Friday, May 08, 2015
Thursday, July 02, 2009
Texas families struggling to provide health insurance for their children with disabilities may soon be able to buy coverage through the state’s Medicaid program.
During the recent session of the Texas Legislature, lawmakers approved an exceptional item in the HHSC appropriation request calling for creation of a Medicaid Buy-In program for children with disabilities whose family incomes are below 300 percent of the federal poverty level. In real dollars that means a family of four with a disabled child and an annual income of $66,150 might qualify. Monthly premiums or cost-sharing payments paid by participating families would help offset some of the cost of the program.
HHSC will now begin work to develop rules for the program, set up eligibility criteria and plan for integration of the new program into HHSC’s eligibility system. At the same time, HHSC must secure approval of the federal Centers for Medicare and Medicaid Services by way of an amendment to the Texas Medicaid State Plan. That process usually takes nine months to a year to complete.
The legislation projects the new Medicaid Buy-In program will serve more than 6,000 children each year once it’s fully implemented.
HHSC already administers a buy-in program for working adults with disabilities who are looking to access or continue Medicaid coverage. For more information on that program, visit the Frequently Asked Questions section of the Medicaid Buy-In website.
Monday, April 27, 2009
Austin, Texas – April 27, 2009 – The Center for LifeLong Living and Planning, a program of the Seaton Foundation, is excited to announce the publication of the revised edition of its free informational booklet, “LifeLong Living and Planning for Individuals with Cognitive Disabilities.” The booklet provides families, guardians, caregivers and other professionals with a basic understanding of issues related to quality of life and long-term planning for individuals with brain injuries and other cognitive disabilities.
Featured authors include David Seaton, Harvey Jacobs, Janet M. Williams, Sandy Ransom, Al Condeluci, John Sassin, Stan Seaton, Randy Lewis, David B. Pharis, Deborah Green, Stephen C. Brewer and Steve Rhatigan.
The Seaton Foundation provides educational and training opportunities for caregivers and professionals who work with individuals affected by cognitive disabilities.
To request a copy, please contact LL@CLLP.org or call Laura Latham at 512-371-1078. A PDF version of the booklet can also be downloaded from http://www.cllp.org/.
Wednesday, November 26, 2008
This demographic event has arrived just as many in the advocacy world are developing new and successful methods for preparing those same individuals for employability and, ultimately, self sufficiency. With a little luck and a lot more work from educators', service providers', benefit administrators' and employers', we could be on the brink of a new paradigm that screams "disabled doesn't mean unable".
Two great sites to catch much of the new information, go to DisabilityInfo.Gov and ODEP
Tuesday, July 29, 2008
“Beginning July 1, Medicare beneficiaries will see lower costs for some of their durable medical equipment and supplies – as much as a 43 percent savings for certain items – and the assurance they will have accredited and financially sound suppliers providing them with equipment and supplies,” said CMS Acting Administrator Kerry Weems. “It is important that people with Medicare who use certain medical equipment and supplies know they can call
1-800-MEDICARE or go to www.medicare.gov to see if their current supplier is a Medicare-contract supplier or what they may need to do to find a new supplier approved by Medicare.”
The resources being mailed to beneficiaries will include a brochure about the new program and a list of Medicare contract suppliers in their area. CMS is also sending similar information about the new program and the list of Medicare contract suppliers to local partner groups and durable medical equipment (DME) referral agents, such as hospital discharge planners, physicians’ office staff and home health agency social workers. The ten Round One communities include certain ZIP codes in the areas of Charlotte, N.C.; Cincinnati and Cleveland, Ohio; Dallas/Fort Worth, TX; Kansas City KS-MO; Miami and Orlando, Fla.; Pittsburgh, Pa.; Riverside, Calif. and San Juan, Puerto Rico.
The new program, required by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), uses the competitive marketplace to establish prices for certain durable medical equipment, prosthetics, orthotics, and supplies. Under the new program, bids submitted by suppliers were evaluated and the bids within the winning range established the competitive prices that beneficiaries – and Medicare – will pay. Suppliers who were accredited, met financial and quality standards and bid within the winning range were offered contracts under the competitive bidding program. By using these selected contract suppliers, Medicare beneficiaries should receive high quality items at an average saving of 26 percent from approved suppliers.
Sunday, July 27, 2008
The Financial Security Accounts for Individuals with Disabilities Act of 2007
The federal government gives American families a helping hand in saving for the future. Accounts with special tax advantages help people save for college, retirement, and other normal life events. But people with disabilities don’t have the same expectations for the future. They need a new savings instrument.
A typical tax-deferred savings plan, such as a “529” college tuition plan, can’t help a family with a child who may not go to college or become financially independent. On the other hand, the need for savings is even greater for a child with a disability because he or she will likely be less able to earn an income, and may require additional spending on medical treatment or adaptive equipment. Without a clear vision of the future, parents of children with disabilities must choose between turning down the advantages of savings plans or risking a penalty if their child cannot use the funds according to the account restrictions.
The Financial Security Accounts for Individuals with Disabilities Act of 2007 was first introduced n the 109th Congress. The legislation amends the Internal Revenue Code of 1986 to provide for the establishment of Financial Security Accounts for Individuals with Disabilities (FSAID) for the care of family members with disabilities.
FSAID’s are exempt from taxation during the period of contribution;
Anyone can contribute to the financial security of a loved one;
Proceeds from the account, when used in accordance with this legislation, are not includible in the gross income of the beneficiary;
Accounts are for the exclusive purpose of paying qualified expenses of an individual who is disabled and who is designated the beneficiary of the trust;
Accounts are used for qualified expenses, not compensated for by insurance or otherwise, as detailed in the legislation. Such expenses include:
Medical and dental care,
Community based support services,
Employment training and support,
Assistive technology, and
After the age of 18, housing and transportation expenses.
FSAID accounts are easy to establish, unlike some other savings instruments.
Anyone – other family members, friends, employers – can contribute to an account on behalf of a beneficiary;
Since they are as easy as a savings account to establish, the costs associated in administering the account are low;
The Beneficiary can serve as the Trustee of the account;
A family who saves money in a traditional account for a child who becomes disabled later in life can roll over the funds into a disability savings account without penalty;
The beneficiary can be changed to other qualified family members.
Unlike some savings instruments, such as “529” college accounts, the FSAID would be created and regulated only on the federal level, so they would operate under the same rules in every state.
3. Financial Security
The Financial Security Accounts for Individuals with Disabilities Act of 2007 would give families of people with disabilities the ability to save for their child’s future just like every other American family, and help people with disabilities live full, productive lives in their communities
Under the proposal, an “individual with a disability” is defined as anyone currently receiving supplemental security income benefits under title XVI of the Social Security Act or an individual otherwise eligible to receive such benefits notwithstanding the income and assets tests required for eligibility for such benefits;
Rollovers from other accounts are allowed without penalty into a FSAID;
Prohibits amounts held by, or paid or distributed from, FSAIDs from being treated as income or assets when determining eligibility for benefits provided by any Federal benefits program;
Any distributions that exceed qualifying expenses are subject to an income tax on the non-qualifying portion of the disbursement;
Contributions to a FSAID are capped at $500,000.00.
Steven C. Rhatigan from The Woodlands, Texas was named as Chair for the President's Committee for People with Intellectual Disabilities (PCPID).
Thirteen new members of PCPID, appointed by President George W. Bush, were sworn in by U.S. Department of Health and Human Services’ (HHS) Deputy Secretary Tevi D. Troy, Ph.D. The President’s Committee for People with Intellectual Disabilities provides advice to the President and to the Secretary of HHS pertaining to matters relating to programs and services for people with intellectual disabilities.
“Persons with disabilities are a unique group and they deserve the same quality of life as all other individuals,” said Daniel C. Schneider, HHS acting assistant secretary for children and families. “The new members will assist in upholding the rights of children and adults with intellectual disabilities and guarantee their capacity to participate in all aspects of community life.”
“This is a diverse and remarkable group of leaders at the local, state and national level, coming together to finish out the president’s New Freedom Initiative, which is to remove barriers to community living for people with disabilities,” said Steve Rhatigan, new chairman for PCPID, appointed by President George W. Bush.
Since its inception in 1965, the President’s Committee has led the charge to improve the lives of people with intellectual disabilities, most recently adopting the goals outlined in President George W. Bush’s New Freedom Initiative to recognize and uphold the right of all people with intellectual disabilities to enjoy a quality of life that promotes independence, self-determination, and full participation as productive members of society. These goals include the assurance of full citizenship rights, the reduction of the occurrence and severity of intellectual disabilities and the promotion of forward thinking programs and services and cutting edge assistive technologies to improve the lives of people with intellectual disabilities.
Monday, February 26, 2007
The programs that federal and state benefits provide are valuable to all qualified individuals and form the financial and security foundation of most long term plans. The nature and structure of these benefits make it difficult to match the need with the supports available, creating a situation not always conducive to actually achieving the stated mission of providing help to those in need with dignity and a sense of self worth.
And, many of the programs actively eschew the natural supports and quite often penalize a beneficiary for their caregiver’s actions and support.
The outcome of such a confusing maze of services is that many qualified individuals, and their caregivers, are not receiving the support that might make positive and profound improvements in their lives. And, even after they are on benefits, the constant flood of communications from the varied sources make it very difficult to maintain equilibrium as to their current status. Even experienced advocates find it a task to keep up with the published regulation changes, and this doesn’t include accounting for the regional interpretations and application of those changes.
Where can individuals get help? There is a cottage industry of attorneys’ who advertise their experience; however, they are usually partial to those cases with large back payment potential. That leaves the single mother with a special needs child largely at the mercy of the “voice” on the other end of the telephone line. And even the most educated person will find it hard to cut through the clutter.
At this particular time it is not unusual for an initial applicant to wait six to nine months to process their file trough 3 levels of evaluation. If they are still not approved, it can take another year to get through levels four and five.
If you consider that many individuals must make application through several agencies to receive their full measure of benefits, most with different terminology and requirements, it is no wonder that 30% of eligible individuals never re apply after their first failed attempt.
Some recent statements from reputable sources about the state of our benefit programs are direct and damning:
The Eligibility Definition used by SSA needs to be changed.
David C. Stapleton Dir, Cornell University Institute for Policy Research
“Further, I have concluded that we have to make fundamental, conceptual changes to both how we define eligibility for economic security benefits, and how we provide those benefits, if we are ever to fulfill the promise of the ADA.”
A User’s Perspective on Federal Disability Data
by Martin Gould, Ed.D. Director of Research and Technology
National Council on Disability
"There are dozens of individual federal funding streams with varying and different eligibility criteria for program access. There is a patchwork quilt of policy and program initiatives that change when Administrations turn over, or that are outmoded – some dating to the 1960s and 1970s -- and uncoordinated. There are no specific or concrete national goals for people with disabilities in a host of critical areas of life.”
Issues in Medicaid Policy and System Transformation:
Recommendations from the President’s Commission on the Freedom Initiative
Stephen L. Day, M.S.W.
“For the longer term an opportunity exists to review the current patchwork of
Medicaid optional services and state-level variations and to consider a more
consistent national Medicaid benefit plan”
A Disability System for the 21st Century
The Social Security Advisory Board
September 2006 Report
“Our Nation’s policymakers need to acknowledge that the current disability programs, though well intentioned, are badly fractured and disjointed. A unifying point of vision, oversight, and management is desperately needed.”
“GAO’s research has found that these programs are neither well aligned with 21st century realities nor are they well-positioned to provide meaningful and timely support for Americans with disabilities. Solutions to these problems are likely to require fundamental changes, including regulatory and legislative action.”
It's time for a new plan for those with lifetime special needs and their caregiver's.