End of Session Report
June 29, 2007
Inside This Issue:
After much debate, SB577 (Shields) was passed the last day of session. SB577 reorganizes the Medicaid program and changes the name to MO HealthNet. Participants are scheduled to begin enrollment on July 1, 2008. By July 1, 2011, all Medicaid beneficiaries are expected to transition into MO HealthNet.
Participants will have a choice of three “Health Improvement Plans.” These plans include managed care, administrative service organizations, and a fee-for-service option. Little detail is included to describe the nature and organization of these plans. However, language is included that will not force persons with disabilities into managed care plans.
While SB577 is vague in nature, it does include some positive provisions for the disability community. HB39 (Portwood) was attached to SB577 and will restore Medicaid services to 3,000 additional workers with disabilities. The sunset for Non-Medicaid Eligible Consumer Directed Services (NME) was extended to 2019, making the program more secure for current participants. In addition, MO HealthNet will fund physician prescribed durable medical equipment. Services such as dental and optometry are also included, but are subject to yearly appropriations. No funding was allocated for dental services. Language restoring coverage for rehabilitative services was removed in the final draft.
SB577 included a provision that may make it easier for some people to meet their spend-down. If a recipient has already paid his/her spend-down and incurs an out-of-pocket medical expense, it can be put towards future spend-down requirements for up to three months. SB577 also allows the Social Security cost of living increases to be disregarded in determining spend-down and eligibility until the federal poverty level is updated each year.
MO HealthNet will also include Pay for Performance provisions where providers will get “rewards” for positive outcomes with their patients. This continues to be a contentious point with disability advocates because of fears that this provision will encourage providers to discriminate against those with greater health needs.
Despite the passage of the bill, most of the details will be decided in the rule making process. Therefore, advocates will continue to monitor the development of MO HealthNet to ensure that it protects and provides necessary medical care for persons with disabilities.
Representative Portwood’s HB39 was attached as an amendment to the Medicaid reform bill, SB577. Despite efforts to scale back the Medicaid buy-in program, the final language includes most of the provisions we sought. The officially named “Ticket to Work Health Assurance Program” will allow workers with disabilities to earn income up to 300% of the Federal Poverty Level and still receive Medicaid services such as personal attendant care. Monthly premiums are set on a sliding scale for persons with income above 100% FPL. Individuals will also be able to disregard certain expenses and savings when determining eligibility. For basic eligibility guidelines, please see below.
The program is expected to take affect on August 28, 2007. An estimated 3,000 individuals are expected to enroll into the Medicaid buy-in program.
Gross Income of 300% Federal Poverty Level (FPL) or $30,630/yr.
Net income, after disregards, equal to 85% FPL or $8,679/yr.
Income disregards include:
Asset disregards include:
SB8 (Kennedy) stalled in the Senate early in the session, leaving many advocates concerned. SB8 provides a tax credit on modifications made to homes of persons with disabilities.
At the end of session, legislators attached SB8 to HB741 (Pearce). HB741 moved through the legislature quickly and consisted of a conglomerate of tax credit provisions. However, persons with disabilities can now receive financial incentives to make their homes accessible.
The program has an annual cap of $100,000 and will not cost the state any additional money. While the amount of tax credit is dependent upon household income, it can provide individuals up to $2,500 for home modifications.
This tax credit will be available on a first come, first serve basis.
The general assembly approved a state budget that included an increase in funding to Centers for Independent Living. This much needed increase will assist 18 CIL’s throughout Missouri to reach the national funding average. Currently, only 4 CIL’s are at or above the national average.
Disability advocates believe that increases to any of the Missouri CIL’s will spread the power of the disability community. The budget increase is the first of three yearly installments. However, the increase in funding will need to be appropriated each year.
HB181 (Sander) was passed and signed by Governor Blunt. This bill would require educational institutions to have captioning on all electronic videos. However, HB181 does provide a few exemptions for publishers who do not have the rights to alter the video material or products that are obtained through other telecommunication sources. These sources include internet, television, or other telecommunication devices. Companies who do not abide by such captioning requirements will be fined accordingly.
Eye exams—SB16 (Scott) requires children enrolled in kindergarten or first grade to have a comprehensive vision exam by an optometrist or physician. It also requires that children completing 1rst and 3rd grades receive a vision screening by a trained school nurse or district employee. The Department of Education and the Department of Health and Senior Services will be required to identify resources for children who do lack the finances to fund the required exams. SB16 was signed by Governor Blunt and goes into law on July 1, 2008.
Special Education—SB112 (Rupp) removed the sunset that had been put on special education services and the First Steps program. It established a pilot child find program in the First Steps program in Greater St. Louis. Additionally, SB112 removed the language “handicapped children” in the state special education statute and replaced it with “children with disabilities”.
SB82 (Griesheimer) included language that changes the requirements for disabled license plates and placards. Persons with disabilities age 75 and older are exempt from obtaining a physician’s statement in order to renew their plates or placards. The renewal period was also changed to every 4 years.
Tax Cuts:
Tax exemptions and credits passed by the legislature (HB327, HB444, HB818, SB30)could harm the future funding for support services. Few people with disabilities will benefit, but we all will feel the negative impact.
Voter Photo ID:
A couple of bills that would have required photo IDs to vote saw little movement this session. The issue is not dead however, and we will keep you abreast of any upcoming action needed.
Several significant bills did not pass, but can try again next year.
Universal Design Tax Credit—HB1111 (Baker) would have created a tax credit for businesses that build or remodel house using universal design standards.
Removing MR from MRDD—SB621 (Engler) would have changed the name of the Division of Mental Retardation & Developmental Disabilities to the Division of Developmental Disabilities.
Seatbelts—HB90 would have required all drivers and passengers to wear seat belts. Seatbelts help to prevent head injuries.
The Road to Freedom, a project of ADA Watch and the National Coalition of Disability Rights,is a year-long, cross country bus tour and multi-media exhibit, highlighting the history of the ADA.
St. Louis Stop - Saturday, July 28th from 2:00-4:00pm
Missouri History Museum, MacDermott Grand Hall
5700 Lindell Bvld. 63112
Join us for a town hall with local and national disability-rights leaders
Jim Ward, ADA Watch/Road to Freedom
Jim Tuscher, Paraquad
Kyle Tate, Paraquad
David J. Newburger, Newburger & Vossmeyer, LLC & Starkloff Disability Institute
Gina Hilberry, Cohen-Hilberry Architects.
Enjoy a reception following the program.
For more information or to RSVP, contact Paraquad at 314/289-4233 or pr@paraquad.org
Limited transportation is available. Contact Paraquad at 314/289-4382 or pr@paraquad.org by July 18th.
Kansas City Stop - Thursday, August 2, 2007
Union Station
Celebrate and educate about the American’s with Disabilities Act.
SAVE THE DATE!
For more information on the Kansas City stop, contact:
Laura Walker at walkerla@umkc.edu
Additional details about the tour including exhibit information are available at www.roadtofreedom.org