No matter where you are this is the coming trend. Heed the warning it's happening right here in Pennsylvania!
Governor's Budget proposes to eliminate Medical Assistance for some children with disabilities!
The Governor's Budget proposes to eliminate Medical Assistance (Access) for several thousand Pennsylvanians including some children with disabilities. The Governor's Budget proposes to start
counting parents' income in determining eligibility for Medical Assistance for children with disabilities. Currently, parental income is not counted for Medical Assistance if the child is determined to have a severe disability. Under the Governor's proposal,children
whose parents had total annual incomes of $100,000 or more for a family of 4 would be INELIGIBLE for Medical Assistance! Presumably, the income limit would be lower for families of 3 or less and perhaps higher for larger families. The State would NOT consider the child's medical expenses or other expenses related to the child's disability. The Governor is proposing this cut to start sometime after July of this year.
If this proposal takes effect, children whose parents' income exceed the cap would have to find other funding sources for or lose services currently funded under Medical Assistance or HealthChoices such as:
· in-home nursing,
· prescriptions,
· nutritional supplements,
· medical equipment (wheelchairs, hearing aids, lifts, etc.)
· supplies (diapers, underpads, etc)
· reimbursement for transportation to medical appointments
· wraparound (TSS)
· residential treatment facilities.
Since some providers don't offer some of these services, like wraparound, for private pay or any other payment source, it could mean that the family would have to use some different service, even if they could afford to pay for the TSS. Furthermore, a family with income at the limit would be entitled to free services while a family with income just $1 above the limit would not get any Medical Assistance funding, regardless of the amount of their expenses.
Although this proposal was announced in the Governor's Budget, it does not need to be adopted as part of the State Budget. In fact, legislative action is not required for DPW to cap this category of Medical Assistance. Nonetheless, because the Governor included it in his proposed Budget, it is expected to be part of the general budget debate in the State Legislature. State Representatives and Senators who are Members of the House and Senate Appropriations Committees will have the opportunity to question the Department of Public Welfare on this and other cuts during hearings on March 5th (Senate) and March 6th (House).
This cut has been proposed as a cost savings measure. The Governor's Budget estimates this cut will save $1.2 million in the first year. However, the Governor's Budget does not appear to take into
consideration additional costs that may be incurred if this cut goes into effect. For example, if a family loses community supports as the result of the loss of Medical Assistance, and this results in the institutionalization of a child, Medical Assistance will HAVE TO pick up the cost of that child's institutional care once the child has been out of the parents' home for 1 month! This is required by current federal law which the State cannot change. The cost of that institutional care is most likely to be much more expensive than the community based supports the child could have received had Medical Assistance not been cut.
In addition, this proposed cut is likely to reduce the amount of federal funds currently available to many school districts for special education. Currently, school districts and IUs in Pennsylvania are eligible to participate in a special funding program run by the PA Department of Education called "Access". Under
this program, school districts can bill the State for certain special education costs incurred for students on Medical Assistance. These costs are then billed by the Department of Education to Medical Assistance which in turn draws down federal matching money. That
federal matching money is then returned to the school districts. Since the federal government only provides matching funds for those students who are on Medical Assistance, the fewer students on Medical Assistance, the less federal money school districts will get. Because the school districts would still have a legal
obligation to provide special education services, the reduction in federal funds will force school districts to make up the revenue shortfall from other sources, including possibly tax increases.
For further information, please contact the PA Health Law Project at 1-800-274-3258 or visit our website at www.phlp.org.
Be At Peace,
Deborah Delp
Mommy to Samantha (NT) and Jr (ASD)
What we do with our lives depends on our
motivation to do something with our lives.
D.A.Delp
Homepage:
http://the_delps.tripod.com/
Group:
http://groups.yahoo.com/group/autism_and_vaccinations
