A General Assembly Update from the MAD Spring 2012 Issue
Reflecting on the 2012 General Assembly
By Pat Nobbie, Ph.D.
As predicted, the legislative session was quick compared to previous years, ending before April Fool's Day. Sine Die is tomorrow. The FY 2013 budget has been agreed upon, but a few controversial legislative items remain to be settled.
A Little Bit of Improvement
An improved economy gave the chairs of appropriations an additional $900 million to spend, which resulted in a total budget of $19,224,524,133. As a result, funds were added back to bolster several areas including education, public health, residency slots for physicians to keep new doctors in Georgia, criminal justice reforms and accountability courts, the DOJ settlement, more pre-k days and cancer research funding at the new Georgia Health Sciences University. On another positive note, the Governor was able to keep the AAA Bond Rating, and add to the "Rainy Day" fund. Compared to what we have faced in past years, this is a small measure of relief.
The Unlock the Waiting Lists! campaign had an ambitious agenda that went beyond the requirements of the settlement agreement, and we were only successful in getting an additional 50 slots in the Independent Care Waiver Program for adults with physical disabilities. However, we may achieve more of our requests in the amended FY 2013 budget as a result of the Balancing Incentive Payment Program funds (BIPP). The BIPP is a federal initiative that authorizes grants to states that have spent less than 50% of their long-term services in the home and community as opposed to in facility-based services. States wanting to make adjustments to that balance are eligible for an extra 2% federal match for Medicaid funding provided by the BIPP to help transform their long-term care systems. The BIPP application requires states to implement three structural guidelines including:
• No wrong door/single point of entry system, which enables individuals to gain access to all long-term services through a single point where they will receive information and financial and functional assessment for eligibility
• "Conflict-free" case management to develop individual service plans and arrange for and conduct ongoing monitoring of services
• A core standardized assessment instrument to be used to determine eligibility and appropriate services
The program makes $3 billion available to states over three years. The Georgia Department of Community Health (DCH) submitted an application in early March, and the BIPP will give Georgia an additional $19,086,355 each year for the next three years. These funds must be used specifically for home and community-based services. The proposal also lists enhanced funding for all waivers, the Georgia Pediatric Program (GAPP), mental health community-based services and training and enhancements for the Aging and Disability Resource Connection (ADRC), so they can function effectively as the single point of entry.
The following items are listed within the adult developmental disabilities services budget in the FY 2013 budget:
Provide funding for developmental disabilities consumers' community settings to comply with the DOJ settlement agreement:
Total: .................................. $4,216,000
This includes
Family Support ................... $1,466,000
9 crisis respite homes,
6 mobile crisis teams ........... $2,300,000
The $1,466,000 figure reflects the average, actual costs of family supports delivered in the past fiscal year to 500 families.
Provide for additional 150 COMP waivers and annualize the cost of 100 NOW and COMP waivers from FY 2012 (community waiver):... $5,290,181
Use the Balancing Incentive Payment Program for an additional 100 NOW and COMP waivers in the community: .......................... YES
Use the Balancing Incentive Payment Program to annualize the cost of 150 FY 2012 COMP waivers:.............................. YES
Use the Balancing Incentive Payment Program to annualize the cost of NOW and COMP waivers for youth aging out of the Division of Family and Children Services (DFCS), Department of Human Services: ............................. YES
Increase funds for the Emory Autism Center: .................. $100,000
Increase funds for the Matthew Reardon Center for Autism: .......... $100,000
In DCH budget, provide funds for 50 Independent Care Waiver Program (ICWP) waiver slots:
State: ............................................. $810,101
Federal: ...................................... $2,362,499
In addition, language was added to the FY 2012 amended budget and the FY 2013 budget stating, "The Department will evaluate criteria for establishing a viable waiting list and report to the General Assembly by June 30th, 2012 with recommendations for maintaining such lists."
Legislative Agenda
Before the 2012 General Assembly got underway, GCDD identified several legislative, budget or public policy issues it would address, support with other groups or watch during the legislative session. The following is an update on the progress made.
Individual Development Accounts (IDA):This legislation enables eligible individuals to save money for assistive technology, accessible vehicles or home modifications that would support them to stay in their homes and work in the community. Individuals save their earned income in a custodial account in a partner bank, and it is matched by nonprofit or foundation funds. Even though it is a small government solution that encourages economic self-sufficiency and doesn't use tax dollars, the IDA account legislation was halted early on in the session. Representative Donna Sheldon has committed sponsorship to the legislation, so we will work with her and the Governor's office on the IDA accounts before the 2013 General Assembly.
The Family Care Act: This legislation would allow individuals whose jobs provide sick leave to use it to care for sick children or aging parents without penalty from their employers. The passage of this act doesn't require additional sick leave or any other benefits, but it would give individuals with sick leave more flexibility to meet the caregiving needs of their families. Although this legislation was favorably reported out of the House Industrial Relations committee, it did not make it out of House Rules. Therefore, we will continue working on it again over the summer.
New Home Access Legislation: Early in the session, our majority party sponsor had to withdraw support on this legislation, and we were unable to get another sponsor to commit. Currently, there is a lot of momentum centered around the issue of accessible, affordable homes supported by the DOJ settlement needs, the progress being made in the Department of Community Affairs, the Department of Housing and Urban Development and the landmark housing study, "Shut Out, Priced Out, Segregated" (SOPOS) report. Advocates are hopeful we will be able to make progress over the summer building support for this legislation.
Medicaid Appeals Reform:This legislation was pulled from the committee calendar the day it was scheduled to be heard. The Department of Community Health (DCH) had addressed a number of issues in the application, eligibility and appeals process for Medicaid clients, particularly in the Katie Beckett program. But the concern with this legislation was focused on a particular aspect of the appeals process that gives the Commissioner of DCH the power to overturn the Administrative Law Judge’s decision.
Our Watch List: Legislation (HB 386) from the Special Council on Tax Reform and Fairness was released in the second week of March. Special rules on the legislation meant it could be brought back up in committee and sent directly to the House for a vote after day 30 without going through Rules. This was passed in both the House and Senate by day 36. The main components of the bill include:
• Repeal of the marriage penalty in the income tax exemptions
• Exemptions for energy resources used in manufacturing and agricultural exemptions, as well as fuel exemptions to all airlines operating in the State
• Cuts or caps to credits and exclusions for film productions
• New revenues through taxing of e-commerce purchases for businesses that have a physical presence in Georgia
• Revamping taxes collected on automobiles, moving from the
“birthday tax” to a 7% tax at point of sale to be shared between the State and local governments
• Capping the tax break for wealthy seniors at $65,000
• Streamlining tax breaks to maximize effectiveness
• Reinstatement of two sales tax holidays
According to the Special Council, the proposal is budget neutral. However, the Georgia Budget and Policy Institute estimates a loss of $49 million in the first year. Fortunately, the legislation did not recommend a tax on groceries, while unfortunately, it did not recommend a dollar increase on cigarettes, which could generate $340 million a year and significantly deter teen smoking. Many still believe that the tax code needs comprehensive reform to meet the needs of a growing State.
Vocational Rehabilitation Agency (HB 1146): This bill transfers the services housed under the Department of Labor to a new agency and attaches the Georgia Vocational Rehabilitation Agency to the Department of Human Services for administrative purposes. This change authorizes the transfer of funds and establishes a new governing board. The programs to be transferred include Warm Springs Rehabilitation Hospital, Blind Enterprises program, Georgia Industries for the Blind, Disability Adjudication Unit and Vocational Rehabilitation. Advocates are now focused on ensuring that the new agency establishes an Employment First Policy for the State, which means that employment will be the first option for day services for people with disabilities and that option will be supported through funding streams, policies and program design. There will be a national search for a new Vocational Rehabilitation director.
Juvenile Justice Reform (HB 641): This legislation makes several long-awaited changes to the Juvenile Justice code and was in Senate Rules as of day 38. A large number of stakeholders worked on this legislation for several years, but nothing came of it this session. Advocates will start again with this legislation next year.
Accessible Taxi Cab Legislation (SB 373):This legislation did not get out of the House Rules for a vote on the floor by Sine Die, so it has died and we will have to work on it again over the summer.The accessible taxi legislation amends the Medallion restrictions for taxi cabs. It allows for a cab that is wheelchair accessible to take a fare outside its jurisdiction of origin, pick up a fare there and return to avoid "dead head" trips. This legislation will encourage current cab operators to include accessible vehicles in their fleets because they can make the service pay.
Child-Only Insurance (HB 1166): When the Affordable Care Act passed, insurers were prohibited from denying coverage to children due to pre-existing conditions and Georgia insurance companies stopped writing policies for children-only. This legislation restores child-only policies to the insurance marketplace, so that parents whose children are not eligible for PeachCare or who do not have coverage under their own employers can buy insurance for their children. This bill was voted on in the Senate on Monday, March 26 and passed.
Although it was short, it was a busy legislative session. While many issues were moved along or gained momentum, there are still several issues that we need to continue promoting and working toward. We urge our advocates and partners to attend their legislators' election events and impress upon them the need for more community-based services for people with disabilities. This is the second year with only 100 waivers available for youth graduating from high school or middle school-aged individuals with disabilities living with aging caregivers, or anyone else in the community at risk of crisis or institutionalization. We cannot sustain people adequately with so few resources. All legislators need to know the individuals in their communities who are "waiting" for assistance. Remember to SHOW UP, STAND UP and SPEAK UP!
