1. January 20, 2015

2.   Dean Gates, Chair  Ric Nelson  Terese Kashi  Banarsi Lal  Rep. Charisse Millett  Art Delaune  Heidi Haas  Christine King  Karli Lopez  Alex Gimarc  Stephanie George  Steve Lesko  Anthony Cravalho Staff  Patrick Reinhart  Johanna Richter Members

3.   Reviewed priorities voted on in May - information updated  Presentation regarding Denali Deaf Center capital project  Presentation on Disability ID and Training bill concept  Staff attended Trust Joint Advocacy meetings  Met with Rep. Millett and her staff, Grace Abbott, about our priorities and got her feedback  Developed position papers two weeks prior to council meeting Important Activities Since October

4.   1. HB ___: Disability Training & Identification Bill  2. Changes to Medicaid and Home and Community Based Services (HCBS) Waivers To Save the State Money  3. Capital project support - Denali Deaf Center ($995,000) 2015 Known Legislative Priorities

5.   Operating Budget Deliberations  Especially around all things Medicaid related (i.e. expansion, reform ideas, waivers & general fund supports like DD grants)  Autism Task Force Recommendations  HB 27&28/SB ? - PCA services  Relating to persons in adult foster care Issues To Follow

6.   Follow legislation and state budget deliberations closely  Key Campaign planning and participation (Feb. 19 & 20)  Collaborate with Alaska Mobility Coalition  Collaborate with Trust  Attend/report at weekly legislative session check-ins  Keep council/citizens/legislators informed and engaged on our issues Next Steps

7.   A “waiver” allows the state to offer Home and Community-Based Services (HCBS) to people who are eligible for Medicaid  It is called the 1915(c ) waiver because it is described in section 1915 of the Medicaid Act  Our current 1915(c ) waiver covers Alaskans with developmental and physical disabilities who need nursing home levels of care (we have several waivers)  The state also covers most PCA services in the state plan Medicaid 101

8.   Federal government reimburses Alaska’s 1915(c ) waiver services at 50%  So for every $10 the state spends, the feds give us $5  If Alaska switches from the 1915(c ) waiver to the 1915(k) plan, the federal reimbursement increases by 6%  For every $10 the state spends, feds would give us $5.60 Medicaid 101

9.  BUT….  1915(k) plan is only for people who meet institutional levels of care (LOC)  To cover additional Alaskans who do not yet meet LOC, we would also need to add the 1915(i) plan  1915(i) allows states to determine who is eligible  Mental illness, Alzheimer’s, TBIs, etc Medicaid 101

10.  Conclusion  Alaska currently has a 1915(c ) waiver for HCBS  If we switch to 1915(k) plan, we get more money  If we add 1915(i) plan, we can also cover more people who need services  Remember: 1915(k) and 1915(i) are not “waivers!” Medicaid 101