◊ JOB MATCH
 

May 16, 2005

As the state prepares to announce proposed changes to a Medicaid program that serves mentally retarded and developmentally disabled children and adults, advocates say they want to be more involved in the decision-making process.

The Title XIX Waiver program's draft renewal application is scheduled to be posted online today at www.wvdhhr.org/bms/ and will be discussed at several public forums next month, said state Bureau of Medical Services Commissioner Nancy Atkins.

"We may be changing the parameters a little bit to do better utilization and to hopefully meet the needs more of the clientele and to make it more self-directed," Atkins said last week.

Advocates say participating in the public forums is not enough because by that time the plan is already written.

"We want to be part of the development, we want to be on the front end," said Ken Ervin, organizer of ADAPT West Virginia. "Don't make us outsiders in our own lives."

"Comments are not the same as dialogue," said Scott Miller, coordinator of the People's Advocacy Information and Resource Services Center.

Atkins said the state has worked with the West Virginia Developmental Disabilities Council and the West Virginia University Center for Excellence in Disabilities, considered volumes of written comment from advocates and consumers and met with advocates earlier this year.

Tailoring Medicaid services to fit a person's individual needs is one idea proposed by advocates that state officials are considering, Atkins said. Clients have complained that service providers require them to accept unneeded help to get the services they do need, so the agencies can boost their bills.

Miller developed a case study of a client whose care cost $12,279 a month for nine services. But the woman only needed three services, which would cost about $6,535, Miller said. If the woman could build her own budget around only the services she needs, that would save the state about $5,744 a month or $68,928 a year, Miller said.

Atkins said that's one direction the state may go.

"We're leaning to where you would have an assessment of a person's needs, and based on those needs they'd have an allocation of so much resources to purchase the services that they want or need as opposed to, ‘Here's your plan of care and you must receive those services,' " Atkins said.

But the state has to balance that with "folks who say, ‘I need every service I get. Don't take anything away from me,' " Atkins said.

West Virginia is considering several proposals to cut $115.7 million out of Medicaid, which faces a $156 million deficit. Overall, about 373,000 West Virginians receive services from the state-federal health care program for the needy, aged, blind and disabled and low-income families with children.

The Medicaid Title XIX Waiver program waives Medicaid family income guidelines for middle-income families and provides services to more than 3,800 adults and children who otherwise would have to live in a residential care facility for the mentally retarded. The idea is it is cheaper for the government to pay for services that allow people to stay in their own homes than it is to pay for institutions.

West Virginia has to renew its waiver application every five years.
 

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This page last updated Friday 17 June 2005