Amid ongoing debate about whether employers should be able to pay people with disabilities less than minimum wage, federal officials are asking the public to weigh in.

The U.S. Department of Labor says it wants to hear about “ideas, individual stories and personal experiences” related to subminimum wage employment.

Under current law, employers can obtain what are known as 14(c) certificates from the Labor Department, which allow them to pay workers with disabilities less than the federal minimum wage of $7.25 per hour. Employees who are paid at a lower rate are supposed to be compensated based upon their productivity level compared to that of someone without a disability.

The agency’s Office of Disability Employment Policy is holding what it’s calling a national online dialogue to solicit feedback on the program.

By the time Julie Callahan reported herself to child protective services, she had done everything in her power to avoid making that phone call.Callahan never abused her teenage son. She didn’t neglect him.

All she did was try, and fail through no fault of her own, to secure the care and treatment 14-year-old Jackson Hurt needs so he won’t be such a danger to himself and others.

So he can stop putting his head through windows. Stop blackening his mother’s eyes and pulling out her hair. Stop traumatizing his younger brother and older sister, who had to be instructed on how to inform police that Jackson doesn’t mean to harm his family and that he has severe autism and mental illness and can’t help it.

“In my mind, I knew I was doing the right thing,” Callahan said of her decision to turn to Franklin County Children Services last fall. “In my heart, it was the worst.”

The Grove City resident is among an untold number of Ohio parents who have had to relinquish custody of a troubled child simply because they don’t have unlimited amounts of money and insurance coverage. Surrendering custody to a system designed to protect kids from abusive or inadequate caregivers is bitter, they say, but it’s sometimes the only way to obtain desperately needed services.

In 2016, a foster baby born with severe defects needed constant monitoring from a nurse, to ensure he didn't pull out his breathing tube and choke to death. The insurance company Texas pays to provide that care refused, saving Superior HealthPlan as much as $500 a day. Then the state's appeal system failed D'ashon, deferring to Superior. Months later, as D'ashon's nurses and foster mother warned would happen, the baby tugged out his breathing tube when his nurse wasn't around and suffocated for so long that he's now in a permanent "vegetative state."

If bills that passed the Texas Legislature this week had been enacted then, D'ashon might have been saved. 

It's too late for D'ashon, but If Gov. Greg Abbott signs those fixes into law, thousands of other sick and disabled Texans might have a fighting chance when they're refused care by Medicaid companies that pocket more money when they spend less on care.

Those measures were prompted by "Pain & Profit," a Dallas Morning News investigation that found widespread failures in Texas' privatized system known as Medicaid "managed care."

The biggest patient protection that cleared both chambers is the creation of an independent arbiter to review cases when so-called managed care organizations, or MCOs, refuse to pay for doctor-ordered treatments and equipment. That "external medical reviewer" represents a potentially life-saving safety net for patients like D'ashon, who currently must exhaust appeals with MCOs, and then if they're determined enough, scale a faulty medical appeal system that heavily favors companies.

Three key bills include other protections, such as more transparency and a bit more oversight — not enough, patient advocates say – around the opaque and ever-changing rules companies cite as justifications when they deny services taxpayers have already paid for.

While Texas and the federal government set broad guidelines, more than a dozen MCOs write their own rules for what is and isn't covered and which treatments require an additional obstacle to being approved.

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The fractured relationship between state legislative leaders and the seven behavioral health managed care organizations (MCOs) surfaced again Tuesday with the release of the state Senate budget plan.

The MCOs would lose $51.4 million in single-stream funding in the 2019-20 and 2020-21 fiscal years in the Senate proposal, while the House budget cuts would total $36.4 million each fiscal year. The Senate cut would be just under $25 million each year for Cardinal Innovations, while the House would reduce Cardinal by $9.64 million each year.

Cardinal is the state’s largest behavioral health MCO. It serves 20 counties, including Forsyth and five others in the Triad.

Cardinal handles more than $675 million in annual federal and state Medicaid money. It said it served about 26,000 individuals with single-stream funds in fiscal 2017-18.

Ongoing court challenges to the DHHS' choices for Medicaid managed care providers threaten to derail the schedule for transitioning the program, set to start this November. More than $30 billion in contracts is at stake.

North Carolina’s ongoing transition to Medicaid managed care system could screech to a temporary halt if an administrative law judge agrees with rejected managed care groups that the process to select contractors was flawed and unfair.

Lawyers for three prepaid health care plans — Aetna Better Health, a commercial managed care company; Optima, a health care group connected to Virginia’s Sentara health care system; and My Health by Health Providers, a provider-led group formed by a dozen of the state’s hospital systems – appeared in administrative law courtrooms in Raleigh this month. All three tried to make the case that each deserved another shot at consideration for a lucrative Medicaid managed care contract.

The groups contend the N.C. Department of Health and Human Services used an inconsistent

With stagnant wages, frequent turnover and the growing pressure of student loan debt, human services providers face a staffing crunch that leaves them without sufficient resources to meet the needs of the state’s most vulnerable populations, advocates told lawmakers Tuesday.

More than a dozen bills were before the Joint Committee on Children, Families and Persons with Disabilities for a hearing, but a common theme ran through many of them: addressing the plight of service employees who, despite helping those with significant physical and mental needs, cannot make ends meet.

“We’re in a crisis,” said Justice Resource Institute CEO Andy Pond, who was one of several speakers to describe the situation that way. “We can’t find the staff we need or keep the ones that want to stay. In many cases, they’re forced to abandon the work that they love, thereby depriving the commonwealth of some of its most important workers.”

Several legislative solutions are on the table that both employees and employers said Tuesday would have significant positive effects, particularly a state-administered loan repayment program and an effort to reduce the wage gap between state and community-based human services jobs.

Under the proposed loan program (S 56 / H 163), full-time human services employees who earn less

More than 400 vulnerable people living in group homes run by Bellwether Behavioral Health, the troubled company barred by the state from future business in New Jersey, should see better conditions as new management takes over the homes, officials said.  

Moving quickly to protect the safety and health of the developmentally disabled residents of Bellwether’s 62 homes after a scathing report by a state-appointed monitor, human services officials have chosen nine different social service providers to assume responsibility for their operations.  

“Each provider agency will take over operations of a specific set of homes and/or day programs by region and service specialty,” said Tom Hester, a

A caretaker at a group home in Mesa is facing charges for allegedly beating up a teenager who has severe autism. The victim’s parents say he had marks and bruises on his body from the assault.

Mesa police say Nick was abused at Care and Dignity, a group home for the developmentally disabled. Fourteen-year-old Nick lived there day and night on weekdays.

“He had a lot of bruising around his eye. He had some marks on his chest from where he got stomped,” said his mom Denise Hill about the alleged abuse occurring on May 13.

Nick’s parents heard what happened from the staff at the home. In an incident report to the state, the staff said: "staff member Anthony Adusei began to punch Nicholas in the face three times then kicked him."