September 30, 2006

 

Dearest Advocates:

 

There was an article in the AJC newspaper today on the Medicaid situation written by Andy Miller (jamiller@ajc.com ).  Although I appreciate the coverage of the Medicaid situation, I do not think this article really explained the urgency and concern families and providers have within the Medicaid system (difficulty in getting services, paperwork, lack of providers due to the amount of paperwork, people being denied, etc). 

 

Here is the AJC article ....Just in case you missed it:

 

In addition, there was a comment in the article about Katie Beckett Waiver families having primary insurance (which kind of makes it sound like it's not a big deal if they don't have Medicaid).......We all know how important having Medicaid as secondary insurance is because most of our primary healthcare insurance companies do not pay for a lot of the services needed (especially for children with disabilities - which includes therapy).

 

PLEASE take a minute to help the AJC newspaper understand the urgency and need for reform in the entire Medicaid system. Explain to them that they need to have more in-depth articles done about this situation!

 

This is why we are having the Healthcare for Kids Rally on November 4th.........To make healthcare a priority in this state! 

 

Send your e-mails to Andy (jamiller@ajc.com) and the editor ( letters@ajc.com) .

 

We need to continue to educate the State on the issues impacting our children and the media is a great tool to do so. Please let the AJC know how this has impacted your family!

 

Thanks again for your continued efforts in making the "real" issues known.

 

United...We Will Make A Difference!

 

Sincerely,

Heidi

 

October 1, 2006

 

(Please note: This is a long e-mail…you may want to print out to read!)

 

Dearest Advocates:

 

As we have started down this path of having a Healthcare for Kids Rally, I’ve discovered that not everyone has been aware of all the activity that has happened in the last few months…….

 

Since June 2006, we have met with Dept. of Community Health’s Director of Medicaid, Commissioner, as well as, the Governor’s office to discuss the concerns and solutions associated with healthcare for children in this State.  Unfortunately, NONE of the recommendations were implemented nor discussed any further for consideration.

 

This is exactly why it has come to a point where we need to get our elected officials attention on healthcare and making it a priority in this state! Working with the media, having the rally, educating the public on our issues is the only other alternative we have in making the necessary changes needed for our children. 

 

This is an election year…..we are hardworking, tax-paying, voting citizens and we don’t want our tax $$$ wasted on red tape, non-productive processes that add no value to the system and continue to decrease the amount of services our children need, as well as, access to providers due to these processes.

 

Here is an example of some of the concerns and solutions that were discussed in these meetings…….

-Implement a 1-800 number to call to check on status, enter your ref # for information on your current status. (Submission approval, deadlines, receipt, denial, appeal status, etc).

-Have DFCS caseworker on the phone prepared to help parents walk through the paper work or tell them resources they can utilize to find answers instead of yes and no answers which lead to no assistance in filing out paper work or meeting criteria.

-Have more explicit instructions on how to fill out all the forms.

-Change renewals from every year to every 3 yrs (depending on the child’s functional / behavioral needs, independence, medical needs, diagnosis, etc).

 

-Parents should receive in writing if they are re- approved or denied. Currently, families only receive notices if they are denied. This will eliminate families wondering and unnecessary calls to GMCF or their DFACS caseworkers.

 

-Fair treatment of providers.   Provide a fair and equitable payment to providers on a timely basis.

 

-Do not require IEP's.

 

-If a child is denied, make the reasons very clear.  It will make it easier to everyone and for the parent to accept the ruling is correct or appeal if warranted.  The information submitted during the appeal would be more accurate and with necessary specifics.

 

-Independent Advisory Committee:  A panel of families who can act as an advisory committee/clearing house for issues and feedback for the Director of Medicaid.  This could provide tremendous support and guidance to the entire Medicaid System.  

 

-Having psychological evaluation done on children (sometimes every year) even though it is very obvious the child qualifies due to the child's diagnosis and ability to not function on their own at all is just another expense Medicaid will pay for with no value added.  Need to really look at the “value” of having psychological evaluations done on an on-going basis (very expensive).

 

-Streamline paperwork - many forms are repetitive information.  Make forms relevant for waivers and not generic across Medicaid.

 

-Having a way to find out the status of our renewal application – whether online or via our caseworker.

 

-Parents would like to receive an Explanation of Benefits (EOB) from Medicaid for services charged to their child’s account. We realize that this is available on the web but it’s hard to get a password and remember to check the account. A quarterly statement would be helpful to make sure the services have been provided. Therefore, possibly saving Medicaid money with less fraudulent charges to the system

 

(Please note: Many of the suggestions were compiled from the 250+ families and providers that submitted their ideas last spring to me specifically in the disability community.  I put together an actual 4 page report that was given to DCH, DFCS and Governor’s office on all those suggestions. The three primary areas of concern were: Communication, Training and Process issues.  The goal is to maximize our resources to better service children with and without disabilities in the State of Georgia.  Thank you so much for everyone that participated in these suggestions)

 

As you can see, I have personally tried very hard to work within the system, but it has not worked. We have to UNITE our voices for OUR children!  I know not everyone feels  that a Rally is going to make a difference but what other options do we have at this point? 

 

We must continue to work with the media to educate the State on our issues and hopefully help our elected officials understand how important this issue is to us!

 

I hope this clarifies some of your questions. Please understand, I am just a parent like many of you (and do not get paid for my advocacy efforts for our children)……..Right now I’m averaging over 400 e-mails a day so please understand that I can not respond to everyone. 

 

I’m very excited about the Rally and hope everyone will participate in the largest grassroots effort this State has ever seen.  We are starting to get the media coverage we deserve on the issues  and need to let the media know we appreciate their continued coverage of these issues like the CBS investigative report and the AJC article this weekend and FOX’s report a few weeks ago on the therapy situation.

 

We need to be a part of the solution and work with our elected officials on getting the services and processes we need for our children’s healthcare!

 

Please go to our website at www.kidshealthcarega.org for more updates. It is currently under construction but more content will be posted very soon. We will be issuing a press release very soon on the full intent our advocacy group….Stay Tuned for further information……..

 

UNITED…WE WILL MAKE A DIFFERENCE!

 

Sincerely,

 

Heidi

 

October 1, 2006

 

Dearest Advocate:

 

I was just informed that CBS WCTV 6 in Valdosta covered the meeting families and providers had with Lt. Gov. Mark Taylor over the weekend regarding concerns with children's healthcare and the Medicaid system. 

 

Here is the link:

http://www.wctv6.com/ (go to "Featured Videos" and click on "Lt. Governor Mark Taylor Campaign".)

 

Please take a moment to thank the reporter, Roxanna Haynes (roxanna.haynes@wctv6.com) and cc: news@wctv6.com for their continued coverage of this very difficult situation for families and providers in the State!

 

As I stated before, education and awareness is the key to making our issues known and hopefully resolved.

 

Healthcare must be a priority for our children and the providers that service them!

 

Thanks to Sara for letting me know about the coverage. Keep up the great work everyone!

 

Sincerely, Heidi

 

Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org

 

October 4, 2006

 

Dearest Advocates:

 

I received this today about the "Foundation" the State of Georgia is putting together as part of the $7.6 million that was allocated for children that were denied the Katie Beckett Waiver due to the changes in criteria from October 05 forward.

 

If you are interested in being part of this group, PLEASE contact Kristina Aranas directly.  I've also attached a document with further information. (I"ll post this info on the "files" section of the list serve as well).

 

This is another way of getting involved for our children!

 

Sincerely,

Heidi

========================================

 

Hello!

The Community Foundation for Greater Atlanta is actively seeking assistance
with the new Health Services Initiative, focusing on medically fragile
children and their families. We hope that you will help us spread the word
about this new opportunity. The Request for Proposals for this new
initiative is attached to this email and will also be available on
Opportunity Knocks and The Community Foundation website. Should you have
any questions, please feel free to contact me via phone or email. Questions
regarding proposal submissions will be fielded in the beginning of October.
Thank you in advance for your help!

Kristina M. Arañas
Program Associate
The Community Foundation for Greater Atlanta
404-588-3213 direct line
http://www.atlcf.org

 

 

October 5, 2006

 

Dearest Advocates:

 

Below is a letter from Children's Healthcare of Atlanta (CHOA) that will be issued out to the parents regarding their recent changes to therapy services this week. In addition they are also going to be issuing an instructional sheet on how to find providers from the DCH system, and Frequently Asked Questions from DCH.

 

The bottom line is CHOA is going to be discharging our children (that are considered "chronic" which means children with disabilities) to a system that does not have the support to handle the additional therapy providers. We can't find providers now....How are those families going to be able to find providers then (that accept Medicaid too)?

 

The paperwork is burdensome, adds no value, increases the time to administer and is costing tax payers more $$ for the system to review these requests...than just to pay for the services the children need to begin with!

 

We have just been given the "proof" that DCH said they did not have with access to care for our children. There is not access now for a large population of children effective 11/1/06 due to these changes at CHOA.

 

I will be working on this issue and hope to have further information next week. Sincerely, Heidi

======================================

Here is the CHOA letter that will issued to parents this week...................................................

 

Dear Parent:

 

Children's Healthcare of Atlanta wants to make sure you are aware of recent changes to the administration of Medicaid implemented by the Georgia Department of Community Health (DCH).  We understand these changes may impact the way your child’s rehabilitation services are provided and want to work with you to help ensure that your child’s rehabilitation care is continued appropriately for your child’s condition.

 

The DCH and Medicaid program:

 

will only authorize treatment at Children's or other hospital-based programs for patients who have an acute injury, illness, or impairment
clarified that children with chronic conditions and impairments must be seen through the Children's Intervention Services (CIS) program, which is community-based therapy rather than hospital-based therapy
indicates that it does not plan to cut, reduce or eliminate therapy services to Medicaid-eligible children
requires prior authorization through your Medicaid health plan for all therapy services
 

Children’s is evaluating these changes to ensure that we are operating within the DCH’s rules and guidelines while continuing to provide our patients with the quality healthcare for which we are known.

 

To find out more about these changes and to help you choose a CIS program for your child’s therapy services, visit Provider Information at www.ghp.georgia.gov or contact Sharon Collins at the Division of Medical Assistance at (404) 463-6096.

 

Sincerely,

 

Carol Salmons

Manager, Rehabilitation

=====================================

--
Heidi J. Moore
(Proud Mother to Jacob - 6 years old with Down syndrome & Jared - 5 years old)

"Help The Children Now, So They Can Help Themselves Later!"

The material contained in this e-mail is for general information only. It
is not intended in any way to provide or offer legal advice. To obtain
legal advice, please consult with your attorney or a qualified legal

Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org

October 16, 2006

 

Dearest Advocates:

 

I just wanted to let you know of some exciting news regarding our media campaign for the Healthcare for Kids Rally.  The more we bring public awareness to our concerns with healthcare in this state the better! If you have a chance to listen and send thank yous to the radio stations- that would be great. We need to let them know we appreciate their support of this important issue!

 

Public Service Announcements and radio interviews will start airing this next week!

• WAEC-AM (860) said they may run the PSA (will follow up to find out time/date)
• WGUN-AM (1010) said they will air the PSA beginning Nov. 1 at the latest
• WYZE-AM (1480) said they will air the PSA the week of Oct. 23.

 

Radio Show Interviews

• Radio Sandy Springs (1620 AM) on the Public Access Show with David Moxley and Marshall Hamilton live on Monday, October 16 from 5:00 to 6:30 p.m. Unless you are very close to the station you may not be able to listen in your car, but you can listen on your computer by going to www.radiosandysprings.com . After 7 PM they will have an Infectious Disease Update Program with Dr. Michael Dailey and his guest tonight Dr. Patrick O’Neal the Director of Georgia’s Emergency Medical Preparedness Program.
• WYAY-FM (Eagle 106.7) on the Eagle Report with Greg Talmadge scheduled for Sunday, October 22 at 6:30 am. 
• WGUN-AM on the “Atlanta Issues” show with Karen Lovejoy to be taped an aired on Saturday, October 28^th from 7:30 to 8 a.m.
•  

As you can see our public relations committee for the Rally has been hard at work and we plan on issuing an “official” press release about the Rally TODAY  to the media. You will find the press release on our website www.kidshealthcarega.org in the "In the News" section.

 

Once again, I just want to say thank you for everyone’s on-going support to this critical issue. Hope to see you on November 4^th (bring your family, friends, neighbors,etc). A large amount of people showing up for the Rally will help us prove to our elected officials how important this issue is to our State! Healthcare must be a priority!  United…WE Will Make A Difference!

 

Sincerely,

Heidi

 

Please join us for the Healthcare for Kids Rally to be held on November 4, 2006 at 9:30am at the GA State Capitol. For more info., please go to: www.kidshealthcarega.org