Medicaid, Medicaid Waivers, Medicare, Supplemental Security Income (SSI), and Family Support
topic to begin:
Covering Kids &
Families - Covering Kids
& Families works to reduce the number of
uninsured children and adults who are eligible for public health care coverage
programs but not enrolled.
$7 Billion Hidden in Small Type
- So much commentary on government focuses on headline issues, the
ones easily chewed and spun into bumper stickers and soundbites. Let us consider
something else, something that those who know the newspaper industry know might
be stuck in the agate columns. If one massed about
220,000 people in Michigan into one spot, it would be a pretty sizeable fondue
of flesh. It would, in fact, qualify as the second largest city in the state...
Florida Medicaid Recipients Want Out of Nursing Homes
- Charles Todd Lee spent a lifetime
going backstage at concerts, following politicians on the campaign trail and
capturing iconic shots of everyone from Martin Luther King Jr. to Mick
Jagger to Mickey Mantle. Today, he enjoys such
freedom only in his dreams.
Districts Face Medicaid Funding Cuts, Increased Compliance Requirements
- What's ahead for school districts in terms of their ability to continue
to access Medicaid? Schools may lose $635 million for the 2008-2009 school
year. In addition, proposed rule changes will in many cases stop payments
for services rendered in schools that Medicaid long has covered.
Medicaid Rule Would Allow Thousands To Choose Community Supports Instead of
Institutional Care - A proposal by the U.S. Centers for Medicare and
Medicaid Services would allow thousands of Americans, who previously could
only receive Medicaid-funded services in nursing homes and other
institutions, to be given the choice to receive them in their homes.
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 arenít eligible for Medicaid),
but administrators say it also will hurt American citizens.
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
Medicaid Fee Schedule Master Site
Manual and Bulletin Updates for Medicaid Program Policy:
Order Form (Word Document)
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.
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.
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).
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.
SSI Federal Benefit
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,
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
or Sharon Ladin
Both Good and Risk in Bush Medicaid Proposal
Michigan Medicaid Summit
Granholm is calling for broad participation
by all stakeholders in shaping the future of the
Medicaid '900-Lb Gorilla'
State Must Wrestle With, Panel Told
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.
Wrong on parent/Non-Parent Benefits
Federal Rule on Medicaid for Emergency Services
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.
Gongwer 12-3-02 U.S.
Court Allows Medicaid Suit
HHS Releases Spanish-Language Guide to Medicaid, CHIP Programs
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.
Read the 29 page brief "Medicaid
and School Billing" (pdf version)
State, Drug Companies
Argue New Medicaid Drug Plan
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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, out of home placement.
with developmental disabilities and who have
challenging behaviors and/or complex medical needs are
served through this program.
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
services include (see State of
Michigan website for most up to date info):
services (e.g. music, recreation, art and message
environmental accessibility adaptations, and
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.
more information regarding eligibility or to submit a
prescreen application for the program contact your
local Community Mental Health Services Program.
Note: The CWP Manual dated
2004 is no longer valid even though it is easily
found across the internet. Please only refer to the
complete Medicaid Manual. Search through the
subsections to find the information you need.
Michigan Medicaid Provider
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
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 -
How to request a Medicaid Fair Waiver
Hearing (Michigan): Instructions
(PDF; size=89k) and Request Form
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.
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
The Alternative to Institutionalization
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 state for this.
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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 Childrenís
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 sessionsí presentations and handouts as well as to additional reports,
Web sites, and other resources.
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.
Doctors to see
decrease in Medicare payments in 2003
Read the article "Bush's
New Freedom Equals a 'little freedom'
for Americans with Disabilities
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.
"Homebound" Rule Update
Medicare intends to
cover use of Neuromuscular
Electrical Stimulation -
to Help People with Spinal
Cord Injury Walk.
Read the article "OmniCare ills haunt health care:
Debt grew under state's watch"
from the Detroit News, July 14, 2002.
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Supplemental Security Income (SSI) Information
Legal Planning for Special Needs In Massachusetts: A Family
Guide to SSI, Guardianship, and Estate Planning -
Attorney Barbara Jackins' new book is a must have resource
for parents of children with special needs and the
professionals and advocates who assist parents. In an
easy-to-read, conversational style, she covers the essential
elements of SSI, guardianship, and estate planning when
there is a child with a disability in the family. Although
some of the materials are specific to Massachusetts, most of
the strategies she discusses are valid in any state. Don't
live in Massachusetts? Then you can simply ignore the fine
points about that state's guardianship laws and procedures.
The rest of the book--her practical estate planning
strategies and SSI pointers-- will get you on track no
matter where you live.
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.
Whatís the Big Idea? - Thereís more than one solution
for Social Security. Here are nine ways to keep the system
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
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.
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
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.
The long awaited Part 3 of 3
in the SSI Parent Brief Series, titled "Supplemental
Security Income: Your Right to Appeal", is now available
the National Center on Secondary Education and
Transition (NCSET) -
FREE Social Security Resource: Sign up for the
Social Security Administration's E-News
- choose your topic of interest and receive a free monthly
Questions and Answers
(Across the state and country, parents communicate
with each other sharing
information and advice via the
Internet. With their permission we are
sharing some of those questions and answers.)
My 18 year old was approved for SSI early this
year. Two weeks ago he got his
Medicaid card with a letter
telling him that he must join a
Medicaid health Plan to receive benefits. We are in Wayne
County and I would like to ask for some input which
plan would be a good choice. The
choices are Botsford Health
plan, Cape health plan, Great
Lakes health plan, M-Care, Midwest, Molina healthcare of
MI, The Wellness Plan and
Total Health Care. I do not have any
experience with any of these plans and would
appreciate any input.
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 and
Medicaid eligible. On the other hand I have used
Wellness Plan and the
Great Lakes Health Care Plan for myself and my other
daughter. You may want to ask
around about the plans you are considering. Try the
hospital you would like to
utilize for your son, the
pharmacy, the doctors and
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).
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Family Support Subsidy (FSS) Information
MICHIGAN Family Support Subsidy (FSS)
Pamphlet & Information (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
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 (Michiganís 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.
The Michigan Department of Community Health's section on the Family
Support Subsidy can be found here: http://www.michigan.gov/mdch/0,1607,7-132-2941_4868_7145-14670--,00.html
Changes to the
Administrative Rules for Special Education and Their Impact on
the Family Support Subsidy (FSS)
Program - Memo from
Jim Haveman, Director of the Michigan Department of Community
Health, to Tom Watkins, Superintendent of Public Instruction,
July 8, 2002
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Children's Special Health Care Services
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
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.
select the "Children's Special Health Care Services" course, create a
FREE account and begin! It's that easy.
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