Medicaid and Mental Health Facilities

Lawmakers and mental health advocates agreed during a Senate hearing Wednesday that Medicaid should pay for short-term stays at residential mental health facilities as part of the broader goal of improving access to such services.
At a hearing of the Senate Health, Education, Labor and Pensions Committee, mental health professionals praised efforts to allow Medicaid to cover these services and otherwise increasing resources for patients with severe mental illness

As NYS Phases Out Workshops, Agencies Seeking Alternatives for Individuals

Sheltered workshops, once considered a progressive alternative to institutionalizing the developmentally disabled, could soon be artifacts of a different era and philosophy. 

Gerard McEneaney, 56, at his
sheltered workshop.

New York State ended new admissions to sheltered workshops as of July 1, 2013, and will stop funding for them in 2020 -- the result of the state's April 2013 agreement with the U.S. Centers for Medicare & Medicaid Services (CMS).

Parents, Advocates Blast Housing Plan

TRENTON — One parent of a man with autism called it confusing and terrifying. A housing developer of community housing for people with developmental disabilities called it "a misguided social experiment."

Marsha Adams testifies about
 her son who needs 24-hour care.

The Christie administration's sweeping proposal to promote community living and wider access to jobs and activities for the developmentally disabled was roundly criticized at an Assembly hearing at the Statehouse Thursday. Parents, advocates speciality home builders and community agencies said they feared the Department of Human Services' blueprint to spend a large portion of its Medicaid funding could disrupt the living arrangements and daily routines of thousands of people.

Delaware Divided on Housing Issue

The debate that divides Delaware's disability community, especially in matters of housing, has plenty of sharp edges.
Those edges have come into plain view since the federal agency that decides how to steer taxpayer support for disability services has changed the rule on how it will fund home- and community-based services.

Presidential Debate Brings Attention to State Medicaid Plans

GOP presidential candidate Mitt Romney has pushed for Medicaid block grants that would significantly cut program spending and provide states with the ultimate flexibility to design the health care program without Washington meddling.
But the two examples of state Medicaid programs he cited as success stories during Monday’s debate don’t quite fit the mold of traditional block grants — at least not the kind that Republicans have been clamoring for.

Editorial: Entitlement Changes, Misplaced Fear

The next time you hear someone say that Mitt Romney wants to “end Medicare as we know it,” consider what New Hampshire has done with Medicaid.
Last week, the federal government gave New Hampshire the final OK to switch to what is being called Medicaid managed care. The state has hired three companies to manage the coverage provided to the state’s Medicaid recipients. (Medicare is the subsidized government insurance program for seniors; Medicaid is for low-income and disabled individuals.)
With Washington’s approval last week, New Hampshire officially has ended Medicaid as we know it. The new managed care plan will end the state Medicaid program’s old fee-for-service model (in which patients go to the doctor and Medicaid pays for services individually) with a managed care plan in which the three contracted companies work with patients to more effectively spend health care dollars and provide better care.

500 Practices Selected for Primary Care Demo

WASHINGTON --  More than 2,000 physicians and health professionals will care for Medicare, Medicaid and private plan beneficiaries under the same new payment model aimed at coordinating care and keeping patients healthy to avoid costly admissions for inpatient care.

Roughly 500 physician practices in seven regions spread out over eight states successfully applied to participate in the Centers for Medicare & Medicaid Services-led comprehensive primary care initiative. Doctors will receive as much as $40 per high-risk patient per month to support care coordination and wellness programs. Practices that keep health spending below expenditure targets will share in the savings, but those that do not meet expectations might be asked to leave the project.

Kansas May File Medicaid Waiver Application Soon

TOPEKA, Kans. — The waiver application needed for Gov. Sam Brownback's proposed Medicaid makeover is nearly complete and could be filed with federal officials before the month is up, Brownback administration officials said yesterday.
Still unclear, an administration source said, was whether public hearings on the waiver application would be required in order to satisfy new federal regulations governing so-called Medicaid 1115 waiver applications.

Maryland to Get $28 Million Bonus for Children's Medicaid Enrollment

Maryland will receive a $28 million performance bonus from the U.S. Centers for Medicare and Medicaid Services for fiscal year 2011 for its consistent efforts to identify and enroll eligible children in Medicaid and CHIP coverage.
"Since 2007, we have expanded coverage to more than 300,000 Marylanders, almost half of them children, and this bonus is a great recognition of those efforts," Lt. Gov. Anthony Brown said in a written statement.
The bonus came as good news to a department that has had a series of negative audits in the past year identifying lack of control over Medicaid payments, benefits paid on behalf of dead people and $8 million in federal dollars that went unspent on those with developmental disabilities.

Brown Request to Cut Medicaid Puts White House In Difficult Position

From Healthwatch, The Hill's health care blog.

President Obama and congressional Democrats have been put in a tough spot by California Gov. Jerry Brown's (D) request to cut Medicaid spending 10 percent.
Brown says he needs to make the cuts to the state Medicaid program, known as Medi-Cal, to ease his state's severe budget woes. But advocates say cuts of that size would be devastating to California's most vulnerable residents.

Seeking a Chance to Live Independently

JACKSONVILLE, Fla. -- How will my child fare when he leaves home? And what will happen to him when I'm gone?
These are questions most parents worry about. But they weigh especially heavily on the parents of children with autism, Down syndrome and other developmental disabilities.
"Parents say this all the time: 'When I'm no longer here, I want to know they're still going to have a place to live and somebody is going to make sure they're OK,'" said Jim Whittaker, executive director of The Arc Jacksonville. "That's the biggest fear the majority of families have."

Study: Medicaid Kids Suffer Treatment Bias

CHICAGO- Children on Medicaid are much more likely than kids with private health insurance to be denied appointments with medical specialists, and they wait longer on average to be seen, according to a “secret shopper” study of clinics in Cook County.

Two-thirds of fictitious Medicaid patients were denied appointments compared to 11 percent of privately insured patients, researchers reported in Thursday’s New England Journal of Medicine.

Research assistants posing as mothers of sick children called to make appointments for specialty care at 273 clinics one month apart. In one call, they told the clinic they had public insurance. In the other, they said they were privately insured.

In 89 clinics that accepted both types of insurance, children with public insurance also waited 22 days longer on average for an appointment with a specialist.

And in more than half of the phone calls, the caller was asked what kind of insurance their child had before an appointment could be scheduled.

Tennessee Limits at-Home Services

NASHVILLE, Tenn. — Tennessee is limiting the amount of home-nursing and personal assistance services for people with intellectual and developmental disabilities to reduce budget costs, an approach that could push more people into community-based homes.
The Tennessee Department of Intellectual and Developmental Disabilities has been notifying families who use the at-home Medicaid waiver programs of the new limits since March. The department has been looking to make the changes for two years and got approval in February from the Centers for Medicare and Medicaid.

Vermont Ranks No. 1 in Medicaid Services

Vermont offers the best Medicaid services for individuals with intellectual and developmental disabilities while Mississippi provides the worst, according to an annual ranking released Thursday.
The 50-state analysis from United Cerebral Palsy compares services offered across the country, giving preference to states where more individuals are served in the community as opposed to institutions.

Nursing Homes See Younger Patients

FLORENCE, Ala. -- An analysis of federal data from the Department of Health and Human Services by National Public Radio found people between ages 31 and 64 comprise 14 percent of the nursing home population. That’s up from 10 percent a decade ago.
The trend is playing out in Alabama as well, according to Louis Cottrell, executive director of the Alabama Nursing Home Association.
"We are seeing younger residents who are either disabled or developmentally disabled coming to nursing homes," he said. "I'm afraid we're going to see that number grow."