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Post by blueskye101 on Feb 12, 2019 0:57:47 GMT -5
Check out @staceyabrams’s Tweet:
Anyone know what this is all about and how it will affect everyday U.S. pwd's?
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Post by darthoso on Feb 12, 2019 10:17:48 GMT -5
The Federal Government requires that State Medicaid programs cover nursing homes as part of their standard coverage. A Medicaid Waiver is basically a permission slip from the Feds to the States authorizing them to offer coverage and services outside the normal scope of Medicaid (both in terms of services and eligibility), many States have a waiver for HIV patients. In the US most home based personal care services are ran by State Medicaid Waiver programs. The issue with the waiver system is that they often have a limited number of slots and in many cases there is a wait list that is several years long. Here in NC, the waiver I should be on has a wait list of over a decade (I'm on a lesser waiver but still had to wait 4 years). Most frustrating from an economic perspective is that slots and services don't carry over from State to State, so if I get offered a job in Virginia, I would have to start completely over again on a Virginia waiver and wait list. Every state runs their program completely differently in terms of the bureaucracy and services offered (in New York I could get 24/7, in NC I get 93 hours a week).
One of the provisions in the Affordable Care Act (Obamacare) was Community First Choice which offered the States a ton of money to eliminate and abolish their wait lists. Unfortunately only 7 States took the offer (California, Oregon, Maryland, Montana, Washington, Texas, Connecticut) despite in some cases the State would actually run surplus from the extra federal money (looking at you Illinois).
Since carrots don't seem to work, the Disability Integration Act is the stick. It gives the States the mandate of eliminating their wait lists in 10 years or lose a ton of money.
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Post by blueskye101 on Feb 12, 2019 21:22:09 GMT -5
The Federal Government requires that State Medicaid programs cover nursing homes as part of their standard coverage. A Medicaid Waiver is basically a permission slip from the Feds to the States authorizing them to offer coverage and services outside the normal scope of Medicaid (both in terms of services and eligibility), many States have a waiver for HIV patients. In the US most home based personal care services are ran by State Medicaid Waiver programs. The issue with the waiver system is that they often have a limited number of slots and in many cases there is a wait list that is several years long. Here in NC, the waiver I should be on has a wait list of over a decade (I'm on a lesser waiver but still had to wait 4 years). Most frustrating from an economic perspective is that slots and services don't carry over from State to State, so if I get offered a job in Virginia, I would have to start completely over again on a Virginia waiver and wait list. Every state runs their program completely differently in terms of the bureaucracy and services offered (in New York I could get 24/7, in NC I get 93 hours a week). One of the provisions in the Affordable Care Act (Obamacare) was Community First Choice which offered the States a ton of money to eliminate and abolish their wait lists. Unfortunately only 7 States took the offer (California, Oregon, Maryland, Montana, Washington, Texas, Connecticut) despite in some cases the State would actually run surplus from the extra federal money (looking at you Illinois). Since carrots don't seem to work, the Disability Integration Act is the stick. It gives the States the mandate of eliminating their wait lists in 10 years or lose a ton of money. Still...10 years not that quick. Thanks darthoso for explaining. |
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Post by darthoso on Feb 12, 2019 21:40:21 GMT -5
The Federal Government requires that State Medicaid programs cover nursing homes as part of their standard coverage. A Medicaid Waiver is basically a permission slip from the Feds to the States authorizing them to offer coverage and services outside the normal scope of Medicaid (both in terms of services and eligibility), many States have a waiver for HIV patients. In the US most home based personal care services are ran by State Medicaid Waiver programs. The issue with the waiver system is that they often have a limited number of slots and in many cases there is a wait list that is several years long. Here in NC, the waiver I should be on has a wait list of over a decade (I'm on a lesser waiver but still had to wait 4 years). Most frustrating from an economic perspective is that slots and services don't carry over from State to State, so if I get offered a job in Virginia, I would have to start completely over again on a Virginia waiver and wait list. Every state runs their program completely differently in terms of the bureaucracy and services offered (in New York I could get 24/7, in NC I get 93 hours a week). One of the provisions in the Affordable Care Act (Obamacare) was Community First Choice which offered the States a ton of money to eliminate and abolish their wait lists. Unfortunately only 7 States took the offer (California, Oregon, Maryland, Montana, Washington, Texas, Connecticut) despite in some cases the State would actually run surplus from the extra federal money (looking at you Illinois). Since carrots don't seem to work, the Disability Integration Act is the stick. It gives the States the mandate of eliminating their wait lists in 10 years or lose a ton of money. Still...10 years not that quick. Thanks darthoso for explaining. It's not, but the biggest issue is the bureaucracy adapting. Each State does it their own way and some just suck at it. Unfortunately it's only getting worse with Electronic Visit Verification coming for PCA services. |
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Post by Deleted on Feb 13, 2019 3:55:23 GMT -5
The Federal Government requires that State Medicaid programs cover nursing homes as part of their standard coverage. A Medicaid Waiver is basically a permission slip from the Feds to the States authorizing them to offer coverage and services outside the normal scope of Medicaid (both in terms of services and eligibility), many States have a waiver for HIV patients. In the US most home based personal care services are ran by State Medicaid Waiver programs. The issue with the waiver system is that they often have a limited number of slots and in many cases there is a wait list that is several years long. Here in NC, the waiver I should be on has a wait list of over a decade (I'm on a lesser waiver but still had to wait 4 years). Most frustrating from an economic perspective is that slots and services don't carry over from State to State, so if I get offered a job in Virginia, I would have to start completely over again on a Virginia waiver and wait list. Every state runs their program completely differently in terms of the bureaucracy and services offered (in New York I could get 24/7, in NC I get 93 hours a week). One of the provisions in the Affordable Care Act (Obamacare) was Community First Choice which offered the States a ton of money to eliminate and abolish their wait lists. Unfortunately only 7 States took the offer (California, Oregon, Maryland, Montana, Washington, Texas, Connecticut) despite in some cases the State would actually run surplus from the extra federal money (looking at you Illinois). Since carrots don't seem to work, the Disability Integration Act is the stick. It gives the States the mandate of eliminating their wait lists in 10 years or lose a ton of money. I need to save this for future reference when I’m needing to argue with my right wing friends on why this is vitally important |
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