Wednesday, October 12, 2011

Tougher Times Ahead for DSHS

This has been a difficult last few years for the Department of Social and Health Services (DSHS) and for the Division of Developmental Disabilities (DDD), where many people with developmental disabilities turn to for state services that will help them live safely in their communities and lead productive lives. With the recession, budget cuts have reduced funding in many of the programs that people depend on. The latest budget proposals from DSHS/DDD (and the Health Care Authority) now would include the complete elimination of services for 41% of the entire DDD caseload, leaving people without needed prescription drugs, personal care assistance, residential and employment services, and many other vital services. (Learn more at

Now we learn, that in addition to the unsettled future of budget cuts, leadership within the agencies will be shaken up again. Read on for a letter of resignation from the Secretary of DSHS, Susan Dreyfus:

October 12, 2011

To: DSHS employees, members of the Cabinet, State legislators, Tribal leaders and our many Partners,


I joined you in leadership as Secretary of the Department of Social and Health Services in May of 2009. I said then that all paths had led me to the state of Washington and my ability to answer the call to serve Governor Gregoire and the citizens of this state. Together, we have been striving to lead change, stay focused on our values and priorities and to adapt with agility to the worst economic recession we have seen since the Great Depression. I am proud of the strategic work we have begun and have accomplished together. My life is forever blessed for the time I have spent with you in this most beautiful state. I am so appreciative of the support my husband and family have given me while I have lived far from our home in Wisconsin these past two and a half years.

I am writing to let you know that effective January 2, 2012, I have accepted the position as President and CEO of Milwaukee-based Families International, Inc. I will stay on the job here in Washington, working hard with you, through special session, which begins November 28.

Families International, Inc. is the nonprofit parent organization of three, national nonprofit organizations: Alliance for Children and Families, United Neighborhood Centers of America (UNCA), and Ways to Work; and one for-profit company, FEI Behavioral Health.

It is important to me that you understand the unique circumstances and timing that led me to accept this new challenge and opportunity now. I had every intention in serving the Governor and working with you until later next year before exploring what I might do after this administration. I was the Senior Vice President and COO of Families International, Inc., and the Alliance for Children and Families for almost five years, Peter Goldberg, the former President and CEO, hired me and became both a close friend and mentor to me over the years. Tragically, he died in August of this year and the Families International Board has extended me the honor of succeeding Peter and leading their outstanding organization into the future.

Families International, Inc., serves as the parent organization for three nonprofit organizations—the Alliance for Children and Families, United Neighborhood Centers of America, and Ways to Work—and one for-profit company, FEI Behavioral Health. These companies, headquartered in Wisconsin, work to strengthen the capacities of the nonprofit human services sector across America and to advocate on behalf of the sector and the people, neighborhoods and communities they serve. You all know that I have committed my life’s work to being a part of having a greater societal impact through partnering across sectors to reduce poverty, improve people’s health and improve their educational and employment success. This new position provides me with the ability to continue this commitment at a national level, and to rejoin my husband at our home in Wisconsin.

Over the next 60 days, we will have many opportunities to see one another and reflect on our work and accomplishments together, as well as the work that is yet to be done. However, right now, we have some very important work to do during special session to emerge from the impacts of this great recession and stay true to the values of our state. I look forward to working diligently with you through special session on these key issues.

I believe we are all stewards of the jobs we have and that they do not belong to us. Our job is to pave the way for those who will follow us and to leave our positions and organizations stronger and better aligned for the future. We have accomplished much together during this unprecedented time.

Again, it is truly an honor to join with you and the Governor in leadership, and my life is forever blessed for the time I have spent with you! We have much work to do and I look forward to seeing you soon.

Susan N. Dreyfus
Department of Social and Health Services

Wednesday, August 10, 2011

2011 Changes to Medicaid Dental and Vision Coverage

Budget cuts in the 2011 Biennial state budget created reductions in a number of services needed by individuals with developmental disabilities. Two programs had changes you need to be aware of. Below are the management bulletins explaining the changes.

Adult Dental Coverage

Effective July 1, 2011, comprehensive dental services were restored for three groups of Medicaid adults:
• Women who are pregnant
• Clients living in nursing homes
• Adults enrolled in 1915 (c) Home and Community Based waiver programs.

Effective October 1, 2011, the following clients will no longer be eligible for comprehensive dental services:

• Adult clients whose care is managed by the Division of Developmental Disabilities but who do not fit in the categories above.

The agency has developed a decision-making tool for providers to use to determine if a Medicaid-covered adult client meets this criteria and is eligible to receive the restored set of dental services. Medicaid also has developed policy for “How to Bill” under these criteria.

A formal provider memo communication, web access to the decision-making tool, and a set of Frequently Asked Questions (FAQ) will soon be available on the dental home page at:

Clients who are eligible for these services may already have received services since July 1 or be scheduled to receive services in the future. Medicaid will reimburse providers for this care. The decision-making tool and the memo will include expedited authorization numbers for each of the eligible groups listed above. Once you have established eligibility, you can bill for these clients’ services using those numbers.

The change in dental coverage for adults with developmental disabilities was intended to become effective July 1, but that date did not allow time to rearrange Medicaid coverage and provide required notice to clients.

There is no change in covered dental services for children – clients 20 years of age or younger. There is also no change in prior authorization requirements.

Adult clients other than the specific groups listed above are not eligible for comprehensive dental services. They are restricted to the emergency oral health benefit implemented on January 1, 2011.

Adult Vision Services

Medicaid providers can now obtain low-cost eyeglass frames and lenses for Medicaid clients who otherwise might not be able to afford vision hardware because of state budget cuts.

Legislation passed this year and signed by Governor Gregoire allows Airway Heights' Correctional Industries Optical Center to continue making vision hardware for Medicaid providers and patients. Under the law, providers can furnish the eyewear to Medicaid patients at the same cost they pay the Optical Center. Prices are expected to range around $20 for a pair of glasses.

The vision benefit budget cut was one of several changes affecting coverage for clients of the Medicaid program ages 21 and older. None of the changes affected children’s benefits, which are generally protected under federal Medicaid law. The cuts also did not change coverage of eye or hearing exams for adults. Those remain covered by Medicaid.

• More information about the bill and copies of the legislation are available on the Internet at:
• Additional information also will be posted on the Airway Heights web page soon:
• Providers are reminded that dispensing codes 92340-92342 are still valid codes, and that Medicaid will reimburse providers for dispensing the glasses.

Substitute Senate Bill 5352, was originally sponsored by Senators Jim Honeyford, R-15, Debbie Regala, D-27, and Dan Swecker, R-20. It passed both chambers unanimously and was signed by Governor Gregoire on April 18.

What's Next?

Because the state must keep a balanced budget in line with the quarterly revenue forecasts, we can expect additional cuts to services and programs. The July revenue forecast was worse than expected and the September forecast will likely bring more of the same news, as recovery is happening slower than anticipated.

Your voice in the legislative process is needed now, more than ever! Be sureyou aresigned up for The Arc's Action Nework, and whether by email, phone or other communication, make sure your legislators know the effect of making additional cuts to the services you, your friends and family, as well as many others in this state need. It is approximated that there are about 80,000 people in Washington State who have a developmental disability. Be one of those making your voice heard! Sign up for Action Alerts at

Thursday, May 26, 2011

History is made: 2SSB 5459 passes the legislature, watch on TVW links

Yesterday, May 25, 2011, marked a historic event in our state with the passage of SB 5459! The five aging Residential Habilitation Centers in our state used to house 4,400 people with developmental disabilities, today those institutions house about 860 people. In addition to this, over 13,600 people with developmental disabilities live at home with their families or in their local communities and have the same level of need as those in the RHCs, yet receive no services at all. 19% of the budget for people with developmental disabilities is used for only 2% of the people who qualify services and receive them in the RHCs, the most expensive model we have.

Your advocacy helped legislators understand the need to consolidate the RHCs and begin using the savings from doing so for those who qualify for services, but receive nothing. Frances Haddon Morgan Center has been downsizing already, the remaining residents will be transitioned to a community setting (or to another RHC if they choose) and the facility will close by December 31, 2011. In addition, Yakima Valley will have no new admissions (except for respite care) and once it has only 16 residents left, it will close. Another very important piece of this legislation is that children under 21 will no longer be institutionalized!

Thank you for your advocacy efforts. Be assured that we will continue to monitor this issue to ensure that people are transitioned in a thoughtful and respectful manner and that their needs are met. We also will make sure that all savings from this consolidation will be used for people with developmental disabilities to get their needs met with services in the community.

TVW recorded the legislative testimony for and against the bill. Below are the links to the House and Senate floor action on 2SSB 5459:

House: 2SSB 5459 is the first bill heard in this segment of floor action so watch starting at the beginning.

Chamber: HOUSE 2011 1st Special Session
Bill No.: 2SSB 5459
Date: 5-25-2011

Yeas: 63 Nays: 33 Absent: 0 Excused: 2

Voting yea: Representatives Anderson, Armstrong, Asay, Bailey, Billig, Blake, Carlyle, Chandler, Clibborn, Cody, Condotta, Darneille, Dickerson, Dunshee, Eddy, Finn, Fitzgibbon, Green, Haigh, Haler, Hargrove, Harris, Hinkle, Hope, Hudgins, Hunter, Jinkins, Johnson, Kagi, Kelley, Kenney, Klippert, Kristiansen, Lytton, Maxwell, Miloscia, Moeller, Morris, Nealey, Orcutt, Orwall, Pearson, Pedersen, Pettigrew, Probst, Rivers, Roberts, Rodne, Ross, Santos, Seaquist, Smith, Springer, Sullivan, Takko, Taylor, Tharinger, Upthegrove, Van De Wege, Walsh, Warnick, Wylie, and Mr. Speaker

Voting nay: Representatives Ahern, Alexander, Angel, Appleton, Buys, Dahlquist, Dammeier, DeBolt, Fagan, Frockt, Goodman, Hasegawa, Hunt, Hurst, Kirby, Kretz, Ladenburg, Liias, McCoy, Moscoso, Ormsby, Overstreet, Parker, Reykdal, Rolfes, Ryu, Schmick, Sells, Shea, Short, Stanford, Wilcox, and Zeiger

Excused: Representatives Crouse and McCune

Senate: Slide the cursor on the blue line at the bottom of the video box until it is 1 hour and 9 minutes (01:09:00 on the left side clock) into the floor action.

Chamber: SENATE 2011 1st Special Session
Bill No.: 2SSB 5459
Date: 5-25-2011

Yeas: 32 Nays: 13 Absent: 0 Excused: 4

Voting yea: Senators Baumgartner, Brown, Delvin, Eide, Ericksen, Fain, Fraser, Hargrove, Harper, Hatfield, Haugen, Hewitt, Hill, Holmquist Newbry, Kastama, Keiser, King, Kline, Kohl-Welles, Litzow, McAuliffe, Murray, Parlette, Pflug, Prentice, Ranker, Regala, Stevens, Swecker, Tom, White, and Zarelli

Voting nay: Senators Baxter, Becker, Carrell, Chase, Conway, Honeyford, Kilmer, Morton, Pridemore, Roach, Rockefeller, Schoesler, and Sheldon

Excused: Senators Benton, Hobbs, Nelson, and Shin

Diana Stadden
Advocacy Partnership Project
The Arc of Washington State

Thursday, May 5, 2011

The Virtual “Museum of disABILITY History”

Recently I ran across a web site for The Museum of disABILITY History. This online wing of the Museum of disABILITY History complements their freestanding "bricks and mortar" Museum. They also have traveling exhibits.

The Museum of disABILITY History is dedicated to advancing the understanding, acceptance and independence of people with disabilities. The Museum's exhibits, collections, archives and educational programs create awareness and a platform for dialogue and discovery. It opened in October 2010 and is located in Buffalo, New York.

This virtual museum is packed with historical information, photographs and old documents that provide an in-depth look at how people with disabilities were perceived and treated throughout history. It addresses some of the harsh realities that society has grown through such as eugenics, sterilization, trepanning (letting the evil spirits out of the head was to cut a hole in the skull) and much more.

The bright side of the museum focuses on the advocacy movement and on reformers such as Dorothea Dix, Josephine Shaw Lowell, William Pryor Letchworth, the Kennedys and many more. I encourage you to take some time to browse this site and glean a glimpse of where we have been, where we are and where we still need to go.

Tuesday, March 8, 2011

Community First Choice Option - the NEW Medicaid Personal Care

Medicaid Personal Care (MPC): A Medicaid program that is allowed under Washington State’s Medicaid State Plan, this program provides assistance with activities of daily living to individuals who receive Social Security Income (SSI) or are approved for other Categorically Needy (CN) medical programs. Services are available in the client’s own home, adult family homes, and boarding homes with an Adult Residential Care (ARC) contract. The program is administered by Home and Community Based Services (HCBS) and Division of Developmental Disabilities  (DDD) administrations.

An assessment is done by a case manager, nurse or social worker from DDD, HCS or Area Agency on Aging (AAA). Clients must meet the functional criteria based on the social service assessment  AND the financial eligibility based on eligibility for a non institutional CN Medicaid program.

MPC is a state plan entitlement program. If clients are eligible for CN without using the higher income and resource standards for institutional  eligibility and meeting the functional eligibility criteria for the program, they are “entitled” to MPC. This makes MPC the priority Medicaid program for personal care services and is usually the first program considered. This is because waiver programs that provide personal care such as HCBS Waivers or DDD Waivers are restricted to a certain number of clients.  MPC services include personal care services and CN medical program. MPC services are authorized by HCBS and DDD. 

The Community First Choice Option (CFCO) would provide individuals with disabilities who are eligible for nursing homes and other institutional settings with options to receive community-based services.  CFCO would support the Olmstead decision by giving people the choice to leave facilities and institutions for their own homes and communities with appropriate, cost effective services and supports.  It would also help address state waiting lists for services by providing access to a community-based benefit within Medicaid.  The option would not allow caps on the number of individuals served, nor allow waiting lists for these services.

There are two significant fiscal reasons that combine with increased independence and self sufficiency for individuals with developmental disabilities.

~ A significant enhanced Federal Medical Assistance Percentages (FMAP) of 6% will be provided to encourage states to select this option. This amounts to an additional $51 million for Washington State EVERY YEAR!

~ A key component of the CFCO is that personal care providers would be teaching skills to clients instead of just providing the service. For example, many individuals with developmental disabilities could cook nutritious meals but just don’t know how, so the care provider fixes the meal. For many, having a care provider teach them how to do it leads to more independence and less reliance on a provider.

The CFCO Waiver won’t be available until October 2011 but now is the time to start preparing. The new federal rules for the CFCO can be found at: and the Governor and Legislators in Washington State need to take the lead and direct the Division of Developmental Disabilities to apply for the CFCO.

Watch for more information to come as we learn specifics of how and when this state plan service could be adopted.

Diana Stadden
Policy & Advocacy Coordinator
The Arc of Washington State

Tuesday, January 18, 2011

Does Federal health care reform make you feel sick?

People around here seem to be pretty anxious about the implementation of the Affordable Care Act. Legislators are worried too. This week the House Health Care and Wellness Committee met to receive an update on implementation. The Health Care Exchange seems to be the biggest concern of policy makers right now. The purpose of the exchange is to provide affordable coverage for individuals and small employers. The due date to have established an exchange is January 1, 2014. Legislator’s questions are about the minimum benefits that must be covered by providers in the exchange. This will likely not be resolved until the Feds issue regulations sometime in 2012.

If you too are feeling a bit queasy about this health business, there is no need to go the doctor for advice. Let me share some home remedy resources you can use to check on our State’s progress. I keep up on the “Next Steps in Washington” by looking at the Governor’s Website at

Additionally, the Office of Insurance Commissioner website has information about current plans and activities and how they impact consumers including a list of his employees that answer questions (if they are still employed to answer the phone) at

And, I follow the Joint Legislative Select Committee on Health Care Implementation which is considering the insurance plans to low income people, the health exchanges, and workforce issues at

Regarding implementing “Federal Health Reform” at the Federal Level, I find Families USA as my best resource. This organization is specifically focused on the things that concern families including families having children with disabilities. They not only have an informative website but they provide free national call-in conferences to learn about and discuss current issues. I have attended a few of them. Anyone who is interested in receiving updates and action notices can subscribe to an email subscription. I subscribe to follow things for the DDC. The website is:

David Maltman – Policy Analyst for the Washingtn State Developmental Disabilities Council

Thursday, December 16, 2010

A Sister's Love and Concern

My name is Tiffany Resendiz and I am a care provider for my little Sister Victoria Trueblood. My sister Victoria is 18 years old and was diagnosed with Rett Syndrome when she was about 5 years old. Her Syndrome keeps her from walking and talking, the things you and I might take for granted. She is mentally about the age of a 6 year old and acts like a little baby would.

I have been caring for my sister for about 4 years now and I couldn't picture myself doing anything else. My sister is such a joy to send time with. My sister is currently on a number of medications. She takes 2 medications for her seizures, 1 for her back pain due to a Harrington rod, 1 for her indigestion problems and the list continues on and on. As of currently, she has 420 hours for care providing for her, without which I don't know what my mom would do.

Taking care of Victoria is a 24 hour job, she even needs to be listened to through the course of the night due to many Rett Syndrome girls passing away in their sleep. The job which entails taking care of Victoria is not a easy job at all but I wouldn't see myself doing anything else. The thought of not having the hours available for taking care of Victoria is a idea that my mind would never want to grasp. I am not in one bit afraid of losing the hours for self pity but the thought of Victoria not having hours to receive proper care for bath time and nightly activities scares me to death.

On the topic of health care such as dentist appointments, eye doctor appointments and prescriptions being cut could be severe and even deadly to a person with special needs like my sister. Without her medications my sister couldn't survive even a day and the thought of living without my sister is the worst thing imaginable. Without eye glasses adults and even children have no way of seeing and for some disabled people seeing is everything to them when they cant walk or talk. Seeing is all they have. Not being able to go the dentist is just as horrible because these are the only teeth they are going to have and if this privilege is taken away how will their teeth be properly cared for?? Could you imagine haveing no money or means to pay for the basic things like a simple teeth cleaning or fluoride treatment.

I'm sure many non-disabled people couldn't imagine what this would be like because they have proper medical care, but for me with hands on experience it could be vital for the survival of someone like my little sister. I love my sister very much and the thought of her turning 18 didn't scare me so much until I saw the cuts that were being made and the decisions that were underway.

I am asking you to think about the many disabled adults who are affected and ask yourself, If I was disabled, would I want for myself what I am cutting from so many other disabled people?? Put yourself In my shoes for a day, taking care of a helpless person that has no means but to be in the graces of others and I bet you will find your answer changes. Please, for the sake of a little girl that is disabled and many others who cant speak for themselves, reconsider your decision. If my little sister cant speak then I alone will be her voice.

Tiffany Resendiz