Summer Spots for Campers at Camp Ramapo

As you may know, Skyer Law attorney Teri Horowitz is the Board president of Ramapo for Children, which, since 1922, has run a residential summer camp in Rhinebeck, NY for children with special needs aged 6 to 16. 
 
Less than two hours from New York City, Camp Ramapo operates on a 250-acre campus of wooded lakefront property. It is an inclusive summer camp designed for children with learning, social, or emotional challenges, including children with autism. You can watch a 2-minute video about the camp by clicking the link above.
 
There are still several spots for new campers remaining in Session 2 (July 10 – July 28) and Session 3 (July 30 – August 18). Applications are open until the spots are filled.
 

AHCA Cuts to Medicaid Will Harm Special Education, Waiver Programs

There is a lot going on in Washington, DC right now. But there is one ball we cannot afford to take our eyes off of: the American Health Care Act (AHCA), which was passed by the US House of Representatives only last week and is now up for consideration by the US Senate. 

We have been watching the progress of the AHCA closely. Here are some of the issues we think our clients should be aware of.

 

Unprecedented Medicaid Cuts

The meat of the bill is the massive defunding of Medicaid by 25% of its entire budget—a total of an astounding $880 billion in cuts by 2026.

Medicaid is arguably our nation’s most critical entitlement, providing health insurance and services for 75 million Americans. But focusing for a moment on our own client community, it touches special needs children’s lives in two very important ways: special education funding and Medicaid Waiver funding.
 
1. Special Education Funding

Since 1988, Medicaid has allowed schools to seek reimbursement for medically necessary services provided to Medicaid-eligible children with IEPs or IFSPs through Early Intervention. This includes diagnostic screenings (Early Periodic Screening Diagnostic and Treatment Benefits or EPSDT), related service instruction, counseling, social workers, school nurses, the purchase and updating of specialized and adaptive equipment and assistive technology, and more. Nationwide, schools currently receive roughly $4 billion in Medicaid reimbursements. If the AHCA becomes law, school districts will have the same obligations to provide these services for students with IEPs and IFSPs under the IDEA, but without these funds to do it. 

What this means practically, is that the AHCA constitutes a $4 billion cut to special education. Whether your child goes to private school or public school, if they are Medicaid-eligible or not, cuts this significant to school districts will have a ripple effect.

You can learn more about how Medicaid cuts impact special education by reading the May 3rd New York Times article ("A Little Noticed Target in the House Health Bill: Special Education") and COPAA’s press statement ("Save Medicaid in the Schools!") from March 21st after the first version of the AHCA was introduced.
 
2. Medicaid Waiver Funding
Many of our clients whose children have significant disabilities receive Medicaid Waiver services. The $880 billion in proposed cuts (25% of the overall Medicaid budget) by 2026 would be implemented via a per capita cap on certain groups of people. These cuts would impact all Waiver services.

Because children constitute half of all Medicaid beneficiaries but less than 20% of Medicaid funds are allocated to them, the overall cuts impact children disproportionately. New York’s Waiver program allows qualifying children to receive home and community-based services. Many of our clients, particularly those with children on the autism spectrum or others with significant disabilities, receive family supports like respite services, or are able to get help paying for specialized recreation programs, therapeutic supports for developing self-help skills in the home, reimbursement for specialized medical or adaptive equipment, job coaching for young adults, transportation funds for medical or therapeutic appointments, toilet training and diapering supplies, and much more. 

These programs are highly individualized to meet the specific needs of the child. And unlike school-based services under IDEA, there is no end date for these services; the Waiver program continues into adulthood, and the offerings evolve to meet the person’s changing needs. 

 

“Pre-existing conditions”

The AHCA as-written would end the ACA/Obamacare’s ban on denying medical insurance to people with “pre-existing conditions.” Instead, it would require the creation of so-called “high-risk pools” that people with pre-existing conditions could join—a separate and very unequal way of insuring sick and disabled people by charging them more expensive premiums. 

The big question for parents is, of course, is my child’s condition on “the list”? But there is no list; insurance companies will determine their own practices. This fact sheet by the Kaiser Family Foundation summarizes what was commonly declinable prior to the ACA. This gives us a sense of what insurance policies might look like in the future if this provision remains in the final law. We know that in the past many conditions and medications (like epilepsy, cerebral palsy, serious mental health issues, or coverage for some autism-related medications) applied to “our kids.”

 

What Next?

If these concerns resonate with you, we are told that the best thing to do is to contact your US Senators. However, New York’s two Senators, Senator Schumer and Senator Gillibrand, have already firmly stated their opposition to the AHCA. 

Ultimately, this fight depends on turning more ‘yes’ votes into ‘no’ votes. So a more impactful strategy may be to encourage your friends and family who live in states with undecided or ‘yes’-declared Senators to make a phone call.

You can call any US Senator’s office by phoning the Senate switchboard and asking to be connected (202-224-3121). For email or district contact information, you can search on the contact page of the Senate website.

You can also write (snail mail) to any Senator using this convention:

Office of Senator (Name)
United States Senate
Washington, D.C. 20510

Jesse Cole Cutler to speak at MCC’s second annual autism conference, May 23

Skyer Law partner Jesse Cole Cutler will be leading a workshop titled "Understanding the Impartial Hearing Process" at MCC's second annual autism conference, First Encounters: A Continuum of Firsts, on Tuesday, May 23rd at the SUNY Global Center (116 East 55th Street).

This comprehensive, day-long, free conference focuses on empowering families throughout the continuum of firsts: diagnosis, treatment options, school selection and funding, OPWDD services, puberty, special needs trusts, and more.

Other expert presenters include: Dr. Bridget A. Taylor, Psy.D. BCBA-D, Sarah Birnbaum, Magdalena Maldonado, Carol Lincoln, Dr. Cecelia McCarton, M.D., Gary S. Mayerson, Esq., Dr. David Salsberg, Psy.D., and Dr. Amy Davies Lackey, Ph.D., BCBA-D.

MCC's SECOND ANNUAL AUTISM CONFERENCE
Tuesday, May 23, 2017 from 9:00 AM to 4:30 PM
SUNY Global Center, 116 East 55th Street
Registration via MCC's Eventbrite page

Greg Cangiano to speak on “Special Needs Advocacy and Resources” panel in Queens on May 3rd

Regina Skyer & Associates senior partner Greg Cangiano will speak Wednesday, May 3rd at 7:30pm on a panel titled “Advocacy and Resources to Your Special Needs Child” at the Reform Temple of Forest Hills in Queens.

This free panel discussion is aimed at New York City families who are still learning what resources are available for their special needs children and what advocacy entails. Along with Mr. Cangiano, the panel will include veteran special education parents, a school psychologist, an educational administration professional, and a pediatric neuropsychologist.

All are welcome to this free event. If you know someone who is at the beginning of their special needs parenting journey, please share this opportunity with them.

Directions: The Reform Temple of Forest Hills is located at 71-11 112th Street in Forest Hills, Queens. LIRR: Forest Hills Station; Subway: Forest Hills - 71st Avenue on the E/F/M/R lines; Bus: Q60, Q23, or Q65.

DOE responds to NYC Council Members on Tuition Reimbursement Delay Issue

We have reported to you extensively about our efforts to advocate for an end to the unacceptable delays in tuition reimbursement payments to our clients. When we last updated you, we reported that, at our request, City Council Education Committee Chair Daniel Dromm, along with Council Members Ben Kallos and Daniel Garodnick, sent a powerful letter to Mayor De Blasio, asking him to honor the commitments his administration made back in 2014 to special needs students and their families.

The Department of Education has now responded to the Council Members' letter, admitting that there have been problems and that there is room for further improvement. It's good to hear that the DOE is cognizant of this and we are hopeful that they will improve their process for 2017-18 based on this stated understanding. The full DOE response is embedded at the bottom of this article. (If you are reading this via our email list, you will need to visit our website to view the letter.)

In its letter, the DOE also made it clear that a significant factor contributing to delays is out of their direct control. Namely, they pointed to rules governing NYC Comptroller approval. Here is what they said:

As noted, as part of the settlement process in each case, DOE submits memoranda and supporting documentation to the New York City Comptroller in which it seeks settlement authority from the Comptroller. One of the challenges of the new process and its subsequent expansion had been a significant increase in the volume of requests to the Comptroller's office, in a concentrated period, resulting in lengthened review time. The Comptroller's office has since built administrative systems to speed up its review process. However, such systems have resulted in new, and more complex requirements that must be followed by the DOE.

We are very grateful to our elected officials for taking action on behalf of our client families. If you have a moment, particularly if you happen to be a constituent of Council Members Dromm (District 25, Queens), Kallos (District 5, Manhattan), or Garodnick (District 4, Manhattan), please take a moment to thank them for their efforts on behalf of New York's special education families.

We will continue to update you as we move forward with our advocacy efforts.