EI Budget Cuts in AZ- Does Anyone Know About it?

• By katek
• Posted February 20, 2009 at 1:35 pm
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I'm worried about the same thing. Our PT canceled today b/c she is attending a forum w/ state legislators about the cuts. The situation is quite troublesome.

• By pandm63
• Posted February 20, 2009 at 2:41 pm
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I know, my son's OT told me they weren't notified until today, and neither was I, had I known I would have been there too, I'm also a little angry I haven't heard from his EI worker either, even though I left messages. I've been writing all my representatives, and even went to the white house website and sent them a note too. I don't know what else to do, Seth isn't in ALTCS but he gets SSI.

• By lola_west
• Posted February 20, 2009 at 3:22 pm
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I've heard the same thing will occur in New York. Don't know when exactly but there are some rumors about it. Too bad... EI is SO helpful!

kathy

• By peacemonger
• Posted February 20, 2009 at 10:08 pm
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I am an EI service coordinator and have been only working part time but here's what I know:

1. All services will be available up into your child's authorization end date in the billing program called FOCUS...this may be 3 years or when the specific date is.

2. You can call this hotline to get more
info:DDDHotline@azdes.gov

If it is a family/individual, have them call 602-364-1379

3. If your child is ALTCS eligible they are covered for now, if they are DDD only without ALTCS this is where the concern is up until their authorization billing date which only your Service Coordinator will know about.

4. This a tragedy to our early intervention community. Please advocate to state legislators about how horrible this is and how it is going to effect our economy in the long run.
The attachment contains all of the names and phone numbers for the legislators and governor if you wish to call and email and encourage the families you serve and your friends to do so. I also encourage each of you to contact the First Things First board and encourage them to use their discretionary funds to provide funding for tried and true programs like Healthy Families rather than starting new programs from the ground up.

Nadine Basha at Nadine@bashas.com (Board Chair)
Elliot Hibbs at ehibbs@azftf.gov (Executive Director)

Board Members:
Steve Lynn slynn@tep.com
Rhian Evans Allvin rgevans@cox.net
Paul Luna pluna@helios.org
Cecil Patterson cpattterson3@cox.net
Pamela Powell Pamela.powel@nau.edu
Vivian Juan-Saunders vsaunders@toua.net
Arturo Gonzalez agonzalez@scottsdalechildrensgroup.com




Here is a letter we were told to pass on:

To: Early Intervention Community 2/20/09

Re: Impact of Budget Cuts to Early Intervention in Pima County

Details are still being worked out, so the following is subject to change as we receive more answers to our questions:

We have been notified by the Division that there are no state funds to continue to provide early intervention services to state funded children. This includes developmental special instruction, nutrition, occupational, physical and speech therapy. Support coordination, including intake and eligibility, will still be provided for children and families.

Children who are eligible for the Arizona Long Term Care System (ALTCS) are not affected by this change.

New Referrals: Effective immediately, all new children referred and eligible for the Division of Developmental Disabilities will be assigned to a state support coordinator with Child Family Services.

Children/Families currently receiving Occupational, Physical, Speech therapies or Nutrition:
• Children who are currently authorized for this service will continue to receive this service until the authorization ends OR until there is a notice provided to families by the Division that there are no state funds for the service. These notices are expected soon.

• Children eligible for AHCCCS Acute Care Health Care (TSC- Targeted Support Coordination) – the Health Plans, including CMPD for children in foster care and Indian Health Services, will be responsible for any needed therapies under EPSDT requirements. Families will be required to get a script and prior authorization from the Health Plan for therapy to begin or continue. Transition to the Health Plan must begin right now!

• Children with private insurance (TPL) – Families will need to get prior approval from that Health Plan for needed therapies.

Children/Families currently receiving Developmental Special Instruction:
• Children who are currently authorized for this service will continue to receive this service until the authorization ends OR until there is a notice provided by the Division that there are no state funds for the service. These notices are expected soon.

• Children who are in Foster Care (ACYF or DDD) may continue to receive this service with state funds.

Support Coordination:
• Children who are eligible for AHCCCS Acute Care Health Care (TSC-Support Coordination) – AHCCCS pays the Division for support coordination for these children so they may be able to continue with their current support coordinator. We are waiting for a final decision on this.

• Children who are receiving support coordination from an early intervention provider and funded with state only dollars, will be transferred to a state support coordinator with Child Family Services when the authorization expires OR when notice is provided by the Division that there are no state funds for the service. These notices are expected soon.


This is very difficult for many people, in all areas of our early intervention community. I will do everything possible to keep you informed as more information is available and clarified. Please feel free to share this with families as you see them and to support their understanding of how they may be affected by these changes.


Sincerely,

Pat

Pat Healy, Area Program Manager
Child/Health/Therapy Services
Division of Developmental Disabilities – District II

• By Twoearly
• Posted February 21, 2009 at 11:00 am
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That is a terribly troublesome situation. And in the long run it will cost the states more money than if they dealt with problems now.

If developmental problems are not treated and improved early, it gets harder and more expensive to deal with them later on. Many of those children will have difficulty in school, and the school will have to address the issues then. That is very expensive.

Children who have difficulties in school are also more likely to have problems in other areas of life. They have a higher likelihood of getting into trouble. If they end up in the legal system down the road, that costs a lot of money.
If they end up unable to succeed academically, they may not be able to effectively support themselves or their family if they have one. That can cost the state in terms of public assistance or other services.

Aslo if they don't succeed academically, they are less likely to succeed in terms of career, meaning they'll work a lower-wage job and won't contribute as much in taxes. Again the government loses.

I'm tired of politicians who shortchange constituents because they don't vote (children) or who aren't big donors like corporations. I'm also tired of them making decisions that work for the short term, but that end up costing a lot more in the long term.

It will be interesting to see what kind of spending DOES survive in the state budgets.

• By pandm63
• Posted February 21, 2009 at 12:53 pm
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Thank you so much for the info, it helps! My son has SSI and AHCCCS, so it looks like I can infer from this he will still recieve services, but instead of DDD, it will be covered by AHCCCS now?

I must admit I am very angry and frustrated about the way this was handled, they told us this on a Friday, nobody has anything in writing, rumors are going like crazy, it is completely inappriopriate. I would think that the parents should have been notified first of what was going on with their child's services, but maybe it's just me.

Thanks again for your help and info, I really do appreciate it, I just needed to vent a little too.

• By katek
• Posted February 21, 2009 at 7:10 pm
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I am very frustrated. Our son's OT just called to cancel our son's Monday OT evaluation. Apparently, our [fill-in-the-blank] developmental coordinator never logged that he was supposed to continue receiving evaluations every 3 months into the system, so he is locked out b/c his occupational therapy (which he has received regularly until we switched to the 3 month schedule) would be considered a "new" service.

I am so mad at the developmental coordinator. I mean she never comes to visit regularly like our old coordinator did. And now it is obvious that she wasn't doing the appropriate paperwork!!!

I asked the OT how much it would cost out of pocket. She said $180 per session. But, she says that they are meeting to reevaluate the cost so that it can be made more affordable...which does make me wonder if they had been jacking up the prices for the state b/c they knew the state would pay w/o asking prior to the "crisis."

Oh, and I found one bill where they charged $700 for a session to the insurance, which got rejected, so the EIP paid it.

Mad at the state for not taking care of kids.

Mad at the therapists if they were jacking up the prices. People should be bilking the state for their services...even when the state did have money. That's not right.

• By pandm63
• Posted February 27, 2009 at 3:05 pm
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If any one needs it, here is some info I managed to get from an AZ advocacy ctr from what I can tell my son is legally entitled to services under IDEA Part c:

The following is a link to the AzEIP Procedural Safeguards document for your review: https://egov.azdes.gov/CMS400Min/InternetFiles/Pamphlets/pdf/PAK-628.pdf

We would suggest is to make a request for written notice of termination of services and use your legally mandated procedural safeguards, available online at: https://egov.azdes.gov/cmsinternet/main.aspx?menu=98&id=2366&ekmensel=15074 e5e_98_0_2366_9
and if there are appeal rights, appeal. Please note that there is some segue between early intervention and a child’s right to a Free and Appropriate Public Education (FAPE).

My understanding with respect to AHCCCS cuts is that most will not impact direct services to members, and in fact, under Arizona law, your AHCCCS health plan is required to provide “medically necessary” services. “Medically necessary” is defined in pertinent part as a “covered service provided by a physician to prevent disease, disability, and other adverse health conditions or their progression; or prolong life.”

There is also a federal law that requires states receiving Medicaid funding, which includes Arizona, to provide Early and Periodic Screening Diagnosis and Treatment (EPSDT) services for persons under the age of 21 who receive Medicaid.

Under federal law, EPSDT services include preventative and rehabilitative services, including any medical or remedial services recommended by a physician or other licensed practitioner of the healing arts within the scope of their practice under State law, for the maximum reduction of physical or mental disability and restoration of an individual to the best possible functional level. You can review the AHCCCS EPSDT policy regarding services for persons receiving Medicaid/AHCCCS/ALTCS under age 21 at: http://www.ahcccs.state.az.us/Regulations/OSPpolicy/chap400/Chap400.pdf

Also, if you have not done so already, you may wish to apply for Arizona Long Term Care Services (ALTCS) for Seth, if he meets their eligibility requirements, which basically requires that his disabilities are of such severity that he is “at risk of institutionalization.”

• By mommytobabyz
• Posted March 1, 2009 at 10:39 pm
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We live in Maricopa County (District 1)...Thank you Pat for the information that you shared!

All services for my son have ended. The SC supervisor has told me that because his services were not put into the FOCUS system prior to 2/18 (his IFSP was on 2/12) they would not be able to input nor would they approve any authorizations. In the same conversation I was told that an "end date" has not yet been determined and that letters were being mailed out to the parents and an"end date" would be listed in the letter. So basically...DES/DDD in our district has stopped authorizations of services effective the 18th, yet an "official" end date has not been determined! Makes a whole lot of sense.

Also, the hotline number is a joke...I left a message and have not received a phone call back and it has almost been 2 weeks.

I am outraged by the cuts, and specifically that we have fallen into a "crack" because my son's SC did not input the info into the system when she said she would. I have spoken with her supervisor and with the supervisor's supervisor and have gotten no where. The supervisor even tried to equate the fact that she has "had to lay off great employees, buy her own pens, pencils and calendars" (due to cuts), with the services that my son has lost. How ridiculous is that?!?!! I know that the SC's are the ones delivering the bad news not making the decisions, however one can be a bit more empathetic without comparing the purchasing of pens, pencils and calendars to the services that my son is losing!

• By katek
• Posted March 2, 2009 at 2:19 am
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Our OT had called last week to cancel our son's appointment b/c it wasn't in the system that he had been approved. I called his agency to find out why they hadn't put the information in the system. Turned out that they did. So I have no idea what the OT was looking at. It looks like we are OK for services until October. Thank goodness.

And then if he needs additional service after that, we are going to have to push hard on the pediatrician for referrals so that the insurance will pay for it. We had to do that once before when the EI couldn't find a PT in our area. The downside of that was that I spent A LOT of time with the insurance company trying to secure visits.

And what a complete nightmare for new preemie parents. The OT was the only one who really helped get my son's feeding on track at 2.5 months adjusted. He probably would have ended up a FTT case but for her bottle techniques, which changed things around for us.

• By pandm63
• Posted March 2, 2009 at 11:40 am
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Don't give up just yet!

I've don some research, and I've spoken with a person at the US Department of Education in Washington DC and they are interested in these cases because 1) under IDEA section C the state is required to provide these services and 2) the state is recieving federal funding from them. She advised me that there are a few things that we have to do before we can file a formal complaint for them to officially investigate:

1. Contact DDD representative and/or hotline, point out that your child's IFSP lists services they are supposed to be recieving , apparently this is a legally binding document, also advise them that you have not recieved a written notice of discontinuation which is your right according to their procedural safeguards, record their response, name, date, time and what agency they were through. If they deny services or if they don't call back document your attempts to contact them, also document name date and time of your discussions with any service providers and their reporting to you they are discontinuing services even though IFSP goals have not been met and you have not recieved written notice

2. Call your local AzEIP office, tell them your services have been discontinued and IFSP goals have not been met, and request to file a complaint, and request your right to appeal, record who you talk to and what they say, names, dates and times.

3. Once this is done and if you don't get any results, contact the US Department of Education in DC and file a formal complaint

The reason we have to go through these steps is because they want concrete evidence that the act has been blatently violated before they can step in, apparently this is also a civil rights issue as well and they want a lot of specifics before they can charge the state with civil rights violations. I'm working on it now, let me know how it goes, and I'll keep you posted too.