Get Ready for the 2013 Legislative Session - MAD Winter 2013

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The following is the Legislative feature article from the Winter 2013 Making a Difference magazine.

Get Ready for the 2013 Legislative Session
By Pat Nobbie, PhD

The phrase, "What a difference a year makes," has never been more meaningful. Since the last session, there have been changes in several levels of leadership in departments that support people with disabilities; we have had continuing challenges with our State budget, a Supreme Court decision was made on the Affordable Care Act and a presidential election was held. In addition, the Georgia Council on Developmental Disabilities (GCDD) is going through some changes too. For the first time in 12 years, I will not be the staff support for the legislative efforts of GCDD in the session. There will be a new public policy director carrying the agenda, and I know that individual will be welcomed by our community and will greatly benefit from the relationships that we have built over the years.

As you may recall, for the 2012 session we aligned the legislative agenda-setting process with GCDD's new five-year plan for our federal administration, recognizing that many legislative initiatives are beyond a one-year time frame. Working within a five-year framework gives us flexibility to take things up when it's time.

The strategic goal for public policy in GCDD's five-year plan covering FY 2011 to FY 2016 continues to be promoting public policy that supports communities that welcome all people and better serves the interests of individuals with developmental disabilities and their families. In addition, it promotes revisions in the systems that provide services and supports that result in authentic choice, opportunities for self-direction and enhanced capacity for the caregiving efforts of families.

As in the past, we will assign the following priority levels to each of the agenda items:

  • Tier I: GCDD Initiates, GCDD is the lead agency
  • Tier II: Another agency is the lead,but GCDD assists
  • Tier II: GCDD allows use of name, but no action otherwise
  • Tier IV: GCDD has a neutral position, won't fight or support
  • Tier V: GCDD opposes, fights against


Additionally, we will continue to organize the public policy activities in the REAL areas that GCDD promotes for integrated life in the community. The following is a summary of the legislative, budget or policy issues that GCDD will be involved in during the legislative session
in each of our REAL areas.

Real Supports: Budget

TIER I: Unlock the Waiting Lists! – Support appropriations to enable people with disabilities to live in the most integrated setting in the community.

For this area, we support the budget items that the Department of Behavioral Health and Developmental Disabilities (DBHDD) requested for the American with Disabilities Act (ADA) Settlement Agreement, which includes:

  •  100 NOW waivers annualized in the FY 2013 amended budget .... $7,450,534
    •  and 150 COMP waivers annualized in the FY 2013 amended budget
  • 100 NOW waivers in the FY 2014 budget (wait list) .................. $6,041,578
    • and 150 COMP waivers in the FY 2014 Budget (hospital transition)
  • Services for 500 new families in state-funded family support .......... $1,872,000
  • Mobile crisis, crisis respite and nursing services .................... $3,842,222


In addition, GCDD is promoting a small appropriation of $98,000 for housing vouchers, estimated at $400 per person per month for 20 individuals who have Medicaid supports but struggle to afford safe, stable and accessible housing. Individuals must use their Supplemental Security Income (SSI) checks for room and board, and at a $694 maximum SSI allocation, it is difficult for individuals to afford their "own home," which is the priority for residential arrangements in the ADA settlement agreement.

Unlock the Waiting Lists! will also work on restoring the proposed cut to the DBHDD budget of $9,409,552, which meets the Governor's instructions to reduce the budget by 3%. This cut will affect mental health, substance use disorder and developmental disabilities direct service areas. Our message is the department cannot bear ANY cuts to direct services, when there are 7,500 people still on the waiting list for supports.

In the Department of Community Health (DCH) budget, Unlock the Waiting Lists! is requesting the following for the Independent Care Waiver Program (ICWP):

  • Fund 100 ICWP waivers for people in the community waiting for support ............... $1,620,202


Finally, Unlock the Waiting Lists! worked on an agreement with the provider community to support a 5% rate adjustment if the providers advocate for continual movement toward more individualized, integrated and person-centered services based on an individual's informed choice, as well as transitions away from segregated day and pre-employment services. The overarching message is that the money in the system is not being used for the most effective state-of-the-art services and supports, and there is not enough money in the system overall to meet the needs of Georgia's citizens with disabilities. The waiting list for people with developmental disabilities was 7,571 at the end of November, with 3,255 of those on the short-term need list.

Real Supports: Legislation

TIER I: Pass State Individual Development Account (IDA) Legislation – This legislation enables eligible individuals to save 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. IDA programs are a "small government" solution that encourages economic self-sufficiency, doesn't use State dollars and fosters job creation and entrepreneurship. We have had majority party sponsorship for this legislation in the past, so we are hopeful we can work on this valuable program again this year with our partner, the Center for Financial Independence and Innovation.

TIER II: Support passage of The Family Care Act – This legislation would allow individuals whose jobs provide sick leave to use that leave to care for sick children or aging parents without penalty from their employers.

This was favorably reported out of the last session of the House Industrial Relations Committee; we have a committed majority party sponsor, but with the start of a new session, we have to start again with a fresh bill. We will work with the Job Family Coalition, Atlanta 9to5, Co-age and others on this legislation.

Real Homes: Legislation

TIER II: New Home Access Legislation – Increase accessibility in all new single family homes by requiring one zero-step entrance, 32" wide interior doorways and blocking to support grab bars in the bathroom.

The need for this legislation has become more prominent with the transition of many individuals from State institutions under the ADA settlement agreement and the transition of individuals from nursing homes under the Money Follows the Person (MFP) program. People needing accessible homes can't find them in the community, and so an enormous amount of money has been spent on renovating residential homes to make them accessible. The Money Follows the Person project spent $914,184.60 on environmental modifications, an average cost of $2,804 per person (326 people). This represented 36% of the total cost of billed services to the MFP program from 2009 through May of 2012. Building the minimum accessibility features into a new home costs on average $200 to $300. We will continue to actively work on this legislation with Concrete Change and the SOPOS Housing Coalition.

Real Learning: Policy

There is currently no specific legislative item related to the high school diploma issue; however, GCDD has been following the evolution of diploma policy for years and observing the impact of these policies on students with disabilities. Of particular concern now is the impact on students with marginal learning difficulties, which do not qualify them for special services, but make it more difficult for them to accomplish the standard core curriculum. According to the recently released United States Department of Education high school graduation rates report, Georgia's graduation rate is 67%, better than only Nevada and New Mexico. Especially disturbing is the 30% graduation rate for students with disabilities. GCDD has supported the development of career pathways that provide EVERY student with a progression of courses in one of 16 career interest areas, as well as the institution of an individual graduation plan that should support students to make good decisions about how to complete high school. Every student that participates fully in these options should be able to graduate with a legitimate diploma that is recognized by post-secondary institutions and the military. The goal of GCDD is to "establish policy that enables each high school graduate to earn one diploma that enables them to continue their education, join the military or be eligible to work or train for a job."

Real Careers: Policy

The goal in this area is to "work with Federal Network Partners, the Department of BHDD, the Department of Labor (DOL) / Vocational Rehabilitation Services and the Department of Education to craft and establish an "Employment First" policy for people with disabilities receiving services and make employment the first priority for their funding and support. Employment provides a social network, better health, discretionary income, self-respect and enables people to contribute to their community and the economy. GCDD has participated in Employment First policy development for many years, and with a new Georgia Vocational Rehabilitation Agency and the beginning of a State Employment Leadership Network (SELN), we have the collective vision and effort to move forward with this important work.

Real Influence: Policy

I have always said that the role of the policy director at GCDD is to promote conceptually coherent public policy and to prevent bad things from happening. As a result, we constantly keep watch over particularly vulnerable populations such as children, who are medically fragile, and foster children with special needs to ensure they are accessing the necessary services and supports and that regulations and funding limitations are not imposing unnecessary barriers. There are a few issues we will monitor closely as the year progresses, and even though they may not become specific issues during the session, GCDD must be prepared to respond to legislative inquiries and provide information on how decisions affect the populations we are concerned about:

  • Continue to advocate for complete implementation of the federal Medicaid Early, Periodic Screening, Diagnosis and Treatment (EPSDT) mandate covering all children receiving Medicaid under the age of 21. This will become particularly important as the State considers bringing all of the aged, blind and disabled populations into a coordinated care management arrangement and brings foster children into managed care.
  • Advocate for implementation of the Olmstead Plan, now in the Governor's Office. The agencies have had time to review the impact of the proposed plan on their staffing and budgets, and the Governor's Office must now present recommendations on how to move it forward. Advocates have submitted recommendations for a tiered approach – first, implement the objectives that don't require funding, only policy or practice changes; next, implement objectives that can be achieved by moving money from less effective to more effective services and outcomes; and finally, propose new multi-year funding to implement the more substantial objectives.
  • Provide guidance and input on legislation or budget items related to managed care for the aged, blind and disabled, foster children and Medicaid redesign. GCDD has been an active member of the task forces organized by DCH to advise and assist on the redesign of Medicaid systems for the aged, blind and disabled and foster children. GCDD also convenes the Coalition to Assure Redesign Effectiveness for Medicaid (CARE-M), which has met regularly to research, review proposals and interview companies interested in providing managed care services to these populations. We have established good communication between the advocates and DCH, and we believe the design proposals are proceeding with a great deal of feedback and participation from all parties. Nevertheless, we need to stay on top of this huge initiative as it goes forward.
  • Advocate for statewide expansion of Medicaid under the Patient Protection and Affordable Care Act (ACA). With Cover Georgia, the Health Advocates Coalition and Georgians for a Healthy Future, GCDD supports the Medicaid expansion option made available in the ACA. This option provides 100% federal funding for three years and 90% after that, to expand the Medicaid health insurance program to individuals under 138% of poverty in new categories, primarily, single adults without children. Georgia has nearly 2,000,000 uninsured people, but bears the cost of their healthcare when they show up in emergency rooms for care. Keep watching because there will be a great deal of debate on this issue in the coming months.


As usual, the work is never dull, and it is never done! GCDD thanks people with disabilities, families and advocates across the State for their energy and attention to these important issues. Please take time to call, write and visit your legislators and let them know what you care about!