarding the survey later today on our website.   Media Coverage Update!   I wanted to send you a quick email letting you know that we are actively working with the media to spread the word regarding our Healthcare for Kids Rally. Here are just a example of a few of the media outlets that have or will be covering the event:   Atlanta Parent Magazine, Johns Creek Herald Newspaper, Revue and News Newspaper, National American Speech-Language Hearing Association(National publication), AJC newspaper, Mundo Hispanic Newspaper, Martha Zoller National Radio talk show on AM 550 (today), Georgia Trend Magazine and the list goes on and on......   We also continuing to work with all TV and local newspapers for the continued coverage of the Rally. Please note: that all the above references are subject to change.   I hope you can see that this is going to be a major event to bring attention to a serious issue....Healthcare for our kids must be a priority!  Hope to see you there. Arrive early, to allow you enough time to park and walk to the event. Kids are welcomed and encouraged to come! See you on Saturday. Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) Additional information regarding the Healthcare for Kids Rally, please visit us at www.kidshealthcarega.org "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 03 Nov 2006 00:00:00 EST http://www.lgtinc.org/articles/204/1/Healthcare-For-Kids-Rally---Quick-Tips%21 October 30, 2006   Dearest Advocates:   Kids around the State of Georgia need your help. On November 4, 2006, Children along with parents, providers, and concerned citizens will rally and raise their voices at Georgia's State Capitol.   We will have a peaceful, fun-filled Rally for the kids, and share our concerns about the recent changes in Georgia's health care programs that have stopped or inhibited the care of Georgia's most vulnerable citizens: our children.     The Healthcare for Kids Rally is an effort to unite parents and those who love and care for our children, together as one, to tell Georgia's leaders that health care for children in our state is a priority. The Rally will encourage our leaders to ensure:   ·          Eligibility of all children in state health care programs: PeachCare for Kids, Babies Can't Wait, Children's Disability Waivers (including the Katie Beckett Waiver), and Medicaid   ·          Full adherence to the Early Periodic Screening Diagnosis & Treatment (EPSDT) Federal Requirements   ·          Granting children access to medicine, doctors, therapy, provider networks, durable medical equipment/medically necessary supplies                     ·          Transitional health care for those in the 18-21 age group   ·          Rectifying the burdensome application, appeal and claims process in all areas of the system   Quick Tips for the Healthcare for Kids Rally Saturday, November 4 at 9:30am at the GA State Capitol!   1. Rally Signs. If you plan on making signs at home, here are some suggestions (No Candidates names or references to politicians, please!!!)  We are a bi-partisan Rally and will not have any signs that have candidate's names on them. Please respect this decision. In addition, you may want to consider putting pictures of our children on the signs.  This puts a "face" to the situation.   From the Capitol Police: No signs can have sticks or handles on them due to safety and visibility issues.   Here are a few Rally Sign suggestions you may want to consider: We value our children! Don't you? Who will save Medicaid? Evaluate Medicaid, NOT Terminate! Ignoring Medicaid Crisis is like Institutionalizing our Kids Medicaid Crisis Is Costing More than $580 Million! Children are Investments, Not Liabilities! $580 Million Surplus but No Healthcare for Kids? Make Kids' Health a Priority in Georgia! First Priority: Georgia's Kids! Wise Medicaid Programs= Wise Kids! 2. Please try to wear RED the day of the event to reflect the emergency state of children's healthcare in Georgia   3. If possible, please try to carpool or take Marta. Parking garages/lot locations can be found on our website: www.kidshealthcarega.org   4. If you would like to make a donation to help defray the costs associated with the rally, please go to our website, www.kidshealthcarega.org. We're volunteers working with virtually no budget and your monetary donations help us pay for basic supplies.    5. We are expecting a large turn out of participates at the Rally.  Please allow yourself enough time to arrive, park, and sign-in. The Rally will start at 9:30AM SHARP. The "Kids on the Block" Puppet Show will start at 9:10am. Washington Street will be closed in order to allow for the high volume of participates expected for the Rally!   6. We are expecting a lot of media attention so don't be surprised to see them there the day of the event.   7. We have invited every legislator in Georgia to attend but we need your help.  Please take a moment and invite them as well.  If you don't know who your state senator or representative is go to the following website and input your 9-digit zip code (which can be found on your junk mail): www.vote-smart.org. Also, please let me know if you get confirmation that they will be attending. We are going to publicly acknowledge every legislator that comes out to support our effort but they will not be allowed to speak due to the nature of the Rally being bi-partisan.   8. Finally…We need to show our strength in numbers by attending the Rally. Please don't assume that someone else will go on your behalf.  This is an election year and we need to unite our voices as one to make sure our message is heard….Healthcare must be a priority for our children and the providers that service them!   Thanks in advance for everyone's support. Look forward to seeing at one of the largest grassroots advocacy efforts this state has ever seen!   United… WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi J. Moore Rally Coordinator Healthcare for Kids Rally   For additional information regarding the Healthcare For Kids Rally, please go to our website: www.kidshealthcarega.org.   Heidi J. Moore Tue, 31 Oct 2006 00:00:00 EST http://www.lgtinc.org/articles/203/1/NBC-Channel-11-Coverage-of-Medicaid-Situation-TONIGHT%21 October 18, 2006   Dearest Advocates:   Atlanta NBC Channel 11 did run more coverage of the Medicaid situation on their 7:00pm news tonight.   You can see that coverage by going to the following website: http://www.11alive.com/news/news_article.aspx?storyid=86266   PLEASE take a minute and thank the reporter, Denis O'Hayer at dohayer@11alive.com  for his coverage of this important issue in our State......Healthcare has to be a priority for our children!     NBC needs to hear from us and how appreciative we are of dealing with these important issues our children face and the providers that service them.     United... WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi   Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 31 Oct 2006 00:00:00 EST http://www.lgtinc.org/articles/202/1/Media-Attention-Regarding-Healthcare-for-kids-in-GA%21 October 19, 2006   Dearest Advocates:   There has been a lot of media attention given to the healthcare issues in this State regarding children in the last few days!  Please see the list below of those articles.  At this time, I do not have time to give you all the contacts of the reporters that wrote these articles but if you could send them all a thank you about educating the community on the issues our children face regarding healthcare or what type of articles you would like to see in the future…..that would be great!   Unfortunately, since this is an election year…..Things are starting to get "heated" BUT the bottom line issue is we want to work with our elected officials on "real" solutions to the Medicaid problems we have been experiencing as parents, providers, and concerned taxpaying citizens of Georgia.   Happy Reading………….   http://www.macon.com/mld/macon/news/local/15790395.htm   http://www.ajc.com/metro/content/metro/election06/electionpage.html     http://www.gwinnettdailypost.com/index.php?s=&url_channel_id=32&url_subchannel_id=&url_article_id=20607&change_well_id=2   http://www.valdostadailytimes.com/homepage/local_story_289000529.html   Summary from yesterday's TV media coverage: WXIA 11 Alive News Atlanta Taylor Promises to Restore Program http://www.11alive.com/news/news_article.aspx?storyid=86266   WGCL CBS 46 Atlanta Gubernatorial Candidates' Response to Georgia's Medicaid Children Reporter Wendy Saltzman continues coverage of the Georgia Medicaid issues effects on our Children Featured Videos Section of http://www.cbs46.com       In addition, please understand coordinating this rally is a full time job right now and I may not be able to get to everyone's individual questions until after November 4th. Please be patient as I do want to help as many families as possible but the Rally has to be my focus at this time.  Thanks again for all your on-going support to this important issue in our state……..Kid's healthcare must be a priority in Georgia!   United…WE WILL MAKE A DIFFERENCE!   Sincerely,   Heidi    Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 31 Oct 2006 00:00:00 EST http://www.lgtinc.org/articles/201/1/NBC-Channel-11-Coverage-of-Medicaid-Situation-TONIGHT%21 October 18, 2006   Dearest Advocates:   Atlanta NBC Channel 11 did run more coverage of the Medicaid situation on their 7:00pm news tonight.   You can see that coverage by going to the following website: http://www.11alive.com/news/news_article.aspx?storyid=86266   PLEASE take a minute and thank the reporter, Denis O'Hayer at dohayer@11alive.com  for his coverage of this important issue in our State......Healthcare has to be a priority for our children!     NBC needs to hear from us and how appreciative we are of dealing with these important issues our children face and the providers that service them.     United... WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi   Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 31 Oct 2006 00:00:00 EST http://www.lgtinc.org/articles/200/1/Healthcare-for-Kids-Rally--Radio-Update October 16, 2006   Dearest Advocates:   I just wanted to let you know of some exciting news regarding our media campaign for the Healthcare for Kids Rally.  The more we bring public awareness to our concerns with healthcare in this state the better! If you have a chance to listen and send thank yous to the radio stations- that would be great. We need to let them know we appreciate their support of this important issue!   Public Service Announcements and radio interviews will start airing this next week! WAEC-AM (860) said they may run the PSA (will follow up to find out time/date) WGUN-AM (1010) said they will air the PSA beginning Nov. 1 at the latest WYZE-AM (1480) said they will air the PSA the week of Oct. 23.   Radio Show Interviews Radio Sandy Springs (1620 AM) on the Public Access Show with David Moxley and Marshall Hamilton live on Monday, October 16 from 5:00 to 6:30 p.m. Unless you are very close to the station you may not be able to listen in your car, but you can listen on your computer by going to www.radiosandysprings.com . After 7 PM they will have an Infectious Disease Update Program with Dr. Michael Dailey and his guest tonight Dr. Patrick O'Neal the Director of Georgia's Emergency Medical Preparedness Program. WYAY-FM (Eagle 106.7) on the Eagle Report with Greg Talmadge scheduled for Sunday, October 22 at 6:30 am.  WGUN-AM on the "Atlanta Issues" show with Karen Lovejoy to be taped an aired on Saturday, October 28th from 7:30 to 8 a.m.   As you can see our public relations committee for the Rally has been hard at work and we plan on issuing an "official" press release about the Rally TODAY  to the media. You will find the press release on our website www.kidshealthcarega.org in the "In the News" section.   Once again, I just want to say thank you for everyone's on-going support to this critical issue. Hope to see you on November 4th (bring your family, friends, neighbors,etc). A large amount of people showing up for the Rally will help us prove to our elected officials how important this issue is to our State! Healthcare must be a priority!  United…WE Will Make A Difference!   Sincerely, Heidi   Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 31 Oct 2006 00:00:00 EST http://www.lgtinc.org/articles/194/1/URGENT%3A-Did-YOU-receive-this-from-Heidi-J.-Moore-directly October 11, 2006   Dearest Advocates:   Unfortunately, I had another "Computer Malfunction".  Somehow Comcast deleted a some of my advocacy distribution lists.  As you can imagine this has been a nightmare for 3 days now! I have been working for hours and hours trying to recover as many names as possible BUT I NEED YOUR HELP!   When you receive this e-mail, please distribute ASAP to anyone you might think would have been on my distribution list letting them know about this problem.   If you received this e-mail from someone else and not directly from me, that means you are no longer on my advocacy distribution list.    If you would like to be added back to the advocacy distribution list, please submit the following information: 1. E-mail. 2. Full name. 3. If you are a provider, parent (child's disability), therapist, or why you want to be on the list, etc   If you received this e-mail in error, please let me know that you want to be taken off the advocacy distribution list as well.   I have been working for hours trying to recreate the information, but I'm sure I still have a number of email addresses deleted.   Thanks in advance for your cooperation in this matter. As always, you can review my past e-mails by going to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore?Page=6   (Please remember that there are multiple pages so page down or go to another page if you can't find the information you are looking for).   Thanks again for your cooperation in this matter, Sincerely, Heidi   Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 11 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/193/1/CHOA-Therapy-Situation--ALERT October 5, 2006   Dearest Advocates:   Below is a letter from Children's Healthcare of Atlanta (CHOA) that will be issued out to the parents regarding their recent changes to therapy services this week. In addition they are also going to be issuing an instructional sheet on how to find providers from the DCH system, and Frequently Asked Questions from DCH.   The bottom line is CHOA is going to be discharging our children (that are considered "chronic" which means children with disabilities) to a system that does not have the support to handle the additional therapy providers. We can't find providers now....How are those families going to be able to find providers then (that accept Medicaid too)?   The paperwork is burdensome, adds no value, increases the time to administer and is costing tax payers more $$ for the system to review these requests...than just to pay for the services the children need to begin with!   We have just been given the "proof" that DCH said they did not have with access to care for our children. There is not access now for a large population of children effective 11/1/06 due to these changes at CHOA.   I will be working on this issue and hope to have further information next week. Sincerely, Heidi ====================================== Here is the CHOA letter that will issued to parents this week...................................................   Dear Parent:   Children's Healthcare of Atlanta wants to make sure you are aware of recent changes to the administration of Medicaid implemented by the Georgia Department of Community Health (DCH).  We understand these changes may impact the way your child's rehabilitation services are provided and want to work with you to help ensure that your child's rehabilitation care is continued appropriately for your child's condition.   The DCH and Medicaid program:   will only authorize treatment at Children's or other hospital-based programs for patients who have an acute injury, illness, or impairment clarified that children with chronic conditions and impairments must be seen through the Children's Intervention Services (CIS) program, which is community-based therapy rather than hospital-based therapy indicates that it does not plan to cut, reduce or eliminate therapy services to Medicaid-eligible children requires prior authorization through your Medicaid health plan for all therapy services  Children's is evaluating these changes to ensure that we are operating within the DCH's rules and guidelines while continuing to provide our patients with the quality healthcare for which we are known.   To find out more about these changes and to help you choose a CIS program for your child's therapy services, visit Provider Information at www.ghp.georgia.gov or contact Sharon Collins at the Division of Medical Assistance at (404) 463-6096.   Sincerely,   Carol Salmons Manager, Rehabilitation ===================================== --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal Heidi J. Moore Tue, 10 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/192/1/Media-Attention%3A-NBC-WALB-in-Albany%2C-GA-AND-AJC-Newspaper%21 October 4, 2006   Dearest Advocate:   I was just informed that NBC WALB in Albany covered the further concerns parents have regarding the children's healthcare and the Medicaid system situation. Speaker of the House Glenn Richardson was interviewed.  You may want to contact him to help him understand what is "really" happening in our world (glenn.richardson@house.ga.gov) . Examples: Lack of services, providers, approvals, denials for eligibility,etc.   Here is the link to see the actual story on NBC last night:   Lawmaker weighs in on Medicaid changeshttp://www.walb.com/Global/story.asp?s=5493978     Please take a moment to thank the reporter, Len Kiese (len.kiese@walb.com)  and cc:  news@walb.com for their continued coverage of this very difficult situation for families and providers in the State! Len has done a number of segments on this situation over the year and we want him to know we appreciate it!   As I stated before, education and awareness is the key to making our issues known and hopefully resolved.   Healthcare must be a priority for our children and the providers that service them!   Thanks to Amy W. for letting me know about the coverage. Keep up the great work everyone!   In addition,  the AJC Newspaper will be printing in their "Letters to the Editor" Section of the Saturday newspaper  a letter from a concerned parent! Thanks Cindy for sending in that fantastic letter!   UNITED... WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi   Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org     --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 10 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/191/1/Katie-Beckett-Waiver-Foundation October 4, 2006   Dearest Advocates:   I received this today about the "Foundation" the State of Georgia is putting together as part of the $7.6 million that was allocated for children that were denied the Katie Beckett Waiver due to the changes in criteria from October 05 forward.   If you are interested in being part of this group, PLEASE contact Kristina Aranas directly.  I've also attached a document with further information. (I"ll post this info on the "files" section of the list serve as well).   This is another way of getting involved for our children!   Sincerely, Heidi ========================================   Hello!The Community Foundation for Greater Atlanta is actively seeking assistancewith the new Health Services Initiative, focusing on medically fragilechildren and their families. We hope that you will help us spread the wordabout this new opportunity. The Request for Proposals for this newinitiative is attached to this email and will also be available onOpportunity Knocks and The Community Foundation website. Should you haveany questions, please feel free to contact me via phone or email. Questionsregarding proposal submissions will be fielded in the beginning of October.Thank you in advance for your help!Kristina M. ArañasProgram AssociateThe Community Foundation for Greater Atlanta404-588-3213 direct linehttp://www.atlcf.org   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 10 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/188/1/Media-Attention%3A-CBS-WCTV6-in-Valdosta%2C-GA October 1, 2006   Dearest Advocate:   I was just informed that CBS WCTV 6 in Valdosta covered the meeting families and providers had with Lt. Gov. Mark Taylor over the weekend regarding concerns with children's healthcare and the Medicaid system.    Here is the link: http://www.wctv6.com/ (go to "Featured Videos" and click on "Lt. Governor Mark Taylor Campaign".)   Please take a moment to thank the reporter, Roxanna Haynes (roxanna.haynes@wctv6.com) and cc: news@wctv6.com for their continued coverage of this very difficult situation for families and providers in the State!   As I stated before, education and awareness is the key to making our issues known and hopefully resolved.   Healthcare must be a priority for our children and the providers that service them!   Thanks to Sara for letting me know about the coverage. Keep up the great work everyone!   Sincerely, Heidi   Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 02 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/187/1/Advocacy-Update-and-History.......... October 1, 2006   (Please note: This is a long e-mail…you may want to print out to read!)   Dearest Advocates:   As we have started down this path of having a Healthcare for Kids Rally, I've discovered that not everyone has been aware of all the activity that has happened in the last few months…….   Since June 2006, we have met with Dept. of Community Health's Director of Medicaid, Commissioner, as well as, the Governor's office to discuss the concerns and solutions associated with healthcare for children in this State.  Unfortunately, NONE of the recommendations were implemented nor discussed any further for consideration.   This is exactly why it has come to a point where we need to get our elected officials attention on healthcare and making it a priority in this state! Working with the media, having the rally, educating the public on our issues is the only other alternative we have in making the necessary changes needed for our children.    This is an election year…..we are hardworking, tax-paying, voting citizens and we don't want our tax $$$ wasted on red tape, non-productive processes that add no value to the system and continue to decrease the amount of services our children need, as well as, access to providers due to these processes.   Here is an example of some of the concerns and solutions that were discussed in these meetings……. -Implement a 1-800 number to call to check on status, enter your ref # for information on your current status. (Submission approval, deadlines, receipt, denial, appeal status, etc). -Have DFCS caseworker on the phone prepared to help parents walk through the paper work or tell them resources they can utilize to find answers instead of yes and no answers which lead to no assistance in filing out paper work or meeting criteria. -Have more explicit instructions on how to fill out all the forms. -Change renewals from every year to every 3 yrs (depending on the child's functional / behavioral needs, independence, medical needs, diagnosis, etc).   -Parents should receive in writing if they are re- approved or denied. Currently, families only receive notices if they are denied. This will eliminate families wondering and unnecessary calls to GMCF or their DFACS caseworkers.   -Fair treatment of providers.   Provide a fair and equitable payment to providers on a timely basis.   -Do not require IEP's.   -If a child is denied, make the reasons very clear.  It will make it easier to everyone and for the parent to accept the ruling is correct or appeal if warranted.  The information submitted during the appeal would be more accurate and with necessary specifics.   -Independent Advisory Committee:  A panel of families who can act as an advisory committee/clearing house for issues and feedback for the Director of Medicaid.  This could provide tremendous support and guidance to the entire Medicaid System.     -Having psychological evaluation done on children (sometimes every year) even though it is very obvious the child qualifies due to the child's diagnosis and ability to not function on their own at all is just another expense Medicaid will pay for with no value added.  Need to really look at the "value" of having psychological evaluations done on an on-going basis (very expensive).   -Streamline paperwork - many forms are repetitive information.  Make forms relevant for waivers and not generic across Medicaid.   -Having a way to find out the status of our renewal application - whether online or via our caseworker.   -Parents would like to receive an Explanation of Benefits (EOB) from Medicaid for services charged to their child's account. We realize that this is available on the web but it's hard to get a password and remember to check the account. A quarterly statement would be helpful to make sure the services have been provided. Therefore, possibly saving Medicaid money with less fraudulent charges to the system   (Please note: Many of the suggestions were compiled from the 250+ families and providers that submitted their ideas last spring to me specifically in the disability community.  I put together an actual 4 page report that was given to DCH, DFCS and Governor's office on all those suggestions. The three primary areas of concern were: Communication, Training and Process issues.  The goal is to maximize our resources to better service children with and without disabilities in the State of Georgia.  Thank you so much for everyone that participated in these suggestions)   As you can see, I have personally tried very hard to work within the system, but it has not worked. We have to UNITE our voices for OUR children!  I know not everyone feels  that a Rally is going to make a difference but what other options do we have at this point?    We must continue to work with the media to educate the State on our issues and hopefully help our elected officials understand how important this issue is to us!   I hope this clarifies some of your questions. Please understand, I am just a parent like many of you (and do not get paid for my advocacy efforts for our children)……..Right now I'm averaging over 400 e-mails a day so please understand that I can not respond to everyone.    I'm very excited about the Rally and hope everyone will participate in the largest grassroots effort this State has ever seen.  We are starting to get the media coverage we deserve on the issues  and need to let the media know we appreciate their continued coverage of these issues like the CBS investigative report and the AJC article this weekend and FOX's report a few weeks ago on the therapy situation.   We need to be a part of the solution and work with our elected officials on getting the services and processes we need for our children's healthcare!   Please go to our website at www.kidshealthcarega.org for more updates. It is currently under construction but more content will be posted very soon. We will be issuing a press release very soon on the full intent our advocacy group….Stay Tuned for further information……..   UNITED…WE WILL MAKE A DIFFERENCE!   Sincerely,   Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 02 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/186/1/AJC-Article--%26quot%3BMedicaid-Rolls-Decline.....%26quot%3B--Need-Your-Help-Educating-the-AJC%21 September 30, 2006   Dearest Advocates:   There was an article in the AJC newspaper today on the Medicaid situation written by Andy Miller (jamiller@ajc.com ).  Although I appreciate the coverage of the Medicaid situation, I do not think this article really explained the urgency and concern families and providers have within the Medicaid system (difficulty in getting services, paperwork, lack of providers due to the amount of paperwork, people being denied, etc).    Here is the AJC article ....Just in case you missed it: http://www.ajc.com/news/content/metro/stories/2006/09/29/0930MESHmedicaid.html   In addition, there was a comment in the article about Katie Beckett Waiver families having primary insurance (which kind of makes it sound like it's not a big deal if they don't have Medicaid).......We all know how important having Medicaid as secondary insurance is because most of our primary healthcare insurance companies do not pay for a lot of the services needed (especially for children with disabilities - which includes therapy).   PLEASE take a minute to help the AJC newspaper understand the urgency and need for reform in the entire Medicaid system. Explain to them that they need to have more in-depth articles done about this situation!   This is why we are having the Healthcare for Kids Rally on November 4th.........To make healthcare a priority in this state!    Send your e-mails to Andy (jamiller@ajc.com) and the editor ( letters@ajc.com) .   We need to continue to educate the State on the issues impacting our children and the media is a great tool to do so. Please let the AJC know how this has impacted your family!   Thanks again for your continued efforts in making the "real" issues known.   United...We Will Make A Difference!   Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 02 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/185/1/CBS-46-is-re-running-the-Investigative-Report-today%21 September 29, 2006   Dearest Advocates:   I just got confirmation from CBS 46 that they are going to re-run the Medicaid Investigative Report  that was aired last night.....It will air today at 12:00 and again on Sunday at 11:00pm.   We are getting their attention (both the media and the Governor's office).   Keep up the great work! Sincerely, Heidi   Here is the link to CBS 46: http://www.cbs46.com/Global/story.asp?S=5473158     --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 02 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/184/1/UPDATE%3A-URGENT......ACT-NOW....CALL-GOVERNOR-PERDUE-TODAY%21%21%21 UPDATE....... Apparently, the Governor's office does not want to take our phone calls (A number of families have contacted me in the last hour stating that his staff are not accepting phone calls now but you can try..............)   Per Gov. Perdue's staff request, please do the following: Fax the Governor at 404-657-7332 and send him an e-mail too at : sperdue@gov.state.ga.us   In addition, I've been informed that the AJC Political Insider site has a blog regarding Gov. Perdue comments to Wendy Saltzman (CBS Reporter for the Medicaid Story last night) at a recent press conference....Please take a moment and click on the below and give your comments.......   http://www.ajc.com/metro/content/shared-blogs/ajc/politicalinsider/entries/2006/09/26/signs_that_you_have_a_20point.html   Obviously, we are getting his attention and need to continue the pressure for him to get involved in healthcare in GA! Keep up the GREAT WORK! Heidi ======================================= September 29,2006   Dearest Advocates:   PLEASE take a moment and make a difference....PLEASE call the Governor's office today. As you saw from last night's CBS airing of the Medicaid segment, Governor Perdue refused to comment on the situation.    He needs to hear from us that Healthcare MUST be a priority for our children.    Act now.....404-656-1776.   Just in case you missed CBS 46 investigative report last night...here is the link (they even have video to watch as well):   http://www.cbs46.com/Global/story.asp?S=5473158   Many thanks to Betsy for this advocacy strategy.  We need to be heard TODAY!   UNITED... WE WILL MAKE A DIFFERENCE!   Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative.   -------------- Forwarded Message: -------------- From: jeff&betsy fester To: Subject: URGENT......ACT NOW....CALL GOVERNOR PERDUE TODAY!!! Date: Fri, 29 Sep 2006 03:46:07 +0000 September 29, 2006   URGENT.....ACT NOW.....CALL GOVERNOR PERDUE TODAY!   As many of you heard last night on the CBS 46 Investigative Report on the Medicaid situation, Governor Perdue refused to comment to CBS on their report.   The time has come for Governor Perdue to hear our voices loud and clear in a different way.   Today- Please call the Governor's office at 404-656-1776 and tell them the following:   "The Governor must make healthcare for children a priority and support the providers that service them".   It only takes a minute but we need to get his attention regarding the issues impacting children's healthcare and the providers that service them.   Thanks in advance for your help, Betsy Fester Heidi J. Moore Mon, 02 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/183/1/Advocacy-Update-for-everyone....... September 28, 2006   Dearest Advocates:   There are many things going on right now that I wanted you to be aware of.......   1. EXCITING NEWS.  We are happy to announce......A website has been formed for the rally and our advocacy efforts. It is under construction so we urge everyone to check back frequently for updates. The website should be fully functional very soon.  The website address is: www.kidshealthcarega.org   2. Thanks to Kelly of Valdosta for letting me know the following: The Lt. Gov. Mark Taylor is coming to Valdosta to speak with us parents & providers about the current Insurance issues and how it's affecting our families and businesses. It's going to be held this Saturday, September 30th at 12:00 at the Central Avenue Church of Christ, 304 E. Central Ave., Valdosta.   We need to continue to have our voices heard to all three candidates running for the Governor of Georgia right now!   2. Please remember to watch CBS 46 investigative report on the 11:00pm news tonight and send your thank you's to them.  (Their e-mail addresses are as follows: Wendy.Saltzman@CBS46.com, cbs46news@cbs46.com, rick.erbach@cbs46.com )  Educating the State on the issue impacting our children and providers that service them is very powerful  and it is an election year. Healthcare must be a priority for our children!   I hope you find this information helpful.   United... WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 02 Oct 2006 00:00:00 EDT http://www.lgtinc.org/articles/182/1/Media-Attention-to-Babies-Can%26%2339%3Bt-Wait-Medicaid-Problems September 27, 2006   Dearest Advocates:   Below is an article from the Citizen Newspaper......It is a great overview of how the Babies Can't Wait (BCW) program is being impacted by the CMO's and Medicaid situation in this State.  This is EXACTLY why we need to unite our voices as one regarding healthcare being a priority for all children in the Medicaid program and have access to providers and proper funding!   Please take a moment and thank the Citizen Newspaper for the article at editor@thecitizen.com.   Here is the actual link to the article: http://www.thecitizen.com/node/10508   See you at the Healthcare for Kids Rally to be held on November 4 at 9:30 at the Georgia State Capitol!   Sincerely, Heidi ============================================ Medicaid funding shortages limit early intervention services Tue, 09/26/2006 - 4:20pm By: The Citizen Wyatt a 29 month old toddler with significant delays in speech and sensory processing is at risk of losing the early intervention he needs to start school ready to learn. Likewise, Sanaya, a toddler with significant delays in communication and cognition is being denied needed speech therapy. Georgia's Interagency Coordinating Council for Early Intervention Programs (SICC) including parents, service providers and other non-Department of Human Resources, Non-Department of Community Health agency members, called for immediate attention to the recent impact of Medicaid changes, funding shortages, and increased Federal requirements on early intervention services in Georgia. The SICC is charged with providing advice and assistance to the Department of Human Resources (the lead agency for early intervention programs). Babies Can't Wait (BCW) is the beginning of special education in Georgia. BCW currently provides early intervention supports and services to families of over 5000 infants and toddlers statewide from birth to age three who have significant developmental delays. Federal funds to support this program come from Part C of the Individuals With Disabilities Education Act (IDEA), the same federal legislation that also funds special education in Georgia's public schools. Although it is an education program, BCW is administered through DHR's Public Health branch and services are provided through Georgia's 18 public health districts. A large body of research in early child development and education indicates that an investment in early intervention results in long-term savings through reduced special education costs as well as other savings realized through productive employment and participation in society. However, the implementation of Medicaid Care Management Organizations (CMOs), past and present funding shortages and federal requirements to increase caseloads statewide have placed the program in serious financial jeopardy. Funds for the program have declined steadily while demands for service have increased. BCW funding and costs are intricately interwoven with and impacted by Georgia's Medicaid policies and rate structure due to federal policies requiring that BCW funds for services be used as a payer of last resort and requiring that other available federal funds such as Medicaid cannot be supplanted by BCW funds. If specific CMOs choose not to provide required BCW services such as service coordination, BCW will have to cover the cost which could mean millions of dollars not available in the current budget.With the implementation of Medicaid CMOs on June 1st in the metro and central CMO regions of the state, the BCW funding base has been further jeopardized by the loss of service coordination revenues and the additional costs associated with providing services which are not being covered by the CMOs. Extensive loss of service is expected with the September 1 statewide roll-out. Babies and toddlers with developmental delays are paying the price. Many infants and toddlers like Wyatt and Sanaya, who have been receiving therapy services through the BCW program have been denied services through Amerigroup. These are children who had been receiving early intervention through BCW but because they are Medicaid recipients they are caught in a bureaucratic quagmire and risk losing developmental gains made through early intervention. These families don't have the means to pay for these services and BCW can't legally supplant Medicaid funded services. Compounding that dilemma, the council discovered that many significant barriers exist for service providers when accessing Medicaid CMO reimbursements to support BCW services. For example, the time intensive, labor intensive, paper intensive, confusing and often redundant prior approval process to get BCW services authorized and approved for reimbursement. Likewise, frequent resubmissions of copies of the same documentation are required in order to obtain prior approvals. We are losing early intervention service providers at an alarming rate. In a call to action letter to Governor Perdue, SICC Chair Cynthia Vail noted, "the bottom line is…that we are losing service providers in a field where critical shortages already exist. Public comment to the SICC during its July meeting in Rome echoed a similar concern, "the State's capacity to provide early intervention services to children and families will be further diminished if the funding system is not addressed. " The Council proposes several suggestions to help remedy this disaster in the making. Allowing children in Babies Can't Wait to be "carved out" of Medicaid CMO enrollment (as is the case for CMS enrolled children) represented a possible remedy among many from the Council. Interested parties can find more information about the State Interagency Coordinating Council, its officers, members and local affiliates by visiting HYPERLINK "http://www.health.state.ga.us/programs/bcw/icc.asp" www.health.state.ga.us/programs/bcw/icc.aspThe State Interagency Coordinating Council (SICC) is required by federal statute to be appointed by the Governor and is an important participant in the development of a well-coordinated service delivery system. The ICC is an independent group which does not "belong to" any particular agency.   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 28 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/181/1/Advocacy-Update-for-everyone....... September 28, 2006   Dearest Advocates:   There are many things going on right now that I wanted you to be aware of.......   1. EXCITING NEWS.  We are happy to announce......A website has been formed for the rally and our advocacy efforts. It is under construction so we urge everyone to check back frequently for updates. The website should be fully functional very soon.  The website address is: www.kidshealthcarega.org   2. Thanks to Kelly of Valdosta for letting me know the following: The Lt. Gov. Mark Taylor is coming to Valdosta to speak with us parents & providers about the current Insurance issues and how it's affecting our families and businesses. It's going to be held this Saturday, September 30th at 12:00 at the Central Avenue Church of Christ, 304 E. Central Ave., Valdosta.   We need to continue to have our voices heard to all three candidates running for the Governor of Georgia right now!   2. Please remember to watch CBS 46 investigative report on the 11:00pm news tonight and send your thank you's to them.  (Their e-mail addresses are as follows: Wendy.Saltzman@CBS46.com, cbs46news@cbs46.com, rick.erbach@cbs46.com )  Educating the State on the issue impacting our children and providers that service them is very powerful  and it is an election year. Healthcare must be a priority for our children!   I hope you find this information helpful.   United... WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 28 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/177/1/Sonny-Do-List--Healthcare-MUST-be-a-PRIORITY%21 September 27, 2006   Dearest Advocates:   Many of you have seen the commercials Governor Sonny Perdue has on TV regarding the "Sonny Do List"....Well, the time has come for Sonny to hear from us!   WE NEED YOUR HELP!   Please take a moment, go to the following website:   http://www.votesonny.com/default.asp?pt=doc&doc=sonnydo Here is a draft text that you can cut and paste into his form. You can modify based on your particular needs but please remember that they only allow 75 words:   Fix the Medicaid Program so that Georgia's disabled children can receive the healthcare services and care they need. Look for ways to improve the system rather than simply looking for ways to reduce costs. Make processes more efficient so Georgia can offer the same level of services for less. These expenditures are an investment, not a liability. Delaying, minimizing or terminating services now will result in a larger liability to the state in the future.    Sonny states on his website the following:  "Sonny believes government should be "of, by, and for the people." During his 2002 campaign and throughout his first term, the Governor sought input from those who know best how to move our state forward: everyday Georgians on the front line. The purpose of his Sonny Do list is to continue gathering the best ideas from across the state and use them to build an even better Georgia. This is a forum for real ideas that can make a real difference. Please submit your idea now." SONNY NEEDS TO HEAR OUR CONCERNS NOW! I noticed on his website their is not one mention of children's healthcare being a priority.......Thank you for your cooperation and getting involved in this important matter! Children's heatlhcare has to be a priority in this State! United...WE WILL MAKE A DIFFERENCE! Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 27 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/176/1/Unlock-the-Waiting-Lists%21-Call-to-Action September 25, 2006   Dearest Advocates:   Please see below Dave Blanchard's Unlock advocacy update. It only takes a few minutes. Like I said before, even if you are not in need of one of these waivers now, you never know......We need to keep up this one area of increasing the number of waivers distributed annually.   Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative.   -------------- Forwarded Message: -------------- From: "Dave Blanchard" To: "Heidi Moore" Subject: Unlock the Waiting Lists! Call to Action Date: Mon, 25 Sep 2006 19:57:04 +0000 Simply, go to http://www.unlockthewaitinglists.com/actionalert.html to make a difference today! The Georgia Department of Human Resources (DHR), recommended 1,970 new MRWP services for the FY08 budget to unlock the waiting lists for home and community based services! This is great news...However, our concern is that they only were able to find a way to pay for 170 new MRWP services! For the remaining 1,800 services, they left it up to the Governor to find a way to fund them. The bottom line...it is up to the Governor! WE MUST SEND A STRONG MESSAGE: Ask the Governor to continue his commitment to people with disabilities waiting for help in Georgia by funding 2,000 new MRWP services in the FY08 budget. Simply, go to http://www.unlockthewaitinglists.com/actionalert.html to make a difference today! We are looking to see over 2,000 e-mails/letters or phone calls to the Governor's office by Nov. 7th. We have made it as easy as possible with just a few clicks. Once you have made your contact, let us know by clicking the link "Once you have sent your letter or made your phone call, let us know by clicking here" on that same page and check back often to see our progress. Thank you for all you do!Dave Blanchard Heidi J. Moore Wed, 27 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/175/1/CBS-46-Investigative-Rpt--Sept.-28-at-11%3A00pm-on-Medicaid-situation%21 September 27, 2006   Dearest Advocates:   I just wanted to remind you that CBS 46 News will be airing their Investigative Report on the Medicaid situation on Thursday, September 28th at 11:00pm.  CBS has been working very hard on this piece and is airing promotional "teasers" throughout the week leading up to the report.    PLEASE take a minute after the show airs and thank the reporter, Wendy Salzman at Wendy.Saltzman@CBS46.com for her coverage of this important issue in our State......Healthcare has to be a priority for our children!  Also- please copy the station as well on your e-mail cbs46news@cbs46.com and the news director at rick.erbach@cbs46.com or you can call them at 404.327.3144.    CBS needs to hear from us and how appreciative we are of dealing with these important issues our children face and the providers that service them. If they get enough response, they have enough coverage to continue to air additional segments! Only through building community awareness of the situation (and working with the media), are we going to impact change in this state!     The bottom line is..... children are not getting the services they need and can't find providers to provide those services due to the bureaucracy of paperwork Medicaid has developed in order to cut costs!   The system is in a crisis and we are not going to take it anymore.  Hope to see you at the Rally- November 4th 9:30am at GA State Capitol.  I will be sending out additional information as the time gets closer and we are going to have a website and press releases as well for those interested very soon.......Stay tuned!   United... WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 27 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/174/1/Cherokee-Tribune--Great-Article September 7, 2006   Dearest Advocates:   Below is a wonderful article written in the Sunday section of the Cherokee Tribune.  Please take a minute and thank the reporter, Sarah Alexander at salexander@cherokeetribune.com for her coverage of this important issue for children with disabilities.  (also thanks to Susan L. for opening up her heart and child to the media to help educate everyone in the community the importance of inclusion!) Once again....Early intervention is the key to success for our children......Enjoy! Sincerely, Heidi   ========================================= Interest increasing in special education preschoolBy Sarah E. Alexander Cherokee Tribune Staff Writer Susan Lumpkin of Ball Ground has an ultimate goal for her 4-year-old daughter, Zana: Self-independence. Mrs. Lumpkin's daughter, who has Down syndrome, is one of a growing number of special needs students participating in the Cherokee County School District's preschool special needs intervention program. Zana started the program last year and now is in a preschool inclusion class at the Ralph Bunche Center in Canton. "I've seen some progress in her ability to follow directions and to stay on task," Mrs. Lumpkin said. "I think it will better prepare her to enter kindergarten next year." More preschool-aged students with special needs are enrolling in the district. During the 1995-1996 school year, the district received 164 referrals for preschool and 161 were evaluated. During the last school year, the district received 418 referrals and 359 were evaluated. Debra Farist, lead preschool facilitator for the district, said she thinks more students are in the program because of better early identification and more knowledge about the students' needs. "We expand every year," she said. "We're usually adding a class or more every year." Ms. Farist said there are 135 children with special needs in the preschool special needs intervention program at the Ralph Bunche Center, First Baptist Woodstock, Bascomb Methodist Church and Arnold Mill, Boston, Hasty, Holly Springs, Johnston, Sixes and Woodstock elementary schools. "Our children come in as they turn 3, so of course we have children coming in every three weeks," she said. Ms. Farist said she thinks the district has improved its ability to identify students' special needs before they enter kindergarten. "That's the whole point of the program - is the earlier we get the child the more likely they are to be able to be in a typical classroom. That's our goal: for every child that comes in is for them to be able to be in a typical classroom in kindergarten with whatever modifications and support they need," she said. "Everybody doesn't always meet that goal, but- last year and the year before last like 96 percent, 97 percent of children were in a typical setting for most of the day that came from our program." Sherry Green, district supervisor of special education, said she is very proud of the program's success. "Early intervention is critical for students to achieve. The research certainly suggests that the earlier we get the child in an intervention program that the more successful that child is going to be moving forward in school," she said. "It is certainly a strength in the school district and something that we're very proud of." Ralph Bunche Center Administrator Dr. Mary Ursits said the school has included students with special needs in class before, but this is the first year they have had a special education teacher in a classroom for half-days with a Head Start teacher. "Inclusion helps many students with special needs," she said. "The inclusion situation gives many students with special needs the opportunity to have age-appropriate peer role models." salexander@cherokeetribune.com Copyright © 2006 Cherokee Tribune. All rights reserved. All other trademarks and Registered trademarks are property of their respective owners.   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 22 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/173/1/More-Media-Attention-to-Therapy-and-Healthcare%21 September 16, 2006   Dearest Advocates:   I just wanted to let you know that our advocacy efforts are continuing to paying off....   NBC WALB from Albany aired on September 15th  a segment regarding the therapy changes in prior approvals and other healthcare issues that will impact our children's access to healtcare in this State!  Here is the actual news segment and you can even view the video at the following address:   http://www.walb.com/Global/story.asp?s=5414040   Please take a moment and thank the reporter, Alicia Eakin   aeakin@walb.com for taking interest in the story and also send an email to  news@walb.com?subject=Medicaid/AE .   It takes a lot of energy and time in order to have these segments aired.  I also want to thank Stephanie H. for being willing to go on camera and state what a lot of parents are experiencing and continue to educate the community on the issues our providers are experiencing with Medicaid right now as well! Thanks to Missy for letting me know about the coverage as well!   Only through building awareness of the situation (and in this case: working with the media), are we going to impact change in the State of Georgia!    I hope you can see that we are continuing to get attention on this matter!  This is exactly why having a Healthcare for Kids Rally on November 4th 9:30am at the GA State Capitol is so important (before the election on November 7th).  It's going to be a major event! More information will be sent out soon including the flyer for the event.    Thanks in advance for writing your thank you's.  If you see media attention in your area, please let me know so we can make sure everyone knows what's going on throughout the State and be able to express our thanks as well.....   Keep up the great work.  UNITED... WE WILL MAKE A DIFFERENCE!   Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 22 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/172/1/CBS-46-Coverage-of-Medicaid-Situation-and-Rally-Update September 18, 2006   Dearest Advocates:   As many of you may be aware, there has been alot of work going on with Atlanta CBS 46 and providers and parents regarding this Medicaid situation in the State.  I truly appreciate CBS wanting to show the true impact on our children and providers due to bad decisions made right now by Dept. of Community Health.    I talked to the reporter today and she said the story is still scheduled to air on Thursday September 28th at 11pm. She said these dates are always subject to change because they are still trying to get some of the final elements for the story.  Last Friday, she was finally able to sit down with Mark Trail to get an interview.  CBS 46 News is planning to run promotions to preview the September 28th story. That means hopefully a lot of people will watch!  They may also do follow-up stories during November ratings period.  So stay turned!   I'll send another e-mail out when the time gets closer to airing but wanted you all to be aware that we are continuing to get TV coverage of the issues our families and providers face due to bad decisions. Ultimately, our children are not getting the services they deserve and need.   I do think having the Healthcare for Kids rally at the Capitol is going to get everyone's attention to this matter. We have a team of over 40 volunteers working on this Rally.  I am convinced the time is now to unite our voices as one and express our concerns with the entire Medicaid system (including CMO's, BCW, Disability Waivers, etc)   The bottom line is..... children are not getting the services they need and can't find providers to provide those services due to the bureaucracy of paperwork Medicaid has developed in order to cut costs!   The system is in a crisis and we are not going to take it anymore.  Hope to see you at the Rally- November 4th 9:30am at GA State Capitol.  I will be sending out the flyer later this week for everyone to distribute. Hope to see you there.   It is going to be an event YOU will not want to miss!   United... WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 22 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/170/1/Healthcare-for-Kids-Rally-Flyer-and-Other-Information--Please-Distribute%21 September 19, 2006   Dearest Advocates:   Please find attached the "official" flyer for our upcoming Healthcare for Kids Rally to be held on November 4th at 9:30am at Georgia State Capitol.    The time has come for us to unite our voices to be heard....HEALTHCARE must be a priority for our children! This rally is being put together for everyone that has been impacted or has a vested interest in the Medicaid system (which includes the following: parents, providers, and concerned tax paying, voting citizens of Georgia....Therefore, everyone is impacted by this issue in the State of GA!)   At the rally, we will be discussing the following issues: + Eligibility + Access to care and provider networks. + Early Periodic Screening Diagnosis & Treatment Federal Requirements. + Burdensome Application, Appeal and Claims Process.   We encourage children to attend and plan on having some entertainment for them as well. It is going to be a family friendly event! We need to put a face to the children being impacted by poor decisions.   The color theme is RED.  Please try to wear red the day of the event.    We recommend that you either car pool with other families or take Marta. There is parking available but it might be easier to come together as a group!    We currently have a wonderful volunteer group of over 40 concerned citizens wanting to make a difference and change in the direction of Medicaid!  I am amazed at how many people are actively wanting to get involved.  If you would like to volunteer (still looking for people the day of the event to help with set-up/clean-up): please send Leanne Manning (leanne_d@bellsouth.net ), my administrative assistant for the Rally, an e-mail with the following information: Name, e-mail, phone numbers, where you live, and if you are a parent, provider,etc.   Also- if you know of a organization and/or person that would like to donate to the Rally, please let us know.  North Metro Miracle League (NMML) has graciously offered to be an administrator of funds for the Rally! Please see the attached flyer for further information. Thanks in advance for your help in this matter.    This is going to be the event of the year for Healthcare in this State....... Let's show our support!   Feel free to distribute this flyer to anyone you think would like to attend and post at therapy clinic's doctor offices,etc. WE need to get the word out about this event. The more people that show up the better........   We are voting citizens and need answers to the healthcare crisis in Georgia!   UNITED... WE WILL MAKE A DIFFERENCE!   Additional information can be found on our website: www.kidshealthcarega.org  Hope to see you there!   Sincerely, Heidi J. Moore Healthcare for Kid's Rally Coordinator   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 19 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/169/1/More-Media-Attention-to-Therapy-and-Healthcare September 16, 2006   Dearest Advocates:   I just wanted to let you know that our advocacy efforts are continuing to paying off....   NBC WALB from Albany aired on September 15th  a segment regarding the therapy changes in prior approvals and other healthcare issues that will impact our children's access to healtcare in this State!  Here is the actual news segment and you can even view the video at the following address:   http://www.walb.com/Global/story.asp?s=5414040   Please take a moment and thank the reporter, Alicia Eakin   aeakin@walb.com for taking interest in the story and also send an email to  news@walb.com?subject=Medicaid/AE .   It takes a lot of energy and time in order to have these segments aired.  I also want to thank Stephanie H. for being willing to go on camera and state what a lot of parents are experiencing and continue to educate the community on the issues our providers are experiencing with Medicaid right now as well! Thanks to Missy for letting me know about the coverage as well!   Only through building awareness of the situation (and in this case: working with the media), are we going to impact change in the State of Georgia!    I hope you can see that we are continuing to get attention on this matter!  This is exactly why having a Healthcare for Kids Rally on November 4th 9:30am at the GA State Capitol is so important (before the election on November 7th).  It's going to be a major event! More information will be sent out soon including the flyer for the event.    Thanks in advance for writing your thank you's.  If you see media attention in your area, please let me know so we can make sure everyone knows what's going on throughout the State and be able to express our thanks as well.....   Keep up the great work.  UNITED... WE WILL MAKE A DIFFERENCE!   Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Sat, 16 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/167/1/Therapy-PA-Update September 6, 2006   Dearest Advocates (specifically therapists that provider services to our children):   Below is a summary of a meeting that took place with the Dept. of Community Health (DCH) last week regarding the paperwork concerns that have developed due to the the Sept. 1st implementation of prior authorizations for therapy over 8 units/month).  PLEASE note that there are a lot of concerns out there right now and the Tri Alliance is continuing to work with DCH regarding these concerns.  PLEASE DO NOT E-MAIL ME QUESTIONS. I AM NOT A THERAPIST. I"m just trying to keep everyone informed at this time of the issues!   Remember that any and all official changes will be communicated by the Department of Community Health.    This email is for informational purposes ONLY.  I hope you find this information helpful.  I know parents truly appreciate the providers that have continued to service our children during this frustrating time. Hopefully, we are moving in the right direction to getting these issues resolved quickly.  Sincerely, Heidi ========================================   In response to concerns surrounding excessive paperwork, unreasonable and unexplainable denials surrounding medical necessity and potential reimbursement delays due to changes in systems requirements, DCH proposed to make the following changes:   1.      Stream line paper work requirements for prior approval requests to allow for one document which will combine the requirements of the Physician Plan of Care and the Letter of Medical Necessity.  This combined revised document will require one physician signature  2.      Prescriptions will still be required which are good for six months 3.      Stream line ACS Web Portal application for prior approval to allow for therapist/s to type in see care plan and see progress notes in the "Description of Services Requested" and or in the "Outcomes" text box if the requested information is already stated on the hard copy care plan or therapists evaluation and or progress notes 4.      Medical Necessity is determined by the EPSDT CMS guidelines which provides for therapy services that correct (fix) and or ameliorate (make better) 5.      Georgia Medical Care Foundation (GMCF) will conduct peer reviews provided by discipline specific experienced therapists.  GMCF should give reasons for denials when refusing to grant total request.  They may not offer reasons for only granting partial requests.  Questions surrounding denials should be directed to GMCF who should provide an e-mail address for contacting them with questions.  6.      IEPs and IFSP are now being requested for peer reviewers to determine if there is duplication in services.  To avoid denials based on presumption of duplicative services and or duplicative billing, therapists will be allowed to explain any justification for services in the "Description of Services Requested" box on the ACS Web Portal Application. 7.      Technical/ Systems concerns which will allow therapists to bill for units for services rendered on the same date of service for procedures that do not need prior approval along with procedures that exceed the threshold and will require prior approvals is still being worked on.  8.      DCH does not anticipate any delays in reimbursement due to major erroneous system denials.  In the event of such, they are prepared to make mass adjustments.  9.      Should Therapists experience erroneous denials their ACS Provider Rep and or the liaison should be the first point of contact.  Should there be unresolved issues, they should then be excelled to Sherrie Collins at DCH. (scollins@dch.ga.gov) 10.  For additional questions or concerns always feel free to contact Sherrie Collins or Mark Trail at Medicaid.   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 06 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/166/1/URGENT%3ASave-That-Date%3A-Children%26%2339%3Bs-Healthcare-Rally%21-11%7B47%7D4%7B47%7D06-at-9%3A30am September 1, 2006   Dearest Advocates:   The time has come for EVERYONE to get involved.......    We are planning a Children's Healthcare Rally at the State Capitol on Saturday, November 4th at 9:30am.  More information will be following but I wanted to make sure you SAVE THAT DATE!   We all need to speak up and have our voices heard for our children and the providers that service them.  This is an election year and we need to make sure the State understands OUR priorities must include healthcare for our children.   The Children's Healthcare Rally will involve some of the following issues:   1. Eligibility Issues for disability waivers (including the Katie Beckett Waiver). 2. Access to a viable provider network (including therapy!) 3. CMO concerns. 4. BCW Concerns. 5. Overall, administrative paperwork problems in the system!   As you can see, we will be advocating for all children with and without disabilities that require healthcare from the State.   The issue is...... all children need healthcare (which includes having service providers to perform those services!).   If you are interesting in getting involved, donating time, or money in helping make this be the most effective rally to get the lawmakers attention....please send me a BRIEF e-mail stating the following:   1. What you think you do to help the cause? 2. Contact information including: name, phone numbers, e-mail address. 3. Where you live? 4. Are you a parent, provider, friend, concerned citizen, etc?   A rally committee is being put together to help make this a successful event.  Thanks in advance for wanting to participate!   Let's show our strength in numbers....OUR VOTE COUNTS!    UNITED... WE WILL MAKE A DIFFERENCE!   Hope to see you there! More detailed information will be following shortly.    Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 01 Sep 2006 00:00:00 EDT http://www.lgtinc.org/articles/165/1/TONIGHT%3A-FOX5-10%3A00pm-news---Therapy-Situation%21 August 29, 2006   Dearest Advocates:   I just was informed that Lisa Crane of FOX 5 News will be airing another segment on the therapy situation in this State due to the Dept. of Community Health's implementation of more paperwork for our children to receive services, as well as, CMO's not approving therapy at all for children under that plan.    The segment will air tonight on FOX 5's 10:00pm news.   I hope you can see that we are continuing to get attention on this matter!    Please take a moment and thank the reporter, Lisa Crane lisa.crane@foxtv.com for taking a continued interest in the story and also send an email to  feedback5@foxtv.com.   It takes a lot of energy and time in order to have these segments aired.  I also want to thank Michelle M. for being willing to go on camera to state what a lot of therapists are experiencing and continue to educate the community on the issues our providers are experiencing with Medicaid right now (as well as parents!).   Only through building awareness of the situation (and in this case: working with the media), are we going to impact change in the State of Georgia!    Thanks in advance for writing your thank you's.  Keep you posted. Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 29 Aug 2006 00:00:00 EDT http://www.lgtinc.org/articles/164/1/Gwinnett-Daily-Post---Article-on-Managed-Care-and-Therapy%21 August 27, 2006   Dearest Advocates:   Today in the Sunday newspaper was a great article by reporter, Dave Williams regarding families having a hard time getting approved for their children to receive therapy under the CMO program.   As you are all aware, this is not just an issue for CMO's but also everyone that receives Medicaid due to Dept. of Community Health (DCH) making it more difficult to receive therapy starting Sept. 1st and increasing the amount of paperwork for our children (with no value added....just making it more and more difficult for our therapists to accept Medicaid!).   Please take a moment and thank Dave at dave.williams@gwinnettdailypost.com for continuing to educate the community on issues effecting our children.  This is an election year and we need OUR VOICES HEARD!    Many thanks to Tammie K. for letting me know about the article.  Keep up the great communication everyone.  The only way I"m able to keep all of us informed on what is going around all over the State is to let me know!   I will be sending an e-mail out later this week regarding what our next steps need to be in order to advocate for this issue and many others regarding healthcare.  UNITED.....WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi =================================== Here is the article just in case you missed it:   Medicaid managed care stressing children's therapy 08/27/2006 - By Dave Williams Staff Writer dave.williams@gwinnettdailypost.com MONROE - When little Dorian Parham wants something, he pulls at his grandmother instead of telling her. Just four months from his third birthday, the boy from Social Circle should be communicating in simple sentences. Instead, he speaks only in phrases that are hard to understand. Without speech therapy, he is going to have a hard time when he starts school, said Ellen Roberts, a speech language pathologist who was working with Dorian one day last week inside Children & Adult Therapy Services in Monroe. "He wouldn't have practiced language as long as the other kids,'' she said. "He's going to be at a disadvantage.'' Down the hall, 7-year-old Tomia Vinson of Monroe, who suffers from seizures that affect her speech and fine motor skills, is learning how to color within the lines of a pattern. The first-grader has been suspended from school three times this semester. "If you can't hold your pencil properly, you get tired,'' Roberts said. Then, you start doing other things, which leads to an outburst. Eventually, you get labeled a behavior problem.'' Both children were being treated for free that day. The therapy office was awaiting authorization to take Dorian as a new patient, while Tomia has used up her authorized visits and been denied coverage for more therapy. Problems common Roberts said the delays and denials her young patients face are typical of what is happening to children's therapy services across metro Atlanta and middle Georgia since the state introduced managed care to Medicaid enrollees in those regions in June. Now, her colleagues in the rest of Georgia are worried that the same fate awaits them when the Department of Community Health completes the rollout of the program this Friday. "The process is time-intensive, labor-intensive, paper-intensive and significantly confusing,'' Marisa Harvey, a physical therapist from Albany, told the board that oversees the DCH last week. "Children are missing needed therapy sessions.'' Three HMO-like plans hired by the state for about $3 billion began covering 600,000 low-income adults and children on June 1. A like number will be added to the program Friday. The concept behind the initiative is to bring the same savings managed care has achieved with private insurance to Medicaid and, thus, to Georgia taxpayers. At the same time, the program's backers say assigning Medicaid patients to a primary care doctor will lead to more continuity in their health care, with a greater emphasis on illness prevention. But the program got off to a rocky start. Doctors have complained - some loudly - about delayed payments that have hurt their ability to treat patients. A lawsuit filed by about a dozen doctors and medical practices this month alleges that some have been forced to lay off staff members. The suit seek s class action status for the plaintiffs, so it could affect thousands of providers. State health officials and representatives of the three "care management organizations'' hired to run the program have conceded that delays in processing and paying claims occurred frequently during the early weeks. But they say they're making steady progress. Through Aug. 11, according to figures supplied by the DCH, the CMOs had paid out about $55 million in claims. In 96 percent of the cases, the companies were disposing of claims by either paying or denying them within 15 business days. "It's not going badly at all,'' said Kathy Driggers, the agency's Medicaid director. Visit limit But the therapists' beef with Medicaid managed care goes beyond administrative glitches. They're upset with a directive that limits children to an initial round of eight visits. If a child needs more therapy after that, the therapist has to request another authorization from a pri m ary care doctor, which may or may not be approved by the CMO. Harvey said the vast majority of children receiving therapy services need more than eight sessions. "If we could fix these children in eight visits ... everybody would be at our doorstep,''  added Roberts. "With children, you're not going to see progress from therapy session to therapy session. We tend to see change in 21D2 to three months.'' With that in mind, Roberts asked Gov. Sonny Perdue in a letter dated Aug. 18 to consider "carving out'' children's therapy services from the new program. Driggers said the state is paying special attention to how the CMOs handle children's therapy. She said that although the companies run Medicaid managed care programs that cover therapy services for other states, each state is different. "There's been a big learning curve for the plans in figuring out how we cover therapy services,'' she said. At the same time, the CMOs defend the eight-visit threshol d as part of well-researched standards they have developed for children's therapy. "When any kind of request for therapy comes in, we use national guidelines,'' said Kent Jenkins, spokesman for Amerigroup, one of the CMOs hired for the program. "If it's something that's medically necessary, we want to cover it. If something diverges from that, we have a pediatrician who examines the case.'' But Roberts said such rationing of care misses the big picture. "We understand about containing costs,'' she said. "(But) if you help children with these skills, they're going to be healthier, stay in school longer and become productive members of the community.''       --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 29 Aug 2006 00:00:00 EDT http://www.lgtinc.org/articles/163/1/Written-Testimony-to-the-Georgia-Senate-on-Mental-Health-Screening Madame Senator Schaeffer and Honorable Senate: I. Introduction I want to thank you for tackling this issue and especially for asking me to be part of this very important Study Commission. Unfortunately I have bronchitis and will not be able to attend the commission tomorrow. However, I will spend the next few hours working on a written testimony which if possible I would like you to include this in the Congressional Record. Georgia appreciates your concern for those that are the least protected and most vulnerable among the population, namely our children. I would have loved to attend this Study Commission as I believe I have one of the most unique perspectives on this issue as I have been researching and reporting on it for years. Most only have a small part of the larger picture and therefore do not understand the full implications of President Bush's New Freedom Initiative, which could unnecessarily threaten the lives of millions of innocent Americans and put at risk families who will not be willing to allow the 'forced drugging' of their children. II. Necessary Background Information To really grasp the scope of this issue, one must first understand the roots and causes of Autistic Spectrum Disorders and how it pertains to this plan. Unless one understand this most important aspect of this discussion, one will not realize the full extent of the autism epidemic in America. In 1990, the recorded rate of autism in America was 1 in 10,000. Today the Centers for Disease Control report that number stands at 1 in 150. I wrote a letter to the entire Georgia Congress several years ago warning legislatures as to possibility that a vaccine preservative called thimerosol was responsible for the rise in autism rates in the United States. Excerpt from my article "Vaccine Preservative Thimerosal And The Destruction Of An Entire Generation Of Kids" Since the 1930s, Thimerosal had been added to vaccines as a preservative to boost drug company profits, allowing vaccine makers to package multi-use dosages in bulk instead of individual doses. The thimerosal preservative prevents bacteria from growing within the vaccine when the needle is dipped in and out of the vial to draw another shot. The FDA estimates that it's use in more than 30 licensed vaccines and biologics even though there have been publications in the most respected journals of medicine since the beginning of its introduction as a preservative on the market; warning about the dangers of mercurial based agents as preservatives to make vaccines multi-usable. "Internal documents reveal that Eli Lilly, which first developed thimerosal, knew from the start that its product could cause damage -- and even death -- in both animals and humans. In 1930, the company tested thimerosal by administering it to twenty-two patients with terminal meningitis, all of whom died within weeks of being injected -- a fact Lilly didn't bother to report in its study declaring thimerosal safe. In 1935, researchers at another vaccine manufacturer, Pittman-Moore, warned Lilly that its claims about thimerosal's safety "did not check with ours." Half the dogs Pittman injected with thimerosal-based vaccines became sick, leading researchers there to declare the preservative "unsatisfactory as a serum intended for use on dogs." In 1997, with the passing of the FDA Modernization Act, all products containing mercury were to be tested for adverse effects to people and environment. Soon thereafter the FDA ordered Thimerosal removed from over-the-counter products. "Once the amount of Thimerosal in vaccines was finally measured in 1999, the FDA discovered that children were receiving more than 100 times the EPA's safe limit for mercury by 18 months of age and yet officials allowed the preservative to remain in vaccines. To this very day flu vaccines given to pregnant women and 6 month old babies contain a full dose of Thimerosal." - Evelyn Pringle Iin 2000, the Centers for Disease Control convened a top-secret meeting of 52 health officials, government scientists, and representatives of major vaccine manufacturers, not to decide how to go public with the information and create a contingency plan to help those affected by the criminal negligence of the vaccination companies; but instead spent the 2 day conference deciding how to spin the negative results of studies implicating autism with the increase in thimerosal containing vaccines required by the immunization schedule for newborns, infants, and children. The epidemic grew quietly from the early 1930's until autism became regularly visible - a part of the fabric of America. The number of vaccines added to the 'required' immunization schedule rose dramatically for children, from 1 (small pox) in 1948, to 21 doses from 9 different vaccines in 1991, to 33 or 34 doses of nine or ten different vaccines in 1998. We are told that nobody had considered what the accumulation of thimerosal from all 'required' vaccines would do to the developing minds of children receiving all these 'necessary' shots. However, we know from Eli Lilly's own 1930's internal documents that thimerosol has never and will never be safe. Robert F. Kennedy Jr. wrote, "I devoted time to study this issue because I believe that this is a moral crisis that must be addressed. If, as the evidence suggests, our public-health authorities knowingly allowed the pharmaceutical industry to poison an entire generation of American children, their actions arguably constitute one of the biggest scandals in the annals of American medicine." Whether one agrees or disagrees with Kennedy's allegations, at least now this issue is in the forefront of American consciousness and with a whole generation of children and their families negatively impacted, this issue won't just disappear as I am sure some big money interests would hope it would. How do we know that this purported meeting took place? SafeMinds.org, an advocacy group of parents who believe that their autistic children were damaged by thimerosal, used the Freedom of Information Act to obtain records showing that as early as December 1999 the Centers for Disease Control knew that the amount of mercury contained as standard for vaccines given in the first three months of life would dramatically increase the risk of autism in children who received those vaccinations. An FDA study found that vaccines administered over the past decade have tripled the dose of mercury that infants got in their first few months of life and as many as 40 million American children may have been exposed to mercury in excess of Environmental Protection Agency guidelines. The CDC and the FDA had recommended in 1991 that three additional vaccines laced with thimerosal be given to extremely young infants; the estimated number of cases of autism then increased fifteenfold, from 1 in every 2,500 children to 1 in every 166 children. On February 15, 2005, the GAO, released a Report titled, "Special Education Children With Autism," that revealed the number of children ages 6 through 21 diagnosed with autism receiving special education services has increased more than 500% over the past 10 years. In an interview with Joe Scarborough on MSNBC, Kennedy, Jr. answered when asked - "Why are they sitting back - if our children are being poisoned, if the science is there. Why are they sitting back and letting our children be poisoned? Kennedy: Because the same regulatory bureaucrats that green-lighted Thimerosal originally are now trying to cover their tracks. We now have the transcripts of the secret meeting that they did in Simpsonwood, Georgia, in the year 2000. And it's the most horrifying thing that you can read, Joe. There are scientists there from the government who are saying - who are reading the reports and saying, this is undeniable. There's no way we can ever deny this. I am not going to give this to my children, but now let's hide this from the American people. And it's that clear. And this is what I write about. It's this language that I write about in the "Rolling Stone" and the "Salon" piece that is so shocking, where we have the guys who are supposed to be protecting Americans` health who are actually conspiring to keep this stuff in the vaccines." Once I discovered the truth behind this issue, I quickly forwarded this article to every member of the US and Georgia congress. The transcripts from Simpsonwood attained through FOIA by SafeMinds.org proves without doubt that the CDC also knew that thimerosol was and is responsible for the rapid increase in autism and Asperger's syndrome related disorders such as ADD/ADHD, etc. I use the CDC's own transcripts to prove that yes, thimerosol had destroyed the lives of upwards of 40 million children in America alone born between 1991-1998 though autistic like symptoms had been showing up in children since the onset of required immunizations. III. The Cover-Up Ensues: CDC Knew of Potential Link between Vaccines, Autism By Melissa Ross - The growing controversy over thimerosal has contributed to its removal from many childhood vaccines, beginning in the late 1990's. But it is still present in some vaccinations, including virtually all flu shots. It is also present in the stockpiled vaccines and will be still given to patients for years to come. The CDC had convened a secret meeting here in Simpsonwood, Georgia to discuss this issue with the leading scientist around the country, but instead of coming clean and telling parents the truth about the thimerosol/autism link, they suppressed the information and even went further to cover-up the link by funding bogus studies which concluded no correlation. Transcripts of the Simpsonwood conference available at safeminds.org showed attendees, many of which were heads of pediatric hospitals, more interested with protecting the pharmaceutical companies' profit, than with preserving and serving the public health. They discussed ways to "handle" future lawsuits, and of how to keep this away from the public. Those that had assembled were not allowed to speak about thimerosal outside of those gathered and were reminded that "there would be no making photocopies of documents, no taking papers with them when they left." In that secret meeting, Tom Verstraeten, a CDC epidemiologist who analyzed the agency's massive database of over 100,000 children's medical information, declared to the 52 gathered that thimerosal appeared to be the culprit for a dramatic increase in autism, attention-deficit disorder, and other speech and behavioral problems. IV: Real Treatment instead of Forced Drugging: I won't spend a lot of time trying to convince you of this reality. If you go to: http://endeavorfreedom.org/Autism.htm you will find links to over 50 different items which conclude as I did several years ago. Also note that family members of many children with autism have been successful in detoxing their children from the thimerosol by using a technique called chelation therapy used by doctors during the 60's to remove lead from the body. Generation Rescue has already reversed autistic symptoms from their children by using oral chelators or a non-invasive skin crème that draws out mercury from the pores of the body. This technique is the only technique which has garnered any kind of measurable success in the lives of these children, however their parents are treating them for mercury poisoning and not autism or ausperger's spectrum disorders; which again proves that the autism was caused by the mercury preservative thimerosol administered through the childhood vaccination program. o Journal: Autism rates are declining after mercury removal from vaccines o UPI Reports Chelation Therapy is Making Kids Better o Wall Street Journal Reports on chelation therapy for autism o Contra Costa Times: Parents Put Faith in Autism Regimen o Des Moines Register: Debated Autism Therapy Gives Hope to Parents o NY Times writer new book exposes CDC, FDA cover-up of autism epidemic • Prof. Boyd Haley explains mercury-autism link to Kentucky Assembly What is EDTA chelation therapy? Dr. Rashid Buttar has produced a creme for Heavy-Metal Detoxification o Dr. Rashid Buttar tells Congress autism is mercury poisoning, offers treatment protocol His Site V. New Studies: Now that several years have passed, many studies have come out from all over the world linking thimerosol and autism. I will provide a few links below so that you can verify the connection for yourself and see that indeed there is something deeply disturbing about this. Internal Eli Lilly Documents on Thimerosol Danger Study: Autism Decline Tied to Removal of Mercury from Vaccines New Study Shows Vaccines Linked to Neurological Disorders Secret Report Reveals 18 Child Deaths Following Vaccinations New York Times: The Not-So-Crackpot Autism Theory Vaccine Dangers Are Vaccines Causing More Disease Than They Are Curing? The National Vaccine Information Center Autism - Mercury Poisoning In U.S. Children... a National Tragedy VI. The Real Situation in America: The real situation in America as it stands, is that over 40 million American children have extreme mercury poisoning and are not getting the help they need. Families, school systems, and governments will not be able to provide the help they need especially if our state follows the Texas Medication Algorithm Project recommended by the Bush administration as that model does nothing to assist families and children, but does everything for the bottom line of drug companies. Any bit of research into who funded the model for the 'New Freedom Initiative' produces undeniable links between big-pharma and this program to do mental health screening on the millions of children tainted with mercury poisoning or those who have a natural inclination to misbehave. Excerpt: Bush to Impose Psychiatric Regime The Texas Medication Algorithm Project (TMAP) was developed with 1.7 million $ of initial financing from pharmaceutical giant Johnson & Johnson, provided indirectly through a connected Foundation, and subsequent direct cash funneled through subsidiary Janssen Pharmaceutica. It was developed and implemented in the Lone Star State's hospitals, prisons, the Juvenile Justice system and the Foster Care system during George W. Bush's watch as governor. Bush used the "extended mental health care" scheme as a point in his 2000 presidential campaign. Before leaving for the White House, he recommended a 67 million $ spending increase to pay for additional medications for the Texas Prison and Mental Health Systems. TMAP, the Texas project, was also exported to other states, including Pennsylvania, where an investigation into what is called PENNMAP there, uncovered improper pharmaceutical pressures and financial enticements in connection with the program. The investigator, Allen Jones, was told by superiors to shut up and look the other way. When Jones refused, he was unceremoniously removed from his job and prohibited to talk to the press. Jones has stood up to the pressure and has filed a civil suit to obtain protection under the "whistleblower" statutes. He continued his investigation as a private citizen and has produced a well documented report, which is available for download as a PDF file. The TMAP medication guide was developed, starting in 1995, in a rather singular way. Instead of reviewing studies that show the relative efficacy of medications, an "expert opinion consensus" was developed, but both the experts and the survey questions were chosen by the pharmaceutical sponsors of the program which included Janssen Pharmaceutica, Johnson & Johnson, Eli Lilly, Astrazeneca, Pfizer, Novartis, Janssen-Ortho-McNeil, GlaxoSmithKline, Abbott, Bristol Myers Squibb, Wyeth-Ayerst and Forrest Laboratories. The subsequent evaluation of the experts' opinions came to recommend several drugs, including Risperdal, Zyprexa, Seroqual, Geodone, Depakote, Paxil, Zoloft, Celexa, Wellbutron, Zyban, Remeron, Serzone, Effexor, Buspar, Adderall and Prozac, manufactured by - who would have thought so - the same companies that sponsored and controlled the development of the Texas guide. As the guide was adopted, doctors working with state health systems had to prescribe these drugs or face disciplinary action. VIII. They Know The Drugs Don't Work In his whistleblower report, Jones not only traces the funding and the influence of the pharmaceutical companies involved in producing and "selling" the Texas Algorithm to other states, but also shows that - according to independent research not financed by the pharma giants - the drugs recommended are neither more effective nor safer than the cheaper ones used before. If anything, their side effects are more serious and of course they are patented and rake in an incredible return for the companies involved - according to one estimate US medicare spends as much as 3.7 billion dollars for the treatment of schizophrenia alone. Peter J. Weiden MD, one of the participants in the "Expert Consensus" process said in an article published in the Journal of Practice in Psychiatry and Behavioural Health in January 1999, three years after the experience: "The most important weakness of the EC Guidelines is that the recommendations are based on opinions, not data. History shows that experts' opinions about "best" treatments have frequently been disproved, and there is no assurance that what the experts recommend is actually the best treatment. One danger here is that clinicians or administrators may misinterpret "current consensus" as truth. Another limitation involves the development of the survey itself. Treatment options are limited to those items appearing on the questions, and it was not possible to cover all situations. Another problem is potential bias from funding sources. The 1996 Guidelines were funded by Janssen (makers of Risperidone [Risperdal]) and most of the guidelines' authors have received support from the pharmaceutical industry. This potential conflict of interest may create credibility problems, especially concerning any recommendations supporting the use of atypical antipsychotics." IX: NFI Will Bankrupt the State Not only will treating these kids with psychotropic drugs not be beneficial to them, it will bankrupt State Medicaid as they try to pay for all of the drugs that will be disposed to treat these children under this program. Excerpt: Nancy San Martin reported on 9 Februay 2001 in the Dallas Morning News - By early 2001, TMAP and TCMAP had all but bankrupted the Texas Medicaid program and the budgets of the state's mental health and prison systems. "Texas now spends more money on medication to treat mental illness for low-income residents than on any other type of prescription drug." "Prescription drugs are the fastest growing expense within the health care system. And the cost for mental disorder treatments is rising faster than any type of prescription drug.""The costs of treating schizophrenia, bipolar conditions and depression have surpassed expenditures for medications to treat physical ailments, such as bacterial infections, high blood pressure, respiratory problems and even chronic disorders, notably diabetes.""According to a report on the state's Medicaid Vendor Drug Program, mental health drugs made up the largest category of expenditures among the top 200 drugs in 1999. They accounted for nearly $148 million. Those costs have more than doubled since 1996." "This week, health officials asked for at least $657 million more to help cover Medicaid costs." X: Why Reward the Same Companies Responsible for this Unbelieveable Tragedy Often the very same companies that destroyed these 40 million children, are also the ones who will reap the benefits of prescribing psychotropic drugs to the children harmed by their vaccines. The 'New Freedom Initiative' will profit big-pharma in a huge way especially if they can get each one of these kids to be prescribed even 1 of their medications daily for as long as they may live on these very dangerous drugs. So it's like they are being rewarded to destroy our children, rather than be held accountable. Instead, these companies will reap the benefits of prescribing drugs to well over 40 million American children displaying any signs of autistic spectrum disorders or even simple restless behavior. XI. Dangers of NFI and Psychiatric Drug Inducements In the states which have already implemented the 'New Freedom Initiative' children are being drugged against their wishes and even the wishes of their parents. Parents are even being threatened with charges of neglect and losing the custody of their children for not wanting their children forcefully drugged. There are many stories of children going off the deep end and doing all kinds of uncanny and bizarre behaviors while being under the influence of the very drugs recommended by the New Freedom Initiative. In some cases as in the case of Shania Dunkel it can lead to death. I won't spend much time relating to you the dangers of the psychiatry drug regiment recommended by the NFI, however here is a direct quote from Lilly to Add Suicide warning to Strattara, " One by one, psychiatry's magic bullets--the new gteneration of antidepressants and antipsychotics--are being unmasked for presenting both unfavorable risk/benefit and unfavorable cost/ benefit ratios for patients and the public purse. The pharmaceutical influence on doctors' prescribing is harming patients and impeding rational public health spending policy: Bloomberg News reports that in the wake of the CATIE study in which the four most prescribed, most expensive antipsychotic drugs were compared to an old cheap drug, failed to demonstrate a clinical difference, the US Medicaid program is considering reducinge the $5.5 billion it misspends annually for these aggressively marketed, high priced drugs." Here are 4 of many websites which follow stories of people exhibiting insane behavior while on these drugs: The Creation Of Senseless Violence, Psychiatric Drugs, And Kids Who Kill Antidepressant-Induced Suicidality and Violence: More About Deception Than Science FDA Alert On Violence- and Suicide-Inducing Stimulants Psychiatry and the Creation of Senseless Violence XII. Just Compensation These children and families will never be compensated for the struggle they have already endured and will never get the justice they deserve unless vaccine manufacturers are held accountable for the damage they have done, support will be sought out from government agencies who cannot possibly fund the scope of need necessary for these children. How can anyone even begin to place a price tag on the amount of suffering these children and their families have already had to endure. What kind of lawsuit could begin to compensate for the destruction of over 40 million American children and their families. Many families have had multiple children born between the years of 91-98, all with severe autism. How can society begin to repay these parents back for all that they have gone through? Another startling trend that has been coming to the forefront of American media, is the fact that parents are taking it upon themselves to end the lives of the autistic children they have rather than deal with the daily regiment of caring for their children. What is more startling is evidence that the media sides with these parents and appeals for sympathy for them rather than treat the cases of murder of autistics as regular murders. This has also lead to an increase in the accounts of these children being starved/dehydrated to death and with the blessing of some of these parents. These children will be vulnerable to all kinds of neglect and abuse unless something is done to provide families with knowledge of chelation and the link between thimnerosol and autism. Another set of data verifying this link is the Amish people of Pennsylvania who do not allow their chilldren to be vaccinated. After an exhaustive and lengthy search, Olmstead writes, "June 14, Washington, D.C. (UPI) - Readers of this column have reacted strongly to our series of reports on autism among the Amish. So far, we have found only a handful of cases of autism and have quoted some experts who think it is nearly non-existent in this group." The Amish of Lancaster County, Pennsylvania, refuse to immunize their infants. Olmsted calculated that there should be 130 autistics among the Amish. He found four - one exposed to high levels of mercury from a power plant and the three other had received their vaccines before they were adopted into Amish families. I know I will not be able to go into great detail on all of the revelations I bring before you know as there is so much contained within this piece of testimony. I would like to challenge each legislature to doubt all that I bring before you. I would ask that rather than just shrug off what I say in this account that you do the research yourself and look into the things I have brought here before you. Georgia has elected you to office because you are the best and the brightest among us. Therefore it is your duty as an elected official to look into what I say as knowing this information will lead you to do what is best for the children, people, and families of our great state. XIII. Alternatives to NFI - Ban Thimerosol!!! Rather than implement the New Freedom Initiative as recommended by the Bush administration. I would ask you to work with the likes of Put Children First.org who upon finding out that thimersol is the true culprit of autism in America, has campaigned to ban thimerosol in this Nation. They have been successful in 6 states so far, please consider making Georgia the 7th state to protect children from the dangers of mercury poisoning and ban thimerosol produced vaccines in this state. It is possible for vaccine manufacturers to produce all vaccines without thimerosol, however it would cost them much more as the thimerosol allows vaccince vials to multi-usable though vaccines with thimerosol are entirely not safe. To truly help families and children here in the State, Congress could mandate a study which looks into the plausibility of treating autism through inexpensive natural means like oral or skin chelators that have been proven affective for heavy metal toxicity for years and then make these available through state Medicaid services rather than expensive psychotropic drugs which do nothing to help these children and only further risk their lives and the unity of their families. The results from GenerationRescue.org are profound and easily convincing. The true great hope for children and families touched by autism lies not in the New Freedom Initiative but in bringing forth knowledge that autism is nothing more than mercury poisoning and that mercury poisoning is treatable. It may not bring all children back fully and may not work on some, but for those it does help, that help can be tremendous. If the state does plan to implement the NFI, please place safeguards into the policy which protects parents from being charged with neglect and being stripped of their custody. As with vaccinations there should be religious or moral exemptions which protect the children and their families instead of the drug companies who are responsible for the situation being as it is already. If I can be of further assistance, I would be glad to address you on these issues and answer any questions you may have. All of this information is available at my website: EndeavorFreedom.org. Thank You and Bless You in Your Work, Zen Garcia   Zen Garcia Thu, 17 Aug 2006 00:00:00 EDT http://www.lgtinc.org/articles/162/1/CNN-Headline-News-and-Our-Jacob%21 Dear Family and Friends and individuals that want to see Jacob succeed in life:   I have exciting news........I was contacted by CNN Headline News two weeks ago about them wanting to do a consumer educational story on Down syndrome! They ended up coming out to our house last week and video taping Jacob in music therapy (many thanks to Jennifer, his Music therapists for being willing to participate on such late notice), crafts with the kids and an interview with me.   Here is the detailed information on when the show will air and where you can see it on the web.  The story will air on CNN Headline News on Monday, August 21.  It will air once an hour, from 1-6pm, at around 7-8 minutes past the hour (provided there is no breaking news).  It will also be fed out to CNN affiliates (around 800-1,000) the same day.  On Tuesday, August 22, the story will appear on http://www.cnn.com/2006/HEALTH/05/26/health.minute/index.html (Health Minute segment).  I really hope we continue to see stories like this in the media.....CNN asked me what was my goal for Jacob. I said " My goals are like any other parent. For Jacob to live a happy, healthy productive life and that I hope society sees my son for his abilities, not disabilities.  It's not that Jacob can't learn, he just learns differently and at his own pace! He is an amazing boy that happens to have an extra chromosome!".   Thanks again to everyone that has been on the "Jacob Team" for many years. We are all seeing the hard work paying off in his accomplishments!   Please take a moment after the segment airs next week and thank CNN for continuing to cover issues that are important to the disability world. (CNN was fantastic to work with on this project and really tried to understand the issues associated with families that have children with Down syndrome).  Building awareness is half the battle to acceptance in society and building a brighter future for our children!   You can send a quick thank you to the following general CNN feedback website: http://www.cnn.com/feedback/forms/form1.html?33   And here is the reporter, Judy Fortin contact info as well: http://www.cnn.com/feedback/forms/form4b.html?21   Let's keep up the positive media for children with disabilities!    I'm so proud of Jacob and how well he did in the interview!  Hope you enjoy! Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 14 Aug 2006 00:00:00 EDT http://www.lgtinc.org/articles/161/1/Athens-Newspaper--FANTASTIC-Front-Page-Article-on-Therapy-and-CMO-situation%21 August 14, 2006   Dearest Advocates:   Today on the front page of the Athens Banner-Herald was a FANTASTIC article on the therapy and CMO situation for children with disabilities.   This is the type of media coverage we need to continue to have on the issues facing our families........Like I said before, only through educating and building awareness in the community, and working with our legislators and Governor and DCH are we going to be  able to make a difference in lives of children and adults with disabilities!   Please take a moment to thank the reporter, Lee Shearer, for his in depth coverage of the situation. His email address is: lee.shearer@onlineathens.com. Also, please copy the following people on your thank you's:   courtney.pomeroy@onlineathens.com - Courtney Pomeroy- Feature Editor william.stewart@onlineathens.com - Bill Stewart - News Editor   In addition, I want to personally thank the Handwork Family and Physical Therapist Peggy Curren for allowing the media into their lives!   You can also find the article by going to the following website:http://onlineathens.com/stories/081406/news_20060814034.shtml   UNITED....WE WILL MAKE A DIFFERENCE! Sincerely, Heidi   ================================================== Here is the article: Medicaid changes could have negative impact on disabled children Physical therapy takes hit with overhaul Jessica Handwork, left, pauses for a moment while working with her 16-month-old son, Seanan, and pediatric physical therapist Peggy Curren recently during Seanan's physical therapy session in Jackson County. Seanan suffers from a genetic disorder known as Noonan Syndrome.Caleb Raynor/Staff   By Lee Shearer   |   lee.shearer@onlineathens.com   |   Story updated at 11:10 PM on Sunday, August 13, 2006 Seanan Handwork can't sit up, feed himself with a spoon or speak like most 16-month-olds due to a genetic disorder called Noonan Syndrome he was born with. Noonan Syndrome slows his development in many ways, and he doesn't yet have the strength to sit on his own or the coordination to use a spoon - but he's getting there, thanks to weekly sessions with Athens physical therapist Peggy Curren and other specialty therapists. The Athens therapist and Seanan's mother, Jessica Handwork of Jefferson, fear massive changes in the state Medicaid program may mean cuts in her son's therapy schedule - and a reduced chance that he one day can live a more normal life despite his developmental barriers. Curren knew the state Department of Community Health was changing to a new way of running the program as the state looks for a way to curb the mounting bill for Medicaid, which costs the state about $2.2 billion last year. Medicaid costs went up about 14 percent a year between 2000 and 2005, mainly because more people have enrolled as Georgia's population swells. But Curren's first taste of what that might mean for therapists like her and children like Seanan came in July, when she first saw a letter from the community health department stating that unless she filed paperwork to get special permission, the state was going to cut back on the sessions she and other therapists can give to severely disabled infants and children she works with. If she didn't get that permission, Seanan's therapy sessions could be reduced to a third of what he gets now, with consequences that would slow him down the rest of his life, she said. The state already has backed off on part of the limits, but therapists like Curren fear that at the least, the changes are going to add to an already large paperwork burden. What Curren and Handwork are seeing is part of a massive overhaul of the state Medicaid system, and they are not the only ones who feel the transformation is off to a bumpy start. Among other changes, the state has contracted with three "Care Management Organizations" to run much of the Medicaid program. The CMOs are similar to a kind of insurance company called a health maintenance organization. Most of those affected are Medicaid's youngest recipients, like Seanan. About a third of Georgia's 2.4 million children are enrolled in Medicaid programs, according to the Healthcare Georgia Foundation. Children make up more than half of the 1.4 million Medicaid enrollees in Georgia, though they account for only about 23 percent of costs. Curren, who specializes in working with very young children, still isn't convinced the new regime will mean less therapy for Seanan, because he needs the therapy. But she's skeptical about whether the state or the CMOs always will approve the services her young clients need. "They say it's not going to be a reduction of services. They can say that, but that's not the result," Curren said. "The result is going to be a reduction in services. And they're going to claim it's not their fault, but the therapists' fault." The three CMOs took over some "service areas" from the state in June, including the Atlanta area. Other areas, including Athens and several surrounding counties, are scheduled to make the move in September. If therapy for children with Noonan Syndrome and other disabilities is reduced, it's likely to have the opposite effect state policymakers want, say some children's health advocates. Reducing children's therapy also will reduce their chances of becoming more independent as they get older, said Lauren Waits, policy director at Voices for Georgia's Children, which describes itself as an independent nonprofit public policy advocacy group. In general, the younger the patient, the more progress they can make in therapy, Waits said. "The state needs to look at therapy as an investment in the future of our children," she said. Doctors also are running into problems with the new system, said pediatrician Martin Michaels of Dalton, president of the Georgia chapter of the American Academy of Pediatrics. By managing care, the CMOs' goal is to save money by reducing emergency room visits and hospital stays without a negative impact on children's health - good goals, Michaels said. But so far, few specialists such as pediatric orthopedists seem to be signing up with the CMOs, which could be at least partly because Georgia pays physicians less than most states for the same services. "It's a market scenario," he said. Another problem is logistics, he said. Physicians and other providers are seeing long delays between the time they submit claims and when they get paid, and some claims aren't being paid at all, with no explanation, he said. That's causing severe cash-flow problems for some pediatric practices, which depend more on Medicaid than most medical specialties since so many of Georgia's children are on Medicaid, Michaels explained. Some pediatricians are choosing to drop out of Medicaid rather than deal with the system, he said. Three things need to change, Michaels said: one, the CMOs need to sign up more specialists such as children's orthopedists, dermatologists and neurologists; second, the companies' billing technology needs to quickly be improved; and third, the amount the state Medicaid program pays for medical procedures needs to be increased. Michaels said he's optimistic the problems will be worked out, however. Hospitals also are having trouble with payments under the new regime, but Georgia Hospital Association spokesman Kevin Bloye also was cautiously optimistic. "At this point, the jury is still out as to whether it's going to be successful or not," Bloye said. "Too many lives, hospitals and health care providers are at stake here," he said. "It's got to work." Published in the Athens Banner-Herald on 081406   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 14 Aug 2006 00:00:00 EDT http://www.lgtinc.org/articles/160/1/Urgent-Update%3A-Advocacy-Needed.-Contact-your-Legislators-now July 29, 2006   Dearest Advocates:   Wanted to update you.......Unfortunately, DCH has decided to continue with their proposal regarding making it more difficult for our children to receive therapy. We really need to push this issue with our legislators and the Governor that this WRONG and needs to be changed ASAP!  DCH is stating that each therapy is only allowed 8 units/month or a combined therapy (ST/OT/PT) of 16 units/month without getting a prior authorization (PA). Anything over that amount will require a PA.   Here are somethings to think about and write about to your legislators:   In a recent interview on Fox 5 10:00pm news, Mark Trail, Medicaid Director at DCH, indicated that the state must be "financially responsible" with how it spends its money.  While prior authorization is generally a good mechanism to ensure that services are properly administered, it can have several negative consequences if not administered properly (as anyone knows who ever had an HMO).  Therefore, we need to determine whether the proposal outlined by DCH is "financially responsible" in this circumstance.   The only rational explanation for implementing prior authorization requirements is that DCH believes parents, doctors and therapists are not qualified to determine the level of services necessary to meet a child's needs.  Even though these caregivers see the child daily, weekly and/or monthly, DCH apparently believes it is in a better position to determine the level of services for a child and believes that by reducing prior authorization levels, it will reduce the number of "unnecessary" therapies.    In order to be financially responsible, governments must determine whether reducing their programs will save money without causing other undesirable results.  For example, the state could simply stop providing any services of any kind.  It could discontinue police, fire fighters, etc.  Although this would save the tax payers money, this would not be a "responsible" decision as it would have serious negative consequences.  Similarly, the state can't just look at the cost of the program when making changes, it must look at all of the circumstances.  It must determine whether the change will achieve cost savings without reducing the necessary level of care.  Therefore, in order t o make sure these prior authorization level changes are responsible, we must ask ourselves these questions:   What will the total costs be for increasing the number of prior authorization reviews? What savings does DCH expect to see as a result of reducing what it believes to be "unnecessary" therapies? Are the savings greater than the cost to implement the changes? Are the pre-authorization levels set appropriately? Are there any other non-monetary factors that must be considered? I hope the above helps you with writing your letters to your legislators and the Governor!   Here is the actual banner message sent out to providers/therapists yesterday for fyi:   https://www.ghp.georgia.gov/wps/output/en_US/public/Provider/BannerMessages/ACSBNR_07272006_1_CIS_Limit_Changes.pdf   Please get involved and write your letters. Therapy needs to viewed as an investment in our children's future!   UNITED... WE WILL MAKE A DIFFERENCE! Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 10 Aug 2006 00:00:00 EDT http://www.lgtinc.org/articles/159/1/Therapy-Update%21%21%21%21 August 8, 2006   Dearest Advocates:   Our advocacy efforts are paying off.  Mark Trail (Director of Medicaid) just released the below statement today stating that Dept. of Community Health (DCH) will NOT be implementing the combined limit of 16 units for all three therapies (PT/OT/ST) that was previously proposed to start Sept. 1, 2006!   We still have issue with the reduction from 20 units/month to 8 units/month for a prior authorization (PA) for all three therapies.  DCH needs to implement levels that are more appropriate for each type of program (It is NOT responsible to have the same PA levels for those with and those without disabilities.  Based on the proposed standards, most of our children with disabilities will need PA in order to receive their current therapy level.)   We must make sure that we are spending our money wisely, but we must also make sure that those who need services can get them.  While the State must look at the big picture, it must also think about the children who could be impacted if there is a disruption of service or lack of service (due to the increase in paperwork and inability to find Medicaid providers to perform the service).   I will meeting with Dept. of Community Health later this week and will give you an update as to what we need to do next regarding advocacy....Keep you posted! Thanks again for everyone getting involved.    UNITED...WE WILL MAKE A DIFFERENCE! Heidi =============================================== Here is Mark Trail's announcement: Wanted to let you guys know we are going to change part of the proposed policy.  Following several discussion with yourselves, and others, we've decided not to implement the cross specialty requirement for the PA.  We will proceed as planned however with the 8 unit requirement within specialty, and will retain the current policy that the threshold applies to more than one therapist within the same specialty.  We are working on revising the banner m essage and FAQs.  Feel free to share with folks if you like.  Plain English:  a SLP could use 8 units; a PT could use 8 units; and an OT could use 8 units without requiring PA.  Hope that makes sense.  Mark Trail, Chief Medical Assistance Plans   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 10 Aug 2006 00:00:00 EDT http://www.lgtinc.org/articles/158/1/FW%3A-Unlock-the-Waiting-lists-Action-Alert Dearest Advocates:   Please see the note below. Please take a moment to send a quick email endorsing the continued funding of the 2,000 MRWP waiver slots for children and adults with disabilities.  Dave with AADD has made it very easy....Just click on the below link.   Even if your child has the Katie Beckett Waiver, we still need continue to add disability waivers (someday your child may need this waiver too!). As advocates, we need to stick together and help the cause!   Thanks, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative.   -------------- Forwarded Message: -------------- From: "Dave Blanchard" To: Subject: Unlock the Waiting lists Action Alert Date: Thu, 27 Jul 2006 13:53:23 +0000 Heidi,   I have a favor to ask you. You were one of the ones that wrote an email recently to DHR to advocate for 2,000 MRWP slots - Thank you!!!   I need you to do this again. This time to DHR's Commissioner and the Chair of their board. The Commissioner is meeting with her staff right now to develop her budget recommendations and we need this extra boost to ensure DHR stays strong in their support. As usual, I've made it just a click for you.     Go to www.unlockthewaitinglists.com/actionalert.html to make this click of advocacy. Thank you for always deciding to act, it makes a difference.   Dave Blanchard Unlock the Waiting Lists Campaign Heidi J. Moore Sat, 29 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/157/1/Urgent%3A-Advocacy-Needed.-Contact-your-Legislators-now. July 27, 2006   Dearest Advocates: We need to step up our advocacy efforts with Dept of Community Health (DCH) now as timing is VERY sensitive. Based on my latest information, DCH is still planning on implementing the prior authorizations for therapy Sept. 1st (which means therapists will need to start submitting paperwork as soon as August 1st in order for children to continue services).  OUR Legislators need to hear from US now on all the DCH proposed administrative changes, as well as, existing problems in the Medicaid system (CMO and BCW)!There have been recent reports of a $580 million surplus, so we need to ask our Legislators and the Governor.....WHY is DCH  trying to add more paperwork, when our children have already demonstrated the need for services (or we would not have qualified to begin with based on the more stringent eligibility criteria implemented in the last year)?  Due to the increase in paperwork, more and more providers are NOT accepting Medicaid. WE have to STOP the trend before it's too late .   Medicaid is not going to be worth the paper it's written on if we can't find providers for the services our children need in order to become active, productive, tax paying citizens in society. Like I said last night on FOX news, Therapy needs to be viewed as an investment in our children's future!   1. Please go to the following website (www.vote-smart.org)  and in put your 5 digit zip code plus 4 digits (you can get that information from junk mail you receive if you don't know it) to find out who your State Senator/Representative is.  Send  a quick e-mail or call them and let them know how important these issues are to you personally.   2. Also: Contact Governor Sonny Perdue Georgia.Governor@gov.state.ga.us  (He just needs to hear from us…..).  3. If you haven't already, Please take a moment and thank the reporter, Lisa Crane (lisa.crane@foxtv.com ) for taking interest in the story and also send an email to feedback5@foxtv.com . I was very impressed with the amount of depth FOX went into the story and how newsanchor Russ Spencer even endorsed how this proposal doesn't make sense to the children! THANKS to everyone that has already contacted FOX.    Also- please give FOX feedback and suggestions on other top ics they can air on in the future.  (Note: I realize that the segment that aired last night was on the prior authorizations for therapy but I also took the opportunity to give the reporter information on the CMO situation.  I know many of you also have concerns about what is happening in Babies Can't Wait and service coordinators positions. The only way they are going to know what stories to do is if they hear from US!).    We all need to get involved to help promote awareness of issues impacting children with disabilities!   I went ahead and copied my previous e-mail below to refresh your memory of the issues...............Hope this helps.   We are starting to get people's attention but need to keep up the effort.  Thanks in advance for your efforts. UNITED.... WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi ================================================== July 19, 2006   Dearest Advocates:   As many of you have been aware, there has been a lot going on recently regarding proposed therapy changes and CMO problems in this State.  A Dept. of Community Health (DCH) Board Meeting was held last week to discuss these concerns.  I want to personally thank all the families and therapists that took time out of their busy schedule to testify.  Based on responses of individuals that attended.....the DCH Board did listen to our concerns but we need to do more in order to impact change now!    PLEASE GET INVOLVED for our children's future!  Here is what I need for you to do:   Parents: 1. WE NEED YOU!  DCH needs to hear from the families that will be affected by this change!  (They just can't hear from the providers/therapists).  Eventually, Medicaid will not be worth the paper it is written on.....if we can't find providers to perform the services necessary for our children!   Please send an e-mail to the entire DCH Board by going to the following website: http://services.georgia.gov/esp/survey.do?surveyId=2330   (I recommend you type your comments in a Word document and then cut and paste into the form above. For those that don't know how to cut and paste text….All you have to do is highlight the text, push the "Control" button and "C", then go into the above form and  paste the information by pushing the  "Control" button and "V". Hope this helps. At least you can spell check your text in Word.)   Also: Please also send the same information to Dr. Rhonda Medows (rmedows@dch.state.ga.us). Dr. Medows is the Commissioner for DCH.  We need to make sure the proper people understand and act on our concerns.  If they don't know there is a problem….how can they fix it?   Here are some of the items that YOU can discuss in your e-mail: 1.      Please stress that this is just an increase in paperwork for providers/therapists with very little value.  2.      Stress that we are already going through major reviews for eligibility criteria for the programs, why do we need more paperwork?  One of the questions on the DMA-6A form is if we receive 5 therapies/week……now they are stating that if you have that….you will need prior authorizations. (Does this make sense?) 3.      If we continue to increase the paperwork, cut rates, etc, we will no longer have therapists to provide the services to our children. 4.      This is not a "cut" in therapy. It is a round about way to increase the paperwork, thus, making this more likely that therapists will not accept Medicaid children.  This is a cost savings "tactic" from DCH. DCH says this is not a cut in services………….They say if the proper paperwork is in place, your child will receive the services! 5.      Let them know that it is getting harder and harder to find providers! 6.      Parents should NOT be made responsible for keeping track of the proposed 16 units of combined therapy (PT/ST/OT).  This should NEVER be implemented and is too hard to keep track of. 7.      For CMO children: IEP's are not a reflection of the child's entire day nor what the child needs in his/her community and home environment. Many times schools are VERY limited on how much therapy they will give you in that setting (even if the child needs more). 8.      We want to understand the cost savings they are projecting to implement this new system at what expense to children/therapists/families.   Therapists: 1. See items # 1-8 above. 2. Also- if you are a therapist that is considering not accepting Medicaid due to these change (or have already decided to no longer accept Medicaid) - please state this in your e-mail. DCH needs to hear that we are reducing the number of providers in this State.....therefore, making it more difficult for families to find services that are provided by Medicaid! 3. If you are not already involved, please consider getting involved with your PT/ST/OT organization. Also consider getting involved with the Trialliance. They have been very involved in helping communicate and negotiate these issues with DCH.   Here is a summary of the 7/13/06 DCH Board meeting for your review (many thanks to Donna for giving me much of this information since I was unable to attend): 1. Prior Authorization changes: The Board definitely heard our concerns and assured us that they do not want children to have a "break" in services while they wait for a prior approval. Concerns continue with the proposed 16 units of combined therapy stating that this would be a huge burden for parents to keep track of. We need to make sure this is NOT implemented. 2. Medical Necessity: Who determines medical necessity for therapy will be an issue.  Unfortunately, we will not know how this is going to pan out until they start making decisions related to prior approvals. 3. CMO re: IEP's. Dr. Medows was surprised to hear that children were still being denied services because they should be getting these from the school. She stated that this was not to occur, although therapists received a new letter from Wellcare on Friday still requesting information regarding treatment in the schools.  4. CMO contract and payment delays DCH is aware of all of these issues. If a clean claim is not paid in 14 days, they should be paying therapist's 15% interest. 5. Savings proposed by these measures: The Board asked Mark Trail how much he was going to save by instituting this model for therapy and he couldn't say. The Trialliance had already asked him this question two months ago and he does not have a "plan" on where the 65 million dollars in cuts is going to come from. (Please note: therapy is a VERY SMALL part of the Medicaid budget and that the department should be looking at areas where there could be significant savings.)   Please take a minute to write your e-mails……UNITED….WE WILL MAKE A DIFFERENCE!   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Sat, 29 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/155/1/TONIGHT%3A-Fox-5-airs-segment-on-therapy-situation-on-10%3A00pm-news%21   July 26, 2006   Dearest Advocates:   I just wanted to let you know that our advocacy efforts are paying off....   As for as we know, Fox 5 will be airing tonight on their 10:00pm news a segment regarding the proposed therapy changes in prior approvals and other issues that will impact our children with disabilities in this State!    I hope you can see that we are continuing to get attention on this matter, as well as, the CMO situation!  Keep up your letter writing to the Dept. of Community Health's Board......It's working!   Please take a moment and thank the reporter, Lisa Crane lisa.crane@foxtv.com for taking interest in the story and also send an email to  feedback5@foxtv.com.   It takes a lot of energy and time in order to have these segments aired.  I also want to thank Betsy for being willing to go on camera to state what a lot of therapists are experiencing and continue to educate the community on the issues our providers are experiencing with Medicaid right now (as well as parents!).   Only through building awareness of the situation (and in this case: working with the media), are we going to impact change in the State of Georgia!    Thanks in advance for writing your thank you's.  Keep you posted. Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 27 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/154/1/Katie-Beckett-Waiver-Denials--DHR-FAQ-for-Transitional-Funds July 20, 2006   Dearest Advocates:   This is hot off the press...................FROM:  the Dept. of Human Resources (DHR), the frequently asked questions for the transitional funding for the Katie Beckett Waiver!  I'm VERY excited that DHR took such a positive step to actively communicate with the families that may be effected by this funding and even gave us a direct contact if questions come up!    I hope you can see that our advocating is paying off and DHR is listening and trying to make changes in their communication style.  I know we still have a long way to go, but this is a step in the right direction.   If you have any questions regarding the below information, PLEASE contact Brian Dowd at DHR. He will be able to assist you.  I was able to give the team that put this together my feedback prior to issuance.  I realize that there are going to be families that were denied from May 05- Sept. 05 that will not receive this assistance.  I was not aware of the October 05 begin date for assistance until months later. Hopefully, those families will be able to receive assistance after the Foundation is up and running.....   Hope you find this information helpful. Sincerely, Heidi ======================================================   DHR - FAQ Transitional Funding for Katie Beckett Waiver (HB 1026)   Q:  What is this transitional funding related to the Katie Becket Waiver?  A:  During the 2005-2006 Legislative Session, $7.6 million dollars were allocated to help transition children and families who were removed from the Katie Beckett Waiver as of October 2005 or after as a result of re-alignment with the federal Katie Beckett (TEFRA) eligibility criteria.     This one-time allocation of funds is intended to help families purchase some limited assistance.  Additionally, a portion of the funds is intended to provide resources for the establishment of a foundation to raise funds for assistance to families with children with disabilities.   Q:  Who is eligible to receive the funding allocated by the Legislature? A:  Any child that was receiving services from the Katie Beckett Waiver program and was denied October 2005 or after due to a Level of Care (LOC) decision.    Q:  What is Level of Care? A:  Level of care is one of the factors that determine whether a child is eligible for Katie Beckett Medicaid.  Level of care for Katie Beckett Medicaid requires that the child need institutional (level of) care, such as a nursing home, if community-based care is not available.   Q:  Who determined which children would be eligible for the transitional funding? A:  The Georgia Legislature determined who would be eligible, indicated by the language written in House Bill 1026 signed by Governor Perdue May 8, 2006. "Add funds for the Katie Beckett waiver for families who don't meet the new criteria used starting October 2005. This funding will be the sole funding for those families as they are not going to be eligible for Federal matching funds." - Georgia HB 1026   Q:  Who decided on the October 2005 date? A:  The Georgia Legislature determined the start date for eligibility in House Bill 1026 signed by Governor Perdue May 8, 2006. "Add funds for the Katie Beckett waiver for families who don't meet the new criteria used starting October 2005. This funding will be the sole funding for those families as they are not going to be eligible for Federal matching funds." - Georgia HB 1026   NOTE: To view the full text, go to http://www.legis.state.ga.us/, select "Legislation", and search for HB 1026.   Q:  How can I find out if my child is eligible to receive the assistance provided by the transitional funding? A:  All children who were removed from the Katie Beckett Waiver after October 2005 will be screened by DHR-DFCS for eligibility.  Parents will receive an option letter in the mail if their child is deemed eligible.   Q:  How can parents check on their child's eligibility for this assistance if they did not receive an option letter? A:  Parents who think they should have received an option letter and did not should contact Brian Dowd at 404-657-3592 or by email at bddowd@dhr.state.ga.us              Q: Will new applicants after October 2005 be eligible to receive the assistance? A:  No.  New applicants who were denied after October 2005 are not eligible.  Only children who had previously been receiving Katie Beckett and whose cases were closed after October 2005 are eligible.   Q:  What about those cases closed prior to October 2005? A:  Children whose cases were closed prior to 10/05 are not eligible for the transitional funding.   Q:  How will the assistance be provided to families? A:  Assistance will be provided after receipt of a signed election form that is included with the option letter indicating that the family wishes to participate and receive the transitional funding.  A card will be issued to the family that is similar to a prepaid debit card.  Instructions will be included with the card when mailed.   Q: When will families be able to use the card to access this assistance? A:  As soon as they receive the card.   Q:  How much assistance will be provided? A:  A one-time amount of $2600.00 will be allotted for each eligible child.   Q:  How much assistance will be provided if there are multiple eligible children in the same family? A:  Each child will receive $2,600, so a family that has 2 eligible children, for example, will receive a total funding of $5,200.   Q:  What about eligible children that need more than $2600? A:  The limit per eligible child is $2,600 for this one-time financial assistance.    Q:  What are the restrictions on the use of this assistance? A:  The funding can be used for any medically necessary service.  In addition, the funding can be used to purchase respite care from participating non-Medicaid providers.   Q:  What is meant by medically necessary service? A:  Specific billing instructions and guidelines will be provided with the card.  The card will be able to be used for medical supplies, pharmacies, hearing aids, optical needs, and dental needs.  It will be able to be used at hospitals, doctor's offices, and medical labs.    Q:  How is payment made to service providers that do not accept a debit card? A:  Paper claims can be submitted for medically necessary services.  Instructions for reimbursement will be mailed with the card.   Q:  Can I be reimbursed for service or equipment I've already paid for? A:  Yes.  Services are covered retroactive to 4/1/06.  So, a paper claim will need to be made with corresponding insurance explanation of benefits (EOB).   Q:  What is the present status of this funding? A:  As of July 14th 2006, 981 option letters have been mailed out to all children deemed eligible from the months of October 2005 to April 2006.  Option letters for children eligible from May 2006 will be mailed out by 7/19/06.  A computer generated report of children eligible from June 2006 is currently being produced.    Q:  Does acceptance of this funding prohibit application for Medicaid benefits? A:  Acceptance of this funding in no way prohibits an individual's right to make application for any benefits.  If the child receiving this interim assistance becomes eligible for Medicaid the interim assistance will be cancelled.   Q:  How does receipt of this assistance impact the hearing process? A:  If you are in the process of appeal and have continued your Medicaid benefits pending the appeal you are not currently eligible for the transitional funding.    If you have not continued benefits pending the appeal's outcome you will receive an option letter to participate.  If the hearing decision is in your favor and your Medicaid is reinstated, you will no longer be eligible for the funding.  If your hearing decision is not in your favor and your Medicaid is closed, you will receive an option letter, funds permitting.   Q:  I have heard that part of the transitional funding is being used to set up a foundation.  What is the status of this foundation? A:  Planning for the foundation will begin in July 2006 with an anticipated completion date in spring 2007.   Q: What is the "foundation"? A:  A condition of the transitional funding requires DHR to provide resources for the establishment of an independent, community-based foundation to administer special assistance benefits to families of children with disabilities.    Q:  Who will be involved in planning and developing the foundation? A:  The foundation development team will include families of children with disabilities, advocacy groups, Georgia legislators, as well as representatives from the Department of Community Health and DHR.   Q: Has the Community Foundation of Atlanta been selected as the home for the foundation? A:  No.  DHR has contracted with The Community Foundation to provide technical assistance to the development team.  Stakeholders on the development team will make decisions about the organizational home of the foundation.   Q: How much of the supplemental funding is being used to set up a foundation? A:  $2.4 million.  This funding will be used to capitalize the foundation and ensure its ability to administer some financial benefit to families after the interim assistance has expired.   Q:  Who will be eligible to receive assistance from the foundation once it's established? A:  The foundation, under the guidance of the development team, will establish its own eligibility requirements.   Q:  How can I apply for assistance from the foundation or get on the waiting list? A:  Currently, there is no application process or waiting list for the foundation.   Once established, the foundation will create their application process.   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 20 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/153/1/Advocacy-Needed-from-YOU%21-%3A-Therapy-Concerns-and-other-issues July 19, 2006   Dearest Advocates:   As many of you have been aware, there has been a lot going on recently regarding proposed therapy changes and CMO problems in this State.  A Dept. of Community Health (DCH) Board Meeting was held last week to discuss these concerns.  I want to personally thank all the families and therapists that took time out of their busy schedule to testify.  Based on responses of individuals that attended.....the DCH Board did listen to our concerns but we need to do more in order to impact change now!    PLEASE GET INVOLVED for our children's future!  Here is what I need for you to do:   Parents: 1. WE NEED YOU!  DCH needs to hear from the families that will be affected by this change!  (They just can't hear from the providers/therapists).  Eventually, Medicaid will not be worth the paper it is written on.....if we can't find providers to perform the services necessary for our children!   Please send an e-mail to the entire DCH Board by going to the following website: http://services.georgia.gov/esp/survey.do?surveyId=2330   (I recommend you type your comments in a Word document and then cut and paste into the form above. For those that don't know how to cut and paste text….All you have to do is highlight the text, push the "Control" button and "C", then go into the above form and  paste the information by pushing the  "Control" button and "V". Hope this helps. At least you can spell check your text in Word.)   Also: Please also send the same information to Dr. Rhonda Medows (rmedows@dch.state.ga.us). Dr. Medows is the Commissioner for DCH.  We need to make sure the proper people understand and act on our concerns.  If they don't know there is a problem….how can they fix it?   Here are some of the items that YOU can discuss in your e-mail: 1.      Please stress that this is just an increase in paperwork for providers/therapists with very little value.  2.      Stress that we are already going through major reviews for eligibility criteria for the programs, why do we need more paperwork?  One of the questions on the DMA-6A form is if we receive 5 therapies/week……now they are stating that if you have that….you will need prior authorizations. (Does this make sense?) 3.      If we continue to increase the paperwork, cut rates, etc, we will no longer have therapists to provide the services to our children. 4.      This is not a "cut" in therapy. It is a round about way to increase the paperwork, thus, making this more likely that therapists will not accept Medicaid children.  This is a cost savings "tactic" from DCH. DCH says this is not a cut in services………….They say if the proper paperwork is in place, your child will receive the services! 5.      Let them know that it is getting harder and harder to find providers! 6.      Parents should NOT be made responsible for keeping track of the proposed 16 units of combined therapy (PT/ST/OT).  This should NEVER be implemented and is too hard to keep track of. 7.      For CMO children: IEP's are not a reflection of the child's entire day nor what the child needs in his/her community and home environment. Many times schools are VERY limited on how much therapy they will give you in that setting (even if the child needs more). 8.      We want to understand the cost savings they are projecting to implement this new system at what expense to children/therapists/families.   Therapists: 1. See items # 1-8 above. 2. Also- if you are a therapist that is considering not accepting Medicaid due to these change (or have already decided to no longer accept Medicaid) - please state this in your e-mail. DCH needs to hear that we are reducing the number of providers in this State.....therefore, making it more difficult for families to find services that are provided by Medicaid! 3. If you are not already involved, please consider getting involved with your PT/ST/OT organization. Also consider getting involved with the Trialliance. They have been very involved in helping communicate and negotiate these issues with DCH.   Here is a summary of the 7/13/06 DCH Board meeting for your review (many thanks to Donna for giving me much of this information since I was unable to attend): 1. Prior Authorization changes: The Board definitely heard our concerns and assured us that they do not want children to have a "break" in services while they wait for a prior approval. Concerns continue with the proposed 16 units of combined therapy stating that this would be a huge burden for parents to keep track of. We need to make sure this is NOT implemented. 2. Medical Necessity: Who determines medical necessity for therapy will be an issue.  Unfortunately, we will not know how this is going to pan out until they start making decisions related to prior approvals. 3. CMO re: IEP's. Dr. Medows was surprised to hear that children were still being denied services because they should be getting these from the school. She stated that this was not to occur, although therapists received a new letter from Wellcare on Friday still requesting information regarding treatment in the schools.  4. CMO contract and payment delays DCH is aware of all of these issues. If a clean claim is not paid in 14 days, they should be paying therapist's 15% interest. 5. Savings proposed by these measures: The Board asked Mark Trail how much he was going to save by instituting this model for therapy and he couldn't say. The Trialliance had already asked him this question two months ago and he does not have a "plan" on where the 65 million dollars in cuts is going to come from. (Please note: therapy is a VERY SMALL part of the Medicaid budget and that the department should be looking at areas where there could be significant savings.)   Please take a minute to write your e-mails……UNITED….WE WILL MAKE A DIFFERENCE!   That's all I know for now. I will not have access to e-mail from July 20-23 (due to attending the National Down Syndrome Congress convention here in Atlanta).  PLEASE do not e-mail your questions; this is all I know right now.   Keep you posted. Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 19 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/152/1/02%7B47%7D20%7B47%7D06-AJC-Article-on-Katie-Beckett-Waiver Dearest Advocates:   AJC had another great article on front page of the Metro section today.  Please take a moment and thank the AJC reporter, Patricia Guthrie for her on-going coverage of the Katie Beckett Waiver situation (pguthrie@ajc.com).  Also take a moment to write the editor to let him know how much we appreciate the AJC's on-going coverage of this important issue (letters@ajc.com).   This type of media coverage is what we needed....... Like I said before, most of our families are hard working middle income, tax paying, voting citizens that need a little help from the State for their special needs children.  Only through educating and building awareness in the community, working with our legislators and Governor are we going to be able to make a difference in this difficult time for the Katie Beckett Waiver children/families.     Sincerely, Heidi   Here is the article: Restoration of kids' Medicaid funds up in airBy PATRICIA GUTHRIEThe Atlanta Journal-ConstitutionPublished on: 02/20/06 Lawmakers and state officials still are trying to figure out how to help special needs children dropped from a state Medicaid program. The state Senate last week included $3.6 million in the current year's state budget to help children cut from the so-called Katie Beckett Medicaid waiver program. The budget now goes to a committee of House and Senate members who will work out the differences between the two versions of the budget. But officials with the state Department of Community Health, which administers the program, said it's too soon to say how they would use the money. The department dropped hundreds of families from the program for disabled and medically fragile children after it tightened its eligibility rules in November 2004to match the federal government's. Upset parents flooded lawmakers and the governor's office with complaints, saying their children were suffering because they couldn't afford the therapy and medication that previously had been covered. The Katie Beckett waiver acts as supplemental insurance so families can care for severely ill and disabled children at home. The $38 million program once covered about 6,000 children. An estimated 1,600 have been dropped or are appealing decisions. Officials with the Department of Community Health say they are re-evaluating the eligibility rules to allow some children back into the program. "There have been some changes to the criteria in interpretation with regard to autism and cystic fibrosis," said Julie Kerlin, department spokeswoman. Eligibility requirements also changed for some children born premature. The changes don't mean that all children with those conditions are eligible, Kerlin said, because they still must meet many other requirements. Additional money from the Legislature would allow the department to help more children, but officials aren't sure how many. "We're grateful for the support, but we just have to figure out how to most efficiently use" the new funding, said Pat Nobbie of the Governor's Council on Developmental Disabilities, a federally funded advocacy group. Numerous suggestions have been made for reinstating families, but a final decision isn't expected for weeks, Nobbie said.       Find this article at: http://www.ajc.com/metro/content/metro/stories/0220metlegwaiver.html   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 18 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/151/1/Oglethorpe-Echo-Local-Newspaper-Coverage---Katie-Beckett-Waiver-Situation February 22, 2006   Dearest Advocates:   I was notified today that the local newspaper, Oglethorpe Echo had an article on the Katie Beckett Waiver situation in this week's edition and it was on the front page- main headline!  Please take a moment to thank the reporter, Jessica Harris, for her in depth coverage of the situation. Her email address is: jharris@oglethorpeecho.com.   This is the type of media coverage we need to continue to have on the issue....... Like I said before, only through educating and building awareness in the community, and working with our legislators and Governor are we going to be able to make a difference in this difficult time for disability issues in Georgia!    Hope to have the eligibility criteria very soon from DCH.   See you tomorrow at Disability Day.   Sincerely, Heidi ===================================================== Here is a copy of the article for your review: Katie Beckett program important to many   By Jessica Harris Staff Writer jharris@oglethorpeecho.com               Imagine being a person with a middle-class income having a child born with a lifelong, crippling disease or disability. Imagine that child needing treatments twice a week that cost $7,000 a piece. Imagine countless surgeries that cost as much as $250,000 each time. Now imagine only having primary insurance coverage whose lifetime maximum is met within a year or two.             That is the situation that thousands of parents in the state are facing right now. Until last year, these parents were able to receive Medicaid coverage as their secondary insurance through the Katie Beckett Waiver program, which was established in 1982. This waiver allowed parents of special needs children with permanent disabilities to receive care at home instead of being institutionalized, and receive coverage even though they make too much money to normally qualify for Medicaid.             Katie Beckett has been so important in the lives of families with special needs children because the monthly co-pays for doctor's appointments, hospital visits, and prescription medicine alone can run in the thousands. In addition, there are countless out-of-pocket expenses every month that nothing will cover, not even Medicaid.             Heidi Moore, mother of six-year-old Jacob, who has Down Syndrome, said that her son has had ten surgeries and 29 procedures in his young life, and without Katie Beckett as their secondary insurance, her family would have gone bankrupt the first year of his life. Their out-of-pocket expenses each month run over $1,000, and the surgeries and procedures are astronomical.             The problems began last year when the state realized that it was not properly enforcing the criteria for those receiving the waiver. To correct the problem, the state actually enforced the guidelines too strictly and began denying children that had been receiving Medicaid and obviously needed the coverage. Families are required to reapply and qualify for coverage every year, and there have been over 1,600 denials since May 2005.             Moore knows of countless families whose children have been denied unjustly. One particular example is a young girl that is on a feeding tube, is blind and deaf, has cerebral palsy, and is in a wheelchair among other things, and yet she was denied when her family reapplied under the newly enforced guidelines. Her family later appealed the decision and was accepted, but as Moore said, "She should not have been denied to begin with."             Now, through the work of parent groups such as Moore's Grassroots Advocacy, the state is reviewing its criteria for receiving the Katie Beckett waiver and plans to make changes to allow more children back under the coverage that they need. However, until those criteria are announced, the families have no way of knowing who will be accepted, and they will continue to struggle from day to day to provide for their children with special needs.             On January 19, over 130 parents and advocates went to the state Capitol for the Katie Beckett Waiver Public Hearing. Several parents presented their stories and information to the legislators to request changes to the current system. A little over a week ago, the State Senate passed an amendment to allow for an additional $3.6 million to the Supplemental 2006 budget for families that do not qualify for the waiver under the criteria that have been changed.             This amendment will now have to go to the House for approval, and it only applies through June 30, 2006. Although Moore said she was very excited about the news of the amendment, "there are still a multitude of issues that need to be resolved involving the eligibility criteria and those serving on the application committee. It's hard enough to raise a special needs child without having to deal with insurmountable medical bills, and this is truly a dire situation for the families affected."             Nikki Johnson-Duffell is the mother of Wright, who is four years old and was born with a chromosomal deletion. He has been receiving Medicaid through the Katie Beckett waiver since he was six months old. Duffell has already sent in Wright's application to again receiving Medicaid this year, but has yet to hear back. She said, "I am praying that his re-application will be approved. I can't imagine how we will continue to provide him the level of care he needs without Katie Beckett."             Kimberly Frey, mother of Ellie, is one of the parents in the area who has not had a good experience with the waiver. Ellie has been in the ECHO recently due to the family's need for financial support from the community. Ellie needs a kidney transplant within a year, and the Frey family has no insurance.             After nine months of applying and waiting, Frey received word that Ellie had been accepted to receive the Katie Beckett waiver. Then, Duffell called Frey to inform her that the criteria guidelines had been changed, and both their children were in danger of losing their coverage because the children are not "wheelchair-bound" and do not need a nurse at their side 24/7. Frey discovered a few weeks later that Ellie had indeed been taken off Medicaid and moved to PeachCare for Kids without any notice. Frey has since called to inquire about the waiver and why Ellie was taken off, and she has not received any information about anything.             Katie Beckett was designed to support families and children with special needs in order to build success in the future. Moore said that she and all the other advocates only ask that the state help their children achieve success by providing them with the financial help they need. She encourages all families with special needs children to contact their State Senators and Representatives and inform them of their situation.             Moore stresses that the majority of waiver families are "hardworking, middle class, taxpaying, voting citizens that never asked anything from the state until they had a child with a disability." For more information on Katie Beckett and the advocacy program, contact Moore at heidijmoore@comcast.net. --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 18 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/150/1/Katie-Beckett-Waiver---More-Media-Coverage-from-the-Echo%21 Dearest Advocates:   Today I received an e-mail from Jessica Harris-the reporter from the Oglethorpe Echo local newspaper saying this...... "I have received so many emails from parents about last week's article in the Oglethorpe Echo on Katie Beckett! I appreciated them all so much, and was so touched by the personal stories that I decided to write my weekly column this week on the response that I received from the parents, and some of the personal stories that were shared with me. I thought you might like to read it, so I attached it to this email. Thanks again for all your help!"  Jessica Harris Thank you to all the families that took the time to write a thank you to Jessica. Obliviously, we are making a difference in educating the community we live of the situation and how it is directly impacting lives.  I have received over 20 e-mails from families in that area due to this article alone wanting information on what is happening with the Katie Beckett Waiver! This once again shows us that getting the proper media attention not only helps educate the community but also helps other families that may not have our network of information available...but do now!   In addition, I should be receiving the new eligibility criteria any day now from the Dept. of Community Health....I know this is a frustrating time....  Hang in there!   Heidi ===================================================== Here is the article for your review:   Column on Katie Beckett Response   By Jessica Harris Staff Writer - Oglethorpe Echo Newspaper jharris@oglethorpeecho.com               Since I began working at the Echo last August, I have received responses to articles I've written on occasion. Usually they consist of a phone call or seeing a person face-to-face who thanks me for writing the article and getting the word out about whatever event they're having or issue they're facing.             Sometimes I even receive a negative response, although this has only happened once or twice, thankfully. These are typically unjustified and short-lived. Until recently, however, I have not received response to an article that has touched me and truly made me glad that I was able to be a part of something in some small way just by making it known to the public.             This past week, I wrote an article that appeared on the front page concerning the Katie Beckett Medicaid Waiver. Thousands of families across the state have depended on this waiver to help them care for their children with chronic, lifelong diseases that require large amounts of medication, treatments, doctor and hospital visits, and procedures. These needs add up to astronomical bills that primary insurance cannot cover.             These families had been relying on the Katie Beckett Waiver as their secondary insurance to pay for many of the medical bills incurred. Once the government began enforcing the criteria to determine who received the waiver too strictly, children began being denied left and right for coverage that they desperately needed.             The day after my article appeared in the paper, I came to work and opened my email to discover I had over thirty emails from parents of special needs children. These parents had all received an email with my article attached from Heidi Moore, who is spearheading the grassroots advocacy movement to have the criteria for Katie Beckett changed to include the children that were once receiving the coverage.             Every single email thanked me profusely for publicizing the issue and making everyone aware of the situations these parents are facing. What truly touched me about the emails, though, were the personal stories so many parents shared with me about their children. Their pride and love for their child was evident in their words, and their desire to do everything they could to insure the health of their child was palpable.        Dawn Shepherd, mother of four-year-old Garrison, said, "My husband and I have not slept through a night in four years due to our son's cerebral palsy and seizure disorder. Most families that live with the kind of physical, emotional, and financial stress that we have end up in bankruptcy or divorce even with Katie Beckett's help. We cannot push these families over the edge. They need glue to help them stay together. For us, it is God and the Katie Beckett waiver that help us get through."             Karen Beauvais of Acworth, GA agreed with Shepherd's consensus about the financial strain of a special needs child: "We have a son with Autism. Our self-pay insurance has gone up in price past our mortgage payment. Our son requires weekly therapy and thousands in out-of-pocket care for metabolic issues. If not for his Katie Beckett speech therapy he would never be talking today. Autism strikes 1 in 166 children and has been on the rise. We have literally emptied our savings to help him."             Almost all of the parents that emailed me stressed the fact that they were taxpaying, voting, middle-income citizens that were only asking the government to help them help their children have the best life they could considering their situations. Jay Ulrich, father of a ten-year-old with moderate Cerebral Palsy, said, "We did not seek to live off the government, or anyone else. My wife and I are middle class, hard workers, trying to teach our son independence now, so that society doesn't have to care for him later. But without Katie Beckett, he will not receive all the therapy he requires, the medication he needs, and the support items, without nearly bankrupting us. We work hard and didn't want to use Medicaid, but at some point we were forced to swallow our pride and do what we must."             Several parents I heard from had already received an initial letter of denial and had appealed that decision. Their appeals were under review, and they were simply waiting to hear whether they would be denied for good or would actually receive the coverage they originally had. Allison Valdes of Alpharetta has a four-year-old with Cerebral Palsy and a seizure disorder. She has appealed the first denial she received and is waiting to hear the results.             She said, "I've only asked for assistance for Reagan with his therapies that ourinsurance doesn't cover, not everything I could claim with our Katie Beckett coverage. Wedon't abuse the system and only ask for what we really need so that there will be funds for everyone that needs help. If the politicians making these decisions to cut funding for this program would come out and see first-hand how their decisions are affecting families, notjust some numbers they see on a "report," they would feel very differently about their decisions."             Chance and Ann McColl are one of the parents who have received their final denial for Katie Beckett this month. Ann said, "Our eight-year-old daughter, Faith, has Mitochondrial Disease. We are devastated that we have lost this wonderful coverage. We aren't sure what we will do when our 20 visits run out and our daughter is no longer able to receive the therapy she needs so desperately. We just can't afford the $240 per therapy three times a week on top of all her medication and hospital bills."             Another parent with a child with Cystic Fibrosis did not find out that their Medicaid coverage was canceled until they went to a pre-op appointment and were told that their Medicaid was being denied. It is blatantly obvious that something must be done within the system to make sure that these children do not "fall through the cracks" and go without the coverage they so desperately need.             Changes are currently being made to the Katie Beckett criteria that will hopefully reinstate many of the children that have been denied and make it possible for others to receive the proper care needed. Until then, all the families can do is continue writing letters, visiting legislators, praying, and waiting.   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 18 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/149/1/Katie-Beckett-Waiver-Media-Coverage-continues...... March 8, 2006   Dearest Advocates:   Today in the Gwinnett Daily Post and the Albany Herald local newspapers were articles regarding the Katie Beckett Waiver funding by reporter, Dave Williams.   Please take a moment to thank Dave at both the Gwinnett Daily Post and Albany Herald for his on-going coverage of this issue: dave.williams@albanyherald.com and dave.williams@gwinnettdailypost.com .   In addition, please take a moment and copy the following editors on your thank you's to Dave: todd.cline@gwinnettdailypost.com kayread@albanyherald.com   This is the type of media coverage we need on the issues that impact our children....... Like I said before, only through educating and building awareness in the community, working with our legislators and Governor are we going to be able to make a difference AND WE ARE MAKING A DIFFERENCE!   Happy Reading. Sincerely, Heidi   =================================================== From the Gwinnett Daily Post Newspaper:   Beckett parents winners in House budget 03/08/2006 - By Dave Williams Staff Writer dave.williams @gwinnettdailypost.com ATLANTA - Georgia families cut off from a Medicaid program for their children with severe disabilities would get their coverage restored under a budget bill the House is expected to pass today. Lawmakers are expected to set aside $7.6 million for families who have been dropped from the Katie Beckett program because of stricter eligibility requirements being enforced by the state. "We're going to take care of these families who were depending on Katie Beckett and lost it,'' Rep. Ben Harbin, R-Evans, chairman of the House Appropriations Committee, said shortly before the panel approved Gov. Sonny Perdue's $18.7 billion 2007 budget request and sent it to the full House. The committee also tacked on 3 percent pay raises for about 10,000 state public safety employees, on top of the 2 percent to 4 percent increases Perdue recommended for teachers and state workers. That means employees of the Georgia Bureau of Investigation and the departments of Corrections, Juvenile Justice, Pardons and Paroles and Public Safety would receive raises of least 5 percent. And House budget writers made a host of changes to the governor's proposals in health care spending, including funds to provide community-based services to an additional 2,000 of Georgia's elderly, mentally retarded and developmentally disabled. The Katie Beckett coverage would go to more than 1,600 Georgia kids with diseases including Down syndrome and autism whose families have lost coverage since last fall. That's when the state Department of Community Health began tightening eligibility on orders from the federal government. Several weeks ago, Senate Democrats spearheaded an amendment to the 2006 midyear budget earmarking $3.6 million to help those families get through the rest of this fiscal year, which ends on June 30. House Republican leaders put in another $4 million during subsequent negotiations with their Senate counterparts. "It's not going to cover everybody who wants to get in the program,'' Senate President Pro Tempore Eric Johnson, R-Savannah, said Tuesday. "The ones we're trying to take care of are the ones who did qualify and then the criteria changed.'' But the money would come with strings that have advocates for the Katie Beckett program concerned. The budget the House will take up today refers to the $7.6 million as "one-time'' funding. It calls for the creation of an independent foundation to handle the program in the future. Johnson said lawmakers hope the foundation will be able to "leverage'' private contributions to augment what the state provides. "The state can't afford to take on the whole Katie Beckett program,'' he said. Harbin said the "supplemental'' raises for public safety employees would let Georgia catch up with what surrounding states pay their troopers and prison guards. "We should have been embarrassed,'' he said. "We were way under everyone around us in payroll for these people.'' The additional funds the budget committee earmarked for community-based services would allow the state to serve another 500 elderly Georgians and 1,500 mentally retarded and developmentally disabled - half children and half adults. The state has been plagued for years with long waiting lists for those services. Gwinnett County also fared well in the House budget. Lawmakers kept a couple of spending items recommended by the governor and made an addition steered in part toward Gwinnett. The spending plan includes $2 million in bonds to build the Hamilton Mill branch library and $1 million in startup costs for Georgia Gwinnett College, both part of Perdue's budget request. The House even goes one-up on the governor with the library money, suggesting that it be put in the midyear budget instead of being held until fiscal 2007. House budget writers also added $500,000 for health departments in 10 fast-growing counties - including Gwinnett - that have outstripped the state's decades-old formula for public health grants. ==================================================== From the Albany Herald Newspaper: Budget request gets OK The House Appropriations Committee approved $5 million in bonds to build a nursing/health science building at Darton College. Dave Williams ATLANTA - State employees, Darton College and families with disabled children are expected to see more state taxpayer money come their way under the budget set for a vote in the state House today. Lawmakers are expected to set aside $7.6 million for families who have been dropped from the Katie Beckett program, which gives financial help to certain families with disabled children, because of stricter eligibility requirements being enforced by the state. "We're going to take care of these families who were depending on Katie Beckett and lost it," Rep. Ben Harbin, R-Evans, chairman of the House Appropriations Committee, said Tuesday before the panel approved Gov. Sonny Perdue's $18.7 billion 2007 budget request and sent it to the full House. The committee approved $5 million in bonds to build a nursing/health science building on the campus of Darton College. John Millsaps, a spokesman for the state University System Board of Regents, said the Darton building was not among 13 "minor" capital projects recommended by the governor for next year -projects costing $5 million or less. However, it was on the list of projects the system requested, he said. The 28,000-square-foot building would allow Darton to consolidate its nursing and allied health programs under one roof. It would include classrooms, labs, faculty offices and a 150-seat meeting room. The House budget panel also rejected Perdue's recommendation to zero out state funding for the Eufaula, Ala.-based Historic Chattahoochee Commission, which operates over a wide swath of western Georgia and eastern Alabama. In fact, the committee wants to double the agency's current funding to $105,000. Doug Purcell, the commission's executive director, said Alabama budget writers also are eyeing the commission favorably, agreeing to a significant increase after yanking its funding during the recent economic downturn. "We hope to be able to expand and get back to some of the things we've been doing in the past," he said. The committee also tacked on 3-percent pay raises for about 10,000 state public safety employees, on top of the 2-percent to 4-percent increases Perdue recommended for teachers and state workers. That means employees of the Georgia Bureau of Investigation and the departments of Corrections, Juvenile Justice, Pardons and Paroles and Public Safety would receive raises of least 5 percent. And House budget writers made a host of changes to the governor's proposals in health-care spending, including funds to provide community-based services to an additional 2,000 of Georgia's elderly, mentally retarded and developmentally disabled. The Katie Beckett coverage would go to more than 1,600 Georgia kids with diseases including Down syndrome and autism whose families have lost coverage since last fall. That's when the state Department of Community Health began tightening eligibility on orders from the federal government. Several weeks ago, Senate Democrats spearheaded an amendment to the 2006 midyear budget earmarking $3.6 million to help those families get through the rest of this fiscal year, which ends on June 30. House Republican leaders put in another $4 million during subsequent negotiations with their Senate counterparts. "It's not going to cover everybody who wants to get in the program," Senate President Pro Tempore Eric Johnson, R-Savannah, said Tuesday. "The ones we're trying to take care of are the ones who did qualify and then the criteria changed." But the money would come with strings that have advocates for the Katie Beckett program concerned. The budget the House will take up today refers to the $7.6 million as "one-time" funding. It calls for the creation of an independent foundation to handle the program in the future. Johnson said lawmakers hope the foundation will be able to "leverage" private contributions to augment what the state provides. "The state can't afford to take on the whole Katie Beckett program," he said. Heidi Moore of Alpharetta, a leading advocate for Katie Beckett parents, said they're worried about getting a foundation up and running. "My concern is what foundation can step up to the plate and implement this as soon as we need it," she said. Harbin said the "supplemental" raises for public safety employees would let Georgia catch up with what surrounding states pay their troopers and prison guards. "We should have been embarrassed," he said. "We were way under everyone around us in payroll for these people." The additional funds the budget committee earmarked for community-based services would allow the state to serve another 500 elderly Georgians and 1,500 mentally retarded and developmentally disabled half children and half adults. The state has been plagued for years with long waiting lists for those services. --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 18 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/148/1/Katie-Beckett-Waiver--Athens-Newspaper%3A-FRONT-PAGE%21 March 19, 2006   Dearest Advocates:   Today on the front page of the Athens Banner-Herald (including 4 pictures too!)was a FANTASTIC article on the Katie Beckett Waiver situation!  This is the type of media coverage we need to continue to have on the issues facing our families........Like I said before, only through educating and building awareness in the community, and working with our legislators and Governor are we going to be  able to make a difference in lives of children and adults with disabilities!   Please take a moment to thank the reporter, Lee Shearer, for his in depth coverage of the situation. His email address is: lee.shearer@onlineathens.com. Also, please copy the following people on your thank you's:   courtney.pomeroy@onlineathens.com - Courtney Pomeroy- Feature Editor william.stewart@onlineathens.com - Bill Stewart - News Editor   In addition, I want to personally thank the following families for allowing the media into their lives: The Kitchens, Steed and McMann families!   UNITED....WE WILL MAKE A DIFFERENCE! Sincerely, Heidi ===================================================== Here is the article: Families fight state to keep aid Georgia changing its tune on a vital Medical Care Program Having taught herself to play piano, Merrell Steed, 16, sings a song from Neil Young's "Prairie Wind" album during her nightly jam session with her father, Doss, at their home last week in Franklin County. Merrell, an accomplished pianist, suffers from autism, and her parents depend on an obscure Medicaid program to help with her care.Caleb Raynor/Staff Jack Kitchens, 6, lies on his side as sonographer Brianna Hay gives him his annual sonogram at St. Mary's Hospital recently. Jack has a rare metabolic disorder called cystinosis, in which an amino acid called cystine accumulates in cells and can lead to kidney failure.Caleb Raynor/Staff Merrell Steed, 16, does her typing excercises at Franklin County High School on Thursday. Despite a difficulty with dexterity, Merrell can type 12 words a minute, which would not have been possible without her occupational therapy.Caleb Raynor/Staff Jack Kitchens, 6, sneaks a french fry while his father, Travis, prepares the rest of the meal at their home in Athens recently. The side effects from his cystinosis causes Jack to hydrate constantly, increasing his craving for salty foods. His parents would rather him eat than rely on a feeding device that many children who are diagnosed with the disease must use.Caleb Raynor/Staff By Lee Shearer   |   lee.shearer@onlineathens.com   |   Story updated at 11:57 PM on Saturday, March 18, 2006 For years, Sharon and Doss Steed have depended on a little-known Georgia Medicaid program called the Katie Beckett waiver, designed, quite literally, to keep families together. For most of their 16-year-old daughter Merrell's life, it's helped the Franklin County couple pay for the hundreds of thousands of dollars in therapy and treatment needed by Merrell, who suffers from autism. The brain disorder severely affects the teen-ager's ability to communicate and socially interact with other people, and shows up in surprising ways. Talking is not a strong point, for example, but Merrell, a talented pianist, plays duets with her guitar-playing father and sometimes weeps when she hears Brahms. Now, thanks to recent changes in state rules, the Steeds may lose the state help that's allowed them to keep them going financially. For years, workers in the state Department of Human Resources approved the family for help from the Katie Beckett waiver, meant to help families with incomes too high to qualify for Medicaid or PeachCare, state programs which provide no- or low-cost health insurance. Though the Steeds' private insurance pays for most costs, even a 10 percent co-pay on medical costs like Merrell's is a financial burden enough to sink most family budgets. Born premature in 1989, Merrell also suffered other medical complications as a child. Medical bills in her first year of life alone amounted to $500,000, said Sharon Steed. The Katie Beckett waiver program, named for the Iowa girl whose parents convinced President Ronald Reagan to authorize Georgia's and 19 similar state programs in 1982, gives financial help up through the age of 18 when a child's disabilities are severe enough to warrant long-term institutional or skilled nursing care. It's called a waiver because normal federal rules for how Medicaid money can be spent were waived -with federal approval - to create it. Funded partly by state and partly by federal dollars, it's available to help families who want to keep their children at home - though the rules say parents must demonstrate that the cost of keeping their child at home is less than the cost of institutionalization. Two years ago, the state of Georgia changed the rules, however, saying many children whose families were getting the help did not have disabilities severe enough to qualify. Of about 6,000 families getting aid, by January about 1,600 had been denied continuing coverage in the program, which requires annual renewal, said Heidi Moore, an Alpharetta woman who has become an advocate for the thousands of families who depend on the Katie Beckett waiver. The Steeds are one of those families denied. They appealed their first denial, but their appeal also was denied. Now, they're moving toward a formal appeal hearing, which could be costly: Under state rules, the family can be required to pay for all treatments between the second denial and the hearing decision, if it goes against the Steeds. "They want to know why the parents are upset," said another mother whose application for renewal was denied last year, Melissa McMann of Winder. "Your kid depends on this to stay alive." Fighting back State officials last year notified McMann and her husband, Chris, that their son J.C.'s disability, cystic fibrosis, was not severe enough to stay in the program, a ruling that astounds Melissa McMann still, even after her appeals got the decision reversed. She appealed not just to the private company that makes eligibility decisions under contract to the state, but repeatedly called and e-mailed U.S. Sen Johnny Isakson, R-Ga., and other elected officials.. McMann's son relies on the Katie Beckett waiver to pay for such things as transportation to the doctor. McMann is visually impaired and can't drive J.C., and it would be too costly for the family if Chris McMann had to leave work as frequently as J.C. must go to doctors, she said. Like many Katie Beckett waiver recipients, what the McMann family gets isn't a lot, about $8,000 last year, she said. But they're far from rich, and that $8,000 means a lot, she said. "It's critical for him," McMann said. One of the effects of cystic fibrosis is that J.C. produces thick mucous, instead of the thinner substance most people's bodies produce in their lungs and stomach. It's a chronic infection, and can turn something that would be an annoyance for many children into a life-threatening condition. "In his case, a cold turns into pneumonia, which lands us in the hospital," McMann said. Before the family found out about the Katie Beckett waiver, they couldn't afford to pay for adequate treatment for their son, McMann said. "We skimped on doctor visits. We took him only when he was sick," she said. McMann has become a "reluctant activist" after her family's experience, not just because of the denial, but because of the annual time-consuming red-tape ordeal of reapplying and getting the same letters from doctors and compiling other documentation. This year, the family received a letter saying their renewal application would be due barely a month after their appeal was granted. "The whole thing is insane. There's nothing that makes sense about any of it," McMann said. "The state wants to make it seem like these kids are not seriously ill. The state is sort of making it seem like it's not a big deal." Off, then on again Travis and Bette Kitchens of Athens have just gone through almost the same experience as the McManns: Denial, then reinstatement, for their son, Jack. The 6-year-old has a rare metabolic disorder called cystinosis, in which an amino acid called cystine accumulates in cells and can lead to kidney failure. Jack has to take medicines at precise intervals seven times a day, and checkups can involve long airplane trips, since so few doctors know much about the rare disorder. Like the other families, the Kitchens' own health insurance pays for most medical expenses, but even the small percent the insurance doesn't cover amounts to big money for the family, so the Katie Beckett waiver is important to them. "It's the greatest thing for us and for a lot of families. Without it I don't know how we'd get by," said Travis Kitchens, a computer programmer at the University of Georgia's Georgia Center for Continuing Education. Help is on the way for at least some of the families the state has kicked off the program, thanks perhaps in part to the activism of people like Moore - the advocate - and McMann. The legislature kicked in $3.6 million to help this year, adding extra funding to take in families who'd been kicked off but not reinstated. But some may have given up by now, Moore said. "It certainly has been more of a bureaucratic nightmare than it should have been," said state Rep. Mickey Channell, D-Greensboro, one of the legislature's top experts on health care. Cuts went too far Channell, one of the principal authors of the PeachCare program that provides insurance coverage for children whose parents have no insurance, said state administrators went too far in tightening eligibility requirements for the Katie Beckett waiver. "I don't mean it was overzealous enforcement of the rules," Channell said. "We just think in some ways the department was incorrect." The state also has relaxed some of the eligibility requirements, though Moore says she's still worried the new rules will keep out children who need and deserve help from the program. Keeping funding up for the program has been a struggle for the past several years, says Moore, whose family receives help from the Katie Beckett waiver because of her 6-year-old son's Down syndrome. And though Moore believes Americans are coming to believe disabled people "should and can play a bigger part in our communities, and do have something to give," the struggles over funding are likely to continue in the future, she conceded. "It all comes back down to money and numbers. It's a numbers game. I think they thought they'd be able to implement this and parents wouldn't fight back. But we did," she said. The money question won't go away, Channell said. "There are always more needs, I mean meritorious needs, than money to pay for them," especially as health care consumes more and more of the state budget, he said "The health care budget has been steadily increasing, not only in real dollars but as a percent of the budget as well," he said. "To some degree, that's of necessity at the expense of certain other things. If one goes up, naturally something else goes down." Published in the Athens Banner-Herald on 031906     --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 18 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/147/1/Katie-Beckett---Johns-Creek-Herald-Newspaper---Front-Page%21 March 29, 2006   Dearest Advocates:   Today in the Johns Creek Herald  newspaper was an article regarding the Katie Beckett Waiver situation by reporter, Rosemary Taylor. When I first talked to Rosemary a few weeks ago, I just wanted to give her a quote for how supportive Senator Dan Moody has been to our children. Well, after a detailed phone conversation, she decided to write an entire article about the advocacy efforts that we ALL have been involved in the last few years..........You never know how speaking up and talking to others about our situation helps our children!    Please take a moment to thank Rosemary at the Johns Creek Herald newspaper for her coverage of this issue:  rosemary.taylor@northfulton.com .   In addition, please take a moment and copy the managing editor on your thank you's to Rosemary: hhurd@northfulton.com (Hatcher Hurd) and also send a quick thank you to Senator Dan Moody - danmoody@bellsouth.net for his on-going support for our children down at the Capitol! We all need more legislators like him!   This is the type of media coverage we need on the issues that impact our children....... Like I said before, only through educating and building awareness in the community, working with our legislators and Governor are we going to be able to make a difference. UNITED....WE WILL MAKE A DIFFERENCE!     Happy Reading. Sincerely, Heidi   ====================================================== JOHNS CREEK HERALD Alpharetta mom fights for disabled childrenMoody, legislators increase state Medicaid funding by Rosemary Taylor write the author March 23, 2006 When Heidi Moore - the mother of a 6-year-old son with Down Syndrome - realized in the fall of 2003 that Georgia's Katie Beckett Medicaid program was in jeopardy, she naturally did what she's always done. She took charge."The simple truth is the majority of our families are hardworking, tax-paying, voting citizens that happen to have a child with a disability. We just need help," said Moore.So the Alpharetta mother organized a grass roots movement - Save Our Special Kids (SOS Kids) - to bring awareness to Katie Beckett that led to state legislators giving it additional money earlier this month and potentially reinstating the 1,700 children who had been dropped from the program since new eligibility requirements were established in 2004."I'm very grateful for our legislators, particularly Sen. Dan Moody, who's been so supportive of us, that they've taken this step to help these children. But making sure that Katie Beckett continues each year is something we're all going to have keep working on," said Moore.Katie BeckettNamed after a severely disabled Iowa girl, whose mother campaigned to take care of her at home, instead of at a costly hospital, the Katie Beckett category of the Medicaid program was signed into law by Ronald Reagan in 1982.It is designed to support families of special needs children who otherwise do not qualify for Medicaid funds based on their family income. Its purpose is twofold: to let the child stay in the home, and also to cut down on the total medical costs borne by Medicaid.Supporters say the funding is needed because even families with a comfortable income can be bankrupted by soaring medical costs associated with caring for a severely disabled child."Without this program these parents would be adversely affected by the enormous medical expenses to care for their child. My husband and I would be bankrupt now without Katie Beckett," said Moore.Today, 22 states offer the program, about a third of which is state-funded and the rest by the federal government. Georgia's Katie Beckett represents less than 1 percent of the state's entire $6.7 billion Medicaid budget.1,700 kids droppedPrior to November 2004, Georgia's program supported 6,500 special needs children, says Mark Trail, Chief of Medical Assistance Plans for the state's Community Health Department (CHD).But that month, Trail says, the state established new eligibility requirements. Parents were sent letters alerting them to the possibility their child would be cut, and ultimately 1,700 families got the dreaded news. Since then, many have appealed the decision and now, thanks to Moore's efforts, their chances have greatly improved.Budget amended, foundation establishedOver the last three years Moore's SOS Kids - now 1,600 people strong - has held rallied on the steps of the State Capitol, launched E-mail and letter campaigns and spoken at every event and service organization meeting they could to bring awareness to Katie Beckett.Their efforts led the Georgia Assembly- prodded by North Fulton delegation members state Sen. Dan Moody, R-N. Fulton, state Rep. Jan Jones, R-Alpharetta, and state Sen. David Shafer, R- Duluth, - to amend the 2006 budget March 8 to include an additional $7.6 million for the Katie Beckett program."Everybody wants to help but its knowing how to within the federal guidelines and the state provisions. It's all about educating the members of the Georgia Assembly on how to do this. Heidi and her advocates are not only catching people up to speed but they're improving that knowledge base," said Moody.The Assembly also directed the CHD to revise the eligibility requirements and proposed establishing a foundation to assure funding for the program. Details of that are still to be worked out, but meanwhile, the parents of the 1,700 children dropped from the program are still waiting to hear if their children will be picked up again.Sen. Moody says he'll continue to fight for these children and their families."As far as I'm concerned, these are the people we should help first," he said. This article can be found by going to: http://www.northfulton.com/ --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Tue, 18 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/144/1/URGENT%3A-Advocacy-Needed---DCH-Board-Meeting-July-13%2C-2006 July 12, 2006   Dearest Advocates: (PLEASE NOTE: May want to print out this long e-mail)   It has been brought to my attention that the Dept of Community Health (DCH) is going to have a board meeting TOMORROW, July 13th in Blue Ridge, GA where we can express our concerns!  (Please note: This is a change of location....The meeting will NOT be at the Twin Towers/Sloppy Floyd Building downtown Atlanta)   If you are a parent or provider/therapist that would be impacted by the proposed prior authorization system DCH is looking to implement in September or if you are having problems getting therapy due to being in a CMO (that is not the case for children that have the disability waivers including Katie Beckett Waiver).....we need you!    Please try to attend to express your concerns as parents and therapists!  Many of you have asked....how can I help....Well NOW is your chance. I realize that it is not a convenient location but DCH needs to hear from both parents and providers/therapists concerns.   Here are some quick suggestions if you can attend:   1. Make your speech short and to the point (2-3 minutes). You can type out your entire speech and read it, if you feel more comfortable doing it that way.   2. Prepare a one page summary of your concerns to be handed out to the committee and media.  (For parents: include a picture of your child...puts a face to the situation!).   3.  Sign up to speak when you arrive.   4. Please contact Deborah Bevelle at (404) 656-4507 or dbevelle@dch.state.ga.us if you have questions or want additional information about this meeting.   5. General Information: The Thursday, July 13, 2006 Board of Community Health meeting  will be held at 12:00 noon in the Community Room, Appalachian Community Bank, 150 Orvin Lance Connector, Blue Ridge, Georgia 30513.    6. Here are directions: DIRECTIONS TO APPALACHIAN COMMUNITY BANK Community Room 150 Orvin Lance Connector Blue Ridge, GA 30513 (706) 258-4000   From Atlanta:                                                                                    Distance (approx.) I-75 to I-575                                                                  20.4 miles   I-575 becomes Highway 515 around Jasper             70.5 miles   You will travel through Cherokee, Pickens and Gilmer Counties.   Blue Ridge is in Fannin County.   Once arriving in Blue Ridge, go through several intersections.    Landmarks:   -The first intersection is June Walker on right. -McDonalds is on the left of second intersection. -Wendy's is on the right of third intersection.   After passing KFC on the right, you will start down hill.  When you start going uphill you will see the bank on the right.  It's a large red brick building.  You will come to a red light and CVS will be on the right and Taco Bell on the left.  Take a right on Orvin Lance Connector.   The Appalachian Community Bank (Community Room) is your second right next to CVS.    Distance:  Approximately 92.88 miles   Drive Time:  Approximately 1 hour, 36 minutes ====================================================== Here is a summary of the situation based on my previous advocacy alerts in the last few weeks...It has been brought to my attention that Dept.of Community Health (DCH) continues to look for ways to reduce their costs (but not necessarily looking at the children's needs, nor the effects on our Medicaid providers).   Recently, DCH announced plans to: implement a "gatekeeper" model for the Aged, Blind and Disabled (ABD) children.  The Trialliance (the OT/ST/PT association that are working together to deal with these issues as they come up)  met with DCH this week. DCH plans to change the "threshold" of visits for the ABD group of children to a total of 5 units per month for a "single" therapy service. This means each discipline (ST, OT, PT) will be able to bill a total of 5 units each month (currently it is a max of 10 for non-timed codes and 20 for timed codes). If the therapist feels the children need more therapy they can submit a "prior approval" (same process as is in place currently) which will be reviewed by Georgia Medical Care Foundation (GMCF).  This would mean that a child will only be allowed approx. 1 PT and OT session / month! and only 2+ ST sessions / month!  This is not acceptable! Our families have already been put thru enough due to difficulties with the eligibility criteria, if a child is approved we should not have to fight another battle of Medical Necessity for therapy.   It is my understanding that PT and OT are billed as 1 unit = 15 minutes. Therefore 4 units = 1 hour (this is how I came up with approx. being allowed only 1 hour of PT/OT per month without a prior approval).    The speech coding is more complex: For 92507 speech code, 1 unit =1 visit.  For speech you can bill 3 units if you  are doing speech, feeding and SI (sensory integration) so then you would only have 1 visit  just like PT and OT.  The 92507(speech) and the 92526(feeding) codes  are just allowed 1 unit=1 session(that is why our rate was cut in  half...it used to be 1 unit=30 minutes so you could bill 2 units of  92507...no more).  The SI code is timed and 1 unit = 15 minutes.  To  summarize, speech is all over the board.  If you are just seeing a  child for speech, you could get 5 sessions.  If you bill speech and  feeding, 2 sessions, speech and feeding and SI would be 1 session. ST is billed at 1 unit = 30 minutes. Therefore 2 units = 1 hour (therefore you would approx be allowed only 2 hours of ST per month without a prior approval).   DCH said this review would be approved based on "medical necessity" guidelines. DCH also attempted to further limit children who had multiple therapies, however the Trialliance discussed the major problems with this and they said they would  reconsider this limitation. The time frame for this implementation  is September 1, 2006. (originally DCH had proposed a August 1st implementation)   These proposed therapy requirements will impact both private and hospital therapy for our children. DCH plans on rolling out the changes Sept.1st for private and sometime later this fall for hospital. This will not impact school therapy.   The Trialliance discussed details of how to make the transition easier and specifically informed DCH staff that they were vehemently opposed to this stringent of a program. (AND I CONCUR!)  The bigger issue is that this is unacceptable and something must be done for the therapists and our children! More and more Medicaid providers are not going to accept our children due to the paperwork involved in getting paid by Medicaid.  We already have our Pediatricians write the prescriptions for service, therapists submit their progress notes to DCH....WHY do we need another step in the process with paperwork?  (especially since one of the items DCH looks for in our application progress for the Katie Beckett Waiver program is if the child has 5 therapy's/week on the DFCS DMA-6A form!)   I'm sorry...but I will not be able to attend due to prior commitments.  PLEASE show your support. I hope you find this information helpful.....   UNITED....WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 12 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/142/1/Katie-Beckett-Waiver---Debit-Card-Information July 2, 2006   Dearest Advocates:   I contacted DFCS (Brian Dowd) and asked him this question:   If a family fills out the form to receive a debit card does this mean that they can not reapply at a future date for Katie Beckett Waiver or any other Medicaid services?    This is the response I got back from DFCS:  "No, it does not mean they cannot reapply.  However, they cannot be eligible for Medicaid and receive the transitional help.(if you are active for Medicaid you are not in transition)  The debit card holds no restrictions to applying or receiving Medicaid.  However, if someone has a card and becomes eligible for Medicaid their card would become inactive or turned off."   For families that have been denied the Katie Beckett Waiver and have questions regarding the opportunity to receive the debit card in the amount of $2,600........................Please contact Brian Dowd. His email address is bddowd@dhr.ga.gov or phone: 404-657-3592.  I am impressed that they have dedicated one person to handling this issue for families.   I hope you find this information helpful.  I received a number of emails on this issue alone this weekend.  Thanks, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 05 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/141/1/July-06---Important-Advocacy-Updates July 1, 2006   Dearest Advocates:   I have a long update based on a few meetings I had with  DCH and DFCS last week....I hope you find this information helpful.(You may want to print this e-mail based on the length of this document)   DFCS Update- Regarding $7.6 million for families being denied the Katie Beckett Waiver:   + Families that were denied the Katie Beckett Waiver from October 05- May 06 will be receiving a letter from DFCS (anyday now) explaining that they may be eligible for a one time prepaid debit card in the amount of $2,600.    +Families who choose to participate in this opportunity will need to fill out a VERY simple one page form and send back to DFCS. The money will be self directed (therefore families can use the funds to pay for physician's visits, therapy costs, durable medical equipment, respite, etc).  The card will be valid from the date you receive it until March 31, 2007.    + It is my understanding that approx. 700 families will fit into that timeframe of denial and will receive a letter from DFCS.   + The Legislature determined who would be eligible for this funding based on denial  after October 05 due to a Level of Care decision.  You can find the specific legislative language on the website at www.legis.state.ga.us. (then choose "legislation", then type HB "1026" and hit "retrieve".  You can read it in PDF format. (I don't understand why October 2005 was chosen and will see what we can do to help/advocate for those families that were denied prior to 10/05 and families that were denied based on their first application to the program)   + Plans for the establishment of a Foundation are underway at this time.  I should have more information regarding the Foundation by mid July.  There is hope that parents will be involved in the Foundation as well.   + If you have specific short questions that need answered regarding this process, please e-mail me by July 9th.  I have another meeting scheduled for mid-July as a follow-up with DFCS. PLEASE keep your emails short. (I receive between 75-200 emails per day right now and can not answer everyone directly. That's why I use this distribution to get the information out to everyone!)   + I also want to express my thanks to the DFCS dept for wanting to make this process as easy as possible for parents. I know we have all had frustration with the communication in DFCS BUT I must say I'm VERY impressed with how they are handling this specific issue.  I met with DFCS in early May to discuss all your concerns (that you had emailed me regarding communication, process, training, etc). and it's working. I realize we have along way to go but it's progress!  Many thanks to DFCS for listening and acting on our concerns! (DCFS even has in their cover letter to parents a "live" contact person families can call regarding questions to this specific process!!!!!!) =====================================================   Meeting with Dept of Community Health (DCH) this week.   If you remember correctly, I requested from you guys a list of concerns that families/providers have regarding the process in the disability waiver system.    Based on input from over 200+ families, there are three primary areas of concern: Communication, Training and Process Issues.  I had a meeting on Wednesday with DCH to discuss this document. I also met with DFCS in May regarding many of the same issues that need to be addressed in their office as well. I wanted to make sure that DCH and DFCS were aware of all the issues and concerns with all the departments in Georgia.  Many of the suggestions would take very little time or money but would have great dividends to everyone involved. The goal is to maximize our resources to better service children with disabilities in the State of Georgia.  The document that I presented to DCH and DFCS is 6 pages long and took hours to put together based on everyone's input.   In addition to talking to DCH about maximizing our state resources to better serve children with disabilities, I also discussed the following items:   1. Many doctors and therapists are NOT accepting Medicaid due to the paperwork involved, timing of payment, etc.  We need to streamline the process so families have more access to more providers, not less. (It is already hard enough to find providers that accept Medicaid now!).   2.  Parents have concerns with the implementation of the "Gatekeeper" model for therapy services under CIS.  Most children that need Medicaid due to a disability need more therapy than once a month.  The proposed 5 units per discipline or need to get a prior approval is just adding MORE paperwork to the system.  Parents are AGAINST the implementation of this model without having more input into the impacts to the system and lack of services for children.  More and more providers are not accepting Medicaid due to the increase in paperwork now!  (Most children with disabilities that have the Medicaid waivers, need therapy more than 1-2 visits/ month.  Therefore, most children will require a prior approval. What value does this add to the service? There is a reason why children with disabilities have the waiver to begin with…..Why make everyone go through another non-value added process?)   (DCH response was that they are working with the Trialliance (OT/ST/PT organization) to further discuss this issue with them.  Now they are saying that DCH is proposing 8 units per discipline and 16 dual units with a possible implementation of September 06. I still feel that is not fair. See previous emails for reasons why.  Also they did confirm that this will not only impact Aged Blind and Disabled populations but also all "fee-service services under Medicaid".  This does include hospitals as well.  Another concern we discussed was who was going to be "qualified" to review these requests.  DCH stated that the medical review team will comprise of nurses, pediatricians and therapists.  There will be an appeal process.  The issue of "Medically Necessary" is going to be the real issue with this one.) Please hold tight and I'll keep you posted on what we need to do with this one......The Trialliance is taking the lead on advocating this issue.    3. Children are still being denied the Katie Beckett Waiver, even though they should not. Therefore, more paperwork, hearings, costs, etc.    (DCH stated that they want to know about those cases that are obvious and should never have been denied based on the paperwork submitted. I do think it has gotten better but still needs improvement).   4. Lack of approval and providers for families needing therapy for their children under the new CMO program for Medicaid.   (DCH stated they are working on this issue. If a provider has submitted to the CMO to become a provider and has had problems let DCH know about this directly ).   5. Status of the $7.6 million for families that have been denied the Katie Beckett Waiver and the process for families to seek reimbursement for services.   (See above for an update based on discussions with DCH and DFCS).   I realize this is a very long email that you might want to print out.......I just wanted to make sure you know everything I know at this point in time.  I don't know anything else....so therefore, PLEASE DO NOT start sending me tons of e-mails right now.  I'm trying to help as much as I can, but I have a child with a disability too that needs my help too.  I can only handle so many e-mails a day. Please be patient and hopefully I've answered the majority of your questions.   Have a great summer. Will keep you posted as I know more....... Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 05 Jul 2006 00:00:00 EDT http://www.lgtinc.org/articles/138/1/Extreme-Makeover-tackles-disabilities Entry for May 26, 2006 - `Extreme Makeover' tackles disabilities `Extreme Makeover' tackles disabilities Home of family with deaf, blind members gets high-tech gadgetry MARTHA MCKAY Knight Ridder/Tribune BERGENFIELD, N.J. - Most everything about the ABC reality show "Extreme Makeover: Home Edition" is spectacle, and the TV show's encampment in Bergenfield is no exception. Roads are closed, corporate sponsors have hospitality tents, celebrities show up and neighbors gawk at the small army of blue-shirted contractors turning one disadvantaged family's modest house into a well-designed home. On Monday, scores of companies donating gadgetry and computer systems for the family arrived to display their wares half a block from the house. The Llanes family includes a blind father, a mother with cancer, a blind grandmother, two daughters who are going blind and a deaf son. Along with demolishing and rebuilding the home's interior, the companies will pack the home with $100,000 worth of the latest technology designed to help people with vision and hearing problems. "This house will have every piece of technology in it that we know exists on the planet Earth to help a family with disabilities," said Brian Stolar, president and CEO of developer Pinnacle, which is handling the 24-hour-a-day building effort. The array of high-tech assistance that the Llanes family will find on its return includes everything from the NoteTeller 2, a gadget that lets a blind person distinguish denominations of paper money up to $100, to the PVO, a 4-inch portable color magnifier that enlarges an image from six to 12 times. Microsoft donated gadgets including alarm clocks that vibrate and smoke detectors that use strobe lights along with sound to alert people of a fire. The house will have the latest solar panels from BP Solar and the latest home-control software from Home Automated Living of Maryland. A member of the Llanes family will be able to speak into a phone or microphone and tell the system, for example, to turn out the lights or raise the thermostat. Victor Llanes, the blind father, will be able to communicate with his deaf son, Zeb, 16, using a software program called iCommunicator, which converts text to sign language. Family members will receive Blackberry handheld devices from GoAmerica that will allow them to type a message to an operator, and then place a phone call. People who can hear "take cell phones for granted," said GoAmerica sales manager Christina Harper. The family also will receive high-speed Internet access from Verizon, computers from HP and a Braille printer that punches raised dots on paper. They'll receive a small black gadget with a laser that can tell a person with vision problems the color of their clothes. And a global positioning system that can tell them what street they are walking down. The show airs on ABC this summer. No date has been set. Alan Weinrib Sun, 25 Jun 2006 00:00:00 EDT http://www.lgtinc.org/articles/135/1/People-First-Language May 29, 2006   Dearest Advocates:   It's been brought to my attention that there is a fantastic handout that I think everyone should read regarding how parents/providers/friends/family talk and write about our children with disabilities.     Kathie Snow has put together a wonderful 4 page handout that helps us understand how powerful our words are and how we can help educate the community we live through proper language........   To print out a copy of her handout and educate yourself of the importance of proper language, please go to the following website:   http://ftp.disabilityisnatural.com/documents/PFL0905.pdf   In addition, when I contacted her a few days ago regarding utilizing her handout at one my upcoming presentations, she informed me about her son, Benjamin.   Benjamin recently entered the Film Your Issue competition---an opportunity for 18-26 year-olds to share their passion in a 30 to 60 second film. He wrote, performed in, and directed THUMBS DOWN TO PITY---about the need for films and TV to move beyond the "pity portrayals" of people with disabilities....and his film has made it to the SEMI-FINALS! Now, the general public has a chance to vote on the 35 semifinalists.....Ifyou have a moment, please visit http://www.msnbc.msn.com/id/12721177 ....and if you agree Benjamin's message is an important one, please cast yourvote for THUMBS DOWN TO PITY! The voting ends on June 7th.   Society needs to recognize the impact of their words for individuals with disabilities and as parents, providers and friends....WE need to help continue to help others understand the need for proper language and respect for our children.   I know personally, I don't like it when people refer to my son as having "Downs". This is very degrading and I try to understand that they don't understand but I also take the opportunity to help educate everyone that has contact with my son that he is a person first that happens to have a disability- Down syndrome!  He has touched more lives in his short 6 yrs than most of us will in a life time.  As you can tell, I'm very proud of my little boy and all of his abilities!   Hope you find this information helpful. Have a great Memorial day weekend. Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 23 Jun 2006 00:00:00 EDT http://www.lgtinc.org/articles/133/1/Possible-Changes-to-Therapy-Requirements-for-our-Children June 23, 2006   Dearest Advocates:   It has been brought to my attention that Dept.of Community Health (DCH) continues to look for ways to reduce their costs (but not necessarily looking at the children's needs, nor the effects on our Medicaid providers).   Recently, DCH announced plans to: implement a "gatekeeper" model for the Aged, Blind and Disabled (ABD) children.  The Trialliance (the OT/ST/PT association that are working together to deal with these issues as they come up)  met with DCH this week. DCH plans to change the "threshold" of visits for the ABD group of children to a total of 5 units per month for a "single" therapy service. This means each discipline (ST, OT, PT) will be able to bill a total of 5 units each month (currently it is a max of 10 for non-timed codes and 20 for timed codes). If the therapist feels the children need more therapy they can submit a "prior approval" (same process as is in place currently) which will be reviewed by Georgia Medical Care Foundation (GMCF).  This would mean that a child will only be allowed approx. 1 PT and OT session / month! and only 2+ ST sessions / month!  This is not acceptable! Our families have already been put thr ough enough due to difficulties with the eligibility criteria, if a child is approved we should not have to fight another battle of Medical Necessity for therapy.   DCH said this review would be approved based on "medical necessity" guidelines. DCH also attempted to further limit children who had multiple therapies, however the Trialliance discussed the major problems with this and they said they would  reconsider this limitation. The time frame for this implementation  is August 1, 2006.   The Trialliance discussed details of how to make the transition easier and specifically informed DCH staff that they were vehemently opposed to this stringent of a program. (AND I CONCUR!)  The Trialliance is preparing a "position paper" early next week.  Depending on how DCH responds, we will need to get your involvement into the situation.   What do you need to do right now....:   Therapists: I strongly recommend you contact your association to see what you can do to help the Trialliance group. In addition, the increased rate for the speech therapy code 92507 is planned to go into effect as of January 1, 2007.   Parents: I will keep you posted on what we can do to help this situation. I want to remind you that if we continue to loose providers due to impossible and unnecessary paperwork.....we will not have providers to conduct the services our children need in the future. We have to stick together on this issue and protect the providers that help our children develop into their true potential.   That's all I know for now.....Will keep you posted. Sincerely, Heidi   P.S. I have not heard any updates on what the status is on the $7.8 million for families that have been denied the Katie Beckett Waiver. I hope to have additional information next week when I meet with DCH for everyone. --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 23 Jun 2006 00:00:00 EDT http://www.lgtinc.org/articles/125/1/Medicaid-Clarification-on-the-New-CMO%26%2339%3Bs May 8, 2006   Dearest Advocates:   Recently it was brought to my attention that there is a lot of confusion out there regarding the new Care Management Organization (CMO) that impacts children on Peachcare for Kids, Right from the Start Medicaid, and strict Medicaid (based on the families income)... Also called the "Georgia Healthy Family program". Only those Medicaid populations will need to pick a CMO provider (with the Atlanta Metro region scheduled for June 1, 2006).    Children that currently receive Medicaid via various waivers (example: Katie Beckett / Deeming Waiver, MRWP waivers, etc) ARE NOT  INCLUDED in this program which means YOU WILL NOT HAVE TO PICK A CMO PROVIDER.   I hope this helps families, as well as providers in understanding that there are different Medicaid populations that receive Medicaid differently.  Some Medicaid populations will have a CMO provider, while others will not.  The good news is those that will be under the new CMO program will be issued a new Medicaid card so providers will be able to tell the difference.   For more information about CMO"S, please go to the following website: http://dch.georgia.gov/00/channel_title/0,2094,31446711_42144860,00.html   Below is the e-mail I sent to Mark Trail (Director of Medicaid for Georgia) and his actual response for your review.   Hope this information helps you better understand what is going on..... Sincerely, Heidi============================================== Dear Mark:I need your clarification on an important issue ASAP.  It has recently been brought to my attention a number of Medicaid providers (doctors, therapists, etc) are very confused by the Georgia Healthy Family program.It is my understanding that those children that receive their Medicaid coverage from strict Medicaid (based on the families income) or Peachcare for Kids will need to enroll in the Care Management Organization (CMO) by June 1,2006 in the Atlanta Metro area.  Children that receive Medicaid from other ways (including Katie Beckett Waiver, MRWP waiver, etc) will NOT be in the CMO program.If you confirm which Medicaid groups are not included in the CMO program, I would appreciate it. Many providers are right now deciding NOT to accept Medicaid at all based on the fact that they think ALL MEDICAID clients will need to be enrolled in a CMO, which is NOT true.My suggestio n to DCH is.......1. That you issue out a memo to the provider network explaining this. Based on your website (it can be confusing). http://dch.georgia.gov/00/channel_title/0,2094,31446711_47494849,00.html2.  That new Medicaid cards be issued for CMO Medicaid participates so families and providers can tell the difference and the Medicaid computer system that the providers use show the difference of each child if a CMO or not so there is not confusion.Please clarify. Many providers are making decisions based on misinformation.Call me if you would like to discuss further.Thanks in advance for your help in this matter.Sincerely, Heidi=========================================== This is the response I received from Mark Trail (Director of Medicaid):   "You are correct about the groups in and out of managed care. The members will receive cards from the CMOs later this month. They will be unique to each plan. We typically communicate with providers thru banner messages, more are planned. "   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 08 May 2006 00:00:00 EDT http://www.lgtinc.org/articles/122/1/Advocacy-Updates%3A-KB-Waiver-Criteria-Changes%2C-ASO-and-Therapy-Updates April 27, 2006   Dearest Advocates:    I have a couple of  advocacy updates for everyone. ==================================================== 1. Effective 4/25/06, the Skilled Nursing and ICF-MR Level of Care has been changed to determine eligibility for the Katie Beckett Waiver. (FYI: These changes due effect children with Spina Bifida.)   To see all three Level of Care criteria, please go to the following website: http://dch.georgia.gov/00/channel_title/0,2094,31446711_31946814,00.html ====================================================== 2. I wanted to clarify the HMO managed healthcare situation (also called the Georgia Healthy Families program).......  Peachcare and children that are on Medicaid (based on family income) will need to enroll in a HMO managed healthcare program that is projected to begin June 1st.  At this time the the Aged, Blind and Disabled populations of Medicaid (which would include waivers such as the Katie Beckett and MRWP) are NOT included in this new program.   For more information regarding this program, please look at the following article that was in today's AJC newspaper entitled "Medicaid to make major shift in statePoor, kids in PeachCare to be moved into HMOs":   http://www.ajc.com/metro/content/metro/stories/0427medicaid.html ====================================================== 3. In addition, DCH is looking to institute a "Gatekeeper" or Administrative Service Organization (ASO) to address the utilization of people in the Aged, Blind and Disabled (ABD) programs under their direction. This would impact EVERYONE.  DCH also plans to apply a "preauthorization" program for therapies as well by July 1st.   Meaning they will ask therapists to submit notes etc. which they will review and determine how many treatment sessions each child will need.   One major concern is that DCH is looking at ways to decrease the amount of therapy our children receive. As you can imagine, we should ALL be concerned about DCH wanting to put additional restraints on how much therapy our children need (when it can be justified by our therapists and a work order is written by our Pediatricians).  As I find out more information and how we can advocate to protect our children, I will let you know. ===================================================== 4. Here are the latest numbers regarding the Katie Beckett Waiver and the denial situation as of this month:   + Since the implementation of the new criteria (11/04): 2,461 children have been denied (Continued placement=2,009 Initial Application = 452)   + Since 6/1/05: 3927 have applied to renew (44% approved) 728 have applied for first time (43% approved) 1,706 have requested 1st appeal (19% approved)   I did ask DCH if they had any tips to parents regarding the process.....I got this response: "Make certain parents consider that Georgia Medical Care Foundation (the subcontractor to DCH that reviews our applications) will look at all documents provided.  If they believe some seem contradictory,go ahead and provide an explanation." ===================================================== Hope you find this information helpful. Keep you posted. Sincerely, Heidi   --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 27 Apr 2006 00:00:00 EDT http://www.lgtinc.org/articles/121/1/Did-YOU-receive-this-from-Heidi-J.-Moore-directly%3F April 13, 2006   Dearest Advocates:   Unfortunately, late Friday night I had a "Computer Malfunction".  Somehow Comcast deleted a few of my advocacy distribution lists (in particular many of the last names beginning with A and B). As you can imagine this has been a nightmare! I have been working for hours and hours trying to recover as many names as possible BUT I NEED YOUR HELP!   When you receive this e-mail, please distribute ASAP to anyone you might think would have been on my distribution list letting them know about this problem.   If you received this e-mail from someone else and not directly from me, that means you are no longer on my advocacy distribution list.    If you would like to be added back to the advocacy distribution list, please submit the following information: 1. E-mail. 2. Full name. 3. If you are a provider, parent (child's disability and if denied the Katie Beckett Waiver), therapist, or why you want to be on the list, etc   If you received this e-mail in error, please let me know that you want to be taken off the advocacy distribution list as well.   I have been working for hours trying to recreate the information, but I'm sure I still have a number of email addresses deleted.   Thanks in advance for your cooperation in this matter. As always, you can review my past e-mails by going to the following website: http://www.lgtinc.org/authors/41/Heidi-J.-Moore   (Please remember that there are multiple pages so page down or go to another page if you can't find the information you are looking for).   Thanks again for your cooperation, Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Wed, 26 Apr 2006 00:00:00 EDT http://www.lgtinc.org/articles/104/1/Katie-Beckett-Waiver%3A-Advocacy-Update%3A-Media%2C-Level-of-Care-Changes%2C-Etc. April 10, 2006   Dearest Advocates:   Hope everyone had a great spring break.  I have a couple of  advocacy updates for everyone. You may want to print this e-mail out to read due to the length................ ==================================================== 1. I have been informed the Skilled Nursing Level of Care has been changed for the Katie Beckett Waiver. The Dept. of Community health has added under Column B #3 the following language: "The beneficiary must require skilled nursing or skilled rehabiliation services or both on a daily basis".  To see entire Level of Care, please go to the following website: http://dch.georgia.gov/vgn/images/portal/cit_1210/27/48/51326660Nursing_Facility_LOC.pdf   ====================================================== 2. Due to all your wonderful Letters to the Editor of the John's Creek Herald and Revue and News Newspapers regarding the recent Katie Beckett Waiver article, they dedicated an entire section to our families comments.  The editor stated the following: "We received a huge response from readers regarding our 3/29 story on disabled children who've lost their Katie Beckett Medicaid benefits. Above is just a sampling from some of the parents of these children".    Many thanks to: Christy Butch, Paige Couper, Amy Adams, Sherry Brooks and Loretta Mitchell for your comments to Rosemary Taylor (Editor).  Let's keep up the great work at continuing to educate the community of the concerns we face of families with children with special needs.  If you would like to write Rosemary, her e-mail address is: rosemary.taylor@northfulton.com. I know last time I spoke to her, she is interested in possibly doing a follow-up article later this year. ==================================================== 3. I have had a couple of families contact me over the last two weeks expressing some concerns with the "process" of renewal even after they appealed last years denial and were reinstated.  Just a reminder: If you know that your renewal date is coming up and have NOT received a Medicaid renew application in the mail, PLEASE contact your DFACS worker and let them know. Don't assume, just because you did not receive any paperwork you don't have to submit this year.  A few families were denied AGAIN due to this procedure problem.   We as parents need to be proactive with our child's Medicaid and make sure we have the necessary paperwork in on time with the DFACS office. ==================================================== 4. I will be posting a parents "Letter of Medical Necessity" that their child's Pediatrician submitted on behalf of their appeal.  Happy to say they were reinstated the Katie Beckett Waiver.  Many thanks to Judy D. for submitting this information to help other families.  If you would like to see this example, please go to the following website for more information: http://www.lgtinc.org/authors/41/Heidi-J.-Moore   If you have a successful letter that may help other parents or tips of how to help families, please submit to my e-mail address: heidijmoore@comcast.net. We can all learn from each other......... ===================================================== 5. Another article was written by reporter, Lee Shearer of the Athens Banner Herald on Sunday regarding the Katie Beckett Waiver situation. Please take a minute to thank Lee for his on-going coverage of the issues! Lee can be reached at lee.shearer@onlineathens.com.  Communication and education are the key for us continuing our advocacy efforts. Keep up the great work. Many thanks to Jodi C. for letting me know about the article!   Here is the article just in case you missed it:Parents unload on Medicaid programs For disabled childrenBy Lee Shearer   |   lee.shearer@onlineathens.com   |   Story updated at 8:57 PM on Sunday, April 9, 2006 ROYSTON - Parents of children with severe and costly disabilities vented their frustrations with state Medicaid programs designed to help them pay big medical bills at a meeting at the Royston Baptist Church on Saturday.Decisions on whether a child is eligible for Medicaid help are sometimes arbitrary, parents said.Jodi Cronic, assistant principal at Madison County's Comer Elementary School, said Medicaid has helped her family pay for overwhelming medical costs over the past three years for her 12-year-old son, who has complex learning and behavior problems.But now, state officials say the family is no longer eligible, she told about 50 people at a meeting of a group called "Connections for Special Parents." The reason for the denial: Part of her son's problem is considered psychological, and help for primarily psychological problems is not allowed under the Katie Beckett waiver, a Medicaid program which has provided financial help to cover her son's medical bills for three years."How fair is that?" she asked. "I think it's discriminatory."Most Medicaid programs are designed to help low-income people, but the Katie Beckett waiver helps families with children with unusually severe disabilities, regardless of family income. It's called a waiver because federal officials have waived normal rules that limit Medicaid spending to people confined to institutions, such as nursing homes. Waiver programs like Katie Beckett allow them to receive treatment in their home or community instead.Cronic, crying as she spoke to the group, said her family will face medical costs they can't pay for if a final appeal fails. Her state health insurance has denied coverage for her son's treatments, and the cost for just part of it, a one-week stay in a psychiatric hospital last year, was $14,000, she said.Hundreds of families have been cut off the Katie Beckett waiver since last year, after the state Department of Community Health, which administers Medicaid, tightened up eligibility requirements.Nancy Durden, a state Department of Community Health administrator, reminded the group that federal regulators, not state ones, make the eligibility rules. Before tightening the eligibility rules, Georgia had gotten "pretty far outside the guidelines," she said.The eligibility rules were not the only target of complaint Saturday.Workers with a private company the state hired to make eligibility decisions for Katie Beckett help often are not qualified to make those decisions, said Joshua Norris, director of legal advocacy for the Georgia Advocacy Office, a nonprofit corporation that helps disabled and mentally ill people in the state.And case managers with the state Department of Family and Children Services, who are supposed to help families negotiate the Medicaid bureaucracy, often don't know the Medicaid programs well enough to help, some parents said."Why can't you tell parents what services are available?" asked one parent, speaking to DFCS representatives at the meeting.The director of state Medicaid programs promised more than a year ago to see that DFCS case managers were trained in Medicaid programs, said Pam Moore, who works with the parents of disabled children in the Madison County School System."They haven't been," she said.Others said it's hard for people who work with Medicaid full-time to keep up with frequently changing rules and programs, much less DFCS workers, for whom Katie Beckett families are a small part of a caseload of hundreds of families."The one thing you need to realize is even if you think you understand it (Medicaid), it will change," said Dottie Adams of the Governor's Council on Developmental Disabilities.Georgia could stretch its Medicaid dollars more, Adams said.The federal government provides generous matching money when states put money into Medicaid waiver programs, but Georgia doesn't get as much federal Medicaid money as some other states, she said."One of our problems is that it has not been a priority for our legislature," she said. "It's a good deal for our state."But good news came out of this year's legislative session, she said.Legislators added enough money to the Medicaid budget to take 1,500 people off waiting lists to receive various kinds of Medicaid services such as in-home nursing care. There are about 6,000 people on these waiting lists, but there ought to be more than 14,000, Adams said. Many people who are eligible for state help don't even bother to sign up because the waits are so long, she said. ==================================================== Hope this information helps. Have a great evening. Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 10 Apr 2006 00:00:00 EDT http://www.lgtinc.org/articles/103/1/Example-of-a-Letter-of-Medical-Necessity-for-the-Katie-Beckett-Waiver April 10, 2006 This is an example of a Letter of Medical Necessity Letter submitted by a Pediatrician for a child that was denied the Katie Beckett Waiver. Happy to say the child was reinstated.  Thanks to Judy D. for this submittal and wanting to help other families...... ++++++++++++++++++++++++++++++++++++++   Dear J and Whom It May Concern,   This document is a partial summary of the current medical condition of, and treatment needs for K who has a diagnosis Mitochondrial Disease (Complex Type I). Her condition has resulted in profound hypotonia and developmental delay and requires caretakers with skilled nursing training continuously. Her weakness requires intensive therapy yet her lack of stamina is the limiting factor for its application. She would get some type of her six different therapies (OT; PI; speech ~ swallowing, trunkal tone hippo. etc) 5 or more days a week if her strength allowed. Her habilitative road has been one of long slow improvement and increasing durations to the maximum her condition will allow. With continued strength improvement. I hope that she will be able to tolerate therapy 5 to 7 days a week.   Swallowing is a particularly important issue because her lack of strength limits her here as well. Because she would easily give up chewing and swallow inadequately masticated food, she is a great risk for choking, aspiration, and inadequate caloric and nutrient intake from vomiting. Careful and skilled attention is absolutely essential and several significant gagging incidents have occurred.   Her four medications, which are oral, must be closely monitored during administration to make sure she actually does get them swallowed. Three of these medications are specifically for her mitochondrial disease and thus intended to improve her strength and her swallowing. The other medication is for seizures. Thus the circular nature of the medications administration and swallowing ability makes for slow improvement on an uphill road.   The purpose of this letter though is not to be complete and comprehensive in the description of K's condition (which would take pages and pages), but to preamble my most important and substantive point. Her condition is one where a setback as a result of inadequate skilled care, inappropriately monitored therapy, or the closest attention to the simplest of life's details could and would lead to a loss of muscle strength in any area that would be permanent and unrecoverable. For example, because she couldn't even pull up a light blanket to get warm during the night, she is at risk for exposure even in a temperature controlled environment. Muscle strength and function are significantly affected by cold, and for K, even this could lead to that permanent loss. In mitochondrial disease, once the muscle is damaged it is damaged permanently.   In summary, my point is that K is so very medically fragile and what ability has been gained could so easily be lost. She requires only the very best skilled nursing at all times (such as her mother and specially trained caretakers now provide). Her rehabilitative therapy needs to be at least 5 or more days a week as soon as her strength can be increased to tolerate it (which hopefully will be soon). Were is not for the skilled care she now receives, her condition would certainly necessitate treatment in an in-patient facility.   Sincerely yours,   Dr. S, MD   Heidi J. Moore Mon, 10 Apr 2006 00:00:00 EDT http://www.lgtinc.org/articles/97/1/Advocacy-Updates%3A-06%7B47%7D07-Budget-%23%26%2339%3Bs%2C-Katie-Beckett-Media-coverage%2C-etc. Dearest Advocates:   I have a few updates for you:   1. Below is an e-mail from Dave Blanchard of AADD. It is fantastic news....The House and Senate agreed to 1,500 Medicaid Waiver slots for MRWP and 152 for ICWP!  Please take a moment to thank your legislators and the legislators on the below link........  The session is finally over! In the final budget, the House and Senate agreed to 1,500 Medicaid waiver services for the MRWP and 152 for the ICWP slots! They also included in the DCH's budget a directive for DCH to research a Medicaid Buy-In initiative for Georgia. This real success reflects the many months of hard work and effort from individuals like yourself all across Georgia. For all the details, go to http://aaddpolitical.blogspot.com/ Now is the time to send a note of thanks to a few of the legislators that helped make this happen - again we have made this very easy for you. Simply, go to http://www.unlockthewaitinglists.com/actionalert.html and click! Thank you for all you are doing and congratulations!! Dave Blanchardhttp://www.unlockthewaitinglists.com ==================================================== 2. I was just informed that Mark Trail will not be attending the Medicaid forum to take place on April 8th in Royston, GA.  Nancy Durden (Acting Director for Recipient and 3rd Party Services from the DCH) will be attending on Mark's behalf.  Just wanted you to have the latest information. ===================================================== 3. Do to your overwhelming thank you's to Rosemary Taylor - Editor of the John's Creek Herald and contributing reporter to the Revue and News newspapers, they plan on having a few your letters that were submitted to her in the next weeks newspaper. Thank you so much for continuing the communication and keeping the issue alive....The more the community understands the issues associated with our families, the better! ===================================================== 4. Many of you have asked if the $7.6 million that was set aside for families that have been denied the Katie Beckett Waiver has been made available yet......It is my understanding at this point they are looking at the best way to have a foundation get up and running quickly so the money will be made available very soon. As soon as I hear of any updates, I will let you know. ====================================================== 5. Here is a great summary of some of the issues from this legislative session prepared by Pat Nobbie of Governor's Council on Developmental Disabilities (GCDD) "Moving Forward": (Heidi's Note: I did delete some of the issues due to the length of the email. I thought this would be the issues you would be most interested in) The legislative session ended last night at midnight, and overall it was a very productive year for people with developmental and physical disabilities in Georgia. Major accomplishments were in the Unlock Budget: 1500 MRWP waiver slots funded for 6 months with important infrastructure funding, 152 ICWP waiver slots for people with physical disabilities and traumatic brain injury, and $7.6 million for families no longer eligible for Katie Beckett access to Medicaid. See below for the budget breakdown! In the DCH 06 budget: Add 152 slots to the Independent Care Waiver Program (ICWP) $3,286,957 state $8,535,333 total ***By December 1, 2006, the department shall conduct an analysis of Medicaid Buy-In programs operational in other states and shall recommend a cost-effective Medicaid Buy-In program that would allow working Georgians with disabilities to receive healthcare through Medicaid.*** ITEMS TO WATCH: Reduce Medicaid costs generated in the Aged, Blind and Disabled populations through the provision of better business practices to ensure that the member receives the right services, at the right time, and the right cost. CC: Reduce Medicaid Benefit costs by implementing an Administrative Services Organization model as a gatekeeper. State: $25,038,336 Total $65,017,751 (Heidi's Note: This is something we are going to have to really watch and see what is recommened) In the DHR 06 budget: Annualize the cost of the 925 waiver slots on the MR/DD Waiting List, adults $2,648,987 state $6,878,700 total Annualize the cost of the 925 waiver slots on the MR/DD Waiting List, children $548,430 state $1,424,123 total Add 750 slots for consumers on the MR/DD Waiting list (total 1500 slots, 6 months funding, adult share) $9,619,528 state $21,837,981 total Add 750 slots for consumers on the MR/DD Waiting list (total 1500 slots, 6 months funding, children's share) $1,970,266 state $4,472,842 total ITEM TO WATCH: Recognize efficiencies within the Department of Human Resources through the implementation of an Administrative Services Organization provided by the Department of Community Health. State ($500,519) Please call or write the legislators on the Appropriations Subcommittees and full committees on Appropriations both House and Senate to THANK them for their commitment to funding for people with disabilities! ·  DHR Fiscal Year 2007 Budget Olmstead - Fund 1500 MR/DD slots to Unlock the Waiting Lists; Adult services, $9,993472; Child and adolescent services, $2,046,857. State funds: $12,040,329 Total funds: $25,148,408 (Senate: Fund 1550 Services for 6 months, state funds $11,598,794: Senate added 1500 MRWP waiver services at 12 months of funding $24,147,199 state funds) ·  DCH Fiscal Year 2007 Budget Reduce Medicaid benefit costs by implementing am Administrative Services Organization model as a gatekeeper and manager of services. House: $24,847,200 Senate: $26,229,750Total $39,674,223 $35,926,380 Add 152 slots to the Independent Care Waiver Program (ICWP) $3,286,957 state $8,535,333 total (Senate, 10 slots annualized from FY 2006 budget, and 142 new slots) Increase reimbursement for Speech Therapy visits. State, $346,590 Total funds $553,410 (Heidi's Note: This is great news for our Medicaid speech providers!) Provide Dental coverage for Medicaid eligible pregnant women (designated codes) State, $2,500,000 Total funds $6,491,820 ==================================================== Have a safe and wonderful Spring Break.  Please note: I will not have access to e-mail next week.  United....WE Will Make A Difference! Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Fri, 31 Mar 2006 00:00:00 EST http://www.lgtinc.org/articles/77/1/Katie-Beckett---NEW-Eligibility-Criteria-posted-and-Process-Issue-with-DCH-Denials March 14, 2006 Dearest Advocates:   The new eligibility criteria for Intermediate Care Facility (ICF-MR) Level of Care (which I sent out early March 06) AND the Nursing Facility Level of Care has  been posted to the Dept of Community Health's website:   http://dch.georgia.gov/00/channel_title/0,2094,31446711_31946814,00.html   Many of you asked about a child that is medically fragile, cystic fibrosis, organ transplant, premature children, hemophilia, sickle cell and Osteogensis Imperfecta, etc.........Your level of care specifics can be found under Nursing Facility Level of Care now..... ================================================= In addition, if your child received a final notice of denial in the mail that stated that you did not submit additional paperwork (when you did).....Please let me know.   Over the weekend a number of families contacted me, regarding this issue and I need to get a list together of parents effected by this "process" breakdown.  If this has happened to you, please submit to me the following information: 1. Name of Child. 2. Medicaid Number. 3. When did you submit your additional information. (if you have a delivery tracking number let me know that too). 4. When did you get a letter stating that you have a final denial based on not submitting additional paperwork (and you did).   This is EXACTLY why I say that you need to send ALL information via certified mail/returned signature receipt. You need to have proof that you submitted to them this information. Also- ALWAYS make copies of everything you submit too!   ====================================================== I hope this information is helpful.   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative.   Heidi J. Moore Tue, 14 Mar 2006 00:00:00 EST http://www.lgtinc.org/articles/71/1/Katie-Beckett-Waiver---New-Eligibility-Criteria-Clarification March 6, 2006 Dearest Advocates:   As you are aware, on Friday the Dept. of Community Health (DCH) issued out the "new" eligibility criteria for the Katie Beckett Waiver under Intermediate Care Facility / MR (which is how the majority of the families are determined eligible for the Katie Beckett Waiver).   I have some clarification from DCH to your concerns based on the hundreds of e-mails I received over the weekend.  Please understand that I will not be able to respond to everyone individually but I'm trying very hard to help everyone with information during this difficult time......   1. Question: If a fair hearing has been schedule, is there going to be any attempt by DCH's legal counsel to review those cases under the new criteria prior to the hearing so maybe some of these families will not have to go through the hearing process and be reinstated?   1. Answer: We have re-reviewed all cases that were pending an appeal.  Those children who are approved under the revised criteria have either received approval letters or will receive the approval letters.  Families whose denials were upheld will not lose their appeal rights.   2. Question: How is this going to be implemented? Immediately?   2. Answer: The criteria go into effect immediately. Those in process will be reviewed using the new criteria. Those in some stage of appeal will be reviewed using these criteria.   3. Question: How will this criteria impact those children that have cancer, CF, and high medical costs but don't have the MR?   3. Answer: This criteria applies only to the level of care for ICF-MR.   4. Question: Are the other two criteria being re-written as well?   4. Answer: The skilled nursing care criteria will have some revisions, and should be released soon.   5. Question: How will these criteria be implemented for babies and young children?  Many children are not given a formal IQ test until they are 8 yrs old in school.  Who will be determining if a child is two standard deviations from the norm (therapists, developmental pediatrician, etc)?   5. Answer: The criteria are inclusive, not exclusive. The standard deviation measure appeals to standardized tests administered by the treating professionals. If there is not standardized test available for a particular age or disorder then the medical reviewers will have to use their professional judgment to assess.   I realize this is a very stressful situation for many families and I'm trying very hard to help everyone but please be patient.........I hope this information is helpful.   I will forward additional information as it's available for distribution.   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Mon, 06 Mar 2006 00:00:00 EST http://www.lgtinc.org/articles/70/1/URGENT%3A-Katie-Beckett-Waiver---NEW-Eligibility-Criteria-for-ICF%7B47%7DMR March 3, 2006   Dearest Advocates:   As promised, please find below the new eligibility Level of Care criteria for Intermediate Care Facility / MR for Katie Beckett Waiver from the Dept of Community Health.    Please note: I have not had a chance to review these criteria in detail. Therefore, I'm sure we will all have questions that will need to be addressed BUT at least we know what the new rules are right now.   If you have concerns about the new criteria, please send me a BRIEF e-mail explaining your concerns and your child's disability and age so I can put together a composite listing to be given to Dept. of Community Health for review and clarification. =======================================   INTERMEDIATE CARE FACILITY (ICF/MR) LEVEL OF CARE   Summary:   1.        ICF/MR level of care is appropriate for individuals who require the type of active treatment typically provided by a facility whose primary purpose is to furnish health and rehabilitative services to persons with mental retardation or related conditions. 2.        An ICF/MR level of care is generally indicated if one condition of Column A is satisfied in addition to the conditions Column B and Column C being satisfied.  Conditions derived from 42 C.F.R. 440.150, 435.1009, and 483.440(a). 3.        Column B refers to "an aggressive, consistent implementation of a program of specialized and generic training, treatment, health services, and related services."   These active treatment services, as defined in 42 C.F.R. 483.440, provide aggressive, consistent monitoring, supervision and/or assistance as defined in the plan of care to address the specific medical conditions, developmental and behavioral needs, and/or functional limitations identified in the comprehensive functional assessment.  This comprehensive functional assessment must be age appropriate. 4.        The following conditions meet ICF/MR institutional level of care criteria, as these individuals would be institutionalized regardless of ability to participate in an aggressive program of specialized and generic training, treatment, health services, and related services as outlined in Column B: ·         Those children with an IQ of 50 or below (moderate to profound mental retardation) or ·         Those children who meet the criteria for Autism, Autism-Spectrum, Asperger's, Pervasive Developmental Disorder, Developmental Delay, Mental Retardation, Down's Syndrome, and any other Developmental Disability as evidenced by:                                                                i.       a score on a standardized adaptive functioning tool of 2 standard deviations below the norm in three or more of any of the following behavior domains: self care skills, understanding and use of verbal and nonverbal language learning in communication with others, mobility, self-direction, and age-appropriate ability to live without extraordinary assistance or an overall standard score < 70, or                                                               ii.      if their age equivalency composite score is less than 50% of their chronological age, and/or                                                             iii.      the child has a Childhood Autism Rating Scale (CARS) score of above 37, a Gilliam Autism Rating Scale (GARS) of  121 or greater, or any other equivalent standardized assessment tool which indicate severe autism.     COLUMN A (Diagnosis) COLUMN B (Plan of Care) COLUMN C (Functional Need)   1. The individual has mental retardation.                OR   2. The individual has a severe chronic disability attributable to cerebral palsy or epilepsy.                      OR   3. The individual has a condition, other than mental illness, (i.e. Autism, Autism-spectrum, Asperger's, Pervasive Developmental Disorder, Down's Syndrome or Developmental Delay) which is found to be closely related to mental retardation because it is likely to last indefinitely, and requires similar treatment and services.   AND   4. The impairment for those conditions outlined above constitutes an impairment of general intellectual functioning, and results in substantial limitations in three or more of the following functional limitations: ·         Self-care skills such as feeding, toileting, dressing and bathing; ·         Understanding and use of verbal and nonverbal language learning in communication with others; ·         Mobility; ·         Self-direction in managing one's social and personal life and the ability to make decisions necessary to protect one's self as per age-appropriate ability; and/or ·         Age-appropriate ability to live without extraordinary assistance       On a continuous basis, the individual requires aggressive consistent implementation of a program of specialized and generic training, treatment, health services, and related services which is directed towards- a. The acquisition of the skills necessary for the individual to function with as much self-determination and independence as possible; and b. The prevention of further decline of the current functional status or loss of current optimal functional status. This is evidenced in the Plan of Care by the individual's participation (at least five (5) days a week) in interventions which are required to correct or ameliorate the conditions/diagnosis; and are compatible with acceptable professional practices in light of the condition(s) at the time of treatment.   Active treatment does not include: interventions that address age-appropriate limitations; or general supervision of children whose age is such that supervision is required by all children of the same age or physical assistance for persons who are unable to physically perform tasks but who understand the process needed to do them   1.  The services have been ordered by a licensed       physician.   AND   2.  The services will be furnished either directly        by, or under the supervision of, appropriately          qualified providers (see definitions):    AND   3. The services, as a practical matter, would have ordinarily been provided in an ICF-MR, in the absence of community services.           Revised 3/3/06   Hope this information helps.   Sincerely, Heidi Heidi J. Moore Fri, 03 Mar 2006 00:00:00 EST http://www.lgtinc.org/articles/43/1/Warning-To-America---Dangers-Of-Being-An-Organ-Donor Truth About Organ Donation As America evolved into a capitalist society, health and long term care systems became for profit institutions which increasingly pit the quality of care of their consumers with the drive to further earnings. As hospitals, hospices, nursing homes, and HMO's try to find more areas from which to increase earnings, ethical questions such as - Should doctors be allowed to deny expensive medical procedures to the seriously ill and disabled in order to provide health coverage for the uninsured, should elderly patients be allowed to die to spare their families and communities the financial and emotional costs of expensive care, should doctors be allowed to kill and harvest the organs of people with cognitive and physical disabilities, or in permanent comas - are likely to come from an increasingly new field of scientists called bioethicists. Wesley J. Smith, a lawyer/author turned citizen, humanitarian advocate has followed closely the rise to prominence of the bioethics movement. He says, "Bioethicists spend much of their time arguing with one another, beneath or, more accurately, above the public radar, in arcane academic journals, books, university symposia, and government-appointed commissions. This is no empty intellectual enterprise, but a project aimed at changing America. In the course of their arguments, bioethicists are arriving at a consensus about the course of our medical future, and they are slowly succeeding at transforming the laws of public health and the ethics of clinical medicine in their own image." For being a relatively new and untested science, bioethicists have somehow firmly placed into their hands the collective fate of American medical and public policy. The obvious danger to the public from mainstream bioethicist is that unlike lawyers, physicians, or even hairdressers, there are no regulations, formal education or trainings conducting the field. One does not have to have a license to practice bioethics. Status can be achieved through a number of "credible" ways according to Smith, including being published in professional journals, writing books or lecturing. One becomes an expert when one finds ones name or articles being aggressively quoted by others also engaged in being a bioethicist. The secondary danger to the public as a whole but especially for the aging and disability communities is that bioethics is instituting 'Personhood Theory' which unlike universal human equality does not automatically confer worth to newborn infants and people with disabilities. Most bioethicists consider fetuses, newborns, psychopaths, severely brain-damaged patients, and various demented patients as 'non-persons' due to their inability to question morality. They even call for 'non-persons' to be used in experimental research in replace of animals and as subjects for organ harvest. John Harris, a prominent bioethicist claims, "Persons who want to live are wronged by being killed because they are thereby deprived of something they value. Nonpersons cannot be wronged in this way because death does not deprive them of something they can value. If they cannot wish to live, they cannot have that wish frustrated by being killed." Bioethicists and for profit health care has put all people at risk. People with disabilities are devalued to the point where we cannot even trust health care workers because we are being targeted to increase the pool of available organs available for hospitals to sell. As of February 2002, UNOS (United Network for Organ Sharing) had a waiting list for 79,523 major organs, while in the previous year the total number of transplanted organs was 22,953. The disparity between number of transplantable organs and the need for such organs has led transplant programs to seek to expand the sources of transplantable organs. Bioethicists working for profit policy boards are giving advice which is quickly moving American society further and further away from an ethic of universal human equality and the Hippocratic oath of Do No Harm. Motive for profit has lead to theories' which create divisions of us and them in an explicit hierarchy of bioethically determined human value. Smith writes, "History teaches us that judging human worth based on subjective criteria -- race, sex, sexual orientation, tribe, religion, nationality or personhood -- invariably results in the oppression, exploitation or even killing of those deemed by the powerful to be less worthy of respect. And considering that many of the people denigrated by bioethics as nonpersons, not coincidentally, also happen to be the most expensive to care for in the age of the HMO when cost-cutting is king, bioethics presents an acute danger to the lives, health and well-being of millions of people who are elderly, disabled, newborn and cognitively or developmentally impaired. Since in the end this could include any one of us, we ignore the threat of bioethics at our own peril." Diane Coleman, founder of NOT DEAD YET, predicted "there is going to be growing pressure on disabled people who are dependent on life support to 'pull the plug'. Allowing them to believe that they are being altruistic by doing so through organ donation will only increase the pressure on disabled people to choose to die in the belief that by giving their organs up, their lives can have some meaning. The danger is especially acute for people who are newly disabled, many of whom believe, falsely, that their lives can never be worth living" as showcased by the Oscar Award winning movie, "Million Dollar Baby." As bioethicists define 'non-persons' as having no more a right to live than animals slaughtered, hospitals push for an era when they can openly deny people service (living will) and harvest the organs of people entrusted into their care. It wasn't so long ago that bioethics deliberated the moral consequence of forced starvation/dehydration of people considered 'non-persons' in hospices, hospitals, and nursing homes across our country. Smith discussed this as being the point when the movement "achieved consensus about a particular approach… Notice the speed with which removing feeding tubes from unconscious, cognitively disabled people became ethical and legal throughout the country, once bioethicists agreed it was no different morally from withdrawing antibiotics." This view was supported by the American Medical Association, who came out in staunch opposition to the implementation of any legislation, criminalizing the withdrawal of food and water from patients unable to make their own medical decisions. Dr. Gregor Wolbring, a disabled bioethicist from Canada declared "There is suicide prevention for the able-bodied but assisted suicide for the disabled. Suicide prevention for you but suicide enhancement for us… Society wants the disabled community to have access to a dignified death when we want access to a dignified life." I'm warning all people about the dangers of being an organ donor. Organ donors do not get quality end-of-life care because they are more valuable to hospitals that stand to make more off harvesting someone's donated organs than they would from saving organ donor's lives. It is of utmost importance for the American people to learn about what is happening in mainstream hospitals that not only embrace personhood theory but also covet the organs of their patients. Ron Panzer, advocate with the Hospice Patients Alliance writes, "We sometimes (and increasingly) have newly injured patients being declared "brain dead" at the hospital without the appropriate tests ever being completed. We have hospital transplant teams being flown in ready to "harvest" organs from patients who have never been properly diagnosed, whose families are not always informed of all the treatment options, and we have doctors ready to "spin" the patient's condition into a "hopeless" category so the family agrees to "allow the patient's death to have some meaning" through organ donation, even though in cases where the family refuses to accept the "final determination of the all-knowing docs," the patient recovers! The glaring reality is that when the docs are wrong, dead wrong, the patient is killed by the harvesting of the organs, not because of the injuries sustained. " A 2000 Institute of Medicine report states, "controlled non-heart-beating organ donation cannot take place unless life-sustaining treatment is stopped." Even basic care or treatment such as food, water and crucial medications like insulin or heart medicine are being withdrawn to make sure a person dies sooner rather than later. Nancy Valko, president of Missouri Nurses for Life claims, "In cases of severe head injuries, strokes or other critical conditions that can qualify a patient for NHBD, it is virtually impossible at the beginning to accurately predict whether the patient will die or what level of recovery he or she may eventually attain. As a nurse for 34 years, I have personally seen many such patients, who initially needed a ventilator and who were even expected to die, go on to completely recover. The laudable goal of saving more lives through transplantation cannot sacrifice ethical principles or occur without vigorous public scrutiny. The quiet implementation of an innovation like NHBD is disturbing, especially when people are urged to sign an organ donor card with little or no awareness of what that action can mean. Organs may be retrieved without depending on a withdrawal-of-treatment decision coupled with a rapid declaration of death and organ removal. Tissues such as corneas, skin and bone can be donated up to several hours after a natural death." Panzer says of NHBD, "There is no more egregious violation of patient rights than to be made dead, without any chance at all to receive care designed to bring about recovery, when recovery is realistically possible. How many inaccurate predictions are made by the doctors who are less eager to provide care and more eager to get healthy organs from the soon-to-be dead, victim of vulture-like organ transplant teams who swoop in and grab whatever they can, selling all the organs and usable body parts for many hundreds of thousands of dollars, even millions." Just remember your organs are worth more to the hospitals than if they were to try to do the procedures to save your life. For people with disabilities and the aging community the real threat to us is the notion that our lives are not worth living. Mary Therese Helmueller, an R.N. with 15 years of experience, warns in an article entitled, "Are You Being Targeted For Euthanasia?" - of the threat to people with disabilities and the aging community from health care staff. Her grandmother had been admitted alert and orientated, to a local hospital with only a left knee fracture. Within 48 hours she fell into a coma and was transferred to hospice where she died upon arrival. Being a skilled nurse, Mary began to question staff until she acquired her grandmother's hospital chart. It then became apparent that her grandmother had been euthanized. According to her grandmother's chart, she only became unresponsive after doses of pain medication were administered by hospital staff. Once enough had entered her system she lapsed into a coma where she was diagnosed as having a stroke. The family was given "a completely hopeless picture of recovery." Nurses and doctors reported that she "was having seizures, going in and out of a coma, and was in renal failure." However her chart indicated everything was normal. "The CAT scan was negative for stroke or obstruction, the EEG states no seizure activity and all blood work was normal indicating that she was not in renal failure! How were we to know that the coma was drug induced and that all the tests were normal?" Her family, heart-broken by the diagnosis, thought her grandmother was dying and without hope. Disappointed they allowed hospital staff to place her on a DNR, withdrawing medical intervention. Within minutes of being 'no code,' staff injected her grandmother with a lethal dose of Dilantin, which over the course of 18 hours put her into a deep coma until she died upon arrival at a hospice. Her death certificate read "Death by natural causes." Distraught Mary now openly warns people, "Your life may be in danger if you are admitted to a hospital, especially if you are over 65 or have a chronic illness or a disability. The elderly are frequently dying three days after being admitted to the hospital. Some attribute it to "old age syndrome" while others admit that overdosing is all too common. Euthanasia is not legal but it is being practiced. Last year the New England Journal of Medicine reported that 1 in 5 critical care nurses admit to having hastened the death of the terminally ill." I will end with a quote from Smith, "Since it is almost surely too late to transform the movement's utilitarian assumptions from within, keeping the movement contained inside the academy appears to be the most promising strategy to prevent our society from being remade in bioethics' image. To do this will require heightened media scrutiny and public awareness of what ideological bioethics is, what it stands for, why it matters, and what consequences will befall us all if the new medicine becomes our future. Beyond the media, a counter-bioethics movement could be created by those who believe that the only truly moral way to resolve the dilemmas with which bioethics grapples is by strict adherence to universal human equality. Perhaps this new, ethical bioethics could be called human-rights bioethics. It would boldly promote the proposition that there is no them and us; only us. Surely, an abundance of academics, physicians, lawyers, disability rights activists, patient advocates, theologians, and just plain people would be willing to stand up proudly for the equal moral worth of all living people. Consider yourself forewarned America. You are worth more tto hospitals for your organs than for what they can milk out of your insurance company. Stay tuned for an article soon on the dangers of using "Living Wills" which are pro-euthanasia documents put out by the right-to-die movement as a way to make certain circumstances in which American's will be asked to be spared from, which then gives tthem legal precedence to withdraw care or never give it in the first place. Never ever take my word for things I say, please research them for yourself. Zen Garcia Fri, 17 Feb 2006 00:00:00 EST http://www.lgtinc.org/articles/38/1/Katie-Beckett-Waiver-Criteria-Changes February 8, 2006   Dearest Advocates:   As you are aware, the eligibility criteria for the Katie Beckett Waiver are being revised DUE TO OUR WONDERFUL ADVOCACY EFFORTS!  Here is the text I received so far from the Dept. of Community Health (DCH) regarding those changes. PLEASE note: that this is just some of the changes and are being used to further clarify the existing criteria (and hopefully reinstate a lot of the children that have been denied): PER DCH: We're working on getting a public document produced.  Some of the changes (in brief) to date include: Cystic Fibrosis: child may receive O2 5-7 days a week intermittently or continuously and/or has to be hospitalized 3-4 times per year (Column A and B). Transplant: child who is medically unstable awaiting organ transplant and/or is in the post-op for one year post transplantation (Column A). Premature Births: child born at 26 weeks or less gestation will be approved for 6 months then re-evaluated. Mental Retardation: child with an IQ of 50 or below will be approved. Autism: child with deficiencies greater than 2 standard deviations below the norm on a standardized measurement instrument in skills like communications, daily living, socialization and motor skills.  While no particular measurement instrument is required, it must be standardized and recognized widely as an applicable tool for the measurement. Please recognize these are not totally inclusive of all criteria and are meant to further refine/improve the existing criteria.  Hope this is helpful.  Also: please remember from my previous posting: (PER DCH) If you are in the process of being denied, requesting a fair hearing, etc......Try to stay in the "hopper" for as long as you can so your application will be reviewed with the new criteria.  If you have received a final denial, you may want to wait to submit a new application until we get confirmation of when the new eligibility criteria will be fully implemented.  ============================================ As soon as I receive the entire eligibility criteria changes, I will let you all know.  PLEASE do not send me emails asking.......I do not have them in my possession.  Right now things are moving so fast....I'm just trying to keep up and communicate that information out to EVERYONE.  I'm currently receiving over 100+ emails a day and having a hard time keeping up. So please be patient with me responding. ============================================ Also- Please remember to watch the show "Lawmakers" tonight regarding the news segment on the Katie Beckett Waiver . PBS- Ga Public Broadcasting's Lawmakers is on at 7:00pm (and is channel 8 of Comcast Cable, check your local listing for your channel).    Hope this information helps everyone. WE ARE MAKING FANTASTIC PROGRESS! I hope this shows you......Advocacy pays off!  and UNITED....WE WILL MAKE A DIFFERENCE!   Sincerely, Heidi --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 09 Feb 2006 00:00:00 EST http://www.lgtinc.org/articles/37/1/Katie-Beckett-Waiver-Presentation-given-at-FOCUS Dearest Advocates:   Based on a number e-mails I received in the last few days…….   Below is the text presentation that I gave at the  FOCUS (Families of Children Under Stress) educational conference held on Feb. 4th regarding the Katie Beckett Waiver program.   I thought everyone could benefit from the below information that I presented. PLEASE note this presentation did not include  the recent changes to the eligibility criteria based on our advocacy effort that I released today!  Also:    The material contained in this presentation is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or qualified legal representative.   Happy Reading. Sincerely, Heidi ===============================================================   What is the Katie Beckett Waiver ?   •         Category for Medicaid eligibility based on the Tax Equity & Fiscal Responsibility Act (TEFRA) 1982. •         State's are allowed to make Medicaid available to a disabled child if: -        18yrs old or younger, AND -        Meet federal criteria for childhood disability, AND -        Meet institutional Level of Care, AND -        Can safely be served at home, AND -        Cost does not exceed the applicable institutional cost. -          What is the KB Waiver criteria based on? •         Federal Regulations established general requirements in 42CFR 435.225.   -        Requires institutional level of care: nursing home, hospital, or intermediate care facility- mental retardation.   1. Intermediate Care Facility - Mental Retardation - 442CFR440.150 & 42CFR483.440 •         Requires 24 hour supervision AND active treatment. 2. Hospital Level of Care - 42CFR440.10 •         Georgia uses Interqual. 3. Nursing Home LOC - 42CFR440.155 •         DHR Rules 290-5-8 & OCGA 31-7-1(1)(b). •         Requires 24 hour nursing care. •           How is the Level of Care determined for the KB Waiver? •         Initial application made to DFCS. -        Clinical detail is sent to and reviewed by Georgia Medical Care Foundation. -        If Level of Care is satisfied, DFCS does cost neutrality assessment. •         Georgia Medical Care Foundation does clinical review. -        A certified Prospective Review Organization. -        Co-Medical Directors and nurse reviewers. What is the Appeal process for KB Waiver? •         An  initial administrative appeal can be requested from GMCF. You have 30 calendar days to supply additional information. •         A 2nd appeal can be made by requesting a hearing directly from the DCH. (Fair hearing in front of a judge)   Background on Katie Beckett Waiver for Georgia •         KB Waiver was created to waive income limits of parents to establish eligibility for Medicaid in 1982. •         This is an optional Medicaid Program for Georgia. •         In 2001, the only national study ever conducted concluded that 20 states enrolled approximately 25,000 children in Medicaid through the KB waiver option. Georgia was the second highest ranked State for KB waivers. •         Increase in KB Waiver denials since May 2005. No specific disability has been targeted. •         Over 6,200 families had the KB waiver before the new guidelines were implemented on 11/15/04. •         Over 1,600 children have been denied with a projection of 48% by FY 2007. •         Over 71% of all KB Waiver families have primary healthcare insurance. Therefore, Medicaid is secondary insurance. •         KB waiver is already a cost reduction program versus the States alternative to institutional care. •         KB Waiver accounted for $33 million of the 2003 Medicaid expense. This represents less than 1% of the total Medicaid budget. •         Based on data given by DCH at the Public Hearing for KB waiver held on 1/19/06: •         GA program has had significant growth: 250% growth in 5 yrs; 2,694 FY2000, 6,299 FY2004. •         Since 6/1/05: •         2,761 have applied to renew: 37% approved. •         461 have applied for 1st time: 33% approved. •         1274 have request 1st appeal: 10% approved. •         246 have requested hearings: 67 resolved Tips and Traps •         Review the new eligibility criteria by going to www.communityhealth.state.ga.us. •         All applications after 11/15/04 have new forms which include the following: -        Pediatric DMA6(A). -        Care Plan (DMA 706). -        Cost-Effectiveness Form (DMA 704 which replaced the Deeming waiver Physicians Referral Form). •         Fill out all forms out as a "Provider" NOT as a "Parent". •         Always send everything to GA Healthcare Partners / DCH by certified mail. •         DCH is currently reviewing applications submitted in September 2005. •         #1 Reason for denials is an administrative denial (lack of paperwork and incomplete package). •         Submit ALL the forms and supporting documentation in one application. •         Put together a Table and Contents and tab each document. Networking & Building Alliances •         If you are denied, contact Governor's Council on Developmental Disabilities (GCDD) via e-mail at pnobbie@dhr.state.ga.us. They are keeping track of denials in the state. •         Contact your State Senator and Representative's by going to www.vote-smart.org and inputting your zip code.  They need to hear from you about your situation and how it impacts your family. •         Contact Governor Perdue:  Georgia.Governor@gov.state.ga.us. •         Stress when talking to your legislators that the majority of the KB waiver families are hardworking, middle class, tax paying, voting citizens that have never asked from anything from the State until they had a child with a disability. •         Atlanta Alliance on Developmental Disabilities is also involved and looking for suggestions. http://aaddpolitical.blogspot.com/ •         Work with the media to get the message out and to help educate the general population of our concerns. •         AJC is currently asking for feedback during this legislative session. http://my.ajc.com/WBRH037AF62C6991AEF773D35A3F10 •         Get Involved! Advocating is the key to success in getting the services we need for our children. Send on e-mail to : heidijmoore@comcast.net if you would like to be placed on my advocacy distribution list. •         My goal: Make the issues easy to understand and explain to advocates what they can do to influence change in this State. •         Tips for Appealing: •         In the original denial letter, the parents have 30 Calendar days to appeal. •         Resubmit any Medicaid documents that you feel you may have not filled out properly based on the new eligibility criteria. •         Prepare a 24 hour Care Plan going into detail about your child's day. Explain everything you do as a parent that goes beyond a "typical" child's duties as a parent. •         Have all your doctors, therapists and any other professional that works with  you child submit a letter explaining why your child needs the waiver. •         Contact your local State Senator and Representative and send copies of e-mails to the Governor. •         Financial Responsibility: •         The first Denial letter allows parents 30 days to provide additional information to support the level of care approval request.  Whether the parents submits additional information or not, the benefits should continue until a Final Denial letter is issued. •         The Final Denial letter allows parents 30 days to request an appeal.  Benefits are terminated at the end of the month, once the Final Denial letter is served. However, upon request, benefits are reopened retroactively if an appeal is requested.  The benefits continue through the hearing process. •         When the appeal decision has been rendered and properly served, the benefits can be terminated at the end of the month that the hearing decision was rendered and served. •         Families could be held liable for coverage provided during the appeal process. If the family is a new applicant, they would receive no coverage during the appeal process. Appeal Process •         Detailed information on the procedural aspects of a fair hearing and instructional video on representing yourself in a hearing without an attorney can be found at: www.osah.ga.gov/ •         If any parent feels that they have been discriminated against during the fair hearing they can report it to Chief Justice Louis Oakley or Deputy Chief Judge Michael Malihi. Contact information can be found on the above website. •         List of helpful websites: •         Medicaid's Main ICF-MR page: http://www.cms.hhs.gov/medicaid/icfmr/default.asp •         ICF-MR level care and "persons with related conditions": http://www.healthlaw.org/library.cfm?fa=download&resourceID=61843&appView=folder&print •         Great site to find current lawsuits in other states re: disabilities: http://www.healthlaw.org/ •         When you see a code w/  "CFR" go here to look it up.  Most healthcare is in title 42.  Medicaid's definitions are listed here. http://www.gpoaccess.gov/cfr/retrieve.html •         An appeals decision re: 24 active care vs. 24 supervision.  This is the court's breakdown of the fed regs and how they interpreted them. http://www.state.in.us/judiciary/opinions/previous/archive/02280101.nhv.html •         Autism Handbook http://www.usd.edu/cd/autism/Autism%20Handbook.pdf Current Concerns and Solutions to KB Waiver Situation •         Consistency of review. We need to make sure that "reviewers" are not just looking at the Individual Education Plans (IEP's) that report the child's progress, not the delays, as well as, the child's disability, appeal info. etc. •         Federal Regulations versus the States interpretation. It is my understanding that the State is currently exceeding the regulations for hospital, nursing home and intermediate care facility levels of care determination for eligibility. "Active treatment" definition also needs to be defined. •         Qualifications of the medical review team. Making sure all those on the review team have pediatric and clinical experience in disability related issues. •         Problems with the overall communication process and training of staff. DFACS case workers are not able to help families as they go through the process due to lack of knowledge of the system.  Also having a "live" person available to help answer questions families may have during the documentation and appeal process. •         Reauthorization Process needs to be modified.  The status of many children does not significantly change from year to year yet our families, doctors, nurses, therapists, etc  have to fill out a stack of paperwork every year that may not be necessary. This adds time and money to the process without adding value. •         Possible Solutions for those that do not qualify for KB waiver but need support.  Create an Insurance Risk Pool, Buy-in insurance program or a State fund pool to help families with costs not met by their insurance.  May also want to look at a new waiver for those children that do not qualify for KB Waiver but have significant behavioral, health related and developmental delay needs. The State may also need to look at increasing the private insurance's responsibility for standards of care for children. •         Overall: Families are asking for a clear and fair review process  for their child's KB waiver Other Things to know: •         Attend Disability Day at the Capitol to be held on February 23, 2006. More info: www.gcdd.org. •         Medicaid Modernization. The Governor's office is looking to reform the entire Medicaid population. This recently was announced to be delayed until 2007. •         Georgia Enhanced Care Program. •         Get involved and monitor your child's Medicaid card. -        www.ghp.georgia.gov and request a password from GA Health Partnership to be able to track Medicaid charges to your child's account. -        This is very important in order to verify and report problems. You can report a complaint via the website as well. -        Only through education, accountability and communication are we going to be able to make a difference in the process.  --Heidi J. Moore (Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 4 years old) "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative. Heidi J. Moore Thu, 09 Feb 2006 00:00:00 EST