Let the Legislature know that all federal funds from the Community Care Waiver should be reinvested into community services.

The New Jersey Developmental Disabilities Coalition, of which ABCD is an active participant, is advocating for the reinvestment of all federal funds from the Community Care Waiver (CCW) into community services.  The CCW is New Jersey’s Home and Community-Based Services Waiver for people with developmental disabilities.  The diversion of this money weakens the funding system and directly impacts the ability of the system to serve people with developmental disabilities.

ABCD has been at the forefront of advocacy efforts to ensure all federal funds from the Community Care Waiver are maximized and that all federal funds are reinvested in community services for people with developmental disabilities. 

The DD Coalition has developed two advocacy related papers on this issue.  The first, Fact Sheet on the Need to Reinvest Federal Funds into DDD Community Services, is a three page explanation of why it is necessary to reinvest federal funds.    The second, Talking Points on Reinvestment, is a one page description which lays out the argument for reinvesting federal funds.

We urge all providers, families, self-advocates and others to meet with your State Legislators to explain why it is important that all federal funds be reinvested in community services.  Please provide them with the Fact Sheet or Talking Points.

Due to the $12 million cut in the Early Intervention in the FY’ 11 budget, the Department of Health and Senior Services is proposing to lower the income threshold for the Family Cost Share from 350% of the federal poverty level to 300% of the federal poverty level.    The effective date of this change is October 1, 2010.

There are other changes due to the budget cuts including a 5% rate cut for Early Intervention providers.  Their reimbursement rates will be below the 2004 level in September.   

Public comments on the changes to the Family Cost Share will be taken by the Department from now until September 27, 2010 and oral comments will be taken on September 1st from 4:00 pm until 7:00 pm.  For more information Notice of Public Comment Period for Family Cost Share.  To view the proposed Family Cost Share tables Proposed Family Cost Share Tables.

ABCD and its Early Intervention Providers Association (EIPA), along with many other advocates, were unsuccessful in eliminating the $12 million cut in Early Intervention.  We developed advocacy materials related to our concerns about the change in the Family Cost Share.  We we will modify this material for our comments on the proposed changes.  Please find a copy of our earlier advocacy materials Family Cost Share Increase to assist you in writing comments.

The American Recovery and Reinvestment Act (ARRA) acknowledged the needs of States during the recession and provided an enhanced FMAP based upon unemployment rates.  Unfortunately, the enhanced FMAP is scheduled to end as of December 31, 2010. 

New Jersey has greatly benefited from the enhanced Federal Medical Assistance Percentage (FMAP) funds which were provided to States under.  It has allowed the State to continue to provided need Medicaid services to the most vulnerable populations.   President Obama proposed an extension of the enhanced FMAP through June 30, 2010. 

In the FY 2011 budget, just recently enacted, New Jersey assumed (as did approximately 36 other states) that the FMAP would be extended for an additional 6 months.   The final budget assumed $580 million in additional enhanced Federal funds. Without the enhanced FMAP

The bill which the US Senate just passed is a reduced amount than originally proposed and will provide only about $399 million in funds for New Jersey.  It is unclear at this time how New Jersey will deal with this $181 million shortfall.

ABCD joined with others members of the Anti-Poverty Network yesterday to celebrate the 45th anniversary of Medicaid and Medicare and to urge the Congressional delegation to vote for the enhanced funds. Please  click on this press statement  to see ABCD’s statement.

•  New Jersey’s 2011 state budget
•  The state’s progress on the College of Direct Support
• Early Intervention Services update
•  ABCD’s upcoming training workshop on Aging and Developmental Disabilities
•  and much more!

Click  ABCD News July 2010 edition to read the ABCD News.

ABCD thanks for Governor and the Legislature for understanding and acting upon many of our concerns related to the initial proposed budget.   We remain concerned about the impact on individuals with developmental disabilities and their families of some of the remaining budget cuts.

Contribution to Care and Maintenance:  Restoration of $10.282 million for “Supplemental Security Income/Personal Needs Allowance For Community-Based Developmental Disabilities Clients”.  This is for some restoration of the change to Contribution to Care and Maintenance. The original proposal for Contribution to Care and Maintenance was to save $15 million by increasing the percentage which individuals contributed to their care in a residential setting from 75% to 100% with the Personal Needs Allowance increasing from $40 a month to $100 a month.  It is not yet clear what the change is to this proposal which will restore $10 million out of the $15 million.

Personal Care Assistance: Restoration of $9.669 million for “Personal Assistance Home Care”.  The original proposal was to cut Personal Care Assistance reimbursement rates by $13 million down to the 1991 level of $13.80 an hour from the rate of $16.15 (except for a small group of providers who received $15.50 an hour). Budget language sets the rates as no higher than $15.50 an hour. 

Adult Medical Day Care:  Restoration of $2.379 million .  The Governor’s original budget included a co-pay for adult medical day care which would bring in savings of about $2.4 million and an additional cut of $18 million to disallow any individuals from the program who received services only because of the need for medication administration.  The restoration eliminates the co-pay.  This is now the 8th year in a row that Medicaid co-pays have been successfully fought.

Respite Care: Restore $800,000.  It is unclear what cut in services these funds restore. 

Sheltered Workshops for People with Disabilities: Restoration of $3 million.  The Governor’s budget cut funds from Sheltered Workshops in the Division of Vocational Rehabilitation  Services.  This restoration is for the workshops, but it is unclear if the transportation for these services have also been restored.

Early Intervention:  Funds were not restored to the Early Intervention program. The Governor’s original budget proposal is maintained which means that thee will be a $10-12 million cut to the program.  This means that the income threshold for the Family Cost Share will be lowered and cuts in reimbursement rates to providers of between 3-5%.  Both of these cuts will have a devastating impact on the infants and toddlers with developmental delays and disabilities and their families who are served in this program.

Pediatric Medical Day Care:  Language has been included in the budget which freezes the reimbursement rate at the fiscal year 2010 level.

Vineland Developmental Center:  Language has been included in the budget which allows the Department of Human Services to transfer an excess state funds due to the closure of the West Campus of Vineland Developmental Center throughout the Department of Human Services.

Out-of State Placements for People with Developmental Disabilities:  Lanugage has been included in the budget which allows expenditure of funds for out-of-state placements conditioned upon a report from the Commissioner of Human Services to the Governor and Legislature by January 2011 setting forth the Department’s efforts to place people back in New Jersey.  Specific information which must be included in the report:  number of persons with developmental disabilities living in out-of-state facilities; the annual costs of those placements; the number of individuals who were re-located to in-State placements in FY 2010; as well a strategy for redirecting additional people who are awaiting relocation to out-of state placements to in-state placements.

Other interesting parts of the budget deal include funds to keep Hagedorn Psychiatric Hospital open, General Assistance funding of $21 million has been restored, as has $3 million for the New Jersey After 3 program.

We have placed below several brief papers laying out our concerns and the concerns of others related to these cuts.  Please feel free to use this information when speaking with legislators and other policy making officials.

1)  Contribution to Care and Maintenance Changes:  ABCD has joined with The Arc of New Jersey issuing a position paper on this proposed change.  The paper explains that at a minimum the personal needs allowance must be increased to $150 a month with an annual increase.  Please click  Joint Paper on Contribution to Care and Maintenance for a copy.

2) Medicaid Co-pays:  The proposed budget includes for the 8th year in a row co-pays for Medicaid, this time for Medical Day Care.  The Coalition for a Moral Budget, of which ABCD is a member, continutes to advocate to eliminate this proposal.  Please click  Medicaid Co-pays for the brief paper explaining why Medical Day Care co-pays will hurt people with disabilities and seniors.

3) Personal Care Assistance Reimbursement Rate cut:  The proposed budget includes a rate cut for personal care assistance back to the 1991 level.  This cut will have a significant impact on providers’ ability to serve people with disabilities and seniors.  Please click on  PCA Cut for a brief paper explaining how this will hurt people. 

4)  Early Intervention:  The proposed budget includes a $12 million cut in Early Intervention services. ABCD is asking that people take action to stop this cut.  Please click on  Action on Early Intervention Needed to send a message to your legislators.

ABCD is also calling upon the legislature to eliminate language in the budget which places a cap on the amount of federal funds which the Division of Developmental Disabilities can use from the Community Care Waiver (the federal Home and Community-based Services Waiver for people with developmental disabilities).  The language must be replaced and say that all federal dollars from the Waiver be reinvested into community services.

We are urging reinstatement of the $12 million cut to Early Intervention services.  Options for the cuts include lowering the income threshold for the Family Cost Share below 350% of the Poverty Level, closing Early Intervention provider programs for two or more weeks out of the year, and reducing services to children at 32 months old.  All options being discussed will have a negative impact on this vital program to children and families.

 It’s easy – use this link to send your email:   Action Alert

ABCD explained that Governor Christie’s budget is a mixture of understanding the needs of people with developmental disabilities, with increases in funds for necessary services and proposals which have a negative impact on these same individuals, the families who care for them and providers who assist them with services.

To view on ABCD’s Budget Testimony, click ABCD Budget Testimony 

ABCD included two appendices to its testimony.  The first is a paper explaining our arguments against changing the Family Cost Share for Early Intervention.  Please click Family Cost Share Increase to view the paper.  The second paper lays out ABCD’s concerns about increasing the amount of cash benefits that individuals contribute to their Care and Maintenance.  To view that paper please click on Contribution to Care and Maintenance arguments

The good news is:  1) there are no co-pays for acute care Medicaid services (although there are co-pays for Medical Day Care); 2) there are funds in the budget for new graduates of special education needing day program services; 3) consolidating one of the Developmental Centers: 4) funds available for Olmstead, Waiting List, and people who are currently in out-of-State placements.

The concern is that there is a proposal to increase the contribution to care and maintenance, significant cuts to Personal Care Assistance Reimbursement rates, changes to the Family Cost Share in Early Intervention, elimination of the cash subsidy program for Family Support, and as mentioned earlier the co-pays for Medical Day Care.

For more information about the specific budget as it impacts people with developmental disabilities and others, please click  on FY’11 budget.  We will provide additional information and Talking Points for the Public Budget hearings as quickly as possible.