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GOVERNOR’S ADVISORY COUNCIL FOR EXCEPTIONAL CITIZENS (GACEC

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GENERAL MEMBERSHIP MEETING
7:00P.M., January 20, 2015
George V. Massey Station, Second Floor Conference Room
516 West Loockerman Street, Dover, DE
MINUTES
MEMBERS PRESENT: Chairperson Robert Overmiller, Dafne Carnright, Al Cavalier, Nancy
Cordrey, Cathy Cowin, Bill Doolittle, Karen Eller, Bernie Greenfield, Terri Hancharick, Brian Hartman,
Karen McGloughlin, Carrie Melchisky, Mary Ann Mieczkowski, Bill O’Neill, Jennifer Pulcinella, Shawn
Rohe, Ron Russo, Howard Shiber, Brenne Shepperson, Kirsten Wolfington
OTHERS PRESENT: Guests: Emmanuel Jenkins, We Stand 4 Something; Bonnie Hitch, DART;
Verna Thompson, Department of Education (DOE); Barbara Mazza, DOE; Trena Kale Rosario, We
Stand 4 Something; Keith Morton, Parent Information Center (PIC); Crystal Sheats, Division of
Vocational Rehabilitation; Wayne Marquess, parent; Rob Scheinberg, parent; Ann Fisher, GACEC
Applicant/Educator; and Katie Cordrey
Staff present: Wendy Strauss, Executive Director; Kathie Cherry, Office Manager and Sybil White,
Administrative Coordinator.
MEMBERS ABSENT: Marie Ann Aghazadian, Jean Butler, Carma Carpenter, Thomas Keeton, Danna
Levy, Chris McIntyre, Beth Mineo, Janella Newman, Lavina Smith
Chairperson Robert Overmiller called the meeting to order at 7:00p.m. Robert reminded everyone that
side bar conversations were distracting and should be avoided.
PUBLIC COMMENTS
Wayne Marquess, a parent with children in the Caesar Rodney school district came to address Council
concerning the School Choice Program in Delaware. Mr. Marquess has two children, one of which
attends a special program at the John S. Charlton School. When trying to ‘Choice’ his son, who does
not have special needs, into a school closer to the Charlton School where his daughter attends, his
request was denied. He appealed the process and was again denied. Mary Ann Mieczkowski asked Mr.
Marquess if the school is telling them they do not have room. Mr. Marquess replied that the response is
that it is a matter of space; however, the school is still open for Choice. Bill Doolittle thanked Mr.
Marquess for bringing this issue to our attention. Wendy asked that the Children and Youth committee
look into this matter (special education choice) and asked that Mary Ann Mieczkowski please join them.
Robert thanked Mr. Marquess for bringing the matter to the attention of the Council.

GENERAL MEMBERSHIP MEETING

Robert asked for a motion to approve the November meeting minutes. The motion was approved.
Robert asked for a motion to approve the November and December financial reports. A motion was
made and approved to accept the November and December financial reports as submitted.

SPECIAL PRESENTATION
Barbara Mazza gave a presentation on the State Performance Plan (SPP) for FFY 2013. She explained
that the SPP and the Annual Performance Report (APR) are now one document. These documents have
been merged by the Office of Special Education Programs (OSEP). OSEP has transitioned from a paper
report to an online system which has been a big learning curve for everyone involved. The report is due
February 2, 2015. GACEC is the last group that will be able to provide final comments. Barbara
covered several Indicators from the APR and the PowerPoint presentation with that information is
attached for your convenience. Bill O’Neill questioned why the data that we were discussing today is
so old. Mary Ann explained that this is lag data and that this is unfortunately the way OSEP requests
the information. She also indicated that this is a frustration for the people at the Department as well.
Bill Doolittle asked to clarify if the GACEC would be getting the initial draft (prior to submission) to
make comments at that point. Mary Ann confirmed that GACEC would in fact be getting a draft and
that the initial submission would be marked first submission. Brian Hartman had a question regarding
Indicator 14 regarding post-secondary training programs. Brian asked to clarify if day programs or
sheltered workshops were considered training programs. Mary Ann did not have that information but
indicated she would be happy to get that information from Dale Matusevitch.
DOE REPORT
Mary Ann gave an update on the Elementary and Secondary Education Act of 1965 (ESEA) Flexibility
Waiver. Mary Ann reported that the waiver request is due in March. Without renewal all schools would
likely be labeled as failing (due to No Child Left Behind standards). The guidance document was
released by the feds in November and it is due in March. DOE is seeking public input on several
changes including: the use of a new multiple measure accountability system for capturing district and
state performance and updating expectations for school performance to be more in line with Smarter
Balanced scores. There are multiple town hall presentations scheduled and those dates and locations
have been sent out by GACEC staff. There is also the opportunity for a public presentation of the
proposal in March and all documents will be available on the Department of Education (DOE) website.
As always people can email the DOE accountability department with any input. Wendy asked Mary Ann
to update Council on the SB 229 regulations. Mary Ann shared that after meeting with Wendy, Robert
and Brian to explain the DOE opinion of how the Extended School Year (ESY) information was
connected. But since Brian explained that DOE was not in line with the state statute, DOE had no
problem making that change. The proposed regulations will be put out for public comment. In the
meantime, DOE is developing the training documents that will be used. Brian asked if the guidance for
districts would be available prior to the regulations being final since IEP meetings will begin taking place
in the spring. Mary Ann stated that the guidance document would be done the first week in February
and that it would be shared with GACEC.
DIRECTORS REPORT
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Wendy shared information about the Heart 2 Heart Hugs project that is ongoing. She shared that
despite little media support we have still managed to receive many items and will continue to collect
items until the distribution event on February 13, 2015. Karen Eller shared that Christina School district
shared information about the project in their newsletter. Howard Shiber asked for a copy of the drop
off locations and Wendy asked staff to forward that information to him. Wendy shared that there were
about 400 attendees at the LIFE conference, where an update on the DELDHUB website was given.
The Americans with Disabilities Act (ADA) Celebration will be held in July, 2015. Wendy shared that
DELDOT will be wrapping a bus to advertise the celebration and the ADA Legacy bus will be visiting
Delaware. Wendy asked for a motion for a letter of support for the Disability Law Program to be able
to share with their funding sources just how important the program is to individuals in Delaware. A
motion was made and approved for the letter of support. Wendy discussed the youth reentry task force
report that was shared with Council. She pointed out that they were requesting transition coordinators,
though they would be used in a different capacity than the transition coordinators recommended in the
State Transition Task Force for Emerging Adults with Disabilities and Special Health Care Needs Final
Report. Wendy encouraged everyone to read the report if they have not already done so. Delaware is
currently above the national average for youth recidivism. Wendy asked the committee chairs and cochairs to begin thinking about their submission for the annual report. Information will be emailed to the
chairs in the coming weeks. Wendy shared that she is pleased to know that GACEC will be
collaborating with the IEP parent satisfaction survey and looks forward to seeing that.
COMMITTEE REPORTS
ADULT TRANSITION SERVICES
Prior to reporting, Chair Cathy Cowin asked Mary Ann to update the group on the Age of Majority
issue. Mary Ann asked to come to the committee meeting in February to report, she will report to full
council during the DOE report and follow up with Adult Transition Services Committee if needed.
Cathy also commented that another topic that needs to be looked in to is mental health and the
transition of mental health services from school age to adulthood. Mary Ann advised that mental health
was identified as one of the behavioral components of the State Professional Development Grant
(SPDG), but that work is just beginning. Cathy shared that progress is being made in Sussex County
for transportation. Bonnie Hitch reported on a new flex program where riders can call in and have a
pick up scheduled for an area, within a half mile of the fixed route, via regular DART instead of using
Paratransit. Bonnie also shared that they are looking into taxi services. These initiatives will begin in
Sussex County. Emmanuel Jenkins presented on his new non-profit endeavor, “We Stand 4
Something”. Emmanuel is a strong self-advocate who has a lot of ambitious ideas on how to help
others and promote self-advocacy.
CHILDREN AND YOUTH
Karen shared that there will be a report called the Plan to Achieve Health Equity for Delawareans with
Disabilities on the Health Care Commission website. The group also spoke about starting the Adapted
PE ad hoc committee up again. Karen shared that Mary Ann will be joining the group in the future to
share data and an update on restraint and seclusion.
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INFANT AND EARLY CHILDHOOD
Verna Thompson, from DOE, shared information on the State Performance Plan and Annual
Performance Report (APR) early childhood indicators 6, 7 and 12. Verna also shared information
regarding the transition from Part C to Part B. The group requested a thank you note be sent to Verna.
POLICY AND LAW
The committee recommended Council take action as recommended in the legal memo on items 7, 8 and
11. The committee recommended taking action on item 9 as noted in the memo with the addition of the
recommendation to define the acronyms in section 3.12 and 4.11 and take action on item 10 as
recommended with the addition of a comment on section 7.3. The committee stated that there is
tension between the authorization to submit an audit electronically versus a requirement of submission
of a bound volume. Items 4 and 5 were addressed by Mary Ann. On Senate Bill 10, Council will
support an amendment to add an additional member, a representative of GACEC appointed by the
Council, to the committee. The recommendation was voted on and approved. Commentary on the
regulations was as follows:
7. DSS Proposed Child Care Subsidy Program, Child Support Policies Regulation [18 DE Reg. 514
(1/1/15)]
The Division of Social Services (DSS) administers a federally subsidized child care subsidy program.
Eligibility extends to individuals meeting several criteria, including Temporary Aid to Needy Families
(TANF) beneficiaries and families with “special needs” children. See 16 DE Admin Code 11002.4.
Historically, participants have been required to cooperate with the Division of Child Support
Enforcement as a condition of eligibility. The Division is proposing to delete all regulations requiring
such cooperation. The rationale is included in the “Summary of Proposed Changes” section on p. 505.
Justification includes the following: 1) elimination of delays in accessing child care services; 2)
undermining informal arrangements in which non-custodial parents provide supports; and 3) fear of
retribution in domestic violence situations.
The committee recommends endorsement. The Child Care Subsidy Program is an important support
service for individuals enrolled in vocational training or engaging in employment. The committee
discussed only one minor observation. Section 11004.11 refers to a six month interim report. The
committee did not identify any other references to a 6-month report within Chapter 11000. DSS may
wish to assess whether the 6-month report is still current practice. If it is, the Division may wish to
revise the following sentence: “Only child care/food benefit cases will receive an interim report.” We
suspect that the word “receive” should be “require”.
8. DMMA Proposed Medicaid Inpatient Rehabilitation Hospital Regulation [18 DE Reg. 509 (1/1/15)]
The Division of Medicaid & Medical Assistance (DMMA) proposes to amend the Medicaid State Plan
in the context of Freestanding Inpatient Hospital Services.

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As background, the Division published a notice of proposed amendment to the standards governing
reimbursement methodology for freestanding inpatient rehabilitation hospitals in November, 2014. It is
now publishing a conforming Medicaid State Plan amendment in the Register with a December 1, 2014
effective date. The standards would apply to patients discharged on or after December 1, 2014.
DMMA is adopting the Medicare payment standards and rates. The Medicare system classifies patients
into distinct groups based on their clinical characteristics and what each patient’s expected resource
needs will be. At p. 512. The Division notes that “Medicare rates are updated annually to reflect
changes in local wages using the hospital wage index.” At pp. 511 and 512.
The committee did not identify any concerns with the proposed standards. At the same time, covered
facilities may benefit from using a similar reimbursement system for both Medicaid and Medicare
patients. The committee recommends endorsement.
9. DMMA Proposed Certification & Regulation of Medicaid MCOs Regulation [18 DE Reg. 504
(1/1/15)]
The Division of Medicaid & Medical Assistance (DMMA) is proposing to adopt standards for fiscal
solvency of Medicaid managed care organizations (MCOs).
As background, DMMA contracts with MCOs to administer the Diamond State Health Plan and
Diamond State Health Plan Plus programs. At pp. 504-505. Federal regulation [42 C.F.R. §438.116]
requires MCOs to either meet state solvency standards for private health maintenance organizations or
be licensed or certified by the state as a risk-bearing entity. Delaware DMMA is adopting the second
option, i.e., it will certify MCOs which meet certain standards contained in the proposed regulation.
The committee identified the following concerns.
First, on p. 504, the references to 42 C.F.R. §483.1 and 42 C.F.R. §483.116 are incorrect. The correct
citations are 42 C.F.R. §438.1 and 42 C.F.R. §438.116 respectively.
Second, §3.1.2 requires an MCO to demonstrate “net equity in excess of $[10] million.” At a
minimum, the brackets should be deleted. On a substantive level, we question whether net equity of
$10 million is sufficient. The Medicaid population in Delaware has grown to approximately 230,000
individuals. See DHSS Secretary’s FY16 budget presentation to OMB (November 20, 2014), available
at http://www.dhss.delaware.gov/dhss/index.html. Most of the Delaware Medicaid population is
served by two MCOs (Highmark; UnitedHealth Care). Assuming equal enrollment, each MCO would
serve 115,000 individuals and have approximately $86 in equity for each participant. Some of the $10
million in equity could be in fixed or non-liquid assets out-of state or out of the country. The
committee recognizes that the managed care system is intended to not tap equity, i.e., monthly State
capitation payments (§5.2) should ideally cover MCO outlays. Moreover, DMMA enjoys the
protection of a performance bond equal to one month’s capitation payment. In reality, an MCO could
suffer huge losses if an epidemic or natural disaster resulted in unanticipated health costs. An MCO
with only $10 million in net equity may be unable to absorb such costs.
Third, §5.0 may merit further review to ensure consistency. On the one hand, an MCO is required to
submit a performance bond equal to the projected first month’s capitation payment “up front”. See
§§5.1 and 5.2. On the other hand, §5.4 requires MCO supplementation of the bond “if the performance
bond falls below 90% of the first month’s capitation in any month”. Literally, this could never occur
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since the performance bond based on 100% of the first month’s capitation amount was already
submitted to DMMA up front. If DMMA intends that the MCO increase the bond based on later
increases in monthly capitation amounts, the regulation should be reworded.
Fourth, §9.1 contemplates MCO maintenance of a system for tracking incurred but unreported costs
and unpaid claims by category (e.g. hospital; nursing facility). The MCO is expected to review its
system annually and DHSS can prompt adjustments. DMMA may wish to consider requiring a 6month report of data under this section. If a year passes, and the system/methodology has resulted in
grossly inadequate reservation of funds, it may be too late to intervene in the face of huge unpaid bills.
Fifth, it is unclear when the performance bond required by §5.0 lapses. Obviously, an MCO which
terminates its participation as an MCO will still have to cover bills incurred during the contract period.
It is possible that the DMMA-MCO contract addresses the duration of the performance bond. If it does
not, the regulation could be revised to include some standards.
The committee recommends sharing these observations with the Division.
10. DLTCRP Financial Capability Reporting Regulation [18 DE Reg. 497 (1/1/15)]
The Division of Long Term Care Residents Protection (DLTCRP) proposes to adopt a set of regulations
covering the financial “soundness” of licensed long-term care facilities with three (3) or more residents.
In general, the standards appeared to be straightforward. However, the committee did identify several
grammatical and formatting concerns.
First, in §3.0, definition of “Affiliate”, the committee recommends deleting the forward slash between
“directly” and “indirectly”. The committee also recommends substituting a comma for the semicolon
after “indirectly”.
Second, in §3.0, insert a period at the end of the definitions of “Department” and “Division”.
Third, in §3.0, definition of “Facility”, the committee recommends substituting “which” for “and”
between “§1102(4)” and “is”.
Fourth, in §4.1.2, the committee recommends substituting a comma for the semicolon before
“including”.
Fifth, the term “home of record” is used in §§4.1.6 - 4.1.9. The committee is not familiar with this
term. It is a term used in the military to denote the location from which one enlisted. It does not
appear to be a “term of art” in corporate or financial contexts. To avoid confusion, the Division may
wish to adopt a different term or provide a definition.
Sixth, in §7.3, delete the “s” in “Departments”.
Seventh, in §13.1.6, consider inserting “of the” between “any)” and “facility”.
Eighth, in §13.1.9, last “sentence”, the grammar is somewhat awkward. Consider substituting the
following sentence: “Prior to the expiration of the emergency order and any extension of such order, the
Department will make a final determination regarding the facility’s ongoing licensure status.”
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Ninth, §14.2 recites as follows:
Financial documents submitted pursuant to these regulations are not departmental records and
are not subject to 29 Del.C. Chapter 100.
This is inaccurate and could adversely impact the ability of the Department to introduce the documents
in any hearing. The financial documents are Departmental records which are acquired in the
Department’s ordinary course of business. They qualify as a “record” but they are not a “public” record
by operation of Title 29 Del.C. §10002(l)(2) which exempts the following:
(2) Trade secrets and commercial or financial information obtained from a person which is of a
privileged or confidential nature;...
Consider the following substitute sentence:
14.2 The Department will consider financial documents submitted pursuant to these regulations
as exempt from public disclosure consistent with Title 29 Del.C. §10002(l)(2).
The committee recommends sharing these observations with the Division.

11. DOE Proposed Alternate Routes to Teacher Licensure & Certification Program Regulation [18 DE
Reg. 496 (1/1/15)]
The Professional Standards Board of the Department of Education proposes to readopt its regulation
entitled “Alternate Routes to Teacher Licensure and Certification Program” with no changes. It was
last reauthorized more than five years ago. See 13 DE Reg. 642 (November 1, 2009). In 2009, the
GACEC and SCPD recommended only non-substantive edits which were incorporated into the
regulation. See 13 DE Reg. at 642.
The committee skimmed the regulation and did not identify any further concerns. We recommend
endorsement.

MEMBERSHIP COMMITTEE
There was no report at this time.
PERSONNEL COMMITTEE
There was no report at this time.
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OUTSIDE COMMITTEE UPDATES
The next meeting on House Bill 90 will be held on Tuesday February 17th at Buena Vista. It appears
that the majority agree that students should not be assessed prior to admission. Robert shared that the
Gateway Lab School has received an extension on their charter renewal and he will be meeting with
them in the coming week to check on their progress. Bill Doolittle shared that the IEP Task Force is
now complete and the report has been published. Wendy asked if Council wanted to issue support for
the Task Force report. Brian Hartman made a motion that Council write a letter endorsing the
recommendations of the report. The motion was approved. Dafne shared information on the Autism
Task Force. The final report is not yet due. The group is meeting twice a month to discuss services for
individuals with autism across the life span. There are subcommittees that are working on some
legislation changes. Once there is a draft prepared, the GACEC will have access to it.
CHAIR REPORT
Robert shared information on the meeting that took place with David Blowman regarding the flexible
funding pilot. Robert shared that the group had additional questions and a letter has been drafted.
Dafne requested approval for a letter thanking Mr. Blowman for his time and presentation and sharing
GACEC concerns that the basic units as well as the pre-K units should be excluded from the flexibility.
Additionally, the group appreciated his willingness to make sure that School Nurses were also excluded
from the flexibility. Dafne asked for a motion to approve the letter. The motion was made and Brian
Hartman shared additional comments regarding the 98% rule, that funding follow the students. It is
important that this rule not be undermined. The group also requested that language be put in the
epilogue about reporting; specifically that it state that DOE can require reporting in a specific format so
that the data can be aggregated. This will allow for more efficient reporting and usable data. The
motion to send the letter to Mr. Blowman was made and approved.
Robert appointed Terri Hancharick as the chair of the Nominating Committee. Anyone interested in
serving on the committee should reach out to Terri. Robert shared a letter from the Vision Coalition
with the Council. The letter is available for reading for anyone who is interested. Wendy shared that
this is progress because although the GACEC has been invited to the table in the past, this is the first
time we have received a response to our comments.
After announcing guests, Robert asked for and received a motion to adjourn. The motion was approved
and the meeting was adjourned at 8:49 p.m.

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