November 26, 2021
VOR Weekly News Update
VOR is a national non-profit organization that advocates for
high quality care and human rights for all people with
intellectual and developmental disabilities.
VOR promises to empower you to make and protect quality of life choices for individuals with developmental disabilities
Happy Hanukkah!

This year, Hanukkah begins on the evening of November 28th and ends on the evening of December 6th.

Wishing all of our families peace and light this holiday season!
Tuesday, November 30th is Giving Tuesday, 2021
At VOR, every day is a day for giving. Whether through interpersonal support, legislative advocacy, or sharing news and views with our members and supporters, VOR's volunteers and staff are always at work to make life better for people with intellectual and developmental disabilities and their families.

For those who like to make annual donations on Giving Tuesday, please check our Facebook page on November 30th, or click here to donate.

If you would like to make a donation any day of the year,
please click the button below:
International News:
Canada - 'We Can't Hit Pause': Parents of Children with Autism Still Waiting for Specifics on Provincial Autism Program
From CBC News, November 25, 2021
A Manitouwadge woman says a Tuesday meeting with a provincial minister didn't leave her hopeful that access to autism support services in Ontario will improve anytime soon.

"We just need transparency," said Danielle Paananen, whose 13-year-old son was diagnosed with moderate autism when he was three. "When it comes to parents of autistic children, like our kid's autism, we can't hit pause. We can't. It doesn't wait until we're able to get them the therapy that they need."

"So a lot of us are kind of sitting in crisis," she said. "Especially those with children with mental health challenges, which is where my son is sitting, or children on the severe end."

The province announced it was revamping the Ontario Autism Program to improve access three years ago.

However, the number of children on the wait list has grown to more than 50,000; so far, about 600 children have been enrolled in the program, which launched in March and provides funding for services — such as applied behavioural therapy and speech language pathology — based on the individual needs of each child.

Paananen was among a group of parents of children with autism who met with Merrilee Fullerton, Ontario's minister for children, community and social services, on Tuesday. She said the meeting left her with the feeling that "nothing is actually happening on the back end."
Krista Smith, whose son Conor was diagnosed with autism at age two, was also at Tuesday's meeting. The families asked a variety of questions, including what was going to be done to build capacity in northern Ontario.

But, Smith said, all the answers they received were vague.

"I need to know what's going to happen," she said, adding her son has been doing "wonderful" as he has access to some of the services he requires. "He is flourishing. He is talking more. It's just it's amazing to see."

But Smith said she and her husband won't be able to afford keeping Conor in therapy in the event funding stops.

A statement from the office of Ontario children, community and social service minister Merrilee Fullerton confirmed the meeting, and said they are working to build a new, equitable Ontario Autism Program to support children and families.

They did not say when or how they will address the growing waitlist of children and families waiting to access the new needs-based program.

State News:
New York - Hochul Allocates $1.5 Billion to Help Caregivers of Developmentally Disabled
By Nicholas Spangler, Newsday, Nov. 19, 2021
Gov. Kathy Hochul has announced $1.5 billion in one-time funding for caregivers of people with developmental disabilities.

The federal funding, in the form of recruitment efforts, retention incentives and vaccination bonuses, will target more than 110,000 workers in New York, known as direct support professionals, who help clients develop daily living skills including feeding and bathing. The state, which once housed developmentally disabled people in institutions [Note: including state operated intermediate care facilities], now relies on those professionals to provide care in small group homes scattered throughout residential neighborhoods.

For months, leaders of some nonprofit agencies that employ many of the support professionals have warned that low pay and challenging workloads were creating a labor shortage. The pandemic worsened the stress because of the job's close-contact requirements, advocates said. Rising wages in retail and other industries also lured workers away as the state-set reimbursements that provide most revenues for nonprofits providing care stagnated.
"The people who take our jobs have so much more responsibility than someone at McDonald’s or Waldbaums," Stockton said, adding that he hoped the move would lead to permanent salary increases for support professionals.

"We are excited about the fact we can pay these people, who through no fault of their own, barely make a living wage."

In a news release Thursday, Hochul said some of money from the federal American Rescue Plan Act will go into a "Heroes Fund," providing incentive payments to support professionals who worked during the pandemic, with additional payments for those who received the Covid vaccine. Another portion of the funds will pay for retention bonuses, "long-term recruitment and retention strategies," and other efforts to build the skills of caregivers and front-line supervisors, the governor said.

Tennessee - More than 1000 Children Enrolled in Katie Beckett Program in Year One
Press Release from the Tennessee Dept. of Intellectual and Developmental Disabilities, Nov. 23, 2021

The Division of TennCare and the Department of Intellectual and Developmental Disabilities (DIDD) announced that more than 1000 children have been enrolled in the Katie Beckett Program since it opened one year ago. There are currently no waiting lists for services in either part of the program.“We’ve already seen how the Katie Beckett Program can change the lives of children and families for the better here in Tennessee,” said DIDD Commissioner Brad Turner. “From providing life-changing supports to medically complex kids to offsetting the financial burden of co-pays and premiums for families, this program is helping families in ways they might not have realized were possible.”

The Katie Beckett Program is for children with disabilities and/or complex medical needs who are not currently Medicaid eligible because of their parent’s income or assets. Tennessee’s Katie Beckett Program has two parts. Part A provides Medicaid services to children with the most significant disabilities or complex medical needs. Part B is a Medicaid diversion program, which means children are not enrolled in Medicaid, but receive a capped package of supports of up to $10,000 annually to help cover the cost of private insurance or care their insurance does not cover.

The program was designed based on feedback from families, advocates, and medical experts. TennCare and DIDD continue to meet with a technical advisory group to review program successes, challenges, and solicit feedback on potential program adjustments.

Maine Group Homes on Verge of Financial Collapse, Possible Closure
By Jim Keithley, WMTW News, Nov. 21, 2021
Staffing shortages and vaccine mandates are hitting Maine group homes hard. A mass exodus of trained workers is putting a strain on the system. Some group homes are on the verge of closing. One family is struggling to keep their son safe.

John and Jan Hanson have been happily married for 50 years. These are supposed to be their golden years but they worry about their son Jess every day.

"He's very happy and healthy and has great relationships with his staff," Jan Hanson said.
"He can be dangerous. There’s no question about it," John Hanson added.

Jess, 42, was born with intellectual and developmental disabilities. The Hansons have been fighting to give him the best life possible. When he was younger that meant a New Hampshire boarding school that specialized in helping people like Jess.

As he got older, he became more aggressive and unpredictable. For 20 years, Jess has been living in a group home in Auburn with staff that works around the clock.
But these days staff are leaving, fed up with the stress, the hours and the low wages.

"The wage allocation is just above $11.22 an hour. State minimum wage $12.15," said Todd Goodwin, CEO of the John F. Murphy homes.

The agency oversees 37 group homes in the Lewiston-Auburn area.

Goodwin says his workers are taking jobs at Home Depot and Shaw's where they have better hours and make more money.

Without additional federal and state funding, Goodwin said he can't raise the wages.
Goodwin says the vaccine mandate also didn't help, even though he supports the governor's mandate that all healthcare workers get the vaccine.

Maine - Health Care Staffing Woes Persist Despite Few Exits after Maine’s Vaccine Mandate
By Jessica Piper, Bangor Daily News, November 25, 2021
Weeks after Maine’s vaccine mandate for health care workers went into effect, data suggest it had only a small impact on total employment in the industry, but the state still faces a shortage of health care workers as the pandemic continues.

The continued staffing challenges come as COVID-19 cases in Maine are as high as they have ever been headed into winter, with a record 327 people hospitalized with the virus on Thursday and unvaccinated people continuing to drive the majority of cases.

Early data from the Maine Department of Health and Human Services suggest total health care employment has declined only slightly following the vaccine mandate, although the effects varied by provider and individual facilities, mostly nursing homes, saw a greater drop.

“When we talk with our members, the No. 1 reason that comes up why workers leave their positions in long-term care is due to burnout and stress,” said Angela Westhoff, CEO of the Maine Health Care Association, which represents nursing homes and long-term care facilities. “I think the pandemic really has just heightened all of that. The vaccine mandate is certainly part of it, but less so.”

The mandate from Gov. Janet Mills, which went into effect at the end of October, is among the strictest in the nation for health care workers, with no testing option or nonmedical exemption. Vaccination rates rose sharply following it — the rate among nursing home staff rose from 72 percent in July to just shy of 97 percent in October, while it rose from 80 percent to 98 percent among hospital workers.

Arizona - Former CEO of Hacienda HealthCare William Timmons Sentenced
By Katie Conner, Arizona Attorney General's Office via Prescott News, November 21, 2021
Attorney General Mark Brnovich announced today that William J. Timmons, the former Chief Executive Officer (CEO) of Hacienda HealthCare, Inc., was sentenced to 3 years supervised probation and financial restitution of $774,000 by a Maricopa County Superior Court judge for his involvement in an elaborate while collar fraud scheme that bilked Arizona taxpayers out of millions of dollars.

Timmons and his long-time Chief Financial Officer (CFO) and co-conspirator Joseph O’Malley were indicted in August 2020.

Timmons was the CEO of Hacienda from July 1989 to January 2019. From 2013 until June 30, 2018, Timmons and O’Malley intentionally misallocated funds from the Arizona Department of Economic Security’s Division of Developmental Disabilities (DES/DDD) and the Arizona Health Care Cost Containment System (AHCCCS) by manipulating costs to make them appear to be allowable expenses in order to avoid repayments
of state funds in favor of inflated salaries and bonuses. The DES/DDD contract was with Hacienda’s Intermediate Care Facility (ICF) only. However, Timmons used the money to pay for a large portion of costs at Hacienda’s other facilities and did not reimburse the State, as required by the contract. This resulted in millions of dollars of overpayment by the State.

South Mountain Health Supply was operated under the umbrella of Hacienda. Between July 1, 2013, and June 2018, South Mountain purchased medical supplies from third-party vendors, and then re-sold the supplies to Hacienda at a 12.5 percent markup. Timmons directed the payment of the inflated prices, including a delivery fee (even though the two entities were located at the same address), with public monies.

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Managed Care:
Arkansas - State Scrutinizing Care Group for more than 20,000 Arkansans with Disabilities
By Lara Farrar, Arkasas Democrat-Gazette, November 25, 2021
State regulators must decide by next week whether Empower Healthcare Solutions LLC, one of the largest managed care providers for Arkansans with developmental disabilities, can continue offering services to clients after Dec. 31.

Should the Arkansas Department of Human Services determine that Empower is not fit to continue, some 20,000 of the group's clients will receive notification by mail before the end of the year that Empower "cannot continue to participate in the program," and those beneficiaries would be transitioned to another provider, a Human Services spokesperson said in a statement to the Arkansas Democrat Gazette.

The deadline for Empower to complete its readiness review by the Department of Human Services was Wednesday. The agency likely will not make its determination until sometime next week.

Empower Healthcare has been embroiled in an ongoing battle with one of its former shareholders, Boston-based Beacon Health Options Inc.
Beacon, one of six stakeholders in Empower, owned a 16.66% share of the entity since it was formed in 2017, and contracts with the company to provide administrative services and to assist in day-to-day operations at the Little Rock offices the companies share.

The remaining five owners are other health care providers, which, in Arkansas, are required to have a majority stake in the Provider-led Arkansas Shared Savings Entity (PASSE) program.
The split between Empower and Beacon and the turmoil between the two companies has resulted in increased scrutiny from regulators, including the Department of Human Services, which required Empower to undergo a "partial readiness review" to determine whether Empower had the capacity to continue to provide care to its clients.

Empower is one of four companies participating in the PASSE program. The participants in this program, created by Act 775 of 2017, receive millions of dollars from the state Medicaid program each month to pay for the services of the more than 50,000 qualifying Arkansans with significant mental illnesses or developmental disabilities.

Such care ranges from nursing services and speech therapy to inpatient psychiatric stays and medical equipment. A lot of money is involved, with participating companies earning tens of millions of dollars annually. In 2020, Empower generated revenue of more than $460 million, according to company documents.

Legislation passed earlier this year prohibited companies from owning stakes in more than one PASSE. In March 2020, the Indiana-based insurance giant Anthem Inc. announced that it had finished its acquisition of Beacon Health Options.

Anthem also owns a stake Summit Community Care, another Arkansas PASSE and competitor to Empower. That acquisition forced the separation of Beacon from Empower.

Michigan - Bills Could Threaten Vommunity 'Safety Net' for Mental Health Patients, Opponents Say
By William T. Perkins, The Petoskey News-Review, November 26, 2021

Five northwest Michigan counties have voiced their opposition to two bills in the state senate they say would sever local control of mental health services. 

Senate Bills 597 and 598 were introduced in the summer. The bills’ sponsors, State Senate Majority Leader Mike Shirkey, R-Clarklake, and State Sen. John Bizon, R-Battle Creek, say the plan replaces a broken, bureaucratic system with a more effective setup by letting private insurance companies take over the coverage of Medicaid recipients with pressing mental health needs. 

It’s, in fact, the way Medicaid coverage is handled for physical health care. For that reason, proponents say the Senate bills would help integrate care for Medicaid recipients, integrating their primary care and mental health coverage under one system.

“Our system can and must be patient-centered and outcomes-based,” said Shirkey in a press release when he introduced the bills. “The trauma suffered during the COVID-19 pandemic magnified and amplified the weaknesses in our current mental health system. The science shows when mental health and physical health care are addressed and evaluated together, it leads to better outcomes for both.” 
But community mental health agencies — the frontlines to providing care for those with the most severe needs — see it as a scheme that would dismantle a vital public safety net. 

“At the basis, the foundation of these bills is to take the money that is earmarked for a very large array of services to support those vulnerable people and to give it to insurance companies — the private insurance companies,” said Christine Gebhard, CEO of North Country Community Mental Health. 

Community mental health agencies primarily aid those “with very serious and persistent mental illness: kids with severe emotional disturbances, adults and kids with intellectual and developmental disabilities, and people with substance use disorders,” according to Gebhard. On top of that, she said they provide important collaboration between various entities, like jails and courts, with public health experts.

Rather than by private insurance companies, Medicaid coverage for mental health concerns in Michigan is managed by what are called Prepaid Inpatient Health Plans. Those are typically comprised of and governed by several adjacent community mental health centers. 

Those community mental health centers would purportedly remain intact under the plan laid out in Senate Bills 597 and 598, but instead of having governance over Prepaid Inpatient Health Plans, they would enter into contracts with private insurance companies. 

Opponents, including Gebhard, say that would diminish the quality of care patients could receive, because commercial agencies have to look out for their bottom line and ensure profits for shareholders. Community mental health agencies, on the other hand, are required to at least serve those with the most severe needs. 

Often, that’s financed through Medicaid, but for individuals who have severe needs without Medicaid, community mental health groups maintain a general fund made up of state dollars. 

But those general funds have been decreasing in recent years, according to a 2019 presentation to a state House subcommittee from the Michigan Community Mental Health Association, which is one source of strain on the system that can lead to inefficiencies. 

But Gebhard said the problems with the current system can be fixed with funding and other solutions. 
“It doesn’t require restructuring, or deconstructing really, a program that’s been built over 40 years,” she said.

Inspirational News:
"Can't is not part of your vocabulary"

VOR's Marilyn Straw passed on this inspirational story, to share with all for this holiday season.

Year-End Giving for VOR

For those members who have been blessed to reach their seventies, and who will be required to take a distribution from their IRA's by December 31, 2021, please consider using this opportunity to make a contribution to VOR.

VOR Bill Watch:
[Please click on blue link to view information about the bill]


Modifying the Build Back Better Act (H.R. 5376) to include language to provide funding for Intermediate Care Facilities in parity with increased funding for HCBS services, and to remove any provisions that would phase out or eliminate 14(c) wage certificate programs.

H.R.4761 - A bill to amend the Rehabilitation Act of 1973 to ensure workplace choice and opportunity for young adults with disabilities.

H.R.4762 - A Bill to amend the Rehabilitation Act of 1973 to clarify the definition of competitive integrated employment.


H.R.4131 & S.2210 - The Better Care Better Jobs Act - To be clear, we don't oppose this bill. We object to the fact that it excludes the most vulnerable members of the I/DD population.

While the Better Care Better Jobs Act would greatly increase the amount of federal funding for people with I/DD, it only supports those in waiver programs receiving Home and Community Based Services. It unjustly discriminates against those who have chosen Intermediate Care Facilities as the necessary and proper form of residential treatment. By giving a 10% increase n federal matching funds only to HCBS clients, and providing training and increased pay only to direct support professionals working in HCBS facilities, the act deliberately favors one form of treatment over another, one ideology over another, and one set of people with I/DD over another.

H.R. 603 & S. 53 - The Raise the Wage Act - These bills are aimed at raising the minimum wage, but they also have provisions to phase out and ultimately eliminate vocational centers and 14 (c) wage certificates over the next six years and to immediately stop the issuing of any new certificates. VOR believes the issue of employment options for individuals with intellectual disabilities should not be buried in a bill for raising the federal minimum wage. Both issues deserve clean, stand-alone bills.

H.R.1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration.

H.R. 2383 - The Transformation to Competitive Integrated Employment Act - this bill purports to assist employers providing employment under special certificates issued under section 14(c) of the Fair Labor Standards Act of 1938 in transforming their business and program models to models that support individuals with disabilities through competitive integrated employment, to phase out the use of these special certificates. We feel that, if enacted, tens of thousands of people with I/DD and autism will still be forced out of opportunities they currently, needlessly, and left without viable alternatives to occupy their time or address their needs and their abilities.
Direct Support Professionals:

Our loved ones' caregivers are essential to their health, safety, and happiness.
In appreciation of their good work and kind hearts, VOR offers free digital memberships to any DSP who would like to join.

We encourage our members to speak with their loved ones' caregivers to extend this offer of our gratitude.

If you are a Direct Support Professional interested in receiving our newsletter and e-content, please write us at

with your name, email address, and the name of the facility at which you work. Please include the name of the VOR member who told you of this offer.

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