SCIL Legislative Wrap-Up
Click here for list of bills that have been signed by the Governor! This year our legislative priorities were to raise eligibility for Medicaid/MoHealthnet to 100% of Federal Poverty, restore dental and therapy services and to protect Missourians with disabilities against policy that could create more barriers, limit spending on programs vital to individuals and have a negative impact on Missouri. We did not have many successes, but were able to defeat a few bills that could have a negative impact. A few items were funded that will help deliver services to individuals to help them stay independent and in their communities. We need to continue to talk to our legislators at home and share our stories with them. All it takes is a phone call or quick email. Check your local paper for events or locations where Senators and Representatives might be and meet them in person. Because this is an election year, many of them will be out campaigning and this is a perfect time to talk to them one on one! If you don’t know who represents you, click here! Also we want to thank you to all of those advocates that worked hard this session making calls, writing letters and making visits to the Capitol. We truly could not make an impact without all of us in the disability community working together! Let’s keep it up and show we have a voice in Southwest Missouri! What didn’t happen in 2008! Dental services for Medicaid/MoHealthnet were not funded. At this time only children, pregnant women and blind individuals receive dental coverage through Medicaid. Even though SB577 in 2007 allowed for the appropriation of these funds, the legislature chose not to fund them for 2009. We will have to continue to work diligently to bring light to why all individuals with disabilities should have access to dental care. Physical, occupational, and speech therapies for Medicaid/MoHealthnet were not funded. We need to continue to tell legislators that individuals may have to choose an institution over staying independent in their homes and communities to get these services that sustain their life. It would also be a cost saving to the state if they were funded, because therapies will help individuals stay out of the hospital and from being further injured or disabled. Hearing aids for Medicaid/MoHealthnet were not funded. We will continue to express the importance of how equipment can help individuals gain employment, increase communication skills, stay active and independent in their communities. Eligibility for Medicaid/MoHealthnet was not raised. Eligibility is still set at 85% of FPL (Federal Poverty Level.) Currently 85% of FPL is $737/mo for an individual. This creates a spenddown for many individuals who receive SSDI (Social Security Disability Income) and have more money coming in. They receive more money, because they have worked in the past and that determines the amount they receive. They also paid into the system when they were working. This creates a situation where they paid into the system and are now paying again so that they can have healthcare that is not accessible or affordable to them otherwise. Assertive Community Treatment programs were not given additional funding for more programs. This is an evidenced-based model that has been successful in helping persons with mental illness (including people with mental illness who are deaf or hard of hearing) live in the community while reducing hospitalization and inappropriate incarceration. ACT provides highly individualized, long-term services that are available when the individual needs them – on weekends and evenings, as well as days. Additionally, helping individuals find safe, affordable housing, as well as employment, are priorities for ACT programs. HJR70, commonly known as TABOR, made it to the Senate floor, but was not brought up for a vote. This bill, which has been introduced several years in a row, made it farther this year than ever before. It is a proposal to limit revenue spending in Missouri and named after a similar proposal in Colorado. Click here for more TABOR info! There was an attempt to amend the constitution to allow for the requirement of a photo identification card when voting. HJR 48 was not brought up for a vote on the Senate floor in the last hours of the session. This could make it extremely difficult for individuals who don’t have the necessary documentation or finances to obtain a photo id and vote. The bill had been introduced early in the session, but was stalled until a Supreme Court decision in Indiana upheld their photo identification requirement. Missouri legislators then made an attempt to pass this bill, but fell short. NPR story on Indiana case! Nuns were turned away in Indiana! What did happen! Vocational Rehabilitation and providers were given an increase in funding. This will help providers offset some of their rising costs when providing services. The funding will also help Vocational Rehabilitation keep their waiting list down so that individuals can get the services they need without a long wait. In-home providers were given an increase. This funding will help offset the cost of providing long term care and attendant care services so that people with disabilities can stay independent and out of an institution. CILS were given an increase. This funding will help bring Centers for Independent Living across the state that are below the national average a little closer to what’s recommended. CILS will use this funding to provide their four core services and supports that help individuals stay independent. AAA’s were given an increase. This funding will help offset the cost of providing services to individuals over 60 years of age who might need transportation, meals on wheels or other supports. Presumptive eligibility for children was funded. This allows children to be eligible for the State Children’s Health Insurance Program if they have exhausted private insurance benefit, or have private insurance that doesn’t cover their special needs. Doctors and dentists who provide services through MoHealthnet were given a reimbursement rate increase. The rate has been low for some time and many providers have stopped accepting MoHealthnet because of it. The hope is that as the rate increases, more dentists and doctors will accept Medicaid/MoHealthnet and services will be more accessible to individuals. The Women’s Health Program that was enacted in 2007 was funded. (This is not comprehensive health coverage, but includes only reproductive health.) Bills that passed! Click here for HB 1807! This bill renames the State Schools for Severely Handicapped Children as the Missouri Schools for the Severely Disabled. We will continue to work to change language that uses words like “handicap” that degrade or hurt people. Click here for SB 768! This bill creates the Missouri Commission on Autism Spectrum Disorders and the Office of Autism Services. In February 2007, the Centers for Disease Control and Prevention issued their ADDME autism prevalence report. The report, which looked at a sample of 8 year olds in 2000 and 2002, concluded that the prevalence of autism had risen to 1 in every 150 American children, and almost 1 in 94 boys. With the rise in numbers, it is crucial to improve services for individuals with autism in our state There is still much to do!! On the federal level, the ADA Amendments Act (was ADA Restoration Act) is moving forward and we need to continue to follow this legislation and ensure that it passes with protections so that the ADA can be interpreted as it was originally intended. So many individuals are being discriminated against and their cases are being thrown out of court. To read more about this, click here! There have been seven separate regulations proposed over the last two years by the Bush administration that could cost state budgets billions of Medicaid dollars. Recently a moratorium was passed that would stop these regulations until April of 2009. To read more about this, click here! This is an election year and you have the right to VOTE! Make sure that you exercise that right and send a message that healthcare and other issues are important to you! If you need assistance in registering to vote, have questions regarding the above information or want to get more involved, please contact our Public Policy Advocate @ 417-886-1188. Please keep checking back for more information and events happening here at SCIL and in our area.
May 9, 2008
One week left of session! Voter identification is back! Bills to follow! TABOR! Spenddown Survey! any blue highlighted word is a link that can be clicked on for further info The budget is finalized and things are winding down. With one week left of the legislative session, many bills are not moving and a few are getting all of the attention.* HJR 48 Voter Identification is back and was voted out of rules this week and given a 150 minute debate on the floor. This happened on Wednesday and with many attempts by the democrats to make a point that the bill was unnecessary it passed by 89-67. It will most likely be assigned to the Senate Governmental Organizations and Elections Committee. We need to contact members of that committee and ask that they oppose this piece of legislation. A talking point sheet below was compiled by Michelle Krajewski, Public Policy Advocate at the Whole Person in Kansas City,MO. There is a hearing Monday, May 8th in the Senate Financial and Governmental Organization, Veteran's Affairs and Elections. Please contact these members and ask them to vote not on HJR 48! OPPOSE HJR 48 People with disabilities will be disproportionately burdened by photo ID requirements People with disabilities, particularly blind people, are much less likely to drive or own vehicles and therefore less likely to have a photo ID Lack of transportation, especially in rural areas, makes it difficult to travel to obtain the necessary documents People with disabilities are much more likely than non-disabled voters to live below the poverty level - no one should have to choose between voting or groceries and medicine A potential voter with an income of $637 (SSI maximum for single) a month may not be able to afford the documents required for ID It is possible to order birth certificates online or by faxing a request to the state – how does that prevent non-qualified individuals from obtaining proof of citizenship? Some states even require showing driver license or state-issued non-driver photo ID (Michigan for example) Many license bureaus are in inaccessible locations or use camera equipment that can’t be adjusted to take a picture of a person at wheelchair level The procedures set up by the department of revenue for the mobile photo ID unit were burdensome and unworkable for the people with disabilities who don’t live in institutions or nursing homes DOR would only allow unit to visit the site once – this was difficult because the folks who needed IDs couldn’t all be available on the same day If individuals signed up were unable to make it, there was no makeup date DOR required site to provide names, DOB and SS# of the people getting ID in advance before the DOR would agree to come out DOR set arbitrary deadlines for setting appointments – stopped taking appoimtments in July, long before election In one case, equipment didn’t work and people were unable to obtain ID People with disabilities already have a low voter turnout rate and photo ID is one more barrier that will discourage even more people from voting Inaccessible polling places Lack of poll worker training on curbside voting procedures OtherBills to watch for! HB 1656 changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. This bill is now on the Informal consent calendar. Contact Majority Floor Leader Senator Charlie Shields and ask that this bill be brought up. TABOR is back and had a hearing this week and the room was packed! There were many groups there to oppose this bill. It has not yet been voted on by the committee so you can still call, write or fax the members of the Governmental Accountability and Fiscal Oversight Committee and tell them that HJR 70 would be bad for Missouri!!!!!!!!!!!!!! As the session comes to an end, many bills will die! A few may survive! Stay tuned for an update that gives an end of session summary! If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list. As we continue to try and improve the updates, please let us know what you like or dislike or whether the updates or alerts are helpful. Your comments might be related to font size, color, format and anything else that we can change to make this update effective and friendly! Thanks!
May 2, 2008
Two weeks left of session! Budget is being finalized! Bills to follow! TABOR has a hearing! Spenddown Survey The budget bills have come out of conference committee and the bills will be finalized by May 9th. The revised budget will still have to be voted on in the Senate and House but any changes are unlikely. The following list show items that increase funding for individuals with disabilities. HB 2002 The VR match request was funded at $280K General Revenue. A 2% provider rate increase was funded at $420K General Revenue. (Note:These monies will need to be used for match as well to pull in all available federal monies.) Independent Living Centers were given an increase of $275K. HB 2010 An Increase of $.88 for InHome Providers HB 2011 Department of Mental Health Community Providers were given a 3% increase. Provider increases were lowered by the Senate. Dental and vision providers as well as physicians were given a rate increase! Dental providers got a 5% increase ($2,500,000). Physicians got a 7.43% increase ($15,000,000). You’ll notice that there were several things that were not funded. Dental and Vision Services for MOHealthnet Adults Physical, Speech and Occupational Therapies for MOHealthnet Adults Assertive Community Treatment programs. ACT is an evidenced-based model that has been successful in helping persons with mental illness (including people with mental illness who are deaf or hard of hearing) live in the community while reducing hospitalization and inappropriate incarceration. ACT provides highly individualized, long-term services that are available when the individual needs them – on weekends and evenings, as well as days. Additionally, helping individuals find safe, affordable housing, as well as employment, are priorities for ACT programs. Bills to watch for! HB 1656 changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. This bill is now included in HB 1516. It was voted do pass by Senator Champion’s Seniors, Families and Public Health committee. Thank these members for their support of transitioning people into the community! TABOR is back! There is a hearing at 9am on Tuesday, May 5th! Call, write or fax the members of the Governmental Accountability and Fiscal Oversight Committee and tell them that HJR 70 would be bad for Missouri!!!!!!!!!!!!!! As the session comes to an end, many bills will die! A few may survive! Stay tuned for an update that summaries everything that happened this year! If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list. As we continue to try and improve the updates, please let us know what you like or dislike or whether the updates or alerts are helpful. Your comments might be related to font size, color, format and anything else that we can change to make this update effective and friendly! Thanks!
April 17, 2008
Four weeks left of session! Status of budget! Bills we’re watching and where they are at! Spenddown Survey! The second half of the session is underway. The budget bills are now in the Senate and the deadlines have passed for filing bills. The items below will go to conference. The conference committee members have not been named, but we will keep you posted. The following items will go to conference. In conference the members will be able to decide on an amount in between the House and Senate position. The House positions gave more money to programs and services to ensure people with disabilities have the services they need to stay independent, at home and working in their communities! HB 2002 There was a little over $700,000 put in for Division of Vocation Rehabilitation to bring down over a million dollar federal match. The Senate only put in $250,000. Centers for Independent Living were given a little over $560,000 to be divided among the 18 centers that are below the recommended national level. The Senate put in zero to increase CIL funding HB 2011 Therapies (speech, physical and occupational) for home health care and for all MOHealthnet participants were included. The Senate did not put in money for therapies for either home health or for MoHealthnet. Department of Mental Health Community Providers were given a 3% increase. Provider increases were lowered by the Senate. Dental and vision providers as well as physicians were given a rate increase. The idea is that this will increase accessibility for those that do receive MOHealthnet dental and eye coverage. Provider increases were lowered by the Senate and will go to conference. Supplemental budget bill! The Senate had added dental and vision in the Supplemental bill which would’ve covered all MOHealthnet individuals until the next budget year. This was taken out in conference committee. The Conference committees will consist of the budget chairs for sure. Those are Representative Icet and Senator Nodler. Please let them know that you want to see the above items in the final budget. Bills to watch for! SB 756 sponsored by Kevin Engler HB 1627 - sponsored by Charles Portwood These bill changes the name of the division of mental retardation and developmental disabilities to the division of developmental disabilities. The Senate bill was slowed down in the Senate by a filibuster and has been placed on the informal calendar! The filibuster was initiated by Senator Green who has a large constituency who feels services will be limited for certain individuals if the word “mental retardation” is taken out! Here are some facts that testifies supporting the bill have stated, including Bernard Simons, the Director of MRDD. All but seven states have removed the term “mental retardation” from the state’s agency name. The name change does not have any impact on funding of supports and services. Changing the name does not change the mission. The term “retarded” is offensive to people with intellectual and developmental disabilities. In Washington D.C., the President’s Committee on Mental Retardation changed its name to the President’s Committee for People with Intellectual Disabilities after surveying constituents and learning how offensive the “R” word is to them. The House bill passed out of committee on April 1st. Please call the legislators on this committee and tell them “thank you” for supporting this effort Special Committee on Health Insurance. It is now time to tell all of the House of Representatives we need their support to keep the momentum up. Click here to look up your legislator! SB 717 - sponsored by Harry Kennedy HB 1345 - sponsored by Charles Portwood These bills increase the amount of tax credits available for taxpayers who modify their home to be accessible for disabled people who reside with such taxpayer. Under current law, up to one hundred thousand dollars in tax credits remaining unused under the rebuilding communities tax credit program are allocated for use by taxpayers who modify their homes for disabled persons residing with such taxpayers. The current amount referenced above will only help about 45 people from around the state if everyone used the maximum amount available. We need these bills to pass so that we will have more money to work with and many more people will be able to use the tax credit. The Senate bill is now on the Informal Calendar S Bills for Perfection--SB 717. Ask Senator Shields to bring this up for a vote and educate the Senators on why this bill is needed!! The House bill has passed out of rules and needs to be placed on the calendar. Educate representatives about this bill so that when it comes to the floor for a vote they know why it’s important! HB 1656 - sponsored by Bob Nance This bill changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. It was passed by the House and has been assigned to the Senate Committee on Seniors, Families & Public Health . Please contact Senator Champion and ask that this bill get a hearing!!!!! HB 2459 sponsored by Rachel Storch AFFORDABLE HOUSING UNIT REQUIREMENTS - Storch, Rachel Establishes design standards and requirements for the construction of an affordable housing unit. This bill is an attempt to incorporate Universal Design features into public housing. It would require “affordable housing” to use these guidelines in the bill. Our aging population is growing rapidly and more people with disabilities want to live in the community. It is time to look at how to address the needs of everyone and ensure that housing is safe and livable. This bill was filed late and has not been assigned to a committee. If you support this effort, please let Representative Storch, Representative Lampe and Representative Baker know that you do! If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list. As we continue to try and improve the updates, please let us know what you like or dislike or whether the updates or alerts are helpful. Your comments might be related to font size, color, format and anything else that we can change to make this update effective and friendly! Thanks!
April 7, 2008

SCIL Legislative Wrap-Up

Legislative Loop figure

Click here for list of bills that have been signed by the Governor!

This year our legislative priorities were to raise eligibility for Medicaid/MoHealthnet to 100% of Federal Poverty, restore dental and therapy services and to protect Missourians with disabilities against policy that could create more barriers, limit spending on programs vital to individuals and have a negative impact on Missouri. We did not have many successes, but were able to defeat a few bills that could have a negative impact. A few items were funded that will help deliver services to individuals to help them stay independent and in their communities.

We need to continue to talk to our legislators at home and share our stories with them. All it takes is a phone call or quick email. Check your local paper for events or locations where Senators and Representatives might be and meet them in person. Because this is an election year, many of them will be out campaigning and this is a perfect time to talk to them one on one! If you don’t know who represents you, click here!

Also we want to thank you to all of those advocates that worked hard this session making calls, writing letters and making visits to the Capitol. We truly could not make an impact without all of us in the disability community working together! Let’s keep it up and show we have a voice in Southwest Missouri!

What didn’t happen in 2008!

Dental services for Medicaid/MoHealthnet were not funded. At this time only children, pregnant women and blind individuals receive dental coverage through Medicaid. Even though SB577 in 2007 allowed for the appropriation of these funds, the legislature chose not to fund them for 2009. We will have to continue to work diligently to bring light to why all individuals with disabilities should have access to dental care.

Physical, occupational, and speech therapies for Medicaid/MoHealthnet were not funded. We need to continue to tell legislators that individuals may have to choose an institution over staying independent in their homes and communities to get these services that sustain their life. It would also be a cost saving to the state if they were funded, because therapies will help individuals stay out of the hospital and from being further injured or disabled.

Hearing aids for Medicaid/MoHealthnet were not funded. We will continue to express the importance of how equipment can help individuals gain employment, increase communication skills, stay active and independent in their communities.

Eligibility for Medicaid/MoHealthnet was not raised. Eligibility is still set at 85% of FPL (Federal Poverty Level.) Currently 85% of FPL is $737/mo for an individual. This creates a spenddown for many individuals who receive SSDI (Social Security Disability Income) and have more money coming in. They receive more money, because they have worked in the past and that determines the amount they receive. They also paid into the system when they were working. This creates a situation where they paid into the system and are now paying again so that they can have healthcare that is not accessible or affordable to them otherwise.

Assertive Community Treatment programs were not given additional funding for more programs. This is an evidenced-based model that has been successful in helping persons with mental illness (including people with mental illness who are deaf or hard of hearing) live in the community while reducing hospitalization and inappropriate incarceration. ACT provides highly individualized, long-term services that are available when the individual needs them – on weekends and evenings, as well as days. Additionally, helping individuals find safe, affordable housing, as well as employment, are priorities for ACT programs.

HJR70, commonly known as TABOR, made it to the Senate floor, but was not brought up for a vote. This bill, which has been introduced several years in a row, made it farther this year than ever before. It is a proposal to limit revenue spending in Missouri and named after a similar proposal in Colorado. Click here for more TABOR info!

There was an attempt to amend the constitution to allow for the requirement of a photo identification card when voting. HJR 48 was not brought up for a vote on the Senate floor in the last hours of the session. This could make it extremely difficult for individuals who don’t have the necessary documentation or finances to obtain a photo id and vote. The bill had been introduced early in the session, but was stalled until a Supreme Court decision in Indiana upheld their photo identification requirement. Missouri legislators then made an attempt to pass this bill, but fell short. NPR story on Indiana case! Nuns were turned away in Indiana!

What did happen!

Vocational Rehabilitation and providers were given an increase in funding. This will help providers offset some of their rising costs when providing services. The funding will also help Vocational Rehabilitation keep their waiting list down so that individuals can get the services they need without a long wait.

In-home providers were given an increase. This funding will help offset the cost of providing long term care and attendant care services so that people with disabilities can stay independent and out of an institution.

CILS were given an increase. This funding will help bring Centers for Independent Living across the state that are below the national average a little closer to what’s recommended. CILS will use this funding to provide their four core services and supports that help individuals stay independent.

AAA’s were given an increase. This funding will help offset the cost of providing services to individuals over 60 years of age who might need transportation, meals on wheels or other supports.

Presumptive eligibility for children was funded. This allows children to be eligible for the State Children’s Health Insurance Program if they have exhausted private insurance benefit, or have private insurance that doesn’t cover their special needs.

Doctors and dentists who provide services through MoHealthnet were given a reimbursement rate increase. The rate has been low for some time and many providers have stopped accepting MoHealthnet because of it. The hope is that as the rate increases, more dentists and doctors will accept Medicaid/MoHealthnet and services will be more accessible to individuals.

The Women’s Health Program that was enacted in 2007 was funded. (This is not comprehensive health coverage, but includes only reproductive health.)

Bills that passed!

Click here for HB 1807! This bill renames the State Schools for Severely Handicapped Children as the Missouri Schools for the Severely Disabled. We will continue to work to change language that uses words like “handicap” that degrade or hurt people.

Click here for SB 768! This bill creates the Missouri Commission on Autism Spectrum Disorders and the Office of Autism Services. In February 2007, the Centers for Disease Control and Prevention issued their ADDME autism prevalence report. The report, which looked at a sample of 8 year olds in 2000 and 2002, concluded that the prevalence of autism had risen to 1 in every 150 American children, and almost 1 in 94 boys. With the rise in numbers, it is crucial to improve services for individuals with autism in our state

There is still much to do!!

On the federal level, the ADA Amendments Act (was ADA Restoration Act) is moving forward and we need to continue to follow this legislation and ensure that it passes with protections so that the ADA can be interpreted as it was originally intended. So many individuals are being discriminated against and their cases are being thrown out of court. To read more about this, click here!

There have been seven separate regulations proposed over the last two years by the Bush administration that could cost state budgets billions of Medicaid dollars. Recently a moratorium was passed that would stop these regulations until April of 2009. To read more about this, click here!

This is an election year and you have the right to VOTE! Make sure that you exercise that right and send a message that healthcare and other issues are important to you!

If you need assistance in registering to vote, have questions regarding the above information or want to get more involved, please contact our Public Policy Advocate @ 417-886-1188. Please keep checking back for more information and events happening here at SCIL and in our area.

May 9, 2008

One week left of session!
Voter identification is back!
Bills to follow!
TABOR!
Spenddown Survey!

*any blue highlighted word is a link that can be clicked on for further info

The budget is finalized and things are winding down. With one week left of the legislative session, many bills are not moving and a few are getting all of the attention.

HJR 48 Voter Identification is back and was voted out of rules this week and given a 150 minute debate on the floor. This happened on Wednesday and with many attempts by the democrats to make a point that the bill was unnecessary it passed by 89-67. It will most likely be assigned to the Senate Governmental Organizations and Elections Committee. We need to contact members of that committee and ask that they oppose this piece of legislation. A talking point sheet below was compiled by Michelle Krajewski, Public Policy Advocate at the Whole Person in Kansas City,MO.

There is a hearing Monday, May 8th in the Senate Financial and Governmental Organization, Veteran's Affairs and Elections. Please contact these members and ask them to vote not on HJR 48!

OPPOSE HJR 48

People with disabilities will be disproportionately burdened by photo ID requirements

People with disabilities, particularly blind people, are much less likely to drive or own vehicles and therefore less likely to have a photo ID

Lack of transportation, especially in rural areas, makes it difficult to travel to obtain the necessary documents

People with disabilities are much more likely than non-disabled voters to live below the poverty level - no one should have to choose between voting or groceries and medicine

A potential voter with an income of $637 (SSI maximum for single) a month may not be able to afford the documents required for ID

It is possible to order birth certificates online or by faxing a request to the state – how does that prevent non-qualified individuals from obtaining proof of citizenship?

Some states even require showing driver license or state-issued non-driver photo ID (Michigan for example)

Many license bureaus are in inaccessible locations or use camera equipment that can’t be adjusted to take a picture of a person at wheelchair level

The procedures set up by the department of revenue for the mobile photo ID unit were burdensome and unworkable for the people with disabilities who don’t live in institutions or nursing homes

DOR would only allow unit to visit the site once – this was difficult because the folks who needed IDs couldn’t all be available on the same day
If individuals signed up were unable to make it, there was no makeup date
DOR required site to provide names, DOB and SS# of the people getting ID in advance before the DOR would agree to come out
DOR set arbitrary deadlines for setting appointments – stopped taking appoimtments in July, long before election
In one case, equipment didn’t work and people were unable to obtain ID

People with disabilities already have a low voter turnout rate and photo ID is one more barrier that will discourage even more people from voting

Inaccessible polling places
Lack of poll worker training on curbside voting procedures

OtherBills to watch for!
HB 1656 changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. This bill is now on the Informal consent calendar. Contact Majority Floor Leader Senator Charlie Shields and ask that this bill be brought up.
TABOR is back and had a hearing this week and the room was packed! There were many groups there to oppose this bill. It has not yet been voted on by the committee so you can still call, write or fax the members of the Governmental Accountability and Fiscal Oversight Committee and tell them that HJR 70 would be bad for Missouri!!!!!!!!!!!!!!

As the session comes to an end, many bills will die! A few may survive! Stay tuned for an update that gives an end of session summary!

If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org.    These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list.

As we continue to try and improve the updates, please let us know what you like or dislike or whether the updates or alerts are helpful. Your comments might be related to font size, color, format and anything else that we can change to make this update effective and friendly! Thanks!

May 2, 2008

legislative loop figure

Two weeks left of session!
Budget is being finalized!
Bills to follow!
TABOR has a hearing!
Spenddown Survey

The budget bills have come out of conference committee and the bills will be finalized by May 9th. The revised budget will still have to be voted on in the Senate and House but any changes are unlikely. The following list show items that increase funding for individuals with disabilities.

HB 2002

The VR match request was funded at $280K General Revenue.
A 2% provider rate increase was funded at $420K General Revenue. (Note:These monies will need to be used for match as well to pull in all
available federal monies.)

Independent Living Centers were given an increase of $275K.

HB 2010

An Increase of $.88 for InHome Providers

HB 2011

Department of Mental Health Community Providers were given a 3% increase. Provider increases were lowered by the Senate.

Dental and vision providers as well as physicians were given a rate increase! Dental providers got a 5% increase ($2,500,000). Physicians got a 7.43% increase ($15,000,000).

You’ll notice that there were several things that were not funded.

Dental and Vision Services for MOHealthnet Adults
Physical, Speech and Occupational Therapies for MOHealthnet Adults
Assertive Community Treatment programs. ACT is an evidenced-based model that has been successful in helping persons with mental illness (including people with mental illness who are deaf or hard of hearing) live in the community while reducing hospitalization and inappropriate incarceration. ACT provides highly individualized, long-term services that are available when the individual needs them – on weekends and evenings, as well as days. Additionally, helping individuals find safe, affordable housing, as well as employment, are priorities for ACT programs.

Bills to watch for!
HB 1656 changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. This bill is now included in HB 1516. It was voted do pass by Senator Champion’s Seniors, Families and Public Health committee. Thank these members for their support of transitioning people into the community!

TABOR is back! There is a hearing at 9am on Tuesday, May 5th! Call, write or fax the members of the Governmental Accountability and Fiscal Oversight Committee and tell them that HJR 70 would be bad for Missouri!!!!!!!!!!!!!!

As the session comes to an end, many bills will die! A few may survive! Stay tuned for an update that summaries everything that happened this year!

If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list.

April 17, 2008

legislative loop figure

Four weeks left of session!
Status of budget!
Bills we’re watching and where they are at!
Spenddown Survey!

The second half of the session is underway. The budget bills are now in the Senate and the deadlines have passed for filing bills.

The items below will go to conference. The conference committee members have not been named, but we will keep you posted. The following items will go to conference. In conference the members will be able to decide on an amount in between the House and Senate position. The House positions gave more money to programs and services to ensure people with disabilities have the services they need to stay independent, at home and working in their communities!

HB 2002

There was a little over $700,000 put in for Division of Vocation Rehabilitation to bring down over a million dollar federal match. The Senate only put in $250,000.
Centers for Independent Living were given a little over $560,000 to be divided among the 18 centers that are below the recommended national level. The Senate put in zero to increase CIL funding

HB 2011

Therapies (speech, physical and occupational) for home health care and for all MOHealthnet participants were included. The Senate did not put in money for therapies for either home health or for MoHealthnet.
Department of Mental Health Community Providers were given a 3% increase. Provider increases were lowered by the Senate.
Dental and vision providers as well as physicians were given a rate increase. The idea is that this will increase accessibility for those that do receive MOHealthnet dental and eye coverage. Provider increases were lowered by the Senate and will go to conference.

Supplemental budget bill!

The Senate had added dental and vision in the Supplemental bill which would’ve covered all MOHealthnet individuals until the next budget year. This was taken out in conference committee.

The Conference committees will consist of the budget chairs for sure. Those are Representative Icet and Senator Nodler. Please let them know that you want to see the above items in the final budget.

Bills to watch for!
SB 756 sponsored by Kevin Engler
HB 1627 - sponsored by Charles Portwood
These bill changes the name of the division of mental retardation and developmental disabilities to the division of developmental disabilities. The Senate bill was slowed down in the Senate by a filibuster and has been placed on the informal calendar! The filibuster was initiated by Senator Green who has a large constituency who feels services will be limited for certain individuals if the word “mental retardation” is taken out! Here are some facts that testifies supporting the bill have stated, including Bernard Simons, the Director of MRDD.

All but seven states have removed the term “mental retardation” from the state’s agency name.
The name change does not have any impact on funding of supports and services.
Changing the name does not change the mission.
The term “retarded” is offensive to people with intellectual and developmental disabilities.
In Washington D.C., the President’s Committee on Mental Retardation changed its name to the President’s Committee for People with Intellectual Disabilities after surveying constituents and learning how offensive the “R” word is to them.

The House bill passed out of committee on April 1st. Please call the legislators on this committee and tell them “thank you” for supporting this effort Special Committee on Health Insurance. It is now time to tell all of the House of Representatives we need their support to keep the momentum up.   Click here to look up your legislator!

SB 717 - sponsored by Harry Kennedy
HB 1345 - sponsored by Charles Portwood
These bills increase the amount of tax credits available for taxpayers who modify their home to be accessible for disabled people who reside with such taxpayer. Under current law, up to one hundred thousand dollars in tax credits remaining unused under the rebuilding communities tax credit program are allocated for use by taxpayers who modify their homes for disabled persons residing with such taxpayers. The current amount referenced above will only help about 45 people from around the state if everyone used the maximum amount available.   We need these bills to pass so that we will have more money to work with and many more people will be able to use the tax credit. The Senate bill is now on the Informal Calendar S Bills for Perfection--SB 717. Ask Senator Shields to bring this up for a vote and educate the Senators on why this bill is needed!!
The House bill has passed out of rules and needs to be placed on the calendar. Educate representatives about this bill so that when it comes to the floor for a vote they know why it’s important!

HB 1656   - sponsored by Bob Nance
This bill changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. It was passed by the House and has been assigned to the Senate Committee on Seniors, Families & Public Health . Please contact Senator Champion and ask that this bill get a hearing!!!!!

HB 2459 sponsored by Rachel Storch
AFFORDABLE HOUSING UNIT REQUIREMENTS - Storch, Rachel
Establishes design standards and requirements for the construction of an affordable housing unit. This bill is an attempt to incorporate Universal Design features into public housing. It would require “affordable housing” to use these guidelines in the bill. Our aging population is growing rapidly and more people with disabilities want to live in the community. It is time to look at how to address the needs of everyone and ensure that housing is safe and livable. This bill was filed late and has not been assigned to a committee. If you support this effort, please let Representative Storch, Representative Lampe and Representative Baker know that you do!

If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list.

April 7, 2008

Spring Break
Legislators head into break! Status of budget! New federal rules could have huge impact on states! Bills we’re watching and where they are at! Disability Rights Rally! Spenddown Survey! LEP (Legislative Education Project) The Missouri State Legislature will be on Spring/Easter break until Tuesday, March 25! This is a good time to contact your local representatives and senators and visit with them about what things are being done this session to protect and ensure Missourians with Disabilities have a good quality of life? Find out who your legislator is! The House Budget Committee has finished rolling out the budget bills and they should be ready to hit the floor the week after Spring break. That means all representatives have to vote on and pass the bills before the go to the Senate. Once the Senate gets them they will look at their version and compare the two. Any differences will have to go to conference (the conference committee is made up of senators and representatives.) Below are things that were included in the house bills that we are watching and feel could improve the lives of people with disabilities. HB 2002 There was a little over $700,000 put in for Division of Vocation Rehabilitation to bring down over a million dollar federal match. Centers for Independent Living were given a little over $560,000 to be divided among the 18 centers that are below the recommended national level. HB 2011 Therapies (speech, physical and occupational) for home health care were included. This appears to be for acute care situations where a person may be leaving a hospital to go home and they need therapy to stay out of the hospital. Department of Mental Health Community Providers were given a 3% increase. Dental and vision providers as well as physicians were given a rate increase. The idea is that this will increase accessibility for those that do receive MOHealthnet dental and eye coverage. So after the break we’ll have the budget to follow in the Senate. The deadline for any senators to file a bill has passed. The house members have until April 1 to file any bills. We’ll keep you updated as to what bills get filed in the remaining weeks of March! The House bill did not add coverage for MOHealthnet Dental and Vision Coverage. It appears that the Senate has included Dental and Vision Coverage in their version. We will need to continue to work on making sure these items are included in the final budget!!!!!! To learn more about the rules that have been proposed by the Centers for Medicaid and Medicare, click here! ! These Proposed rules could have a dramatic impact on state funding for Medicaid. 17.5% of Medicaid dollars in the state are spent on people with disabilities. NCIL (National Council on Independent Living) is asking for an increase of $100 million (for a total funding of $173.3 million annually for Independent Living) to not only restore funding cuts over the past three years, but also to reinvest the millions of dollars in savings to the Federal government that IL provides by transitioning and preventing thousands of Americans from forced institutionalization in by providing people with disabilities the information and tools they need to remain in their communities. Call your Representative today and tell them to attend the hearing and support increased funding for the Independent Living Program! If your Representative serves on the House Appropriations Labor, Health and Human Services, Education, and related Agencies Subcommittee (see list below), then your phone call is critical! Bills to watch for! SB 756 sponsored by Kevin Engler HB 1627 - sponsored by Charles Portwood These bills change the name of the division of mental retardation and developmental disabilities to the division of developmental disabilities. The Senate bill was slowed down in the Senate by a filibuster and has been placed on the informal calendar! The filibuster was initiated by Senator Green who has a large constituency who feels services will be limited for certain individuals if the word “mental retardation” is taken out! The House bill had a hearing on March 11 and it was packed with opponents. Here are some facts that testifies supporting the bill have stated, including Bernard Simons, the Director of MRDD. All but seven states have removed the term “mental retardation” from the state’s agency name. The name change does not have any impact on funding of supports and services. Changing the name does not change the mission. The term “retarded” is offensive to people with intellectual and developmental disabilities. In Washington D.C., the President’s Committee on Mental Retardation changed it’s name to the President’s Committee for People with Intellectual Disabilities after surveying constituents and learning how offensive the “R” word is to them. SB 717 - sponsored by Harry Kennedy HB 1345 - sponsored by Charles Portwood These bills increase the amount of tax credits available for taxpayers who modify their home to be accessible for disabled people who reside with such taxpayer. Under current law, up to one hundred thousand dollars in tax credits remaining unused under the rebuilding communities tax credit program are allocated for use by taxpayers who modify their homes for disabled persons residing with such taxpayers. The current amount referenced above will only help about 45 people from around the state if everyone used the maximum amount available. We need these bills to pass so that we will have more money to work with and many more people will be able to use the tax credit. The Senate bill is now on the Informal Calendar S Bills for Perfection--SB 717. Ask Senator Shields to bring this up for a vote and educate the Senators on why this bill is needed!! The House bill has passed out of rules and needs to be placed on the calendar. Educate representatives about this bill so that when it comes to the floor for a vote they know why it’s important! HB 1656 - sponsored by Bob Nance This bill changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. It was passed by the House and has been assigned to the Senate Committee on Seniors, Families & Public Health . Please contact Senator Champion and ask that this bill get a hearing!!!!! HJR 48 - sponsored by Stanley Cox This bill proposes a constitutional amendment requiring photo identification to vote in elections. The bill had a public hearing. The Missouri Disability Vote Project, which SCIL is a member of, testified in opposition as well as the Secretary of State’s office. This bill has not had any movement, but we will continue to keep our eye on it!! HJR 70 -sponsored by Allen Icet This bill proposes a constitutional amendment prohibiting appropriations in any fiscal year from exceeding certain limits. The amount of money appropriated for state funded programs could be dictated by a formula. This bill had a hearing and passed out of rules. It will go to the Senate next. We’ll continue to keep an eye on this one as well!!! To learn more about TABOR like initiatives click here! Don’t forget about…………………………… Let’s show legislators that Missourians in Southwest Missouri want to be heard!!!!!!!!!!!! Call Cari Wright if you would like to join us on the SCIL van! The Governor's Council on Disability and the Statewide Independent Living Council will once again be sponsoring the Legislative Education Project (LEP). The LEP's mission is to educate about the Missouri legislative process and motivate individuals by providing opportunities to become actively involved in positive public policy for people with disabilities. SCIL will be taking a group to Jefferson City for LEP during the week of April 14th. If you are interested and would like more information or to sign up, please contact Cari Wright, Program Manager at SCIL @ 417-886-1188. This has been a weekly update. If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list. As we continue to try and improve the updates, please let us know what you like or dislike. Your comments might be related to font size, color, format and anything else that we can change to make this update effective and friendly! Thanks!
February 25, 2008
Stay in touch with the Legislative Loop! Insure Missouri Update! Hearing schedule for week ahead! Bills to watch for and action steps! Disability Rights Rally! Spenddown Survey! LEP (Legislative Education Project) The Department of Social Services has asked that the Secretary of State hold off on approving the emergency rules for Insure Missouri. Last year, the governor announced Insure Missouri, which uses several funding sources, including $46 million in state funds. Its first phase would have provided caregivers with children with health insurance, encompassing about 54,000 Missourians. According to the Columbia Tribune, Blunt said his administration would delay implementation of an emergency rule that would have allowed people to start signing up for the first phase of the plan in March. The governor said in a prepared statement he wanted to get broader legislative consensus before parts of the program take effect. Nonetheless, Blunt insisted, "Our plan has support from many legislators and from health-care advocates across the state, but we need greater support in the House to begin helping nearly 200,000 Missourians purchase their own personal health insurance." Many in the disability community felt as though Insure Missouri did not go far enough to cover individuals who were cut from Medicaid rolls back in 2005, but it was a first step in covering the close to 800,000 Missourians without health insurance. We will continue to follow the efforts made during this legislative session to cover more people and we will keep up the fight to make sure that seniors and people with disabilities are top priorities. Hearings for the week Monday, Feb 25th @ 11:30 am in SCR2, Senate Appropriations will review the Department of Mental Health budget. Tuesday, Feb 26th @ 8am in Hearing Room 3, the Budget Committee will start reviewing reports from the Appropriations Committees. Tuesday, 8am in SCR 2 Department of Mental Health continued and Department of Health & Senior Services. Tues, @ 1pm in the Senate Lounge there will be a public hearing in Senate Health and Mental Health regarding SB972, which adds comprehensive day rehab services to MO Healthnet. Wed at 8am, in SCR Senate Appropriations will continue the DHSS budget. Go to http://www.moga.state.mo.us/hearings.htm for an update to the hearings and who the committee members are. Bills to watch for! SB756 - sponsored by Kevin Engler This bill changes the name of the division of mental retardation and developmental disabilities to the division of developmental disabilities. This bill passed out of committee with a 5-0 vote and needs to be reported out and put on the calendar for the entire Senate to vote on it. Please contact your Senator and ask that they support SB756 when it comes to the floor!!!! SB717 - sponsored by Harry Kennedy This bill increases the amount of tax credits available for taxpayers who modify their home to be accessible for disabled people who reside with such taxpayer. Under current law, up to one hundred thousand dollars in tax credits remaining unused under the rebuilding communities tax credit program are allocated for use by taxpayers who modify their homes for disabled persons residing with such taxpayers. The current amount referenced above will only help about 45 people from around the state if everyone used the maximum amount available. We need this bill to pass so that we will have more money to work with and many more people will be able to use the tax credit. This bill passed out of committee but needs to come to the floor for a full Senate vote. Educate the Senators! HB1656 - sponsored by Bob Nance This bill changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. It will come to the House floor soon. Educate your representative so that they will see the importance and vote yes for HB1656. HJR48 - sponsored by Stanley Cox This bill proposes a constitutional amendment requiring photo identification to vote in elections. The bill had a public hearing. The Missouri Disability Vote Project, which SCIL is a member of, testified in opposition as well as the Secretary of State’s office. We need to keep our eye on this one! Don’t forget about…………………………… Disability Rights Legislative Day! March 26, 2008 Jefferson City @ the Capital!!!! Let’s show legislators that Missourians in Southwest Missouri want to be heard!!!!!!!!!!!! Call Cari Wright if you would like to join us on the SCIL van! The Disability Coalition on Healthcare Reform (DCHR) is doing a survey regarding the impact of spenddown for individuals with disabilities. SCIL is a member of DCHR and we are looking for stories to share with legislators. If you feel you have a story to share which may help change current legislation and help yourself and individuals who have shared similar experiences, we urge you to complete this survey and share your story. http://www.surveymonkey.com/s.aspxsm=BYRGwiVxQaz2fOL57gZrlA_3d_3d The Governor's Council on Disability and the Statewide Independent Living Council will once again be sponsoring the Legislative Education Project (LEP). The LEP's mission is to educate about the Missouri legislative process and motivate individuals by providing opportunities to become actively involved in positive public policy for people with disabilities. SCIL will be taking a group to Jefferson City for LEP during the week of April 14th. If you are interested and would like more information or to sign up, please contact Cari Wright, Program Manager at SCIL @ 417-886-1188. This has been a weekly update. If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list. As we continue to try and improve the updates, please let us know what you like or dislike. Your comments might be related to font size, color, format and anything else that we can change to make this update effective and friendly! Thanks!
January 28, 2008
To look up information or to find out who your legislator is, go to http://www.moga.state.mo.us/ . Each week hearings are held. The link below will give you the hearing schedule. http://www.moga.state.mo.us/hearings.htm. Action needed: HB1345 (Rep. Portwood) was heard in House Ways and Means and public testimony was given. This bill Increases the cap for the income tax credits (to $1 million annually) available to certain individuals for the costs of modifications to a home in order for it to be accessible for a disabled person who resides with them. Contact these committee members and ask them to vote yes on HB1345. http://www.house.mo.gov/billtracking/bills081/commit/com036.htm The House Appropriations Committee for Education heard testimony for the Division of Vocational Rehabilitation and the requested funding increases that were not recommended in the Governor's budget. Contact the committee members http://www.house.mo.gov/billtracking/bills081/commit/com123.htm and ask them to support these increases. $556,000 General Revenue for Centers for Independent Living. The Statewide Independent Living Council recommended a three year phase-in to bring Missouri CILs to the national average. This funding request is for the second year increase. $770,000 General Revenue for a state match to draw down $1.6 million federal funds for vocational rehabilitation services. Missouri should not give up its opportunity for an increase in federal dollars and see our money go to another state. DVR has been able to reduce the waiting time for vocational rehabilitation services. As college tuition and health care costs increase, DVR needs the increase to continue to meet the need and not go back to long waiting lists. The House Appropriations Committee for Health, Mental Health and Social Services heard from the Department of Social Services, which includes the MO HealthNet program. Contact the committee members and urge them to support the following health care priorities for people with disabilities: http://www.house.mo.gov/billtracking/bills081/commit/com161.htm Support the Governor's recommendation to fund dental and optometric services and give dental providers a rate increase. Address the spenddown problem by increasing the MO HealthNet eligibility for elderly and people with disabilities to 100% of the federal poverty level. This would eliminate spenddown for about 17,000 people living below the poverty level. Fund therapies, including physical, occupational, speech and comprehensive day rehabilitation. Access to therapies and rehabilitation increases the independence of people with disabilities and prevent the need for more costly health care. Support funding for the Non-MO HealthNet Eligible Consumer Directed Services program (otherwise known as NME) for those people who are not eligible for MO HealthNet, but can afford attendant services. Governor Blunt recently announced that he will no be seeking re-election. We will keep you posted on new candidates running for Governor and where to find information about them. To find out more about Governor Blunt’s new insurance plan “Insure Missouri” go to http://www.insuremissouri.org/. This plan does not restore coverage to individuals with disabilities who were cut from the healthcare rolls in 2005. To read a recent article highlighting the program http://www.newsleader.com/apps/pbcs.dll/article?AID=/20080118/NEWS01/801180397/1007/NEWS01 Also check out what “Families USA says about “Insure Missouri.” http://www.familiesusa.org/assets/pdfs/mo-too-little-too-late.pdf. We’ll keep you posted on opportunities for you to let your voice be heard!!!!!!! MO Healthnet MO Healthnet is continuing to unfold. The Oversight committee met for the first time in January and will meet again on Tuesday, Feb. 5th. The location is 205 Jefferson St. Rm B on the 10th floor. It is open to the public. Go to http://www.dss.mo.gov/press/2007/103107gov.htm for a list of members. Despite the program being implemented there is still no dental coverage, limited vision, limited therapies and transportation. The eligibility limit for coverage is still at 85% of federal poverty and many people have a high spenddown. Disability Rights Legislative Day! March 26, 2008 Jefferson City, MO Stay tuned for more details! If you are interested in attending the Legislative Education Project let us know. This is several day training and hands on experience in Jefferson City that is sponsored by the Governor’s Council on Disability and the Statewide Independent Living Council. SCIL takes a group of individuals every year to show advocates how to be implement change and be effective to make our state a better place for Missourians with disabilities. We will be taking a group the week of April 14th. http://www.gcd.oa.mo.gov/LEP.shtml And don’t forget the Missouri Presidential Primary is Tues, Feb. 5th! To get national election results go to http://www.usaelectionpolls.com/. For more information to educate yourself on the candidates and healthcare go to http://www.kaisernetwork.org/health_cast/health2008hc.cfm?hc=2216. This has been a weekly update. If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list.
January 7, 2008
The 2008 legislative session has officially started. We will keep you posted as it progressives on things pertinent to Missourians with disabilities. Close to 800 bills have been filed so far and hearings are being scheduled. To look up information or to find out who your legislator is go to http://www.moga.state.mo.us/ . The House Appropriations Committee for Health, Mental Health and Social Services held two hearings. Testimony was heard related to the absence of dental coverage, high spenddown amounts for individuals and the need to raise provider reimbursement. Other testimony included the need for more funding for autism services, mental health services and children’s health insurance. For the week of Jan 14th, the following house hearings were scheduled. To get changes or updates go to go to http://www.moga.state.mo.us/hearings.htm. Monday, January 14 12pm in hearing room 3 The Budget Committee will hear public testimony on HB2015, which appropriates money for supplemental purposes for the Department of Social Services. 2pm in hearing room 5 The Special Committee on Healthcare Transformation meets. This committee will study all aspects of healthcare and how they relate to the problem of the uninsured in Missouri. Tuesday, January 15 8am in hearing room 5 The House Appropriations Committee for Health, Mental Health and Social Services will meet to go over the Department of Mental Health budget. 12pm in hearing room 5 The Special Committee on Healthcare Transformation meets. This committee will study all aspects of healthcare and how they relate to the problem of the uninsured in Missouri. Wednesday, January 16 8am in hearing room 5 The House Appropriations Committee for Health, Mental Health and Social Services will meet to go over the Department of Mental Health budget. 12pm in hearing 1 The Special Committee on Healthcare Transformation meets. This committee will study all aspects of healthcare and how they relate to the problem of the uninsured in Missouri. Thursday, January 17 8am in hearing room 7 The Special Committee on Healthcare Transformation meets. This committee will study all aspects of healthcare and how they relate to the problem of the uninsured in Missouri. We’ll keep you posted on opportunities for you to let your voice be heard!!!!!!! MO Healthnet MO Healthnet is continuing to unfold. The Oversight committee met for the first time in January and will meet again on Tuesday, Feb. 5th. The location is 205 Jefferson St. Rm B on the 10th floor. It is open to the public. Go to http://www.dss.mo.gov/press/2007/103107gov.htm for a list of members. Despite the program being implemented there is still no dental coverage, limited vision, limited therapies and transportation. The eligibility limit for coverage is still at 85% of federal poverty and many people have a high spenddown. Divided We Fail January 23rd Divided We Fail will hold a rally in the Capitol rotunda. The rally will include state legislators from across Missouri signing pledges to stop the partisan gridlock and work to ensure that every Missourian has access to quality, affordable, health care and lifetime financial security. For more information go to http://www.dss.mo.gov/press/2008/010808.htm. SCHIP update Congress has now extended the SCHIP program until March 2009 despite the President vetoing the bill twice. The legislation includes enough funding to keep 6 million children on the program. There is no funding to cover children who are eligible, but not enrolled. Disability Rights Legislative Day! March 26, 2008 Jefferson City, MO Stay tuned for more details! And don’t forget the Missouri Presidential Primary is Tues, Feb. 5th! To get national election results go to http://www.usaelectionpolls.com/. For more information to educate yourself on the candidates and healthcare go to http://www.kaisernetwork.org/health_cast/health2008hc.cfm?hc=2216. This has been a weekly update. If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list.
December 17, 2007
The Senate Appropriations and House Committees met the week of December 3rd to hear public testimony. The 2008 Legislative Session will officially begin on January 9th. Go to http://www.moga.state.mo.us/ for hearing schedules and important dates. Below is a list of a few bills that have been pre-filed. These bills are important to Missourians with disabilities. We’ll continue to provide updates on the status of these bills and others that are filed. SB 768 has been pre-filed by Senator Rupp, St. Charles. This bill creates the Missouri Commission on Autism Spectrum Disorders. The Commission will be composed of four legislators; seven state agency representatives one each from the departments of education, mental health, health and senior services, public safety, higher education, social services and insurance; two representatives of institutions of higher education, a local district special education director, a speech-language pathologist, a diagnostician, a mental health provider, a primary care physician, three parents of and one individual with autism spectrum disorder, and an private or non-profit provider or organization. All appointments will be made by the Governor with Senate consent, except the legislators will be appointed by the president pro tem and speaker. Responsibilities of the Commission are to make recommendations to the governor, general assembly and relevant state agencies regarding healthcare, education and adult and adolescent services for autism spectrum disorder and to make recommendations for a comprehensive statewide plan for integrated training, treatment and services for individuals of all ages with autism spectrum disorder. The Commission is charged with issuing preliminary recommendations by July 1, 2009 to the general assembly. It is assumed this Commission would extend the work of the Blue Ribbon Panel on Autism, chaired by Senator Rupp, that met in the summer and fall of 2007. There is no sunset clause, so it appears the Commission would be a new advisory body permanently established in state law. This bill has not yet been assigned to committee. SB 717 - Senator Kennedy (Senator Shields co-sponsor) HB 1345 - Rep. Portwood (7 co-sponsors) These bills improve upon the Home Access tax credit that was signed into law last session. The measure that passed last session gives a tax credit for persons who have expenses to make their home accessible. Even persons who don't earn enough income to pay state income tax can still receive the credit for their home access expenses. Persons who earn under $30,000 a year can receive a credit for 100% of their home access costs up to $2,500. Taxpayers who earn between $30,000 to $60,000 would be eligible for a credit up to half of their access costs up to $2,500. Under the bill that was signed into law, the total amount of credits that can be awarded statewide is $100,000. Obviously, this sharply limits the number of Missourians who could benefit. SB 717 removes the $100,000 cap completely and the House bill would raise the cap to $1 million. Passage of either bill would make the credit a significant tool in helping persons with disabilities remain in their homes and communities. SB 770 has been pre-filed by Senator Rupp, St. Charles. This bill establishes scholarships for students with developmental disabilities to attend a public school other than the one to which the student is assigned (either a different building within the same district or a different district) or to attend a private school. The bill does not provide or reference a definition of "developmental disability", but to be eligible the student does need to have an IEP which would require IDEA eligibility. The bill identifies some examples of students with developmental disabilities as those with mental retardation, a speech or language impairment, a traumatic brain injury, or autism spectrum disorder. To be eligible students must have attended a Missouri public school the year prior. Home schooled students and those participating in the Missouri Virtual Instruction Program (MoVIP) are not eligible. The amount of the scholarship is the per pupil state funding distributed to the school district or the actual cost of tuition, whichever is less. It appears this bill is patterned after the Florida statute (McKay Scholarship Program) but there are significant differences. The Florida statute uses IDEA eligibility rather than "developmental disabilities" and the scholarship amount appears to be substantially different. In addition, the option of attending an adjacent school district has different implications in a state like Missouri with over 500 individual school districts compared to 67 county-wide school districts in Florida. SB 756 - MRDD NAME CHANGE has been filed by Senator Engler This bill would change the name of the Division of Mental Retardation and Developmental Disabilities to the Division of Developmental Disabilities. SB 848 - CAPITOL ACCESS has been filed by Senator Shoemyer This bill would require that all offices in the State Capitol building be readily accessible and usable by persons with disabilities. MOHealthnet The MO Healthnet Oversight Committee also held it’s first meeting the first week of December. There has been controversial debate in regards to the committee. A recent article in the Kansas City Star highlights this. http://www.kansascity.com/115/story/388394.html. To view a list of the committee: http://www.dss.mo.gov/press/2007/103107gov.htm. If you would like to sign up for our legislative email alerts please call SCIL at 417-886-1188 or by emailing amcelwain@swcil.org. We also have updates listed frequently on our web site @ http://www.swcil.org.
2007 Legislative Session Final Summary
Below is a list of legislation that was Truly Agreed and Finally Passed and is now awaiting the Governor’s signature. If the Governor does not sign or does not veto a bill by July 14, 2007, it becomes law in the same manner as if the Governor had signed it. A lot of hard work went into following SB577 to ensure that if it did pass it would include protections for individuals with disabilities. In the last days of the session a compromise was made between the Senate version and the House version. The Conference Committee report was adopted and that is what passed. The bill changes the name from Medicaid to “MO Healthnet.” Medicaid is scheduled to end June 30, 2008. Many programs which the bill implements would start at that time. The Ticket to Work program should start sooner. It is unclear at this time exactly when it should start. The following breaks down the bill and gives the page number and line for each subject. The bill is 146 pages and includes many other changes to Medicaid and healthcare in general. The list looks at the areas that will affect individuals with disabilities. A link to the bill is also listed. SB577 was sent to the Governor on May 30, 2007. It awaits his signature. CCS HCS SS SCS SB 577 http://www.senate.mo.gov/07info/pdf-bill/tat/SB577.pdf Creates the Ticket to Work Health Assurance Program (page 43 line 5) This program will allow individuals who meet the definition of disabled under the federal guidelines for the Supplemental Security Income (SSI) program to be eligible for medical assistance if s/he is employed and has proof that federal taxes are being paid. To be eligible, an individual must have a gross income less than or equal to 250% of the Federal Poverty Level (FPL), excluding any earned income between 250 and 300% FPL (approximately $30,000). Any person whose gross income exceeds 100% FPL shall be required to pay a premium. If an individual who is eligible for this program is also eligible for employer-sponsored insurance (ESI) that is determined to be more cost-effective, the individual must participate in ESI. In this case, the state shall pay premiums, co-payments and other costs associated with ESI. The Ticket to Work Health Assurance Program is subject to appropriations and has a six-year sunset. Certain deductions and asset limits apply to eligibility determinations. These are listed below. Income disregards: all earned income, first $65 and 1/2 of non-disabled spouses remaining earned income, $20 standard deduction, health insurance premiums, and $75/mo standard deduction for dental and optical insurance, $50 for SSDI, all of SSI payment, and a standard deduction for impairment - related employment expenses equal to 1/2 of the disabled worker's earned income. Premiums for incomes over 100% of FPL (federal poverty level) are on a sliding scale from 4% to 6% of a person's income. Asset disregards: $5,000/yr in medical savings accounts and $5,000/yr independent living accounts. Any income earned by individuals eligible for certified extended employment at a sheltered workshop is exempt. NON-MEDICAID ELIGIBLE (page 120 line 19) The sunset date for Non-Medicaid Eligible Consumer Directed Services Program (NME) was extended to 2019. The program is subject to appropriations. DURABLE MEDICAL EQUIPMENT (page 67 line 7) Covers prescribed durable medical equipment as a MO HealthNet benefit. Adds that an electronic, web-based system will be used to ensure prior authorization. HOSPICE CARE (page 67 line 12) Hospice Care Is a Covered MO HealthNet Benefit. DENTAL CARE (page 68 line 2) Prescribed medically necessary dental care is covered, subject to appropriations. VISION CARE (page 68 line 7) Prescribed medically necessary optometric care is covered, subject to appropriations. OPTIONAL SERVICES FOR SPECIFIC POPULATIONS (page 68 line 25) Funds for optional services will still be appropriated to needy children, pregnant women and blind persons. CO-PAYMENTS (page 71 line 3) Starting July 1, 2008, the MO HealthNet Division pay requires additional co-payments for covered MO HealthNet benefits. PAY FOR PERFORMANCE (page 78 line 6) A “professional services” committee will design and maintain the guidelines for a pay-for-performance program. Providers operating under a risk-based (managed care) plan and under administrative services organization plans are required to participate in pay-for-performance. Providers operating under the State’s coordinated fee-for-service plan “shall” participate. The employers of physicians whose work earns the pay-for-performance reward must pass on the pertinent portion to the physician, without any corresponding decrease in the compensation to which they would otherwise be entitled. Pay-for-performance shall ensure quality of care, foster the relationship between the patient and provider, use accurate data, evidence-based measures, provide fair and equitable program incentives, and not discourage providers from caring for those with complex/high-risk conditions. COLA (COST OF LIVING ALLOWANCE (page 77 line 26) Allows Social Security cost of living increases to be disregarded until the federal poverty level for such year is updated. COLAs are implemented before the federal poverty level is updated. PUBLIC ASSISTANCE BENEFICIARY EMPLOYER DISCLOSURE ACT (Page 101 lines 17) The Department of Social Services must prepare a quarterly report that documents the number of individuals who are a beneficiary, or the financially responsible spouse or custodial parent of a MO HealthNet beneficiary of each employer with more than 50 employees. The report also must include whether the employees are full or part time, whether the employer offers insurance as a benefit, and the cost of MO HealthNet benefits being provided to the employer’s employees. SPENDDOWN (page 78 line 1) There is a provision that may make it easier for some persons with disabilities to meet their spend-down amount. If a recipient has out-of-pocket medical expense during a month in which they have already paid their spend-down, the recipient can carry over those medical expenses for future required spend-down amounts for up to three months from the date of the expense. HEALTH IMPROVEMENT PLANS (page 121 line 13) The bill requires the Department of Social Services to create health improvement plans including, but not limited to, risk-bearing managed care plans, administrative services organizations (ASOs), and coordinated fee-for-service plans. Enrollment into plans will begin July 1, 2008 and be completed by July 1, 2011. The managed care plans and ASOs will be required to meet quality targets or be penalized financially. Every participant shall be provided a health care home. All health improvement plans are required to help participants remain in the least restrictive level of care possible. All health improvement plans shall use best practices that are evidence based. MANAGED CARE (page 122 line 5) Older adults, blind and disabled will not be required to sign onto a managed care option. However, most of the description of services for all the managed care type plans was removed, and as a result the health plan development is left up to the departments and oversight committee. The bill states, "No provisions of any state law shall be construed as to require any aged, blind, or disabled (ABD) person to enroll in a risk-bearing coordination plan". It is not known whether the Department of Social Services might still choose to enroll the ABD population in managed care, perhaps on a voluntary basis or through a pilot project. PUBLIC INPUT (page 123 line 1) The bill states "the Department of Social Services will engage in a public process for the design, development, and implementation of the health improvement plans and other aspects of MO HealthNet. Such public process shall allow for but not be limited to input from consumers, health advocates, disability advocates, providers, and other stake holders". MENTAL HEALTH CARVE OUT (page 63 line 21) Services under the state plan provided by community mental health facilities operated by the department of mental would be provided. PSYCHOTROPIC MEDICATIONS (page 140 line 8) Protects Access to Psychotropic Medications for those in Fee-For-Service Plans. COMPREHENSIVE ENTRY POINT (page 129 line 3) The oversight committee will designate a subcommittee devoted to advising the department on the development of a comprehensive entry point system for long-term care. Members of the committee will include a wide variety of representatives appointed by the Governor. This includes a representative of Centers for Independent Living. CHILDREN’S PRE-EXISTING CONDITIONS (page 106 line 7) Regarding CHIPS, Health insurance plans that do not cover an eligible child’s preexisting condition shall not be considered affordable employer-sponsored health care insurance or other affordable health care coverage. CREATES “PREMIUM OFFSET” PILOT PROJECT (page 82 line 3) Subject to appropriations, the Department of Social Services” can choose one rural and one urban area in the state and implement a pilot program that makes insurance available to uninsured individuals that qualify. AREAS OF DEFINED NEED AND ELIGIBLE FACILITIES (page 36 line 3) The Department of Health and Senior Services may designate eligible facilities in “areas of defined need”. The factors that will contribute to the establishment of these eligible facilities will include: the health status of the local population, the ability of the population to pay for health care services, the accessibility of health care services, and the availability of health care professionals in the area. These facilities will be eligible to receive funds from the Healthcare Access Fund. OTHER BILLS THAT PASSED….. SS SCS HCS HB 327 -- ECONOMIC DEVELOPMENT This bill includes language from SB8 that creates the accessible home credit that provides a tax credit for persons who incur expenses to make their home accessible. Taxpayers earning up to $30,000 a year would be eligible for a credit for 100% of the cost they incur or $2,500,whichever is less. The credit is refundable which means that even taxpayers who would not normally earn enough income to be eligible can still receive assistance from the credit. Taxpayers earning between $30,000 to $60,000 would be eligible for a credit up to 50% of their costs or $2,500, whichever is less. Total credits statewide would be capped at a maximum of $100,000 per year. CCS HCS SCS SB 82 Modifies various provisions relating to the regulation of motor vehicles. This bill modifies various provisions relating to motor vehicles, was Truly Agreed and Finally Passed. The bill includes language to exempt persons ages 65 or older from having to provide a physician's statement when renewing disabled license plates or placards. HCS HB 181-ELECTRONIC VIDEO INSTRUCTIONAL MATERIALS This is the bill that requires publishers or manufacturers of video instructional materials designed for educational institutions to be captioned. A penalty of three times the amount paid by the purchaser to have the video captioned will be assessed to a publisher or manufacturer who fails to comply. SS HB 579 -EMERGENCY MANAGEMENT This bill transfers the State Emergency Management Agency from the Office of the Adjutant General to the Department of Public Safety and allows for the deployment of any health care professional who is licensed, registered, or certified in this or any other state and volunteers during an emergency declared by the Governor. Currently, only workers licensed, registered, or certified in this state are allowed to be deployed. The bill grants the volunteers immunity from civil damages for their services. The Department of Health and Senior Services is allowed to recruit, train, and accept the services of citizen volunteers to dispense medication in a public health emergency. The bill contains an emergency clause. BUDGET-During the budget process to appropriate funds for the 08’ fiscal year, a few increases were appropriated to increase programs for individuals with disabilities. Independent Living Centers received $560,000 increase. This will be divided among the 18 centers that are not regarded as being at the national level of funding. $150,000 was appropriated to add a Blind Skills Specialist to the public school system to work with children who are blind. There was an increase to Vocational Rehabilitation that was needed to bring down a little over $1 million in federal funds. This money should decrease the waiting time for people seeking services from VR. There was also an increase for Department of Health and Senior Services to reduce the waiting time for individuals who need assessments to receive Home and Community Based Services. Summarized by : Shelby Butler, Public Policy Advocate Southwest Center for Independent Living/Ozark Independent Living
May 7, 2007
Two weeks remaining and HB39 (Ticket to Work) has not come up on the Senate floor. It is crucial to call your Senator and Senator Charlie Shields (1-573-751-9476) and ask that Senator Shields bring HB39 to the floor. The HCS (House Committee Substitute) for SB577 (Healthnet) adds language that partially restores Ticket to work, but more along the lines of the Senate Committee Substitute of HB39 than the more favorable version that passed the House. There was discussion that this would get taken out of SB577 with the second House Committee Substitute. That substitute should be available on Tues., May 8th. SB577 (Healthnet) Committee hearings are now finished for the draft House Committee Substitute (HCS) for SB577. A committee vote doesn't appear likely until at least Tuesday according to the Chair, Rep. Schaaf. Debate on the House floor would not be likely until Thursday, May 10th at the earliest. There are considerable differences between the draft HCS and the version that passed the Senate. Below are a just a few of the important aspects relating to persons with disabilities. The bill still does not address those in the Spend-down program and those that were cut from Medicaid in 2005. Restoration of Adult Durable Medical Equipment (DME) coverage: Both the Senate and House version restore coverage for prescribed, medically necessary durable medical equipment for adults. The HCS version changes the coverage guidelines from the Senate's "accepted care and treatment guidelines" to "care and treatment guidelines consistent with national standards". If "national standards" refers to consistency with Medicare coverage guidelines, one concern would be that guidelines should not mirror Medicare criteria for covering wheelchairs or scooters only if needed for use inside the home. Restoration of other adult service coverage: The HCS would restore in state law the Medicaid services that were eliminated for most adults in 2005, including, but not limited to dental services, vision services, hearing aids, prosthetics, and comprehensive day rehabilitation. However, during the Department of Social Services appropriations bill (HB11) neither the House or Senate version fully funds these services, so it is questionable whether they will remain in the final version of SB577. Managed Care for the Aged, Blind and Disabled (ABD) Medicaid population: The Senate version appeared to force the ABD population into capitated managed care plans in those areas (36 counties) where Medicaid managed care now exists along the I-70 corridor. The draft HCS states that "The administration shall not design or implement any health improvement plan under MO HealthNet for ABD using a managed care model". The H Special Committee on Healthcare Facilities has posted multiple meetings next week. It will meet on 5/7, Monday upon afternoon adjournment in HR3. It will meet for an executive session for a number of bills, including SB577 on Tuesday, 5/8 at 8 AM in HR5. It is also scheduled to meet upon recess on 5/8, the location TBA, and upon adjournment in HR6. The Budget Conference Committees finished work

Spring Break

Legislators head into break!
Status of budget!
New federal rules could have huge impact on states!
Bills we’re watching and where they are at!
Disability Rights Rally!
Spenddown Survey!
LEP (Legislative Education Project)

The Missouri State Legislature will be on Spring/Easter break until Tuesday, March 25! This is a good time to contact your local representatives and senators and visit with them about what things are being done this session to protect and ensure Missourians with Disabilities have a good quality of life?

Find out who your legislator is!

The House Budget Committee has finished rolling out the budget bills and they should be ready to hit the floor the week after Spring break. That means all representatives have to vote on and pass the bills before the go to the Senate. Once the Senate gets them they will look at their version and compare the two. Any differences will have to go to conference (the conference committee is made up of senators and representatives.) Below are things that were included in the house bills that we are watching and feel could improve the lives of people with disabilities.

HB 2002

There was a little over $700,000 put in for Division of Vocation Rehabilitation to bring down over a million dollar federal match.
Centers for Independent Living were given a little over $560,000 to be divided among the 18 centers that are below the recommended national level.

HB 2011

Therapies (speech, physical and occupational) for home health care were included. This appears to be for acute care situations where a person may be leaving a hospital to go home and they need therapy to stay out of the hospital.
Department of Mental Health Community Providers were given a 3% increase.
Dental and vision providers as well as physicians were given a rate increase. The idea is that this will increase accessibility for those that do receive MOHealthnet dental and eye coverage.

So after the break we’ll have the budget to follow in the Senate. The deadline for any senators to file a bill has passed. The house members have until April 1 to file any bills. We’ll keep you updated as to what bills get filed in the remaining weeks of March!

The House bill did not add coverage for MOHealthnet Dental and Vision Coverage. It appears that the Senate has included Dental and Vision Coverage in their version. We will need to continue to work on making sure these items are included in the final budget!!!!!!

To learn more about the rules that have been proposed by the Centers for Medicaid and Medicare, click here! ! These Proposed rules could have a dramatic impact on state funding for Medicaid. 17.5% of Medicaid dollars in the state are spent on people with disabilities.

Text Box: There will be a budget workshop at the Missouri Career Center on Friday, March 20th! If you would like to attend and learn more about the future of Missouri’s budget!!! Friday March 21, 2008 Noon – 2:00 The Missouri Career Center “Dogwood Room” 1514 S. Campbell Springfield, MO Please RSVP to Kerri McBee at kmcbee@centurytel.net There is no cost to attend this meeting.

NCIL (National Council on Independent Living) is asking for an increase of $100 million (for a total funding of $173.3 million annually for Independent Living) to not only restore funding cuts over the past three years, but also to reinvest the millions of dollars in savings to the Federal government that IL provides by transitioning and preventing thousands of Americans from forced institutionalization in by providing people with disabilities the information and tools they need to remain in their communities.

Call your Representative today and tell them to attend the hearing and support increased funding for the Independent Living Program! If your Representative serves on the House Appropriations Labor, Health and Human Services, Education, and related Agencies Subcommittee (see list below), then your phone call is critical!

Bills to watch for!

SB 756 sponsored by Kevin Engler
HB 1627 - sponsored by Charles Portwood

These bills change the name of the division of mental retardation and developmental disabilities to the division of developmental disabilities. The Senate bill was slowed down in the Senate by a filibuster and has been placed on the informal calendar! The filibuster was initiated by Senator Green who has a large constituency who feels services will be limited for certain individuals if the word “mental retardation” is taken out! The House bill had a hearing on March 11 and it was packed with opponents. Here are some facts that testifies supporting the bill have stated, including Bernard Simons, the Director of MRDD.

All but seven states have removed the term “mental retardation” from the state’s agency name.
The name change does not have any impact on funding of supports and services.
Changing the name does not change the mission.
The term “retarded” is offensive to people with intellectual and developmental disabilities.
In Washington D.C., the President’s Committee on Mental Retardation changed it’s name to the President’s Committee for People with Intellectual Disabilities after surveying constituents and learning how offensive the “R” word is to them.

SB 717 - sponsored by Harry Kennedy
HB 1345 - sponsored by Charles Portwood

These bills increase the amount of tax credits available for taxpayers who modify their home to be accessible for disabled people who reside with such taxpayer. Under current law, up to one hundred thousand dollars in tax credits remaining unused under the rebuilding communities tax credit program are allocated for use by taxpayers who modify their homes for disabled persons residing with such taxpayers. The current amount referenced above will only help about 45 people from around the state if everyone used the maximum amount available.   We need these bills to pass so that we will have more money to work with and many more people will be able to use the tax credit. The Senate bill is now on the Informal Calendar S Bills for Perfection--SB 717. Ask Senator Shields to bring this up for a vote and educate the Senators on why this bill is needed!! The House bill has passed out of rules and needs to be placed on the calendar. Educate representatives about this bill so that when it comes to the floor for a vote they know why it’s important!

HB 1656   - sponsored by Bob Nance
This bill changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. It was passed by the House and has been assigned to the Senate Committee on Seniors, Families & Public Health . Please contact Senator Champion and ask that this bill get a hearing!!!!!

HJR 48 - sponsored by Stanley Cox
This bill proposes a constitutional amendment requiring photo identification to vote in elections. The bill had a public hearing. The Missouri Disability Vote Project, which SCIL is a member of, testified in opposition as well as the Secretary of State’s office. This bill has not had any movement, but we will continue to keep our eye on it!!

HJR 70 -sponsored by Allen Icet
This bill proposes a constitutional amendment prohibiting appropriations in any fiscal year from exceeding certain limits. The amount of money appropriated for state funded programs could be dictated by a formula. This bill had a hearing and passed out of rules. It will go to the Senate next. We’ll continue to keep an eye on this one as well!!!
To learn more about TABOR like initiatives click here!
Don’t forget about……………………………
Text Box: Disability Rights Legislative Day! March 26, 2008 Jefferson City @ the Capital!!!!

Let’s show legislators that Missourians in Southwest Missouri
want to be heard!!!!!!!!!!!!
Call Cari Wright if you would like to join us on the SCIL van!

The Governor's Council on Disability and the Statewide Independent Living Council will once again be sponsoring the Legislative Education Project (LEP).
The LEP's mission is to educate about the Missouri legislative process and motivate individuals by providing opportunities to become actively involved in positive public policy for people with disabilities.
SCIL will be taking a group to Jefferson City for LEP during the week of April 14th. If you are interested and would like more information or to sign up, please contact Cari Wright, Program Manager at SCIL @ 417-886-1188.

This has been a weekly update. If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list.

As we continue to try and improve the updates, please let us know what you like or dislike. Your comments might be related to font size, color, format and anything else that we can change to make this update effective and friendly! Thanks!

February 25, 2008

Stay in touch with the Legislative Loop!

Insure Missouri Update!
Hearing schedule for week ahead!
Bills to watch for and action steps!
Disability Rights Rally!
Spenddown Survey!
LEP (Legislative Education Project)

The Department of Social Services has asked that the Secretary of State hold off on approving the emergency rules for Insure Missouri. Last year, the governor announced Insure Missouri, which uses several funding sources, including $46 million in state funds. Its first phase would have provided caregivers with children with health insurance, encompassing about 54,000 Missourians.
According to the Columbia Tribune, Blunt said his administration would delay implementation of an emergency rule that would have allowed people to start signing up for the first phase of the plan in March. The governor said in a prepared statement he wanted to get broader legislative consensus before parts of the program take effect. Nonetheless, Blunt insisted, "Our plan has support from many legislators and from health-care advocates across the state, but we need greater support in the House to begin helping nearly 200,000 Missourians purchase their own personal health insurance."
Many in the disability community felt as though Insure Missouri did not go far enough to cover individuals who were cut from Medicaid rolls back in 2005, but it was a first step in covering the close to 800,000 Missourians without health insurance. We will continue to follow the efforts made during this legislative session to cover more people and we will keep up the fight to make sure that seniors and people with disabilities are top priorities.
Hearings for the week

Monday, Feb 25th @ 11:30 am in SCR2, Senate Appropriations will review the Department of Mental Health budget.
Tuesday, Feb 26th @ 8am in Hearing Room 3, the Budget Committee will start reviewing reports from the Appropriations Committees.
Tuesday, 8am in SCR 2 Department of Mental Health continued and
Department of Health & Senior Services.
Tues, @ 1pm in the Senate Lounge there will be a public hearing in Senate Health and Mental Health regarding SB972, which adds comprehensive day rehab services to MO Healthnet.
Wed at 8am, in SCR Senate Appropriations will continue the DHSS budget.
Go to http://www.moga.state.mo.us/hearings.htm for an update to the hearings and who the committee members are.

Bills to watch for!

SB756 - sponsored by Kevin Engler
This bill changes the name of the division of mental retardation and developmental disabilities to the division of developmental disabilities. This bill passed out of committee with a 5-0 vote and needs to be reported out and put on the calendar for the entire Senate to vote on it. Please contact your Senator and ask that they support SB756 when it comes to the floor!!!!

SB717 - sponsored by Harry Kennedy
This bill increases the amount of tax credits available for taxpayers who modify their home to be accessible for disabled people who reside with such taxpayer. Under current law, up to one hundred thousand dollars in tax credits remaining unused under the rebuilding communities tax credit program are allocated for use by taxpayers who modify their homes for disabled persons residing with such taxpayers. The current amount referenced above will only help about 45 people from around the state if everyone used the maximum amount available.   We need this bill to pass so that we will have more money to work with and many more people will be able to use the tax credit. This bill passed out of committee but needs to come to the floor for a full Senate vote. Educate the Senators!

HB1656 - sponsored by Bob Nance
This bill changes the laws regarding the assistance provided to nursing home residents who are transitioning back into their communities. It will allow a line item in the budget so that General Revenue can be used to help transition people from institutions into their communities. The money can be used as a one time grant for each person moving to help pay for expenses. It will come to the House floor soon. Educate your representative so that they will see the importance and vote yes for HB1656.

HJR48 - sponsored by Stanley Cox
This bill proposes a constitutional amendment requiring photo identification to vote in elections. The bill had a public hearing. The Missouri Disability Vote Project, which SCIL is a member of, testified in opposition as well as the Secretary of State’s office. We need to keep our eye on this one!

Don’t forget about……………………………

Disability Rights Legislative Day!
March 26, 2008
Jefferson City @ the Capital!!!!

Let’s show legislators that Missourians in Southwest Missouri
want to be heard!!!!!!!!!!!!
Call Cari Wright if you would like to join us on the SCIL van!

The Disability Coalition on Healthcare Reform (DCHR) is doing a survey regarding the impact of spenddown for individuals with disabilities. SCIL is a member of DCHR and we are looking for stories to share with legislators. If you feel you have a story to share which may help change current legislation and help yourself and individuals who have shared similar experiences, we urge you to complete this survey and share your story.
http://www.surveymonkey.com/s.aspxsm=BYRGwiVxQaz2fOL57gZrlA_3d_3d

This has been a weekly update. If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245 or by emailing amcelwain@swcil.org. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list.
As we continue to try and improve the updates, please let us know what you like or dislike. Your comments might be related to font size, color, format and anything else that we can change to make this update effective and friendly! Thanks!

January 28, 2008

To look up information or to find out who your legislator is, go to http://www.moga.state.mo.us/ .

Each week hearings are held. The link below will give you the hearing schedule. http://www.moga.state.mo.us/hearings.htm.

Action needed:

HB1345 (Rep. Portwood) was heard in House Ways and Means and public testimony was given. This bill Increases the cap for the income tax credits (to $1 million annually) available to certain individuals for the costs of modifications to a home in order for it to be accessible for a disabled person who resides with them. Contact these committee members and ask them to vote yes on HB1345. http://www.house.mo.gov/billtracking/bills081/commit/com036.htm

The House Appropriations Committee for Education heard testimony for the Division of Vocational Rehabilitation and the requested funding increases that were not recommended in the Governor's budget. Contact the committee members http://www.house.mo.gov/billtracking/bills081/commit/com123.htm and ask them to support these increases.

$556,000 General Revenue for Centers for Independent Living. The Statewide Independent Living Council recommended a three year phase-in to bring Missouri CILs to the national average. This funding request is for the second year increase.
$770,000 General Revenue for a state match to draw down $1.6 million federal funds for vocational rehabilitation services. Missouri should not give up its opportunity for an increase in federal dollars and see our money go to another state. DVR has been able to reduce the waiting time for vocational rehabilitation services. As college tuition and health care costs increase, DVR needs the increase to continue to meet the need and not go back to long waiting lists.

The House Appropriations Committee for Health, Mental Health and Social Services heard from the Department of Social Services, which includes the MO HealthNet program. Contact the committee members and urge them to support the following health care priorities for people with disabilities: http://www.house.mo.gov/billtracking/bills081/commit/com161.htm

Support the Governor's recommendation to fund dental and optometric services and give dental providers a rate increase.
Address the spenddown problem by increasing the MO HealthNet eligibility for elderly and people with disabilities to 100% of the federal poverty level. This would eliminate spenddown for about 17,000 people living below the poverty level.
Fund therapies, including physical, occupational, speech and comprehensive day rehabilitation. Access to therapies and rehabilitation increases the independence of people with disabilities and prevent the need for more costly health care.
Support funding for the Non-MO HealthNet Eligible Consumer Directed Services program (otherwise known as NME) for those people who are not eligible for MO HealthNet, but can afford attendant services.

Governor Blunt recently announced that he will no be seeking re-election. We will keep you posted on new candidates running for Governor and where to find information about them.
To find out more about Governor Blunt’s new insurance plan “Insure Missouri” go to http://www.insuremissouri.org/. This plan does not restore coverage to individuals with disabilities who were cut from the healthcare rolls in 2005.
To read a recent article highlighting the program http://www.newsleader.com/apps/pbcs.dll/article?AID=/20080118/NEWS01/801180397/1007/NEWS01
Also check out what “Families USA says about “Insure Missouri.” http://www.familiesusa.org/assets/pdfs/mo-too-little-too-late.pdf.
We’ll keep you posted on opportunities for you to let your voice be heard!!!!!!!
MO Healthnet
MO Healthnet is continuing to unfold. The Oversight committee met for the first time in January and will meet again on Tuesday, Feb. 5th. The location is 205 Jefferson St. Rm B on the 10th floor. It is open to the public. Go to http://www.dss.mo.gov/press/2007/103107gov.htm for a list of members. Despite the program being implemented there is still no dental coverage, limited vision, limited therapies and transportation. The eligibility limit for coverage is still at 85% of federal poverty and many people have a high spenddown.

Disability Rights Legislative Day!
March 26, 2008
Jefferson City, MO
Stay tuned for more details!

If you are interested in attending the Legislative Education Project let us know. This is several day training and hands on experience in Jefferson City that is sponsored by the Governor’s Council on Disability and the Statewide Independent Living Council. SCIL takes a group of individuals every year to show advocates how to be implement change and be effective to make our state a better place for Missourians with disabilities. We will be taking a group the week of April 14th. http://www.gcd.oa.mo.gov/LEP.shtml

And don’t forget the Missouri Presidential Primary is Tues, Feb. 5th!
To get national election results go to http://www.usaelectionpolls.com/.
For more information to educate yourself on the candidates and healthcare go to http://www.kaisernetwork.org/health_cast/health2008hc.cfm?hc=2216.

This has been a weekly update. If you would like to receive legislative alerts as a part of our “alert system” please contact SCIL @ 417-886-1188 or 800-676-7245. These alerts will include any federal or state issues that need immediate action or attention. Please call and add your name to our list.

January 7, 2008

The 2008 legislative session has officially started. We will keep you posted as it progressives on things pertinent to Missourians with disabilities. Close to 800 bills have been filed so far and hearings are being scheduled. To look up information or to find out who your legislator is go to http://www.moga.state.mo.us/ .

The House Appropriations Committee for Health, Mental Health and Social Services held two hearings. Testimony was heard related to the absence of dental coverage, high spenddown amounts for individuals and the need to raise provider reimbursement. Other testimony included the need for more funding for autism services, mental health services and children’s health insurance.

For the week of Jan 14th, the following house hearings were scheduled. To get changes or updates go to go to http://www.moga.state.mo.us/hearings.htm.

Monday, January 14

12pm in hearing room 3 The Budget Committee will hear public testimony on HB2015, which appropriates money for supplemental purposes for the Department of Social Services.
2pm in hearing room 5 The Special Committee on Healthcare Transformation meets. This committee will study all aspects of healthcare and how they relate to the problem of the uninsured in Missouri.

Tuesday, January 15

8am in hearing room 5 The House Appropriations Committee for Health, Mental Health and Social Services will meet to go over the Department of Mental Health budget.
12pm in hearing room 5 The Special Committee on Healthcare Transformation meets. This committee will study all aspects of healthcare and how they relate to the problem of the uninsured in Missouri.

Wednesday, January 16

8am in hearing room 5 The House Appropriations Committee for Health, Mental Health and Social Services will meet to go over the Department of Mental Health budget.
12pm in hearing 1 The Special Committee on Healthcare Transformation meets. This committee will study all aspects of healthcare and how they relate to the problem of the uninsured in Missouri.

Thursday, January 17

8am in hearing room 7 The Special Committee on Healthcare Transformation meets. This committee will study all aspects of healthcare and how they relate to the problem of the uninsured in Missouri.

We’ll keep you posted on opportunities for you to let your voice be heard!!!!!!!

MO Healthnet
MO Healthnet is continuing to unfold. The Oversight committee met for the first time in January and will meet again on Tuesday, Feb. 5th. The location is 205 Jefferson St. Rm B on the 10th floor. It is open to the public. Go to http://www.dss.mo.gov/press/2007/103107gov.htm for a list of members. Despite the program being implemented there is still no dental coverage, limited vision, limited therapies and transportation. The eligibility limit for coverage is still at 85% of federal poverty and many people have a high spenddown.

Divided We Fail
January 23rd Divided We Fail will hold a rally in the Capitol rotunda. The rally will include state legislators from across Missouri signing pledges to stop the partisan gridlock and work to ensure that every Missourian has access to quality, affordable, health care and lifetime financial security. For more information go to http://www.dss.mo.gov/press/2008/010808.htm.

SCHIP update
Congress has now extended the SCHIP program until March 2009 despite the President vetoing the bill twice. The legislation includes enough funding to keep 6 million children on the program. There is no funding to cover children who are eligible, but not enrolled.

Disability Rights Legislative Day!
March 26, 2008
Jefferson City, MO
Stay tuned for more details!

December 17, 2007

The Senate Appropriations and House Committees met the week of December 3rd to hear public testimony.
The 2008 Legislative Session will officially begin on January 9th. Go to http://www.moga.state.mo.us/ for hearing schedules and important dates.

Below is a list of a few bills that have been pre-filed. These bills are important to Missourians with disabilities.
We’ll continue to provide updates on the status of these bills and others that are filed.

SB 768 has been pre-filed by Senator Rupp, St. Charles.

This bill creates the Missouri Commission on Autism Spectrum Disorders. The
Commission will be composed of four legislators; seven state agency
representatives one each from the departments of education, mental health,
health and senior services, public safety, higher education, social services
and insurance; two representatives of institutions of higher education, a
local district special education director, a speech-language pathologist, a
diagnostician, a mental health provider, a primary care physician, three
parents of and one individual with autism spectrum disorder, and an private
or non-profit provider or organization. All appointments will be made by
the Governor with Senate consent, except the legislators will be appointed
by the president pro tem and speaker.

Responsibilities of the Commission are to make recommendations to the
governor, general assembly and relevant state agencies regarding healthcare,
education and adult and adolescent services for autism spectrum disorder and
to make recommendations for a comprehensive statewide plan for integrated
training, treatment and services for individuals of all ages with autism
spectrum disorder. The Commission is charged with issuing preliminary
recommendations by July 1, 2009 to the general assembly. It is assumed this
Commission would extend the work of the Blue Ribbon Panel on Autism, chaired
by Senator Rupp, that met in the summer and fall of 2007. There is no
sunset clause, so it appears the Commission would be a new advisory body
permanently established in state law.

This bill has not yet been assigned to committee.

SB 717 - Senator Kennedy (Senator Shields co-sponsor)
HB 1345 - Rep. Portwood (7 co-sponsors)

These bills improve upon the Home Access tax credit that was signed into law
last session.

The measure that passed last session gives a tax credit for persons who have
expenses to make their home accessible. Even persons who don't earn enough
income to pay state income tax can still receive the credit for their home
access expenses. Persons who earn under $30,000 a year can receive a credit
for 100% of their home access costs up to $2,500. Taxpayers who earn
between $30,000 to $60,000 would be eligible for a credit up to half of
their access costs up to $2,500.

Under the bill that was signed into law, the total amount of credits that
can be awarded statewide is $100,000. Obviously, this sharply limits the
number of Missourians who could benefit.

SB 717 removes the $100,000 cap completely and the House bill would raise
the cap to $1 million. Passage of either bill would make the credit a
significant tool in helping persons with disabilities remain in their homes
and communities.

SB 770 has been pre-filed by Senator Rupp, St. Charles.

This bill establishes scholarships for students with developmental
disabilities to attend a public school other than the one to which the
student is assigned (either a different building within the same district or
a different district) or to attend a private school. The bill does not
provide or reference a definition of "developmental disability", but to be
eligible the student does need to have an IEP which would require IDEA
eligibility. The bill identifies some examples of students with
developmental disabilities as those with mental retardation, a speech or
language impairment, a traumatic brain injury, or autism spectrum disorder.

To be eligible students must have attended a Missouri public school the year
prior. Home schooled students and those participating in the Missouri
Virtual Instruction Program (MoVIP) are not eligible. The amount of the
scholarship is the per pupil state funding distributed to the school
district or the actual cost of tuition, whichever is less.

It appears this bill is patterned after the Florida statute (McKay
Scholarship Program) but there are significant differences. The Florida
statute uses IDEA eligibility rather than "developmental disabilities" and
the scholarship amount appears to be substantially different. In addition,
the option of attending an adjacent school district has different
implications in a state like Missouri with over 500 individual school
districts compared to 67 county-wide school districts in Florida.

SB 756 - MRDD NAME CHANGE has been filed by Senator Engler
This bill would change the name of the Division of Mental Retardation and
Developmental Disabilities to the Division of Developmental Disabilities.

SB 848 - CAPITOL ACCESS has been filed by Senator Shoemyer
This bill would require that all offices in the State Capitol building be
readily accessible and usable by persons with disabilities.

MOHealthnet

The MO Healthnet Oversight Committee also held it’s first meeting the first week of December.
There has been controversial debate in regards to the committee.
A recent article in the Kansas City Star highlights this. http://www.kansascity.com/115/story/388394.html.

To view a list of the committee: http://www.dss.mo.gov/press/2007/103107gov.htm.

If you would like to sign up for our legislative email alerts please call SCIL at 417-886-1188
or by emailing amcelwain@swcil.org. We also have updates listed frequently on our
web site @ http://www.swcil.org.

2007 Legislative Session Final Summary

Below is a list of legislation that was Truly Agreed and Finally Passed and is now awaiting the
Governor’s signature. If the Governor does not sign or does not veto a bill by July 14, 2007, it
becomes law in the same manner as if the Governor had signed it.

A lot of hard work went into following SB577 to ensure that if it did pass it would include protections
for individuals with disabilities. In the last days of the session a compromise was made between the
Senate version and the House version. The Conference Committee report was adopted and that is
what passed. The bill changes the name from Medicaid to “MO Healthnet.” Medicaid is scheduled to
end June 30, 2008. Many programs which the bill implements would start at that time. The Ticket to
Work program should start sooner. It is unclear at this time exactly when it should start.

The following breaks down the bill and gives the page number and line for each subject.
The bill is 146 pages and includes many other changes to Medicaid and healthcare in general.
The list looks at the areas that will affect individuals with disabilities. A link to the bill is also listed.
SB577 was sent to the Governor on May 30, 2007. It awaits his signature.

CCS HCS SS SCS SB 577

http://www.senate.mo.gov/07info/pdf-bill/tat/SB577.pdf

Creates the Ticket to Work Health Assurance Program (page 43 line 5)

This program will allow individuals who meet the definition of disabled under the federal guidelines for
the Supplemental Security Income (SSI) program to be eligible for medical assistance if s/he is employed
and has proof that federal taxes are being paid. To be eligible, an individual must have a gross income less
than or equal to 250% of the Federal Poverty Level (FPL), excluding any earned income between 250 and
300% FPL (approximately $30,000). Any person whose gross income exceeds 100% FPL shall be required
to pay a premium. If an individual who is eligible for this program is also eligible for employer-sponsored
insurance (ESI) that is determined to be more cost-effective, the individual must participate in ESI. In this
case, the state shall pay premiums, co-payments and other costs associated with ESI. The Ticket to Work
Health Assurance Program is subject to appropriations and has a six-year sunset. Certain deductions and
asset limits apply to eligibility determinations. These are listed below.

Income disregards: all earned income, first $65 and 1/2 of non-disabled spouses remaining earned
income, $20 standard deduction, health insurance premiums, and $75/mo standard deduction for
dental and optical insurance, $50 for SSDI, all of SSI payment, and a standard deduction for
impairment - related employment expenses equal to 1/2 of the disabled worker's earned income.
Premiums for incomes over 100% of FPL (federal poverty level) are on a sliding scale from 4% to 6% of
a person's income.
Asset disregards: $5,000/yr in medical savings accounts and $5,000/yr independent living accounts.
Any income earned by individuals eligible for certified extended employment at a sheltered workshop
is exempt.

NON-MEDICAID ELIGIBLE (page 120 line 19)
The sunset date for Non-Medicaid Eligible Consumer Directed Services Program (NME) was extended to 2019.
The program is subject to appropriations.

DURABLE MEDICAL EQUIPMENT (page 67 line 7)
Covers prescribed durable medical equipment as a MO HealthNet benefit. Adds that an electronic, web-based
system will be used to ensure prior authorization.

HOSPICE CARE (page 67 line 12)
Hospice Care Is a Covered MO HealthNet Benefit.

DENTAL CARE (page 68 line 2)
Prescribed medically necessary dental care is covered, subject to appropriations.

VISION CARE (page 68 line 7)
Prescribed medically necessary optometric care is covered, subject to appropriations.

OPTIONAL SERVICES FOR SPECIFIC POPULATIONS (page 68 line 25)
Funds for optional services will still be appropriated to needy children, pregnant women and
blind persons.

CO-PAYMENTS (page 71 line 3)
Starting July 1, 2008, the MO HealthNet Division pay requires additional co-payments for
covered MO HealthNet benefits.

PAY FOR PERFORMANCE (page 78 line 6)
A “professional services” committee will design and maintain the guidelines for a pay-for-performance
program. Providers operating under a risk-based (managed care) plan and under administrative
services organization plans are required to participate in pay-for-performance. Providers operating
under the State’s coordinated fee-for-service plan “shall” participate. The employers of physicians whose
work earns the pay-for-performance reward must pass on the pertinent portion to the physician, without
any corresponding decrease in the compensation to which they would otherwise be entitled.

Pay-for-performance shall ensure quality of care, foster the relationship between the patient and provider,
use accurate data, evidence-based measures, provide fair and equitable program incentives, and not
discourage providers from caring for those with complex/high-risk conditions.

COLA (COST OF LIVING ALLOWANCE (page 77 line 26)
Allows Social Security cost of living increases to be disregarded until the federal poverty level for such
year is updated. COLAs are implemented before the federal poverty level is updated.

PUBLIC ASSISTANCE BENEFICIARY EMPLOYER DISCLOSURE ACT
(Page 101 lines 17) The Department of Social Services must prepare a quarterly report that documents
the number of individuals who are a beneficiary, or the financially responsible spouse or custodial parent
of a MO HealthNet beneficiary of each employer with more than 50 employees. The report also must
include whether the employees are full or part time, whether the employer offers insurance as a benefit,
and the cost of MO HealthNet benefits being provided to the employer’s employees.

SPENDDOWN (page 78 line 1)
There is a provision that may make it easier for some persons with disabilities to meet their spend-down
amount. If a recipient has out-of-pocket medical expense during a month in which they have already paid
their spend-down, the recipient can carry over those medical expenses for future required spend-down
amounts for up to three months from the date of the expense.

HEALTH IMPROVEMENT PLANS (page 121 line 13)
The bill requires the Department of Social Services to create health improvement plans including, but not
limited to, risk-bearing managed care plans, administrative services organizations (ASOs), and coordinated
fee-for-service plans. Enrollment into plans will begin July 1, 2008 and be completed by July 1, 2011.
The managed care plans and ASOs will be required to meet quality targets or be penalized financially.

Every participant shall be provided a health care home. All health improvement plans are required to help
participants remain in the least restrictive level of care possible. All health improvement plans shall use best
practices that are evidence based.

MANAGED CARE (page 122 line 5)
Older adults, blind and disabled will not be required to sign onto a managed care option. However, most
of the description of services for all the managed care type plans was removed, and as a result the health
plan development is left up to the departments and oversight committee. The bill states, "No provisions of
any state law shall be construed as to require any aged, blind, or disabled (ABD) person to enroll in a
risk-bearing coordination plan". It is not known whether the Department of Social Services might still
choose to enroll the ABD population in managed care, perhaps on a voluntary basis or through a pilot project.

PUBLIC INPUT (page 123 line 1)
The bill states "the Department of Social Services will engage in a public process for the design, development,
and implementation of the health improvement plans and other aspects of MO HealthNet. Such public process
shall allow for but not be limited to input from consumers, health advocates, disability advocates, providers,
and other stake holders".

MENTAL HEALTH CARVE OUT (page 63 line 21)
Services under the state plan provided by community mental health facilities operated by the department of
mental would be provided.

PSYCHOTROPIC MEDICATIONS (page 140 line 8)

Protects Access to Psychotropic Medications for those in Fee-For-Service Plans.

COMPREHENSIVE ENTRY POINT (page 129 line 3)

The oversight committee will designate a subcommittee devoted to advising the department on the
development of a comprehensive entry point system for long-term care. Members of the committee
will include a wide variety of representatives appointed by the Governor. This includes a representative of
Centers for Independent Living.

CHILDREN’S PRE-EXISTING CONDITIONS (page 106 line 7)

Regarding CHIPS, Health insurance plans that do not cover an eligible child’s preexisting condition shall
not be considered affordable employer-sponsored health care insurance or other affordable health care
coverage.

CREATES “PREMIUM OFFSET” PILOT PROJECT (page 82 line 3)
Subject to appropriations, the Department of Social Services” can choose one rural and one urban area
in the state and implement a pilot program that makes insurance available to uninsured individuals that qualify.

AREAS OF DEFINED NEED AND ELIGIBLE FACILITIES (page 36 line 3)

The Department of Health and Senior Services may designate eligible facilities in “areas of defined need”.
The factors that will contribute to the establishment of these eligible facilities will include: the health status of
the local population, the ability of the population to pay for health care services, the accessibility of health
care services, and the availability of health care professionals in the area. These facilities will be eligible to
receive funds from the Healthcare Access Fund.

OTHER BILLS THAT PASSED…..

SS SCS HCS HB 327 -- ECONOMIC DEVELOPMENT

This bill includes language from SB8 that creates the accessible home credit that provides a tax credit for
persons who incur expenses to make their home accessible. Taxpayers earning up to $30,000 a year would
be eligible for a credit for 100% of the cost they incur or $2,500,whichever is less. The credit is refundable
which means that even taxpayers who would not normally earn enough income to be eligible can still receive
assistance from the credit. Taxpayers earning between $30,000 to $60,000 would be eligible for a credit up
to 50% of their costs or $2,500, whichever is less. Total credits statewide would be capped at a maximum of
$100,000 per year.

CCS HCS SCS SB 82
Modifies various provisions relating to the regulation of motor vehicles. This bill modifies
various provisions relating to motor vehicles, was Truly Agreed and Finally Passed. The bill includes language
to exempt persons ages 65 or older from having to provide a physician's statement when renewing disabled
license plates or placards.

HCS HB 181-ELECTRONIC VIDEO INSTRUCTIONAL MATERIALS
This is the bill that requires publishers or manufacturers of video instructional materials designed for
educational institutions to be captioned. A penalty of three times the amount paid by the purchaser to have
the video captioned will be assessed to a publisher or manufacturer who fails to comply.

SS HB 579 -EMERGENCY MANAGEMENT

This bill transfers the State Emergency Management Agency from the Office of the Adjutant General to the
Department of Public Safety and allows for the deployment of any health care professional who is licensed,
registered, or certified in this or any other state and volunteers during an emergency declared by the Governor.
Currently, only workers licensed, registered, or certified in this state are allowed to be deployed. The bill grants
the volunteers immunity from civil damages for their services. The Department of Health and Senior Services is
allowed to recruit, train, and accept the services of citizen volunteers to dispense medication in a public health
emergency. The bill contains an emergency clause.

BUDGET-During the budget process to appropriate funds for the 08’ fiscal year, a few increases were appropriated
to increase programs for individuals with disabilities.

Independent Living Centers received $560,000 increase. This will be divided among the 18 centers that are not
regarded as being at the national level of funding. $150,000 was appropriated to add a Blind Skills Specialist to
the public school system to work with children who are blind. There was an increase to Vocational Rehabilitation
that was needed to bring down a little over $1 million in federal funds. This money should decrease the waiting
time for people seeking services from VR. There was also an increase for Department of Health and Senior Services
to reduce the waiting time for individuals who need assessments to receive Home and Community Based Services.

Summarized by :
Shelby Butler, Public Policy Advocate
Southwest Center for Independent Living/Ozark Independent Living

May 7, 2007

Two weeks remaining and HB39 (Ticket to Work) has not come up on the Senate floor. It is crucial to call your Senator and Senator Charlie Shields (1-573-751-9476) and ask that Senator Shields bring HB39 to the floor.

The HCS (House Committee Substitute) for SB577 (Healthnet) adds language that partially restores Ticket to work, but more along the lines of the Senate Committee Substitute of HB39 than the more favorable version that passed the House. There was discussion that this would get taken out of SB577 with the second House Committee Substitute. That substitute should be available on Tues., May 8th.

SB577 (Healthnet) Committee hearings are now finished for the draft House Committee Substitute (HCS) for SB577. A committee vote doesn't appear likely until at least Tuesday according to the Chair, Rep. Schaaf. Debate on the House floor would not be likely until Thursday, May 10th at the earliest.

There are considerable differences between the draft HCS and the version
that passed the Senate. Below are a just a few of the important aspects
relating to persons with disabilities. The bill still does not address those in the Spend-down program and those that were cut from Medicaid in 2005.

Restoration of Adult Durable Medical Equipment (DME) coverage:
Both the Senate and House version restore coverage for prescribed, medically
necessary durable medical equipment for adults. The HCS version changes the
coverage guidelines from the Senate's "accepted care and treatment
guidelines" to "care and treatment guidelines consistent with national
standards". If "national standards" refers to consistency with Medicare
coverage guidelines, one concern would be that guidelines should not mirror
Medicare criteria for covering wheelchairs or scooters only if needed for
use inside the home.

Restoration of other adult service coverage:
The HCS would restore in state law the Medicaid services that were
eliminated for most adults in 2005, including, but not limited to dental
services, vision services, hearing aids, prosthetics, and comprehensive day
rehabilitation. However, during the Department of Social Services appropriations
bill (HB11) neither the House or Senate version fully funds these services, so it is questionable whether they will remain in the final version of SB577.

Managed Care for the Aged, Blind and Disabled (ABD) Medicaid population:
The Senate version appeared to force the ABD population into capitated
managed care plans in those areas (36 counties) where Medicaid managed care
now exists along the I-70 corridor. The draft HCS states that "The
administration shall not design or implement any health improvement plan
under MO HealthNet for ABD using a managed care model".

The H Special Committee on Healthcare Facilities has posted multiple meetings next week. It will meet on 5/7, Monday upon afternoon adjournment in HR3. It will meet for an executive session for a number of bills, including SB577 on Tuesday, 5/8 at 8 AM in HR5. It is also scheduled to meet upon recess on 5/8, the location TBA, and upon adjournment in HR6.

The Budget Conference Committees finished work