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 Williams Staff Writer dave.williams@gwinnettdailypost.com ATLANTA - 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.

 

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

 

====================================================

 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'.

###

 

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:

 

 

 

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:

 

1. 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?
2. 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.
3. 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.
4. We do not want managed care to interfere with the implementation of the MRWP/NOW waiver.
5. There needs to be a lot more thought and input into this option before putting into the budget at the last minute.  
6. 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

 

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:

 

 

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  home
In 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 castle
At  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 future
In 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!"

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