The first “Tuesday at the Capitol” is February 14th! We need your voice at the Capitol to encourage legislators to protect our children. Each Tuesday starts 10:00 AM in the State Office Building Cafeteria with a briefing, and is followed by meetings with legislators. Learn more and sign up at http://mnccd.org/?page_id=36 or send an email to meredith@arcgreatertwincities.com.

Essential Benefits Set

Under federal health care reform, Minnesota has the opportunity to define the “essential health care benefits set” that all private health insurance plans must cover.  As Minnesota moves forward with this effort, the big question for the Autism Advocacy & Law Center is whether children who have autism will have private health care coverage for evidence-based, medically necessary care?If you care about this question, please sign up for action alerts to keep informed.
On Tuesday, January 31st, the Senate Committee on Health and Human Services received an update on the Health Insurance Exchange Advisory Task Force from Commerce Commissioner Mike Rothman. The Task Force consists of 15 members appointed by the Commissioner, including consumers, employers, labor, health care providers, health insurers, those with experience navigating health plan enrollment, and experts. The Task Force is also supported by ten technical work groups, designed to increase the involvement of stakeholders. Although the Task Force has begun meeting, there is still significant uncertainty about the format of the Health Insurance Exchange and how the essential benefits set will be defined.

The future of private insurance coverage for individuals who have autism may hang in the balance of this process.

Medical Assistance Reform

The Autism Advocacy & Law Center is advocating to prevent reductions in coverage to therapy, services, and supports for individuals who have autism. The AALC is particularly concerned that Medical Assistance Reform will reduce access to early intervention for children who have autism.

This week the House Health and Human Services Finance Committee met to hear testimony on Emergency Medical Assistance, and County Service Delivery Authority. Although a DHS update on Medical Assistance Reform Waivers was on the agenda, this discussion was postponed.

On Monday, January 30th, Representative Gottwalt introduced the DHS technical bill, H.F. 1994. Of note is Section 21 of this bill, which requires the Health Services Advisory Council to review currently available literature regarding treatments for ASD and recommend authorization criteria for services by December 31, 2012.

Legislative Bills of Interest to the Autism and Disability Communities
H.F. 1994 (Gottwald)/S.F. n/a: Section 21 requires the Health Services Advisory Council to review currently available literature regarding treatments for ASD and recommend authorization criteria for services.  “The Health Services Advisory Council shall review currently available literature regarding the efficacy of various treatments for autism spectrum disorder, including an evaluation of age-based variation in the appropriateness of existing medical and behavioral interventions. The council shall recommend to the commissioner of human services authorization criteria for services based on existing evidence. The council may recommend coverage with ongoing collection of outcomes evidence in circumstances where evidence is currently unavailable, or where the strength of the evidence is low. The council shall make this recommendation by December 31, 2012.”  The bill is available at: http://www.house.leg.state.mn.us/bills/billnum.asp?Billnumber=HF1994&Go.x=0&Go.y=0&Go=Search&sessionvar=20110&ls_year=87.

It is estimated that this change will directly affect about 200 young children in Minnesota, and their families. What will these families do? Well, one option is to sue BCBS in court and the Autism Advocacy & Law Center stands ready to help! Please contact us if your child will be losing coverage to learn how we can help you.

Unless we fight back now this will be a devastating blow to children in Minnesota who have autism and their families! We pay our health insurance premiums and deserve to have coverage of medically necessary, evidence-based treatment for autism covered. Intensive early intervention behavior therapy (“IEIBT”), a sub-set of applied behavior analysis (“ABA”), is highly effective and recommended by the American Academy of Pediatricians as well as by many local experts in the field of autism. If private health insurance doesn’t cover IEIBT then many families will be forced to turn to state-run health care programs and pay extra to gain access to coverage. Other families will be forced to sue school districts so that their child will be able to receive effective early intervention. (Fortunately, the Autism Advocacy & Law Center has recently added an attorney with special education law experience to expand our ability to assist families in this regard.)

With the legislative session fast approaching, parents, friends, family members, and health care providers must unite to fight for affordable access to medically necessary care for all individuals who have autism. Please join us by signing up for action alerts — just click on the button on the right side of your screen.

Two Part Series: Join us at 5 p.m. on Sept. 28th and October 12th.

Determining the correct treatments, therapies and services for your child is difficult. Paying for them can be even harder. Join Amy Dawson to learn more about your options to pay for your child’s needs — whether it is biomedical intervention, PCA services, consumer support grants (CSG), consumer directed community supports (CDCS), intensive early intervention behavior therapy, speech therapy, ABA, RDI, PLAY, TEACH, Floortime or just about anything else! Topics covered will include understanding private and public insurance appeals as well as strategies to access county services.

For September 28th:

Meeting information
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Topic: Part One: How To Pay for What Your Child Needs
Date: Wednesday, September 28, 2011
Time: 5:00 pm, Central Daylight Time (Chicago, GMT-05:00)
Meeting Number: 802 063 681
Meeting Password: autism

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To start or join the online meeting
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Go to https://autismlaw.webex.com/autismlaw/j.php?ED=159190127&UID=491905062&PW=NMzlhMjczZDQx&RT=MiM3

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Audio conference information
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Call-in toll number (US/Canada): +1-408-600-3600

Access code:802 063 681

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For assistance
——————————————————-
1. Go to https://autismlaw.webex.com/autismlaw/mc
2. On the left navigation bar, click “Support”.
To add this meeting to your calendar program (for example Microsoft Outlook), click this link:

https://autismlaw.webex.com/autismlaw/j.php?ED=159190127&UID=491905062&ICS=MS&LD=1&RD=2&ST=1&SHA2=CtvCfSGa0SZevA9Pt0BU2DVI9rLzkEa2IxBU-Yr45sQ=

To check whether you have the appropriate players installed for UCF (Universal Communications Format) rich media files, go to https://autismlaw.webex.com/autismlaw/systemdiagnosis.php.

http://www.webex.com

For October 12th:

Meeting information
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Topic: Part Two: How To Pay for What Your Child Needs
Date: Wednesday, October 12, 2011
Time: 5:00 pm, Central Daylight Time (Chicago, GMT-05:00)
Meeting Number: 806 385 378
Meeting Password: autism

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To start or join the online meeting
——————————————————-
Go to https://autismlaw.webex.com/autismlaw/j.php?ED=159190172&UID=491905062&PW=NNzg4MzBhY2Nm&RT=MiM3

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Audio conference information
——————————————————-
Call-in toll number (US/Canada): +1-408-600-3600

Access code:806 385 378

——————————————————-
For assistance
——————————————————-
1. Go to https://autismlaw.webex.com/autismlaw/mc
2. On the left navigation bar, click “Support”.
To add this meeting to your calendar program (for example Microsoft Outlook), click this link:

https://autismlaw.webex.com/autismlaw/j.php?ED=159190172&UID=491905062&ICS=MS&LD=1&RD=2&ST=1&SHA2=3a0jUOtN/IaKJTJd6NHefeSrNP9/-EzpmjHnvBoeDy8=

To check whether you have the appropriate players installed for UCF (Universal Communications Format) rich media files, go to https://autismlaw.webex.com/autismlaw/systemdiagnosis.php.

http://www.webex.com

August 30th, 2011

Join us for a free Web workshop on August 30th at 3 p.m.

Learn how a supplemental needs trust and specialized estate planning can help you ensure that your child’s guardian will have the financial resources to take care of your child. Learn why failing to plan for the future can disrupt just about every aspect of your child’s life. This information concerns kids on the spectrum regardless of age.

Government benefits and programs are predicated on absolute poverty. What does this mean? That in order to qualify for assistance for items such as shelter, food, health care, vocational supports and residential supports, an individual who has a disability cannot have assets worth more than $2,000. If you want your child to have resources to pay for items such as clothing, let alone educational or entertainment expenses, then you should consider establishing a supplemental needs trust.

Many parents choose to establish a supplemental needs trust and fund it with life insurance proceeds or assets such as a retirement account that pass into the supplemental needs trust after the parents have passed away. This gives parents peace of mind because they know that their child will have resources that will enhance his or her quality of life. Resources held in a supplemental needs trust can be used for items that are not otherwise covered by programs like social security and Medical Assistance — such as clothing! That’s right, social security used to cover food, shelter and clothing — but now it only covers food and shelter. If you want your child to have financial resources for items such as clothing, then a supplemental needs trust should be the cornerstone of your estate plan.

The Autism Advocacy & Law Center, LLC specializes in supplemental needs trusts and estate planning for families affected by autism and other disabilities.

Please RSVP to info@autismlawcenter.com, and use the information below to join the Web workshop.

Meeting information
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Topic: Future Planning for Special Needs
Date: Tuesday, August 30, 2011
Time: 3:00 pm, Central Daylight Time (Chicago, GMT-05:00)
Meeting Number: 808 075 791
Meeting Password: autism

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To start or join the online meeting
——————————————————-
Go to https://autismlaw.webex.com/autismlaw/j.php?ED=159190077&UID=491905062&PW=NOWM1YjEwOGZl&RT=MiM3

——————————————————-
Audio conference information
——————————————————-
Call-in toll number (US/Canada): +1-408-600-3600

Access code:808 075 791

——————————————————-
For assistance
——————————————————-
1. Go to https://autismlaw.webex.com/autismlaw/mc
2. On the left navigation bar, click “Support”.
To add this meeting to your calendar program (for example Microsoft Outlook), click this link:

https://autismlaw.webex.com/autismlaw/j.php?ED=159190077&UID=491905062&ICS=MS&LD=1&RD=2&ST=1&SHA2=n-T7x9uwkExKyI5VTWZeTqfva//bzmVRK7VLpmVw3NA=

To check whether you have the appropriate players installed for UCF (Universal Communications Format) rich media files, go to https://autismlaw.webex.com/autismlaw/systemdiagnosis.php.

http://www.webex.com

Late last week, Governor Mark Dayton and Republican legislative leadership reached a tentative budget agreement that appears to have ended the government shutdown that commenced on July 1.  The budget agreement is based on an offer submitted by Republican legislative leadership to Governor Dayton on June 30.  Specifically, the June 30 offer proposes a $35.5 billion total budget, which is $1.4 billion greater than the budget passed by the Republican legislature.  In order to fund the increased spending, the budget deal relies on the issuance of state bonds against future tobacco revenues and increases the aid payment shift for schools from 70-30 to 60-40.  In addition, Governor Dayton outlined three stipulations the legislature must agree to in order for the budget deal to be signed into law: a removal of controversial policy issues from finance bills, removal of the fifteen percent across-the-board reduction to the state agency workforce, and passage of a bonding bill that spends at least $500 million.  A copy of the Governor’s July 14 letter to Republican legislative leadership, which includes the June 30 budget offer, can be accessed here: http://mn.gov/governor/newsroom/pressreleasedetail.jsp?id=102-14140.

As of this morning (Tuesday, July 19th), the Governor and Republican leadership have agreed to the details of four major spending bills — but no agreement has yet been announced regarding the education and health care bills. The spending bills that have been finalized during the secret negotiations are transportation, public safety and judiciary, environment and natural resources, and Legacy funds.

The details of the HHS budget bill will be negotiated and determined by key legislators and administration officials behind closed doors.  We will continue to learn more about the details of the HHS budget bill as it is negotiated and finalized and will keep you apprised of any new developments as they occur.

Legislative Bills of Interest to the Disability and Autism Communities

H.F.  1717 (Daudt)/S.F. 1476 (Thompson).  The bill prohibits medical providers from inquiring about a patient’s or resident’s use, possession, or access to firearms or firearms ammunition:

https://www.revisor.mn.gov/bin/bldbill.php?bill=S1476.0.html&session=ls87

With the closing of the conference committee report, the next step in the process is for the legislature to pass the report and send it to the Governor for his signature or veto.  The rejection of the Governor’s tax plan on the House floor yesterday and legislative passage of conference committee reports means budget negotiations between the Governor and Republican legislative leadership have likely stalled.  Barring a breakthrough in the next few days, a special session appears probable.

HHS Conference Committee Report Summary

Notable provisions and fiscal changes in the report that impact the disability community include:

• Reduction or elimination of various mental health grants for adults and children
• Implementation of a freeze on long-term care waivers for various groups
• Requirement that individuals with disabilities enroll in managed care (with an opt-out option)
• Reduction of 20% to payment rate for personal care attendants (PCAs) who provide services to relatives
• Repeal of funding for an alternative program for those who will lose PCA services in July
• Elimination of the early opt-in Medical Assistance (MA) program
• Reduction of 10% to capitation rates for managed care plans and county-based plans, with discretion to plans to reduce payments to providers on the basis of a provider’s risk-adjusted total annual cost of care
• One-month delay of 71% of medical assistance (MA) capitation payments for families with children to managed care plans and county-based purchasing plans by one month
• Limitation of specialized maintenance therapy for physical therapy, occupational therapy, speech-language pathology and audiology services for medical assistance recipients to individuals age 20 and under
• Creation of a high-deductible, basic plan under the Minnesota Comprehensive Health Association (MCHA)
• Extension of temporary TEFRA parental fee increases implemented in 2010
• Permission to CTSS providers to have background studies conducted through the Department of Human Services’ NETStudy system
• Direction to DHS Commissioner to analyze and make recommendations to provide different benefits for different demographic populations under MA

Notable provisions that impact the disability community that are not included in the report:

• Elimination of rehabilitation services (physical, occupational, and speech-pathology) and optional benefits (chiropractic, podiatry, therapies, eyeglasses, contact lenses, and prosthetics) in MA and MNCARE for adults
• Requirement that the Commissioner of the Department of Health (DOH) study the causes of autism in a population where the incidence rate is greater than two percent
• Direction to DHS Commissioner to review the autism treatment benefits under TEFRA and make recommendations to extend the same autism treatment benefits to MA managed care and county-based purchasing

When the 2011 legislative session kicked off in early January, a new cast of characters – a Republican-controlled legislature and a DFL Governor – assumed control at the State Capitol.  Confronting them was a large $5 billion budget deficit that needed to be solved.  First up was Governor Dayton, who presented his biennial budget to the legislature in late February.  The Governor’s solution to the budget deficit was to offer a mix of tax increases and spending reductions.  In the area of Health and Human Services (HHS), the Governor proposed to reduce spending by $850 million.

Following the unveiling of the Governor’s budget, the Republican legislature went to work, passing omnibus budget bills out of committee in late March and early April.  The Republican legislature chose to solve the budget deficit by spending reductions alone.  In the area of HHS, the House and Senate both proposed to reduce HHS general fund spending by $1.6 billion.

Following passage of the HHS Finance Omnibus Bills in late March and early April, the HHS Conference Committee met to begin its work in earnest.  Over the ensuing weeks, the Committee developed the crux of a conference committee report by adopting major policy provisions and a fiscal spreadsheet (i.e., a proposed budget for HHS).  Intriguingly, the Conference Committee did not adopt a final report but instead left the committee “open.”  This was done in other conference committees as well.  The purpose of leaving the conference committee “open” is to allow legislative leadership to negotiate budget differences with Governor Dayton.  The Governor stated he would not begin budget negotiations with Republican leadership until they develop a unified budget position (through the conference committee process).
And that is where we are now, with the Governor and the Republican leadership engaged in budget negotiations.  So what happens next?  Let’s start with what we know.  The regular legislative session ends in approximately one week (May 23rd).  At first blush, sis days might seem to be sufficient for the Governor and legislative leadership to forge a budget deal, but, in reality, a deal needs to be reached at least a couple days prior to adjournment if legislative business is to finish on time.  The reason for this is because conferees need time to negotiate and adopt new language if new budget targets are created.  In addition, non-partisan staff needs time to process any new language adopted by conferees before the reports can be placed before the body for a vote.

That being the case, how do we know if the legislative session will end on time?  A good indication will be whether the Governor and Republican leadership reach a budget deal by Friday or Saturday.  If they do not reach agreement by late this week, then look for conference committees to “close” via the adoption of conference committee reports, which will then be passed by the Republican-controlled legislature and sent to Governor Dayton for his signature or a veto.  If that scenario materializes, then what happens next is anyone’s guess.  For obvious reasons, the Governor would need to call a special session in order for the budget deficit to be resolved.  When that special session will be called, however, is unclear.  If the past is any guide, a special session would not occur until a global agreement is reached by Republican leadership and the Governor.

All of this is a long way of stating: stay tuned.  A lot will occur in this last week of the regular session to tell us about the outcome of the 2011 legislative session.

In other news, the HHS Conference Committee continued to meet this week.  The Committee met twice to discuss various provisions contained in the House and Senate language.  The AALC spoke to Representative Jim Abeler about the autism treatment disparity study in the House conference committee language.  The AALC fully supports his focus on ending the inequality encountered by children enrolled in MA-PMAP and has been a driving force behind ending this injustice.  We will continue to monitor this issue and other activity in the HHS Conference Committee and the legislature in the coming weeks ahead.  Please be on the look-out for updates from us as the fluid nature of legislative activity can alter circumstances quickly

Have a great weekend, everyone!

Legislative Bills of Interest to the Autism and Disability Communities

H.F. 1461 (Abeler)/S.F. 1305 (Newman).  The bill changes data collection required for licensed persons and concerns preventing maltreatment of vulnerable individuals.  The bill also contains a provision to require approval of the educational program from the Commissioner of Education prior to grant of a license for a children’s residential facility by DHS:

https://www.revisor.mn.gov/bin/bldbill.php?bill=H1461.0.html&session=ls87

H.F. 1498 (Liebling)/S.F. 1288 (Hann).  The bill makes technical changes to administrative appeal procedures and establishes a Disparities Reduction Advisory Council to reduce racial and ethnic disparities in service access and outcomes: https://www.revisor.mn.gov/bin/bldbill.php?bill=S1288.0.html&session=ls87

H.F. 1550 (Liebling)/S.F. n/a.  The bill creates a Disparities Reduction Advisory Council, whose purpose is to reduce racial and ethnic disparities in service access and outcomes for programs administered by the Department of Human Services: https://www.revisor.mn.gov/bin/bldbill.php?bill=H1550.0.html&session=ls87

H.F. 1552 (Wardlow)/S.F. n/a.  The bill prohibits the creation, operation, or existence of a health benefit exchange as defined in the Affordable Care Act: https://www.revisor.mn.gov/bin/bldbill.php?bill=H1552.0.html&session=ls87

H.F. 1341 (McDonald)/S.F. 1269 (Benson).  The bill requires an accounting of children’s health care expenditures as part of the November and February annual budget forecasts: https://www.revisor.mn.gov/bin/bldbill.php?bill=H1341.0.html&session=ls87

H.F. 1543 (Gottwalt)/S.F. 1284 (Hann).  The bill is a Department of Human Services policy bill that limits medical assistance coverage for investigative health services and defines grounds for sanctions against medical providers: https://www.revisor.mn.gov/bin/bldbill.php?bill=S1284.0.html&session=ls87

H.F. 1500 (Anderson, D.)/S.F. 1285 (Hann).  The bill is a Department of Human Services policy bill that makes changes to chemical and mental health services: https://www.revisor.mn.gov/bin/bldbill.php?bill=S1285.0.html&session=ls87

H.F. 1453 (Kahn)/S.F. 1314 (Torres Ray).  The bill requires health plans to cover routine patient care costs incurred by an enrollee in a qualified clinical trial: https://www.revisor.mn.gov/bin/getbill.php?number=HF1453&session=ls87&version=list&session_number=0&session_year=2011

H.F.1616 (Hoppe)/S.F. n/a.  The bill alters Minnesota law to conform to various provisions of the federal Affordable Care Act: https://www.revisor.mn.gov/bin/bldbill.php?bill=H1616.0.html&session=ls87