TheDesk.info:
New
Online Resource for Navigating Medicaid - Announcing
the nation's first online Medicaid reference desk created
by advocates and consumers. Medicaid is the largest source
of funding for people with disabilities and those who
provide their care, but it is extremely complicated to
navigate. The content of the site was tailored with the
assistance of people who are using the Medicaid system and
is geared to help people with cognitive disabilities
better understand the system.
Covering Kids &
Families - Covering Kids
& Familiesworks to reduce the number of
uninsured children and adults who are eligible for public health care coverage
programs but not enrolled.
Medicaid Funding for Schools Cut - The new rule is expected to save
the federal government $3.6 billion over 5 years but will affect a wide
range of medical services such as speech, physical therapy.
New Medicaid Eligibility:
Documentation of Citizenship Now Required -
Health officials in many states warn that a federal law requiring Medicaid
recipients to prove citizenship starting July 1 could lead to long lines,
dropped coverage and general confusion for the program's participants. State
officials are scrambling to implement the new rules, because the Department of
health and Human Services told states only three weeks before the changes kick
in what documents are acceptable as proof of citizenship.At least 46 million poor people on Medicaid for the first time will need
to produce documents showing they were born in the United States or are here
legally, the result of a budget-cutting measure signed by President Bush in
February. The law targets illegal immigrants (who aren’t eligible for Medicaid),
but administrators say it also will hurt American citizens.
Protecting
Children's Health in Schools Act of 2006 (PDF) - Senator
Edward Kennedy of Massachusetts has introduced a new bill in the
U.S. Senate called the "Protecting Children's Health in Schools
Act of 2006". This act sets forward clear guidelines in the
statute for providing and receiving reimbursement for medical
care in schools, rather than put schools, families, and their
disabled children, and States in a situation where they are
uncertain whether or not these medically-necessary services and
related administrative and transportation costs will be covered
under Medicaid.
Deficit Reduction Act of 2005: Implications for Medicaid
(PDF) - This issue brief summarizes the Medicaid
provisions of the budget reconciliation law signed in February
2006 and discusses the implications of the proposed changes. The
changes would net reductions of $4.8 billion over the next five
years and $26.1 billion over the next ten years from current
Medicaid spending. Read about the many policy changes in the DRA,
which both reduces federal and state Medicaid spending and also
changes health care access and coverage for low-income
beneficiaries.
Commentary: A Trapped Quadriplegic
Speaks About Nursing Homes - I was told
Medicaid pays exactly $4,470 dollars a MONTH to house me in a nursing home.
If I were given two thousand dollars less, I could live in the community,
paying for my own assistance, and have a better quality of life. It would
save Medicaid $24,000 each year. Now, multiply that figure by the number of
people living in nursing homes who desire to live in the community and we
will quickly begin to get the System of Medicaid back on track and end the
momentous waste of your hard earned tax dollars.
Living in a House of Cards - Who gets hurt
when the Medicaid cuts kick in? To make ends meet, Brenda Benedict relies on
Medicaid to pay for her vital prescription drugs, and Missouri is weighing
proposals for deep cuts in that federal-state program, which provides health
care for more than 53 million poor, older and disabled Americans. Coverage
for people like Benedict, disabled but employed, has been targeted for
elimination by the state’s new Republican governor, Matt Blunt, who says
such cuts are needed to make Medicaid "sustainable and affordable for
Missouri taxpayers."
Understanding Medicare & Medicaid:
Fundamentals and Issues for the New
Congress - This briefing book was
distributed at an invitation-only seminar requested by congressional staff
to provide an overview of the Medicare, Medicaid, and State Children’s
Health Insurance programs. The sessions featured experts from the General
Accounting Office, Medicare Payment Advisory Commission, Congressional
Research Service, and Centers for Medicare and Medicaid Services, in
addition to other public and private entities. This book contains links to
the sessions’ presentations and handouts as well as to additional reports,
Web sites, and other resources.
Advice on Implementing a “Money Follows the Person” Program
- CMS issued another of its "Dear State Medicaid Director" letters
(dated 8/17/04, SMDL #04-005). This letter is an important handle you can
use to PERSUADE YOUR STATE Medicaid agency to move disabled persons into the
community. This CMS letter will help you when your State agency offers
excuses for why it cannot move disabled people into the community. CMS says
it can move them into the community and can do it under existing rules!
New Legislation Announced to Increase Wages of Direct Support Professionals
(PDF) - New legislation amending Title XIX of the
Social Security Act was announced by U.S. Representatives Lee Terry (R-NE) and
Lois Capps (D-CA) at the recent governmental activities seminar of the American
Network of Community Options and Resources (ANCOR) in Washington. The
legislation is designed to provide more funds to states to increase wages of
direct support professionals, who provide services to persons with disabilities.
IL
State Violating Medicaid
Laws - Illinois' health-care program for poor children violates federal
law because it fails to ensure that youngsters receive appropriate preventative
medicine, from immunizations to tests for lead in their blood, a federal judge
has ruled.
MI
Michigan Medicaid Long Term Care
Task Force Named - Today, Gov. Jennifer Granholm announced that she has
appointed the members of a task force specifically designed to improve
Michigan's long-term care service network.
MI
Cutting Health Plan Could Leave Kids in Michigan Vulnerable
- Cutting back on Medicaid means more than just crossing line items
off a ledger. Saving money on government health care can hurt people like LeAnna
Dickerson and her daughter, Kaytya. The 31-year-old Detroit mom relies on
Medicaid to pay the bills for care of her 3-year-old daughter, who has a rare
disease that causes her brain to protrude from her skull.
[4-04]
The Special Education &
Medicaid KnowledgeBase is a project of the Region VII Comprehensive Center
and Northrop Grumman Information Technology. The purpose of the Special
Education & Medication KnowledgeBase is to support schools through the difficult
process of claiming Medicaid dollars for eligible services by explaining in
plain language the process of Medicaid claiming. There is no fee and no
registration required to access the KnowledgeBase at
http://www.helpforschools.com/medicaid/.
Medicaid Reform
Information - Medicaid is the most valuable public resource for children
and adults with disabilities to access health and long-term supports and
services in the community. The nation's largest program serving the needs of
low-income Americans with disabilities, Medicaid serves nearly 11 million people
with disabilities, of whom 7 million are under age 65. With so many federal
policy decisions being made related to Medicaid, AUCD has created this site to
help network members and the public navigate all the information about new
proposals to reform Medicaid and information about legislation and public policy
changes related to Olmstead.
MI Michigan Medicaid Expanded To
Relatives - Low-income grandparents and other
relatives who live with and care for non-birth children may qualify for medical
coverage under new rules from the Department of Community Health (DCH) and
Department of Human Services (FIA).
MI Kinship Caregivers May
Receive Medicaid -
Low-income grandparents and other relatives living with
and caring for non-birth children may be eligible to
receive Medicaid benefits as the result of a federal court
order in a case brought by kinship caregivers.
Medicaid Fact Sheets Available: The National
Association of Children's Hospitals and Related
Institutions (NACHRI), together with the American Academy
of Pediatrics (AAP), has produced a series of one-page,
state -specific fact sheets about the issue of children
and Medicaid. The fact sheets are written in simple, easy
to understand language, and focus on why Medicaid is
important to the health of so many of America's children.
NACHRI and AAP have mailed copies of the fact sheets to
every candidate for Congress or governor. All 51 fact
sheets are now available on the NACHRI web site,
www.childrenshospitals.net,
however you must have Acrobat Reader, as they are in PDF
format. NACHRI encourages you to share these fact sheets.
If you have any questions about the fact sheets, please
contact either Suzanne Hansen
shansen@nachri.orgor Sharon Ladin
sladin@nachri.orgat
703-684-1355.
Schools Decry New Guidance on Medicaid - A battery of
district officials nationwide are alarmed by proposed Medicaid
guidelines that they say could mean striking losses in aid for
coordinating medical services for needy students, particularly
those in special education.
MI
Ruling won't force in-home Medicaid - Ingham County Circuit Judge Peter Houk has
upheld a ruling saying Medicaid is not required to pay for
medical services for people living in their own homes.
HHS Releases Spanish-Language Guide to Medicaid, CHIP Programs
- HHS
Secretary Tommy Thompson on July 23 released a new bilingual booklet
to provide information to low-income Spanish-speaking parents whose
children may qualify for CHIP or Medicaid. HHS will distribute the
13-page booklet, titled "Protect Your Family's Health ... With
Confidence," to community health centers and other organizations and
will work with states that "want to add information about their
programs" to the booklet. The booklet includes four sections: one that
explains the importance of health insurance in children's health care,
one that explains the enrollment process and benefits for CHIP and
Medicaid, one that provides answers to questions about eligibility
requirements and other issues; and one that provides explanations of
terms used in the enrollment process. Thompson said, "States have made
the SCHIP program a dramatic success, and a key element of that is
making sure families sign up their eligible children." He added, "The
new booklet will help to expand health insurance coverage to eligible
children in the Hispanic community by providing information to
families about benefits available to their kids."
- from Monday Morning in Washington, D.C.
The
Children's Waiver Program (CWP)is a federal entitlement program that provides
Medicaid funded home and community-based services to
children (under age 18) who are eligible for, and at
risk of, placement into an Intermediate Care Facility
for the Mentally Retarded (ICF/MR).
Children
with developmental disabilities and who have
challenging behaviors and/or complex medical needs are
served through this program.
The CWP
enables children to remain in their parent's home or
return to their parent's home from out-of-home
placements, while receiving regular Medicaid State
Plan services (i.e., case management, private duty
nursing) and waiver services, regardless of their
parent's income.
The waiver
services include:
family
training
specialty
services (e.g. music, recreation, art and message
therapy)
community
living supports
transportation
respite
care
environmental accessibility adaptations, and
specialty
medical equipment.
The program
has a capacity to serve 417 children statewide.
Although the program is at capacity, a waiting list is
maintained, using a priority rating system to add new
children to the program when openings occur.
To request
more information regarding eligibility or to submit a
prescreen application for the program contact your
local Community Mental Health Services Program.
MiChildWaiver Listerv: This list is intended to be a place for
recipients of the Michigan Child Waiver to engage in
dialog on Self-Determination and the Children's Waiver/Choice Voucher.
The
National
Association of State Medicaid Directors (NASMD) - A very informative
website that contains different types of information, data, and statistics. It
also contains data on children enrolled in 1915c waivers by state, age and
program. Also includes information on 1915b and 1115 Waivers. This group is a
bipartisan, professional, nonprofit organization of representatives of state
Medicaid agencies. The primary purposes of NASMD are: to serve as a focal point
of communication between the states and the federal government, and to provide
an information network among the states on issues pertinent to the Medicaid
program.
Understanding Medicaid Home and Community Services: A Primer, is an
excellent resource manual available online from the U.S. Department of Health
and Human Services. It can be downloaded in PDF format, but is 246 pages long
and may take a long time to print it.
Overview of the Michigan Dept. of
Community Health (MDCH) Children's
Home and Community-Based Services (HCBS)
Waiver Program -
click here.
How to request a Medicaid Fair Waiver
Hearing (Michigan): Instructions
(PDF; size=89k) and Request Form
(PDF; size=113k)
Medicaid Manual Chapter III (PDF; Michigan) has been updated to correct some
errors and to add information regarding children's waiver.
Medicaid Waivers: Tips & Comments From
Parents - click here.
Medicaid Waivers in the State of Michigan: The
Michigan Department of Community Mental Health handles the
Medicaid Waivers. They have closed the waiver slots for
all adults and children. Michigan Protection and Advocacy
has initiated action against the state for this. Here is a
link to the article from MPAS regarding the waiver issue:
http://www.mpas.org/Article.asp?TOPIC=10854.
Additionally the requirements to meet skilled nursing
needs in the state of Michigan changed radically as of
February 1, 2002.
MI
Children's
Waiver Program: The Children's Waiver Program is a
federal entitlement program which enables Medicaid to fund
necessary home and community-based services for children
(under age 18) who are eligible for, and are at risk of,
placement into an Intermediate Care Facility for the
Mentally Retarded.
State
Freezes Waiver Slots, Litigation Filed -
The Michigan Department of Community Mental Health
handles the Medicaid Waivers. They have closed the waiver slots
for all adults and children.
Michigan Protection and Advocacy has initiated action against
the statefor this.
Understanding Medicare & Medicaid:
Fundamentals and Issues for the New
Congress - This briefing book was
distributed at an invitation-only seminar requested by congressional staff
to provide an overview of the Medicare, Medicaid, and State Children’s
Health Insurance programs. The sessions featured experts from the General
Accounting Office, Medicare Payment Advisory Commission, Congressional
Research Service, and Centers for Medicare and Medicaid Services, in
addition to other public and private entities. This book contains links to
the sessions’ presentations and handouts as well as to additional reports,
Web sites, and other resources.
Low Income
Americans on Medicare Receive Drug Discount Cards -
The U.S. Health & Human Services reports that HHS Secretary Tommy G.
Thompson announced on September 22 that nearly two million low-income Americans
on Medicare will soon be automatically eligible for prescription discounts
through the Medicare Drug Discount card and qualify for an additional $1,200 in
savings over the next 14 months.
HHS
Urges States To Continue To Expand Home & Community
Based Care For Disabled Residents - HHS Sec. Tommy G. Thompson yesterday urged
America's governors to make continued efforts to overcome the
institutional bias in Medicaid programs by providing benefits outside
of nursing homes to Americans with disabilities. Secretary Thompson
noted that states already have many affordable community-based options
for serving people with disabilities, and he pointed to a new Web site
identifying promising practices.
Locate your local
Social Security Office -
click
here.
Social Security
Revamps Disability Benefits - People seeking disability
benefits from Social Security can expect to spend less time
waiting for a decision under changes rolled out Tuesday on the
anniversary of the Americans with Disabilities Act. Social
Security Commissioner Jo Anne Barnhart said people who are
clearly disabled could be approved for benefits in as little
as 20 days under the new procedures, which the agency expects
to start putting into action next spring.
What’s the Big Idea? - There’s more than one solution
for Social Security. Here are nine ways to keep the system
solvent.
Social Security Options Abound - As it stands now, by
2017 the system will begin paying out more in benefits than it
collects in taxes. By 2041, it will have exhausted its
reserves and be able to pay 74 percent of benefits, according
to the program's trustees. Most options involve cutting
benefits, raising taxes or a combination of both.
Social Security: What We Can Learn From
Chile's Experiment by Susan Q. Stranahan, AARP Bulletin, April 08, 2005 As the debate over President Bush's proposals for Social
Security heats up, you can expect to hear a lot of talk about
Chile-if you haven't already. Why Chile? In 1981 it became the
first country to use private accounts as part of its
retirement system, and since then more than a dozen nations in
Latin America and Europe have followed suit. Bush has said
that the United States could "take some lessons from Chile"
and has called its system "a great example". The program's
chief architect is Jose Pinera, a Harvard-educated economist
who was Chile's minister of labor and social security from
1978 to 1980 in the government of Gen. Augusto Pinochet. He's
now co-chairman of the Cato Institute's Project on Social
Security Choice-an idea the free market think tank has been
pushing since 1979. In Chile, workers can invest 10 to 20
percent of their pretax income in private retirement accounts,
selecting stocks or bonds from half a dozen pension funds.
Investments are tax free until retirement. Historically, the
rate of return has exceeded 10 percent. But now, as the first
wave of participants reaches retirement age, many of them are
discovering that their private nest eggs are far smaller than
they expected, partly because the fees and commissions paid to
fund managers have typically ranged from 25 to 30 percent.
Many retirees are learning they would have fared better in the
government-run system, which provides pensions of $140 to
$1,250 a month. Only about half of Chile's workers have
private accounts. The rest stayed in the government system or
have no retirement insurance at all. Consequently, Chile still
spends 5 to 6 percent of its gross domestic product on
retirement benefits; by comparison, Social Security costs in
the United States total 4.2 percent of GDP.
The
Other Side of the Social Security
Debate: What Social Security Means to Children and
Families: The National Center for Children in
Poverty (NCCP)notes that
over five million children benefit from
Social Security, either directly as beneficiaries, as
dependents of workers who have become disabled, or
indirectly as family members in households where an adult
relies on Social Security. Here are
several documents from the NCCP on this matter:
Why Social Security Matters to Children and Families: What
Every Policymaker Should Know-
Five page fact sheet
loaded with information and statistics, with endnotes.
Whose Security? What Social Security Means to Children and
Families- Policy brief
describes the role that Social Security plays in
protecting America's children
and argues that the current debate ignores how
privatization and benefit cuts will impact our most
vulnerable population's
children.
Social Security
Debate and Persons With Disabilities (PWD) - As the
Administration begins to push to privatize Social Security,
persons with disabilities have been virtually absent from the
public discourse. The disability community should be asking
their elected federal representatives some critical questions
regarding the program.
Report Examines How The
Federal Government Defines Disability in Different Ways - A
report by the AARP examines how four national surveys
conducted by the federal government in the U.S. define and
measure a critical aspect of disability--whether the
disability limits the person's ability to perform daily
activities. Read Disability: Federal Survey Definitions,
Measurements, and Estimates at
http://research.aarp.org/il/dd98_disability.pdf.
The long awaited Part 3 of 3
in the SSI Parent Brief Series, titled "Supplemental
Security Income: Your Right to Appeal", is now available
from
the National Center on Secondary Education and
Transition (NCSET) -
click here.
FREE Social Security Resource: Sign up for the
Social Security Administration's E-News at
http://www.ssa.gov/enews/
- choose your topic of interest and receive a free monthly
newsletter.
Parent-to-Parent
Questions and Answers (Across the state and country, parents communicate
with each other sharing
information and advice via the
Internet. With their permission we aresharing some of those questions and answers.)
Question:
My 18 year old was approved for SSI early this
year. Two weeksago he got his
Medicaid cardwith a letter
telling him that he must join a
Medicaid health Plan to receive benefits. We are in WayneCounty and I would like to ask for some input which
plan would be agood choice. The
choices are BotsfordHealth
plan, Cape health plan, Great
Lakes health plan, M-Care, Midwest, Molina healthcare ofMI, TheWellness Plan and
Total Health Care. I do not have anyexperience with any of these plans and wouldappreciate any input.
Answer:I choose to stay with the Basic Plan (as
opposed to the more traditional
HMO you listed above) for my
daughter who is 18 and happens to be CSHCS andMedicaid eligible. On the other hand I have usedWellness Plan and the
Great Lakes Health Care Plan for myself and my other
daughter. You may wantto askaround about the plans you are considering. Try the
hospital youwould like to
utilize for your son, the
pharmacy, the doctors and
specialist's office. Here are a few other informational
pages that may beofinterest for you.
http://www.mlan.net/cle/PB/questions_to_ask_MI_enrolls.PDF
and
http://www.michigan.gov/documents/Your_Rights_-_English_10585_7.pdf
Social Security for
Parents: Benefits for Disabled Children -
A child who is
disabled may depend on your help for the rest of their
lives. Social Security has two programs that pay
disability benefits to disabled children: Social Security
Disability Insurance and Supplemental Security Income (SSI).
MICHIGAN Family Support Subsidy (FSS)
Pamphlet & Information (PDF)
http://www.michigan.gov/documents/brochure03(english)_92625_7.pdf
If you have a child who is labeled (educationally) as AI, SXI, or SMI (see
brochure for definitions) you may qualify for a subsidy of $222.11 per
month. Comes in the form of a check made out to the parent/guardian each
month. Taxable income MUST fall below $60,000 per year. In cases in which
the child is not receiving special education services or if it is not known
if the child is receiving special education services, parents may contact
the director of special education at their local or intermediate school
district. They can also call Early On/Project Find at 1-800-252-0052 to be
connected with their local ISD, Early On Coordinator, or Project Find
Coordinator. For information on Early On, visit
http://www.bridges4kids.org.
For information on Project Find, visit
http://www.projectfindmichigan.org. Don't want to download the
brochure? Here's another way to get info: CMHSPs (Michigan’s Community
Mental Health Services Programs) can provide additional information on the
Family Support Subsidy Program. Questions or requests for applications
should be directed to your local CMHSP. If you are unable to find the name
of the contact person and telephone number at your CMHSP, call the Michigan
Department of Community Health Family Support Subsidy Program office in
Lansing at 517-335-9480. The TTY number is 517-373-3573.
MI
Federal Court Upholds State Medicaid Formulary - Michigan's Medicaid drug
formulary - a program to save the state money by requiring drug companies to
agree to discount the cost of their drugs to be included on an approved drug
list - has been upheld as lawful by the U.S. Circuit Court of Appeals for the
District of Columbia.
Exercise Religiously
- As he signed the Americans with Disabilities Act in 1990,
President George H. W. Bush said that the law would "ensure that
people with disabilities are given the basic guarantees . . .
freedom of choice, control of their lives, the opportunity to
blend fully and equally into the . . . mosaic of the American
mainstream."
U.S.
Beltway Briefs - SSA To Update
Rules For Evaluating Mental Retardation and OSEP Indicates
Respite Services Not Required Under IDEA Part C
MI Update on
Maternal & Infant Support Services (MSS/ISS) Changes - At
recent System Update meetings several Coordinators had asked
for further information about the changes to MSS/ISS program.
The revised policy relating to MSS/ISS has been posted at the
Michigan Department of Community Health website as of today.
If you would like to read/print it for yourself, see below.
Go to
www.michigan.gov/mdch. Scroll down to the bottom of
the page, and find a box labeled "Feature". Click on "Medicaid
Policy" - scroll down to the section labeled "Policy
Bulletins" and click on "Maternal and Infant Support Services
03-01" with an issue date of April 1.
National Governors Association (NGA) Center for
Best Practices - The
mission of the NGA Center for Best Practices is to help Governors and
their key policy staff develop and implement innovative solutions to
governance and policy challenges facing them in their states Through
the staff of the NGA Center, Governors and their policy advisors
can: quickly learn about what works, what doesn't, and what lessons
can be learned from others grappling with the same problems; obtain
assistance in designing and implementing new programs or in making
current programs more effective; and receive up-to-date information
about what is happening in other state capitals and in Washington,
D.C., so Governors are better prepared to react to emerging issues.
Children's Special Health Care Services (CSHCS) is a
program within the Department of Community Health.
It is for children and some adults with special
health care needs and their families. It
helps persons with chronic health problems by providing:
Coverage and referral for specialty services, based on the
child's health problems. Family centered services to
support you in your primary role as caretaker of your
child. Community-based services to help you care for your
child at home and maintain normal routines. Culturally
competent services which demonstrate awareness of cultural
differences. Coordinated services to pull together the
services of many different providers who work within
different agencies.
Free Online Course: "What is Children's Special
Health Care Services?" - This course covers the basics of
Michigan's Children's Special Health Care Services (CSHCS) program.
The course is designed to assure that all "relevant" professionals
have sufficient knowledge to respond appropriately to potentially
eligible families. It also may help families understand who may be
eligible for the CSHCS program and get other information.
Professionals and families who are in touch with persons with
disabilities/special needs will gain straight-forward, useful
information. The aim of offering this course is to boost understanding
so that all who may be eligible will be referred to CSHCS. Course
features: ten sections that cover a wide range of topics; links to
resources for families; readily accessible and easy to use; take in
one sitting or many; average completion time is 45 minutes or less.
Visit http://healthcare.mivu.org,
select the "Children's Special Health Care Services" course, create a
FREE account and begin! It's that easy.
