Budget Adjustment Act FY’12 – I’ve attached a self-explanatory email sent yesterday to members of the Senate Appropriations and Health and Welfare committees. At the last minute the House added a floor amendment to this bill that would divert half of any
surplus in any given year to the Education fund, with the idea that this would provide property tax relief.
The Administration is strongly opposed to this amendment as it denies it, and the legislature, the flexibility to use these potential waterfall funds for the most pressing needs
(as they see them) in any given year. The Senate is unlikely to go along with this amendment and it will produce some interesting politics should a committee of conference be appointed.
FY ’13 Budget - Most departments have yet to make their budget presentations. However, we do know that DAIL has proposed approximately $800k in Choices for Care cuts through reduced services and payments for case management. [CFC HCBS - case mgmt - change from 15-minute units with cap of 48 hours/year to monthly rate of $110; CFC ERC - eliminate ERC case management CFC HCBS - change reimbursement rates from $15/hour to half-day and full-day rates.] These cuts seem odd given that the Choices for Care budget appear to be healthy and there have not been provider increases in years. We
will likely oppose these cuts as unfair to beneficiaries and providers and inconsistent with the reinvestment provisions of the CFC waiver.
There are no additional funds being proposed for licensing and protection or for
Adult Protective Services (see below).
Adult Protective Services – one administrative position and one investigatory position is apparently being added to this program. Information is being released very summarily as the lawsuit seems to curtail details being shared. Discovery is beginning in the case so more information on history, policy and protocol will soon be a public record. As best we can tell, the department continues to read the law narrowly and insists it is now complying with its statutory charge. It is hard to understand how such a statute could be read with anything but the remedial intent with which it was enacted.
Civil Remedies for Abuse, Neglect and Exploitation(H.413) - I testified before the House Judiciary in support of this bill which would provide civil remedies to the Attorney General when Abuse Neglect or Exploitation is found in a residential or nursing care
setting. Currently the AG only has the power to bring criminal charges, which frequently would also have the effect of shutting down the entire facility. If passed, The AG could seek civil monetary fines, so that the home could keep running, but still face prosecution for narrower, less serious offenses.
Fuel Assistance - Last month I reported on our successful efforts to have the Administration add $6.1 m to fuel assistance so added money could get out the door quickly. A second, but important, part of the Governor’s announcement was to ask Commissioner Yacavone to find a future sustainable funding source to preserve the program beyond this winter.
I have been talking with the Commissioner about a series of potential ideas, which we will
discuss more fully this Friday. Also the Fuel Assistance Task force, upon which Cove has a statutory seat, met this past Monday for a half day to brainstorm ideas. The commissioner needs to file a report in the next month or so for legislative approval that effectively needs to increase revenue, cut costs, or make fuel go further by approximately $8m.
One of the ideas that were put forth was to reinstate income and asset tests that were
changed/eliminated two years ago. That could throw upwards of 1000 seniors off the program, an idea COVE would no doubt oppose.
Health Care Reform (H.559) – a) I testified today before the House Healthcare Committee on section 31, which would ban so called discretionary clauses. These clauses effectively allow insurance companies to interpret their own coverage contracts and deny patients any meaningful level of appeal. 18 states have banned the use of these discretionary clauses and section 31 of H.559 of Vermont’s proposed law would extend beyond health insurance to disability insurance and life insurance.
b) We have also been speaking to several members of the committee to possibly consider adding Medicare supplement policies to the Exchange. The very basic idea behind the exchange is to allow for simple one-stop apples to apples comparison-shopping for health care insurance. There is no reason why an online exchange could not also be offered as convenience to seniors on Medicare.
c) Section 33– 35 permit the state to apply for new waivers from the federal government on how they would run their Medicaid, Choices for care an dual eligible programs. As written the provisions give very broad discretion to the DVHA as to how they would structure the program and it could even be written in a way that beneficiaries could lose certain coverage they currently have. We need to make sure the basic parameters of the waivers are set forth in statute and/or that the process of designing the waiver is transparent and has legislative oversight. (We did this with the original CFC waiver so the precedent exists.)
We are meeting with the director for health care reform on Friday morning and are
testifying before 2 committees this week and next on the waiver issue.
Rooms and Meals Tax on Assisted Living and other residential care facilities – (H. 582) – Apparently some senior living settings such as Wake Robin is now being charged tax when guests visit their community dining facilities. This bill would disallow that and apparently is being supported by the Administration. We will likely be testifying in favor tomorrow.
Motor vehicle eye exams at age 80 - This issue has been discussed this year in the ways and means committee and has traditionally been opposed by COVE as an example of ageism when the testing is strictly based on age. We are told nothing will move this year, but it could very well be considered next session.
