Federal investigators will look into whether private Medicaid management companies, including those covering more than 600,000 poor or disabled Iowans, are unfairly denying services.

U.S. Sen. Bob Casey requested the review last week. The Pennsylvania Democrat wrote to the Department of Health and Human Services that he was troubled by media reports that the companies were cutting care to disabled Americans who rely on Medicaid.

Casey cited articles from the Des Moines Register and the Dallas Morning News about managed care organizations denying care.

“It is the duty of MCOs, as a steward of taxpayer dollars, to spend Medicaid funds responsibly in pursuit of the health of our families,” he wrote.

“What the Dallas Morning News and Des Moines Register uncovered, however, were actions taken by the MCOs focused squarely on delivering

New federal figures indicate that autism prevalence among young children is on the rise.

The number of 4-year-olds with the developmental disorder increased from 1 in 75 children in 2010 to 1 in 59 kids in 2014, according to data published late last week in the Center for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

The findings are the latest to emerge from the CDC’s Autism and Developmental Disabilities Monitoring Network. Traditionally, the network tracks prevalence among 8-year-olds using a review of health and educational records in certain geographic areas across the country. More recently, the agency has expanded its surveillance work to look at 4-year-olds and 16-year-olds.

The group representing about 300 U.S. safety net hospitals warned in a new report the facilities are struggling to keep up with uncompensated and charity care. Medicaid's pending disproportionate share hospital cuts would push the facilities to a "breaking point" unless Congress steps in, America's Essential Hospitals CEO Bruce Siegel said. A $4 billion reduction in DSH payments is slated to go into effect in October.

AEH hospitals operated with an average margin of 1.6% in 2017, which was half what they had in the previous year and below the 7.8% average of other hospitals, according to the annual financial report released Thursday.

Safety net hospitals make up about 5% of U.S. hospitals but in 2017 provided 17.4% of uncompensated care, totaling $6.7 billion, and 23% of charity care, which added up to $5.5 billion. That's up from 20% of all charity care and $5.5 billion in overall uncompensated care in 2016.

The AEH report confirmed that safety net hospitals take on a disproportionate share of at-risk patients,

Last month’s proposal from Secretary of Education Betsy DeVos to cut millions of dollars in funding for Special Olympics caused a public uproar and a bipartisan backlash fierce enough to force President Trump to restore it days later. That reversal was welcome. But it was also incomplete. Most Americans do not know that the 2020 budget is still full of cuts that aim directly at many other programs that support people with disabilities.

The Trump administration’s fiscal year 2020 budget would make cuts across multiple agencies and offices that serve Americans with disabilities, stripping them of essential resources. Of particular urgency to me and many of my colleagues are the devastating impacts that the weakening of these agencies would have on job seekers with disabilities.

Independent living centers, assistive-technology programs, supports for individuals living with brain injuries and family caregiver support services are among those programs and services on the chopping block.

The Louisiana Legislature, for once, is not facing a major fiscal crisis as lawmakers craft the state’s budget.

But advocates for people with disabilities, the elderly and people with mental health disorders still showed up in full force for public testimony day at the House Appropriations Committee, where they pleaded for additional money for services and lamented funding levels for certain programs that have remained low for a decade.

“We’re here today asking you, pleading with you, restore our funding so we can continue to operate, so our doors can continue to open,” said Sharon Gomez, of Evergreen Life Services, which provides services for people with developmental disabilities. “35,000 citizens with intellectual and developmental disabilities are counting on you to do what it takes so their livelihood can continue.”

When the fire alarm sounded before lunch in November of 2017, the staff at Alta Vista Elementary School knew they had a problem. A 6-year-old boy confined to a wheelchair needed to evacuate with the rest of his class. Unfortunately, the school had never purchased a chair that would let him leave the building. As the alarm kept sounding, teachers hovered nearby and debated what to do. The school had never put together an evacuation plan for the child. Finally, a physical therapist picked up the distraught boy and carried him out in her arms.

Though it wasn’t a real emergency (a student had pulled the alarm as a prank), the event laid bare the dire situation of special needs students in a district that suffers from severe – and often self-inflicted – budget woes.

The mountain-rimmed village of Questa, just south of the Colorado border, is home to one of the worst performing districts in the state, its schools earning multiple F’s from the Public Education Department.

But in recent years, its most immediate problems have centered on failures providing services to its 68 special needs students. Administrators have time and again denied pay to nurses, therapists and special education staff, according to complaints filed with the state.

Further complicating the problem, the district has lost an astounding number of employees. Michael Lovato, the current superintendent of the Questa Independent School District, is the fifth person to take on the job in two years.

Four school nurses have left since 2018, according to staff emails; in recent years the school has also lost physical therapists, speech therapists and special education teachers. Some lasted only a few weeks.

Families across Tennessee waiting to see if the governor would fund legislation to support children with severe disabilities were disappointed on Tuesday.

Gov. Bill Lee's supplemental budget did not include appropriations for the medically needy children who cannot get state health care because their parents' income exceeds qualifying limits.

Currently, the cost for caring for children with disabilities can bankrupt Tennessee families as working parents pay for the therapies, nursing care and vital equipment that private insurance does not cover.

Legislation making its way through the state House and Senate would allow these children to qualify for TennCare regardless of their parents' salaries and relieve families of what can amount to hundreds of thousands in medical bills each year.

Parents rallied Thursday at Barnett Park in Orlando to confront the state about proposed cuts they believe could impact their children with special needs.  

Parents brought their signs, their children and their stories.

 

“I drove an hour today to be here today and cried almost the whole way in the car,” parent Chantal Buck said.

 

Buck's daughter is on the autism spectrum.

 

“It’s heartbreaking to hear from your doctor that your child will never say, ‘Mommy.’ She'll prob never be a functioning adult. Services like behavioral therapy give you hope,” Buck said.

Parents said the special services are in jeopardy because of a series of changes proposed by the Agency for Health Care Administration, or ACHA.

The proposed changes include upcoming reviews of therapy plans and a 50% cut in Medicaid reimbursements for the therapists who work with the children.

Since March 2014, 20 state-licensed skilled-care nursing homes have closed for financial reasons, while many of those continuing to serve the state’s neediest elderly populations face staffing shortages and operating deficits caused by diminishing state government investment.Nursing home advocates warn that the industry is already in crisis, and a continuance of this trend could mean an unavailability of care for Illinois’ aging population within a decade.

“These facilities are closing, and I can tell you more are going to close,” said Pat Comstock, executive director of the Health Care Council of Illinois, a nursing home advocacy group. “It’s happening because we have a situation in Illinois where they can no longer financially survive.”

The pace of closures has quickened in recent years, with five skilled-care nursing facilities – those that house the sickest and most vulnerable – closing from 2014 to 2016, six closing in each of 2017 and 2018, and three already shutting their doors in 2019, according to the Illinois Department of Public Health. 

The head of a shuttered Chicago-area network of group homes for adults with disabilities has been convicted of accepting kickbacks in a scheme to steer biological samples to a St. Louis laboratory for publicly funded testing.

A federal jury found Reuben F. Goodwin Sr., 53, guilty of 11 counts of health care fraud and a conspiracy-related charge earlier this month in Missouri. A sentencing hearing is set for July 12.

The state-funded group homes run by Goodwin were among those spotlighted in a November 2016 Tribune investigation that detailed deaths, injuries and mistreatment inside various facilities and day programs across Illinois. The Illinois Department of Human Services revoked Goodwin’s license to operate his facilities after state inspectors visited the properties and determined that all 45 residents faced an “imminent risk” of harm.

Nicholas Diaz acted out last summer when staffers at the group home for the intellectually disabled in Langhorne where he was staying denied him a snack. Diaz, a 21-year-old who has autism and suffers seizures, was beaten up by the caretakers, who left him with a black eye and other injuries to his face, neck, and arms.

Patricia Legare, another resident under the care of Langhorne-based Woods Services, had a shoe print on her back after an assault by a staffer in May 2017. Legare, 15 at the time, has autism and obsessive-compulsive disorder.

Those allegations are part of two lawsuits alleging abuse and neglect at Woods, which claims to serve 4,000 children and adults with intellectual and developmental disabilities, behavioral problems, and brain trauma.