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MR Update #06-06: Death Penalty, UCP Report, Altoona Center, Social Security, Federal Medicaid, HCSIS Update, and Freedom March
April 5, 2006

Death Penalty Legislation
PCPA has signed with eight other agencies to support state legislation providing for pre-trial determination of mental retardation in death penalty cases. Legislators are considering two bills to implement a US Supreme Court decision banning capital punishment for persons with mental retardation. In 2002 the US Supreme Court, in Atkins v. Virginia, ruled that the execution of people with mental retardation violated the Eighth Amendment of the Constitution which prohibits cruel and unusual punishment.

The debate before the state Legislature in House Bill 698 and Senate Bill 631 is the pre-trial determination of mental retardation. Opponents to this position want the defendant to prove mental retardation after they are tried and determined guilty by a jury. This is asking a jury to make a clinical decision after being subjected to a barrage of evidence regarding a heinous crime. On April 4 the Senate Judiciary Committee voted Senator Mary Jo White’s Senate Bill 631 favorably out of committee. This bill includes the pre-trial determination.

UCP Report
United Cerebral Palsy (UCP) has released a national analysis of state Medicaid services for people with developmental disabilities and mental retardation. A Case for Inclusion includes state rankings and letter grades in key areas of Medicaid service delivery including Home and Community Based Services (HCBS), self-directed services, and cost efficiency. The report shows that successful states support the smallest possible and most home-like residential settings in communities, assist individuals’ transition from Medicaid to work, give people the ability to direct their own services, and utilize nationally recognized quality assurance programs.

Pennsylvania’s ranking is 32. The letter grades were:
• HCBS – B
• Small residential settings – D
• Self-directed services – F
• Reaching those in need – C
• Cost Efficiency – A

For an electronic copy of the report access www.ucp.org/medicaid.

Altoona Center
The Public Interest Law Center of Philadelphia has filed a Petition to Intervene along with a proposed Complaint in Intervention in federal district court in Pennsylvania to prevent guardians of institutionalized persons from having a veto over whether the residents of the Altoona Center and Ebensburg Center can be moved to small scale community-based settings. The intervention arises out of a case (Alexander v. Rendell) filed by parents objecting to the state’s proposed closing of the Altoona Center and the state’s agreement that they would transfer to another state institution (Ebensburg) any resident of Altoona whose guardian objected to community placement.

In January the Western Pennsylvania District Court filed a Memorandum of Opinion and Order conditioned upon compliance with an order prohibiting transfer of any resident to a community-based facility without the written consent of a resident’s legal guardian. The intervenors have asked the district court to vacate this order.

Social Security Changes
The Social Security Administration has published final regulations for the Disability Service Improvement Process, establishing new procedures for determining if a person is disabled for purposes of Social Security Disability programs and the Supplemental Security Income program. The rule’s implementation will be piloted in the northeastern states starting in August. Any implementation problems will be addressed before the regulations are expanded across the country.

College Work Study
The US House of Representatives passed House Resolution 609 to reauthorize for five years portions of the Higher Education Act. This bill includes an amendment to allow students with mental retardation to obtain paid work experience in college work study jobs while pursuing post-secondary studies.

Federal Medicaid Issues
The federal Deficit Reduction Act (DRA) signed by President Bush in February contains a provision that will allow states the option to change their policies governing federal Medicaid premiums and cost-sharing. States will be allowed to vary the premiums and cost sharing they charge by and within groups, by geographic area, and by type of services. Some individuals are exempt, such as those in institutions, dual eligibles, hospice patients, special needs populations, and people with disabilities, but they can be charged up to $3 for non-preferred drugs or for non-emergency use of an emergency room.

The DRA also provides for several new fraud-monitoring programs including the Medicaid Integrity Program to review, audit, identify, and recover any overpayments. There will be 100 new employees hired to focus on fraud and abuse issues. Expansion of the Medicare-Medicaid Data Matching Project, known as Medi-Medi, allows the Centers for Medicare and Medicaid Services and the states to share and analyze data from both programs to reduce fraud. Pennsylvania is one of nine states that have been involved in this effort.

HCSIS Update
HCSIS Release 5.5.0 is scheduled for June 24 and highlights include:

  • Lifesharing questions will be added to the draft ISP screen;
  • Office of Mental Health and Substance Abuse Services will be able to use the Incident Management and demographic modules;
  • The Department of Health will be able to use selected parts of HCSIS; and
  • ISP print plan functionality will be modified to allow more choices.

Mental Retardation Bulletin #00-05-05: 2005-2006 Persons/Family Directed Support Waiver Cap announced an increase from $21,225 to $22,083 for the current fiscal year.

Prior to July 1 providers, counties, and support coordination entities need to complete additional changes because of service unit changes. These changes are:

  • Adding the new services to all sites within all counties with an effective begin date of July 1 and no effective end dates;
  • Creating service contracts in HCSIS;
  • Revising affected ISPs and submitting them for approval; and
  • Approving draft ISPs.

Freedom March
Speaking for Ourselves will be sponsoring a Freedom March for Real Self-Determination on June 6 at the Capitol in Harrisburg. For details contact Speaking for Ourselves at 610-825-4592.

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