Background - Adults with developmental disabilities have seen significant cuts in their budgets since July 1, 2011 when the HB260 language went into effect. The Idaho Department of Health and Welfare was directed by the legislature to save $6.7M total ($2M state dollars) in budgets of services for adults with developmental disabilities. The budget tool/methodology was modified and has resulted in adults seeing huge changes in their budgets from the previous year. HB260 includes language that states budget modifications can only be made if there are health and safety issues. Interpretation of this language and the new rules that limit the appeal process have had huge impacts on the lives and services of adults. Idaho Legal Aid filed a lawsuit on behalf of twelve adults is KW v Armstrong.
Here is a quick synopsis of the decision by the court on Friday, Feb. 3rd:
On Friday, February 3rd, the Judge in KW v Armstrong ruled that the notice given to the 12 plaintiffs was legally deficient and that their budgets must be restored to their pre-July 1st levels. He indicated to the AG that the notices were similarly deficient for everyone else but that their cases are not before him. Still IDHW was admonished to treat them similarly, at least those who have appealed. Therefore it would be good advice to anyone receiving a notice of cuts to their budgets to appeal. The Temporary Restraining Order (TRO) which will be signed today will reflect this.
The judge is allowing IDHW to come into court next week (possibly Wednesday) to present evidence on their proprietary (trade secret) claim, without giving them any encouragement to think that they can defend the practice. The Judge signaled that he is likely to find that the hearing process (where the Hearing officer is limited to deciding whether H&W followed the rules and prohibited from ruling on the validity of the rules or processes) is similarly inadequate, but this is not a ruling ...yet. Idaho Legal Aid's attorney, Mr. Eppink, is negotiating with H&W on the wording of an order which would stop the use of the budget formula for everyone and return those who have been cut back to their July 1st budget levels but this has not happened and it may not happen until a class action suit is filed. (Idaho Legal Aid is prohibited from filing class actions by their federal funding statute).
We will have more definitive information next week. For now we only have a ruling that the notice in the 12 plaintiffs cases was deficient and that they must restore their budgets. IDHW is restrained from cutting any more budgets until they get a notice procedure (and probably a hearing procedure) which meets with the court's approval. This notice procedure will probably have to include information on how the formula was applied in each case. So far, the court has not ruled on the validity of the formula since there is no evidence of the secret formula before the court.
Mon. Feb. 6th House H&W Committee Meeting at 1:30 p.m. in EW42 to hear rule dockets:
- Changes to the Dental Coverage Enhanced Plan (Docket 16-0310-1103)
- Changes to the Dental Coverage Basic Plan (Docket 16-0309-1103)
- Changes to PT, OT, ST Coverage Basic Plan (Docket 16-0309-1107)
Wed., Feb. 8th House H&W Committee Meeting at 1:30 p.m. in EW42 to hear rule dockets:
- Changes to Reimbursement for Providers (Docket 16-0310-1104)
- Docket 16-0310-1105 includes all of the following:
a. Elimination of collateral contact and supportive counseling
b. Requiring individuals with dual diagnosis to choose to access skill training in either mental health services (PSR and Partial Care) or developmental disabilities services (Developmental Therapy, Residential Habilitation, and IBI)
c. Capping PSR services for adults with mental illness to 4 hours/week
d. Eliminating service coordination for individuals on the Aged and Disabled waiver
e. Changing the methodology for developing an individual's budget including limiting the appeal process unless the services are "medically necessary" and are not included in their current needs assessments
Reminders on H&W committee meetings:
The Senate committee meets Mon, Tue, Wed and Thu afternoon at 3:00 p.m. in room WW54. The House H&W Committee meets every even day at 1:30 p.m. in room EW42. They post their schedules on the legislative website www.legislature.idaho.gov under the "Calendars and Agendas" (click on each of the two H&W committees). The public can come and testify on any of the rules on the day's agenda. You will need to sign in as you enter the room, indicate which rule docket you are speaking to and whether you support or oppose the rules. You should bring a copy of your testimony in writing to be given to the committee secretary (it is also very helpful to provide enough copies for everyone on the committee).
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