Friends -
DRN’s Priorities for FY 2013-2014 are final and posted on our website under About DRN/Priorities. Or you can click here to view the Priorities.
DRN would like to thank everyone who took the time to review and comment on the Priorities.
Thank you,
Disability Rights Network of Pennsylvania
Philadelphia, Harrisburg, Pittsburgh
800-692-7443
www.drnpa.org
Forwarded by the Disability Rights Network of Pennsylvania -
Friends -
We recognize that in order to design a system of supports that meets the needs of individuals and families, it is important to reach out to individuals and families beyond the ODP Futures Planning website. From October 21 to November 5, draft Action Plans will be released for public comment. During this time, several public forums will be arranged throughout Pennsylvania to gather comments from individuals and families.
A Futures Planning Forum for individuals and families will be co-hosted by Vision for Equality in Philadelphia on October 28, 2013. For information on this Forum, click here for an English version and click here for a Spanish version. We are finalizing a few more of these too. If you live in the Philadelphia area or have friends or family that may have interest in participating in this Forum, please share this with them.
Thank you for your help,
Fred Lokuta
Deputy Secretary
Office of Developmental Programs
Friends -
The Disability Rights Network of Pennsylvania is pleased to announce the publication of a series of fact sheets and videos called Rights of Deaf and Hard of Hearing People. This project has been supported by a grant from the Pennsylvania Developmental Disabilities Council.
While these fact sheets and videos do not cover every situation, they do explain the rights of people who are Deaf or hard of hearing in the following locations/situations:
Medical Settings (Doctors and Hospitals)
Courts and Lawyers
Police and Jails
Employment (At work)
Entertainment
Intellectual Disability Services
We hope that these fact sheets and videos help people who are Deaf or hard of hearing, their family members, service providers, and others to understand their rights to clear communication and what steps they can take to help make sure that their rights are honored.
The publication Rights of Deaf and Hard of Hearing People, along with videos and DVDs with the information presented in American Sign Language and open-captioning, is available by calling DRN at (800) 692-7443, ext. 400 or on DRN’s website, Rights of Deaf and Hard of Hearing People or on the Pennsylvania Developmental Disabilities Council’s website at www.paddc.org.
Forwarded by the Disability Rights Network of Pennsylvania -
Friends -
It has been four weeks since the start of the new Health Insurance Marketplace, where Americans, regardless of income or health status, can find quality, affordable health coverage. The launch of the Marketplace website, HealthCare.gov, has been rocky but we are working tirelessly to make the online process better.
And we are taking other steps to meet the consumer demand for affordable health insurance. There are four basic ways to apply for health coverage through the Marketplace:
Before you choose a plan, you may want to explore your options. You can use this calculator to see if you qualify for lower costs on coverage and preview Marketplace plans here.
If you need help:
Disability Rights Network of Pennsylvania 1-800-692-7443 (voice) 1-877-375-7139 (TTY)
The Disability Rights Network of Pennsylvania (DRN), one of the most highly regarded and influential disability protection and advocacy organizations in the country, is looking to fill the position of Chief Executive Officer. For more information, including a complete job description, please click here.
Please note that the deadline to apply is January 15, 2014. DO NOT respond to this alert but to the email provided in the job description.
Thank you,
Disability Rights Network of Pennsylvania
Philadelphia, Pittsburgh, Harrisburg
1-800-692-7443
www.drnpa.org
From the Disability Rights Network of Pennsylvania -
Friends -
November is Assistive Technology Awareness Month!
Click here to read the Governor’s Proclamation about the importance of assistive technology for people with disabilities.
Click here for links to assistive technology resources.
Click here for assistive technology publications.
If you need help getting assistive technology, contact us at:
1-800-692-7443 (voice)
1-877-375-7139 (TTY)
intake@drnpa.org
Thank you,
Disability Rights Network of Pennsylvania
Friends -
The expansion of Medicaid health coverage in some states is being called an “early success story” of the Affordable Care Act — but you won’t find any success stories here in Pennsylvania. While other states are accepting federal funding to expand Medicaid coverage, Pennsylvania is creating a dangerous gap that will leave hundreds of thousands of Pennsylvanians uninsured. Governor Corbett has proposed a much more complicated plan, known as Healthy PA, which likely will not happen until 2015, if at all.
We are asking you to join in a statewide day of action TODAY to urge Governor Corbett and your lawmakers to expand Medicaid coverage in 2014.
All hardworking families deserve the security of knowing they can see a doctor when they get sick without facing enormous medical bills. If Pennsylvania fails to expand Medicaid, hundreds of thousands will be left out in the cold with no options for affordable coverage in 2014.
Tell Governor Corbett and your lawmakers that Pennsylvania cannot afford to turn down federal funding that states like New Jersey and Ohio will use to provide coverage for their citizens and give their health care economies a needed boost in 2014.
As many as 400,000 Pennsylvanians will have no other affordable health care options if we do not act soon. These Pennsylvanians are our neighbors and friends. They take our orders at restaurants, fix our cars, and take care of our kids when we’re at work — but do not earn enough to buy private health coverage.
Expansion will open the door to affordable quality coverage for them AND give Pennsylvania’s health care sector a boost.
Please click here and follow the instructions for contacting Governor Corbett and your state legislators TODAY to urge them to take part in this “success story” by providing hardworking families with the security of quality health care.
Please contact Kelly Whitcraft, Policy Coordinator for the Disability Rights Network of Pennsylvania, at kwhitcraft@drnpa.org for additional information.
Thank you,
Kelly A. Whitcraft
Policy Coordinator/Advocate
Disability Rights Network (DRN) of PA
1414 N. Cameron Street, Suite C
Harrisburg, PA 17103
1-800-692-7443
TTY: 1-877-375-7139
Fax: 717-236-0192
kwhitcraft@drnpa.org
Visit us online at: www.drnpa.org
We have been working hard to fix the technical problems that some users have seen on HealthCare.gov, and we are happy to report that 90 percent of users are now able to create accounts. We also recently extended the application deadline to December 23, 2013 for health coverage that is effective January 1, 2014.
If you want to apply for health coverage through the Marketplace, there are four basic ways:
Before you choose a plan, you may want to explore your options. You can use this calculator to see if you qualify for lower costs on coverage and preview Marketplace plans here.
If you need help:
Disability Rights Network of Pennsylvania
1-800-692-7443 (voice)
1-877-375-7139 (TTY)
Forwarded by the Disability Rights Network of Pennsylvania -
News for Immediate Release
Nov. 14, 2013
Auditor General DePasquale Says Department of Public Welfare Mismanaged Home Care Worker Payroll Providers
Pay Delay Caused Undue Stress on Workers, People Receiving Care; Unnecessarily Costing Taxpayers Millions of Medicaid Dollars Per Year
HARRISBURG – Auditor General Eugene DePasquale today said an audit of a Department of Public Welfare shows long-term mismanagement of home care worker payroll providers caused undue financial and emotional strain on tens of thousands of people. Thousands of workers had paychecks delayed for up to four months. Thousands of care recipients switched to a more expensive care model that is costing taxpayers at least $7 million annually.
“Thousands of people who provide services that help the elderly, and children and adults with disabilities, stay in their home — out of institutional care — went for weeks and months without a paycheck because DPW failed to provide adequate oversight and demand accountability of contracted payroll providers,” DePasquale said about the problematic transition in January from 36 payroll providers to Public Partnerships Limited LLC (Public Partnerships Limited), of Boston, Mass.
“Our audit found that problems with the transition caused so much fear and confusion that at least 1,500 people receiving home care services switched to a more expensive model of care that is unnecessarily costing at least $7 million more per year.”
Prompted by calls and complaints from home care program participants and their direct care workers across the state, DePasquale launched the special performance audit in February.
Home care services provide the elderly, and children and adults with disabilities, with personal care assistance that enables them to remain in their homes rather than entering long-term care facilities. Such services include assistance with bathing, meal preparation and breaks for family caregivers. Home care services are supported by state and federal funds through the Medical Assistance (Medicaid) program.
Beginning in December 2008, DPW had agreements with 36 different providers for payroll services of home care workers across the state. However, from 2009 through 2012, auditors found that DPW did not adequately monitor these providers resulting in numerous instances of noncompliance with applicable state and federal laws, regulations, and financial services standards by some of the providers.
“Instead of taking corrective actions against the providers, auditors found that DPW allowed the noncompliance to continue for years,” DePasquale said. “Then they took the easy way out when they decided to start over with a new provider because DPW believed aggressive monitoring of the former providers was ‘cumbersome.’”
DPW issued a request for applications in January 2012, and in August 2012 selected the Boston, Mass.-based vendor, Public Partnerships Limited, to provide payroll service statewide. In the short time frame that DPW had to transition 20,000 care recipient files to Public Partnerships Limited, DPW ignored many red flags — including concerns expressed by the vendor — that the new vendor was not fully prepared to pay all direct care workers by the DPW-imposed Jan. 1, 2013 deadline.
The audit also found significant flaws in the procurement process used to select Public Partnerships Limited.
“The fact that the procurement process was unfair to other vendors is nearly as disturbing as DPW’s disregard for the workers and home care participants harmed in this process,” DePasquale said. “For example, DPW initially told interested vendors that no cash advance would be provided as working capital during the transition. Then, after awarding the contract to Public Partnerships Limited, the company requested, and DPW provided, an $18 million cash advance for payroll expenditures. The state provided $18 million up front — and cash advances that continue — and still workers’ paychecks were delayed. ”
Also troubling was DPW’s unfair “conflict-free” requirement in the procurement process that eliminated potential vendors from being selected or competing because it mandated — among other things — that the provider cannot work for, or be affiliated with, an existing provider of home and community-based services.
“By doing a flip-flop on the multi-million dollar cash advance and mandating a conflict-free requirement, DPW essentially rolled out the red carpet for the Boston-based firm to take over Pennsylvania payroll provider services. At best, this procurement process appears to be questionable,” DePasquale said.
The audit also found that DPW:
· failed to ensure that only allowable hourly wage rates were paid to direct care workers and allowed this noncompliance to continue for years which resulted in a significant decrease in pay when Public Partnerships Limited followed the appropriate guidelines; and
· continues to put the well-being of home care program participants and care workers at risk by not adequately monitoring Public Partnerships Limited.
The audit report includes six findings and seven recommendations for DPW to implement to improve its oversight of home care worker payroll services. The report also includes DPW’s response to each finding.
“DPW said that they will ‘consider’ our recommendations,” DePasquale said. “It is clear through our audit findings that DPW must do more than ‘consider’ our recommendations.
“People are tired of state and federal governments not taking responsibility for their actions and the consequences of those actions. DPW must make sure that a situation like this does not happen again.
“Knowing Secretary Mackereth, I would be surprised if she doesn’t demand her staff do more than ‘consider’ our recommendations,” DePasquale said.
The full audit report is available online at: www.auditorgen.state.pa.us/reports/performance/special/speDPWPPL111413.pdf
# # #
Media contact: Susan Woods, 717-787-1381
EDITOR’S NOTE: A 2-page summary of the audit and a 1-page sampling of messages from people affected by DPW’s contract transition to Public Partnerships Limited is available online at http://www.auditorgen.state.pa.us/.
Sent by the Disability Rights Network of Pennsylvania
Friends -
You are invited to attend a training on….
ADVOCATING THE RIGHTS OF PEOPLE WITH DISABILITES
Presented by Martine DeLorenzo – Community Advocate in Southeastern Pennsylvania
Intended Audience: People with Intellectual Disabilities, families, and interested others.
Date: December 16, 2013
Time: 7 p.m. to 9 p.m.
Where: Cardinal Krol Center – Theater
1799 S. Sproul Road
Springfield, PA 19064
RSVP – Space is limited so please respond by December 9, 2013 to let us know you will be attending.
Please confirm your attendance by sending an email to jbeilharz@drnpa.org – please note the date of the training you plan to attend, your name and contact information. Also let us know if you need a Sign Language interpreter or another accommodation.
We look forward to seeing you.
Thank you,
Disability Rights Network of Pennsylvania
Philadelphia, Pittsburgh, Harrisburg
1-800-692-7443
www.drnpa.org
(This training is funded in part by the Pennsylvania Department of Public Welfare/Office of Developmental Programs).
Forwarded by the Disability Rights Network of Pennsylvania -
Friends -
Please find “Save the Date” information by clicking here for the upcoming ADARA mental health breakout conference which will be held March 13-15, 2014 in Pittsburgh, PA.
A full schedule of presenters will be established by mid-December.
Please check out registration and conference details at www.adara.org.
Please share with interested others!
Happy Holidays!
Kim Mathos/Steve Larew
Conference Planning Chairs
On December 6, 2013 the Department of Public Welfare (the Department) released its Healthy Pennsylvania Plan Draft 1115 Waiver Application. The Draft 1115 Waiver details the Department’s proposal to reform Medicaid and expand access to health care coverage to uninsured adults ages 21 to 64 whose income is up to 133% of the federal poverty level. The Department is proposing significant changes to Medicaid benefits, new cost sharing requirements in the form of monthly premiums, and work search and healthy behavior requirements. The Draft 1115 Waiver application can be accessed here. [http://www.dpw.state.pa.us/healthypa/index.htm.]
It is important for the disability community to submit comments on the Draft 1115 Waiver application. Written comments must be submitted to the Department by January 13, 2014. Written comments may be emailed to ra-PWHealthyPA1115@pa.gov or mailed to: Department of Public Welfare, Attention: Healthy Pennsylvania Waiver, P.O. Box 2675, Harrisburg, PA 17105-2675. Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at 800-654-5984 (TDD users) or 800-654-5988 (voice users).
The Department is also holding 6 public hearings and 2 public webinars. The schedule for the public hearings and webinars is below. You may register for the hearings and webinars here. [http://www.dpw.state.pa.us/healthypa/index.htm] Please note that registration is required if you will be providing testimony at the hearing or webinar. Please consider attending at least one of the public hearings or webinars and providing testimony on the Draft 1115 Waiver.
Public Hearings
Thursday, December 19, 2013
10:00 AM – 1:00 PM
Bayfront Convention Center
1 Sassafras Pier
Erie, PA 16507
Registration Deadline: December 16, 2013
Friday, December 20, 2013
10:00 AM – 1:00 PM
Allegheny Courthouse
436 Grant Street
Pittsburgh, PA 15219
Registration Deadline: December 17, 2013
Friday, January 3, 2014
10:00 AM – 1:00 PM
National Constitution Center
525 Arch Street
Philadelphia, PA 19106
Registration Deadline: December 30, 2013
Monday, January 6, 2014
10:00 AM – 1:00 PM
Hilton Scranton and Conference Center
100 Adams Avenue
Scranton, PA, 18503
Registration Deadline: January 2, 2014
Tuesday, January 7, 2014
10:00 AM – 1:00 PM
Blair County Convention Center
1 Convention Center Drive
Altoona, PA 16602
Registration Deadline: January 2, 2014
Thursday, January 9, 2014
10:00 AM – 1:00 PM
The State Museum of Pennsylvania
300 North Street
Harrisburg, PA 17120
Registration Deadline: January 6, 2014
Public Webinars
Monday, December 16, 2013
9:00 AM – 11:00 AM
Registration Deadline: December 11, 2013
Wednesday, January 8, 2014
9:00 AM – 11:00 AM
Registration Deadline: January 3, 2014
Questions or comments may be directed to Kelly Whitcraft, DRN Policy Coordinator, at kwhitcraft@drnpa.org or 800-692-7443 x323.
Friends -
Disability Rights Network of PA (DRN) is the protection and advocacy system for
the state of Pennsylvania with offices located in Pittsburgh, Harrisburg and
Philadelphia. We offer services to individuals with disabilities and
disability advocacy groups and organizations.
Disability Advocacy Support Hub (DASH) is a program started in April 2007 by
the Disability Rights Network of PA (DRN) with funding from the PA
Developmental Disabilities Council. It is designed to support and help
disability advocacy groups all across Pennsylvania. DASH provides free
trainings and technical assistance to disability advocacy groups to help them
build their groups and improve their advocacy. We have helped groups with
a variety of advocacy issues, strategic planning, board development, use of
media, lobbying rules, outreach, fund raising, networking and lots of other
topics and activities.
DASH is trying to improve our outreach so that more people know about our
training sessions. Please help us by filling out a brief survey (see
survey links below); it will help us deliver the training that you want. Please
have all responses completed by Friday January 3, 2014. If you are able to help
to distribute the surveys to a greater audience, please do. Thanks for
all your help.
Complete survey through the internet
Surveys can be completed through the internet, saved/scanned and emailed to Ldo@drnpa.org, faxed to 717-236-0192,
or phoned in to 1-800-692-7443 ext. 312.
December 2013
On December 6, 2013, the Department of Public Welfare (the Department) released its Healthy Pennsylvania Plan Draft 1115 Waiver Application. The Draft 1115 Waiver details the Department’s proposal to (1) limit the existing Medicaid (Medical Assistance) program, and (2) cover uninsured adults ages 21 to 64 whose income is less than 133% of the federal poverty level, and who do not otherwise qualify for Medicaid, by using Medicaid dollars to pay for private health insurance for them. The Draft 1115 Waiver application can be accessed here.
It is important for the disability community to submit comments and testify at the public hearings that are being held. The deadline to submit comments is Monday, January 13, 2014. Information on how to submit comments and how to register to testify at a public hearing is below. Webinars are also being held, and information on how to register is below.
After the public comment period, the Department still has to submit the 1115 Waiver Application to the Centers for Medicare and Medicaid Services (CMS) for approval.
The Department is proposing the following significant changes, which will affect persons with disabilities:
BENEFITS:
Medicaid for Adults Ages 21 through 64: The Department proposes to modify the benefits available in the current Medicaid program into two benefits packages, a High-Risk Plan for adults with complex health needs and a Low-Risk Plan for adults with less complex health needs. Those who are eligible for Medicaid under the current eligibility requirements will be enrolled in one of these two plans. This includes people already on Medicaid and those who become eligible for Medicaid in the future.
A health risk screening tool will have to be filled out by the person, family member, or representative. People on Supplemental Security Income (SSI) or deemed eligible for SSI do not have to fill out this tool. The following people will always be enrolled in the High-Risk Plan unless they choose to be enrolled in a different plan: all SSI beneficiaries, pregnant women, people who are dually eligible for Medicare and Medicaid, people in institutions, and people receiving home and community-based services. Other Medicaid-eligible adults will be assigned to a High-Risk Plan or Low-Risk Plan based on the results of the health risk screening tool. If the health risk screening tool is not completed, the person will be enrolled in the Low-Risk Plan.
New Limits on Medicaid Benefits for Adults: Benefits available under the High-Risk Plan and Low-Risk Plans would have new, lower limits. For example, medical supplies and durable medical equipment would have a combined annual limit of $2,500 in the High-Risk Plan and $1,000 in the Low-Risk Plan. Outpatient surgery would be limited to four visits per year in the High-Risk Plan and two visits per year in the Low-Risk Plan. Outpatient mental health visits would be limited to 40 visits per year in the High-Risk Plan and 30 visits per year in the Low-Risk Plan.
Children’s Plan: The Medicaid benefits for children under 21 years of age would not change.
Private Option: Adults ages 21 through 64 with incomes up to 133 percent of the federal poverty level who are not otherwise eligible for Medicaid would receive health insurance coverage through a private, commercial health insurance plan or an employer-sponsored insurance plan. The bulk of the cost sharing for the plan would be paid by Pennsylvania using federal Medicaid funds. These private insurance plans must include at least a minimum set of benefits, known as essential health benefits. Adults in this group who meet at least one of the following criteria would be deemed medically frail and given the choice to enroll in the High-Risk Medicaid Plan instead: disabling mental disorder; active chronic substance use disorder; serious and complex medical condition; physical, intellectual or developmental disability that significantly impairs functioning; or determination of disability based on Social Security Administration (SSA) criteria.
COST SHARING:
Copayments: Most copayments would be eliminated for Medicaid recipients, with the exception of a new $10 copayment for non-emergency use of emergency rooms. Newly-eligible adults receiving health coverage under the Private Option (described above) who are at least age 21 would also have to pay the $10 copay when they go to the emergency room for non-emergency care.
Premiums: Adults ages 21 through 64, who are in Medicaid or who are in the Private Option, would also have to pay a monthly premium. Premiums would begin for adults with incomes above 50 percent of the federal poverty level. Certain people would not have to pay premiums: people on SSI or deemed eligible for SSI, pregnant women, people who are dually eligible for Medicare and Medicaid, and people in institutions.
Monthly Premium Amounts: There would be two types of premium amounts: “individual” for one adult, and “household” for two or more adults. Single adults with incomes greater than 50 percent of the federal poverty level up to 100 percent of the federal poverty level would pay $13 each month. Households in the same income range would pay $17 each month. Single adults with incomes greater than 100 percent of the federal poverty level up to 133 percent of the federal poverty level would pay $25 each month. Households in the same income range would pay $35 each month. Premiums would be adjusted upward every year. People would lose Medicaid benefits for up to nine months for not paying premiums.
Premium Reductions for Health Habits: Adults who pay premiums on time who complete an annual health risk assessment and have an annual physical examination would pay a monthly premium reduced by 25 percent.
Premium Reductions for Working: Adults who work 30 or more hours per week would pay a monthly premium reduced by 25 percent. Adults who work more than 20 hours but less than 30 hours per week would have a reduction of 15 percent in their premium, after six months of working.
WORK SEARCH REQUIREMENTS:
Work Search Activities: Adults ages 21 through 64 who are in Medicaid or in the Private Option and working less than 20 hours per week would have to register with the JobGateway online program and complete 12 approved work search activities per month. Failure to register or complete the work search activities would result in ineligibility for health coverage.
The following people would not have to enroll with JobGateway and would be exempt from the work search requirements: people on SSI or deemed eligible for SSI, pregnant women, people 65 years of age and older, people under 21 years of age, people in institutions, and people who are dually eligible for Medicare and Medicaid. Full- and part-time students would have to register with JobGateway but are exempt from the work search requirements.
PUBLIC COMMENT PERIOD:
It is important for the disability community to submit comments on the Draft 1115 Waiver application. Written comments must be submitted to the Department by January 13, 2014. Written comments may be emailed to ra-PWHealthyPA1115@pa.gov or mailed to: Department of Public Welfare, Attention: Healthy Pennsylvania Waiver, P.O. Box 2675, Harrisburg, PA 17105-2675. Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at 800-654-5984 (TDD users) or 800-654-5988 (voice users).
The Department is also holding 6 public hearings and 2 public webinars. The schedule for the public hearings and webinars is below. You may register for the hearings and webinars here. Please note that registration is required if you will be providing testimony at the hearing or webinar. Please consider attending at least one of the public hearings or webinars and providing testimony on the Draft 1115 Waiver.
Public Hearings
Thursday, December 19, 2013
10:00 AM – 1:00 PM
Bayfront Convention Center
1 Sassafras Pier
Erie, PA 16507
Registration Deadline: December 16, 2013
Friday, December 20, 2013
10:00 AM – 1:00 PM
Allegheny Courthouse
436 Grant Street
Pittsburgh, PA 15219
Registration Deadline: December 17, 2013
Friday, January 3, 2014
10:00 AM – 1:00 PM
National Constitution Center
525 Arch Street
Philadelphia, PA 19106
Registration Deadline: December 30, 2013
Monday, January 6, 2014
10:00 AM – 1:00 PM
Hilton Scranton and Conference Center
100 Adams Avenue
Scranton, PA, 18503
Registration Deadline: January 2, 2014
Tuesday, January 7, 2014
10:00 AM – 1:00 PM
Blair County Convention Center
1 Convention Center Drive
Altoona, PA 16602
Registration Deadline: January 2, 2014
Thursday, January 9, 2014
10:00 AM – 1:00 PM
The State Museum of Pennsylvania
300 North Street
Harrisburg, PA 17120
Registration Deadline: January 6, 2014
Public Webinars
Monday, December 16, 2013
9:00 AM – 11:00 AM
Registration Deadline: December 11, 2013
Wednesday, January 8, 2014
9:00 AM – 11:00 AM
Registration Deadline: January 3, 2014
IF YOU HAVE QUESTIONS:
Questions or comments may be directed to Kelly Whitcraft, DRN Policy Coordinator, at kwhitcraft@drnpa.org or 800-692-7443, extension 323.
Thank you,
Disability Rights Network of Pennsylvania
Philadelphia, Pittsburgh, Harrisburg
1-800-692-7443
www.drnpa.org
Alert for the Disability Community:
Healthy Pennsylvania Comments Due January 13
The Department of Public Welfare is proposing “Healthy PA,” which is not simple Medicaid expansion. Healthy PA would (1) cut benefits for adults on Medicaid (Medical Assistance), and (2) provide private insurance coverage for other uninsured adults, without the rights and protections of Medicaid. The Draft 1115 Waiver application can be found here. The Pennsylvania Bulletin notice can be found here.
Healthy PA would affect people with disabilities, and so it is very important for people with disabilities to submit comments.
Comments are due this Monday, January 13. Email comments to ra-PWHealthyPA1115@pa.gov or mail them to: Department of Public Welfare, Attention: Healthy Pennsylvania Waiver, P.O. Box 2675, Harrisburg, PA 17105-2675. Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at 800-654-5984 (TDD users) or 800-654-5988 (voice users). Every comment matters.
Big changes are being proposed, which include:
For more information, go to DRN’s overview of Healthy PA.
Contact: Kelly Whitcraft, DRN Policy Coordinator, at kwhitcraft@drnpa.org or 800-692-7443, extension 323.
Friends -
The Department of Public Welfare is proposing “Healthy PA,” which would (1) cut benefits for adults on Medicaid (Medical Assistance), and (2) provide private insurance coverage for other uninsured adults, without the rights and protections of Medicaid.
The Disability Rights Network of Pennsylvania has submitted comments to the Department of Public Welfare on Healthy PA and also testified at public hearings by DPW earlier this month. Please feel free to use portions of the letter in drafting your own comments. You can view the comments here and view the testimony here. Comments are due this Monday, January 13.
Email comments to ra-PWHealthyPA1115@pa.gov or mail them to: Department of Public Welfare, Attention: Healthy Pennsylvania Waiver, P.O. Box 2675, Harrisburg, PA 17105-2675. Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at 800-654-5984 (TDD users) or 800-654-5988 (voice users). Every comment matters.
Thank you,
Disability Rights Network (DRN) of PA
Philadelphia, Pittsburgh, Harrisburg
1-800-692-7443
TTY: 1-877-375-7139
Visit us online at: www.drnpa.org
Sent by the Disability Rights Network of Pennsylvania -
Friends -
The Disability Rights Network of Pennsylvania is presenting a training on “Advocating the Rights of Persons with Disabilities” in February.
For more information on this training click here for a Word version and click here for a pdf version.
Thank you,
Disability Rights Network of Pennsylvania
Philadelphia, Pittsburgh, Harrisburg
800-692-7443
www.drnpa.org
On March 11, 2014
Please join us for a FREE WEBINAR on getting durable medical equipment through Medical Assistance (Medicaid) managed care.
The Disability Rights Network of Pennsylvania and the Institute on Disabilities at Temple University present
Getting Your Equipment Repaired Under Medical Assistance Managed Care WEBINAR
March 11, 2014
Tuesday / 3:00 – 4:00 pm (Eastern Standard Time)
To register for this webinar:
1. GO TO
https://tueducation.webex.com/tueducation/j.phpED=262187142&RG=1&UID=0&RT=MiMxMQ%3D%3D
2. REGISTER FOR THE MEETING
Once the host approves your request, you will receive a confirmation email with instructions for joining the meeting.
To view in other time zones or languages, please click the link: https://tueducation.webex.com/tueducation/j.php?ED=262187142&RG=1&UID=0&ORT=MiMxMQ%3D%3D
FOR MORE INFORMATION, including requests for reasonable accommodations (e.g., CART) or to participate via telephone contact Jamie Arasz Prioli, RESNA Assistive Technology Practitioner (ATP).
EMAIL: Jamie.Prioli@temple.edu
PHONE: 215-204-5967 voice / 866-268-0579 TTY
All requests for reasonable accommodations must be submitted no later than March 4, 2014.
Thank you,
Disability Rights Network of Pennsylvania
www.drnpa.org
Pennsylvania’s Initiative on Assistive Technology, a program of the
Institute on Disabilities at Temple University
www.disabilities.temple.edu
Sent by the Disability Rights Network of Pennsylvania -
The Disability Rights Network of Pennsylvania and the Institute on Disabilities at Temple University present -
Getting Your Equipment Repaired Under Medical Assistance Managed Care
Free Webinar.
March 11, 2014
Tuesday / 3:00 – 4:00 pm (Eastern Standard Time)
To register for this webinar:
1. GO TO
https://tueducation.webex.com/tueducation/j.phpED=262187142&RG=1&UID=0&RT=MiMxMQ%3D%3D
2. REGISTER FOR THE MEETING
Once the host approves your request, you will receive a confirmation email with instructions for joining the meeting.
To view in other time zones or languages, please click the link:
https://tueducation.webex.com/tueducation/j.php?ED=262187142&RG=1&UID=0&ORT=MiMxMQ%3D%3D
FOR MORE INFORMATION, including requests for reasonable accommodations (e.g., CART) or to participate via telephone contact Jamie Arasz Prioli, RESNA Assistive Technology Practitioner (ATP) at –
EMAIL: Jamie.Prioli@temple.edu
PHONE: 215-204-5967 voice / 866-268-0579 TTY
All requests for reasonable accommodations must be submitted no later than March 4, 2014.
Thank you,
Disability Rights Network of Pennsylvania
www.drnpa.org
Pennsylvania’s Initiative on Assistive Technology, a program of the Institute on Disabilities at Temple University
On February 19, 2014, the Department of Public Welfare (the Department) submitted its final Healthy Pennsylvania Plan 1115 Waiver Application to the Centers for Medicare and Medicaid Services (CMS). The Healthy PA 1115 Waiver details the Department’s proposal to (1) limit the existing Medicaid (Medical Assistance) program, and (2) cover uninsured adults ages 21 to 64 whose income is less than 133% of the federal poverty level, and who do not otherwise qualify for Medicaid, by using Medicaid dollars to pay for private health insurance for them. The Draft 1115 Waiver application can be accessed here.
It is important for the disability community to submit comments to CMS. The deadline to submit comments is Thursday, April 10, 2014 by 11:00 PM. Information on how to submit comments is below.
After the federal public comment period, CMS and the Department will negotiate the terms of the final Healthy PA 1115 Waiver.
The Department is proposing the following significant changes, which will affect persons with disabilities:
BENEFITS:
Medicaid for Adults Ages 21 through 64: The Department proposes to modify the benefits available in the current Medicaid program into two benefits packages, a High-Risk Plan for adults with complex health needs and a Low-Risk Plan for adults with less complex health needs. Those who are eligible for Medicaid under the current eligibility requirements will be enrolled in one of these two plans. This includes people already on Medicaid and those who become eligible for Medicaid in the future.
The following people will always be enrolled in the High-Risk Plan unless they choose to be enrolled in a different plan:
Other Medicaid-eligible adults will be assigned to a High-Risk Plan or Low-Risk Plan based on the results of the health risk screening tool or review of the Department’s Medicaid claims data.
Reducing the existing benefits packages to only two packages would eliminate some successful and important programs, such as the Medical Assistance for Workers with Disability (MAWD) program. MAWD provides Medicaid health insurance for people with disabilities who do not meet the general resource and income requirements for Medicaid, typically because they are working. MAWD provides vital services to recipients so they can maintain their health, remain in a community setting, and continue working. The elimination of MAWD would impact around 34,000 Pennsylvanians, many of whom will be left without an affordable option for health care outside of the Medicaid system.
New Limits on Medicaid Benefits for Adults: Benefits available under the High-Risk Plan and Low-Risk Plan would have new, lower limits. For example, medical supplies and durable medical equipment would each have an annual limit of $2,500 in the High-Risk Plan and $1,000 in the Low-Risk Plan. Outpatient surgery would be limited to four visits per year in the High-Risk Plan and two visits per year in the Low-Risk Plan. Outpatient mental health visits would be limited to 60 visits per year in the High-Risk Plan and 30 visits per year in the Low-Risk Plan. See the Healthy PA Benefits Chart at XXX for the proposed limits for other Medicaid services.
Children’s Plan: The Medicaid benefits for children under 21 years of age would not change.
Private Option: Adults ages 21 through 64 with incomes up to 133 percent of the federal poverty level who are not otherwise eligible for Medicaid would receive health insurance coverage through a private, commercial health insurance plan or an employer-sponsored insurance plan. The bulk of the cost sharing for the plan would be paid by Pennsylvania using federal Medicaid funds. These private insurance plans must include at least a minimum set of benefits, known as essential health benefits.
Adults in the newly eligible group who meet at least one of the following criteria would be deemed medically frail and given the choice to enroll in the High-Risk Medicaid Plan instead:
COST SHARING:
Copayments: During the first year of the Healthy PA Waiver (calendar year 2015), Medicaid beneficiaries and adults in the private option would pay copays that currently apply for Medicaid services. During years two through five (calendar years 2016 through 2019), all adults with incomes less than 100 percent federal poverty level (FPL) would continue to pay these copays, as well as a new $10 copayment for non-emergency use of emergency rooms.
Medicaid beneficiaries and adults in the private option with incomes above 100 percent FPL would also have to pay the $10 copay for non-emergency use of emergency rooms but would not be assessed any other copayments during years two through five.
All Medicaid beneficiaries under the age of 18 and those residing in an institution are exempt from the $10 copayment for non-emergent use of emergency rooms.
Premiums: For years two through five of the Healthy PA Waiver (calendar years 2016 through 2019), adults ages 21 through 64 who are in Medicaid or who are in the Private Option with incomes above 100 percent FPL would also have to pay a monthly premium. The premium amount for year two (calendar year 2016) would be $25 per month for an individual and $35 per month for a household.
The Healthy PA Waiver includes language that indicates premiums may also be established for Medicaid or Private Option beneficiaries with incomes below 100 percent FPL.
Certain people would be exempt from paying premiums:
Premium Reductions for Health Habits: For years two through five of the Healthy PA Waiver (calendar years 2016 through 2019), adults who pay premiums on time may qualify for reduced premiums or copays for participating in healthy behavior activities, such as health risk assessments, preventive services and annual wellness visits
Premium Reductions for Working: For years two through five of the Healthy PA Waiver, adults who pay premiums on time may qualify for reduced premiums or copays for employment-related activities.
WORK SEARCH REQUIREMENTS:
Work Search Activities: Adults ages 18 through 64 who are in Medicaid or in the Private Option and working less than an average of 20 hours per week would be asked to register with the JobGateway online program and complete approved job training or employment-related activities every month to receive a 15 percent reduction in cost sharing. People who are working between 20 and 29 hours per week would receive a 25 percent reduction in cost sharing. People working 30 or more hours per week would receive a 40 percent reduction in cost sharing.
The following people would not have to enroll with JobGateway and would be exempt from the work search requirements:
PUBLIC COMMENT PERIOD:
It is important for the disability community to submit comments on the Healthy PA 1115 Waiver application. Written comments must be submitted to CMS by 11:00 PM on April 10, 2014. Written comments may be submitted at https://public.medicaid.gov/connect.ti/public.comments/view?objectId=1852995 or emailed to 1115DemoRequests@cms.hhs.gov. CMS will review and post comments received, but will not respond to each individual comment.
IF YOU HAVE QUESTIONS:
Questions or comments may be directed to Kelly Whitcraft, DRN Policy Coordinator, at kwhitcraft@drnpa.org or 800-692-7443, extension 323.
Thank you,
Disability Rights Network of Pennsylvania
Philadelphia, Pittsburgh, Harrisburg
1-800-692-7443
www.drnpa.org
