gwinnettdailypost.com

Parents frustrated with veto of therapy bill

06/08/2007 -

By Dave Williams
Staff Writer
dave.williams@gwinnettdailypost.com

ATLANTA - 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."