Let's Get Together, Inc.

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:

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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

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 � 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 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."

--
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.

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.