Tag Archives: Arizona

The History of Medicaid and How it Can Affect Your Life

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This blog is going to be a little different as I am going to write about the history of Medicaid. Why, you ask, is this important? Well I am going to let you, as the reader, decide if it is or not. What I hope is that this information will encourage you to look up your own state’s Medicaid system information available from the “Medicaid Info by State” menu tab above.

As early as 1945, President Truman proposed a national health care program to Congress. He was concerned about the lack of health care for all Americans, but particularly for children. It took 20 years for the United States Congress to vote on a national health care program and pass it into law. President Johnson signed the law in July, 1965, to create the Medicaid and Medicare programs. Medicaid was designed to provide health services to people who cannot afford them on their own. Medicaid services and programs are managed by each state. The services provided and eligibility requirements may vary from state to state although minimum levels are set by the federal government. Use the “Medicaid Info by State” or the “What is Medicaid?” menu tabs above to get more information.

Of course, the Medicaid program has changed over the years. For example, in 1981 the waiver program was added to allow people to have some choice in selecting their health care provider and their home- or community-based care program. The waiver program is not just to pay for traditional physical care but also to help people learn how to do tasks. For example, a provider of Medicaid waiver services might teach people how to clean their home so that they can live on their own in the community. It also allows people to have more say in which services are the most important to them, because they have the greatest impact on their lives.

Although President Johnson signed the law to create Medicaid (and Medicare) in 1965, it took until 1982 for all 50 of the states to participate. The last state to join the Medicaid program was Arizona.

Another of the services that has been added to Medicaid is dental care. Getting access to dental care has been a big problem for people with intellectual and developmental disabilities—one study found that more than one-fifth of people with I/DD did not brush their teeth daily. Medicaid can help solve this problem. Not all states participate in the dental care portion of Medicaid so check above (in the “Medicaid Info by State” tab) to see if your state provides it.

A change in the Medicaid program will be coming in 2014 with the Affordable Health Care Act of 2010, which will expand the number of people who will be eligible for Medicaid services. It will provide Medicaid for more low-income families, even if they do not have children.

I encourage you to find out more about your own state’s Medicaid program so that you know if you are eligible for Medicaid, if you might become eligible, and so you know of all of the appropriate services you can get. If you would like more information about the history of Medicaid, please see:

http://www.cms.gov/About-CMS/Agency-Information/History/index.html?redirect=/history/
http://www.ssa.gov/policy/docs/statcomps/supplement/2011/medicaid.html

Providers’ Perspectives on Cuts to Medicaid

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I am very excited about writing this issue of my blog because I think it is on a very important and timely issue. Over the next few months I will present different perspectives of self-advocates, families and providers regarding how they feel about Medicaid budget cuts.

In this month’s blog, providers from Arizona, Ohio, and Colorado were interviewed. They did not wish to be identified by their full names.

The Answers

Medicaid services in many states have been cut in the past few years. First, I asked providers if they had experienced any cuts to their state Medicaid budgets.

S.W. from Arizona said, “The rate providers are paid for our home and community based waiver has been cut. The people we serve have talked to me about how concerned they are about losing their staff and services. We are also worried about keeping the same quality of staff we have had in the past.”

J.R. from Ohio said their Medicaid funding had been reduced. Ohio has 88 counties and each of those counties has to raise their own state match for their Medicaid funding. Ohio is a diverse state with urban and rural counties and this can make it hard for the rural counties to make the state match. He said, “the state of our economy has forced us to have people live together whether they want to or not.”

M.E. from Colorado said, “Our services were cut by 4.5% last year. We also have had a delay in the growth of services in the past 2 years.”

In addition to affecting the amount of services they can provide, cuts to Medicaid can also change the way states deliver and pay for services.

S.W. said: “All organizations and agencies have to be more effective and productive with the resources we have. Staff have to be more creative also when they are working with the people we provide services to so that all the people we serve feel safe and still feel like they can do all the things they have in the past.”

M.E. says that Colorado has proposed capping their behavioral services program. Their day programs were recently capped at 200 days for a 50 week year due to shortfall in their budget. In 2009 Colorado went to a fee for services model, and he says that after 3 years everyone agrees it was a mistake. But he says that there is a light at the end of the tunnel: “We will have 173 people taken off our waiting list in the 2014 budget.”

Providers are also trying to work with self-advocates to educate legislators and the rest of the community about how cuts affect service delivery.

S.W. said, “We are educating ourselves, the individuals we serve, and other providers and community organizations or agencies to work together so we can educate our legislators.  Everyone wants to be treated with respect and dignity.”

J.R. said, “Families have developed partnerships in all of our communities so we can educate and support each other.”

M.E. says, “The providers all work together to stay in contact. We have a state newsletter to share information with all interested parties. We have a strong partnership between people with developmental disabilities and the organizations or agencies that support them. I think we have a great partnership that is invested in working very hard to make it the best it can be for all citizens of Colorado.”

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