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Meeting held to consider benefit waiver redesign

Posted: Friday, Apr 26th, 2013

EVANSTON — Deep cuts are coming rapidly to the budgets of disability programs, providers of disability services and case management personnel. The problem comes from four percent cuts to the federal Medicaid and Medicare programs which subsidize much of the care for the disabled and handicapped. The federal government is cutting those funds by four percent, and other federal funding reductions may be on the way, as well.

On April 17, a presentation was given at Evanston High School on proposed changes to the design of state waivers that will incorporate the changes. Chris Newman, senior administrator for the Wyoming Department of Health, gave the presentation and explained the cuts coming to local residents and residents across the state.

The bottom line of the presentation was that 534 individuals across the state have been on waiting lists for much-needed assistance, and new federal regulations require these individuals be added to the existing programs — but with no additional funding from them to the state. What this means is individuals already receiving assistance through the state department of health’s behavioral health division will likely see cuts made to their benefits to accommodate new additions to the system.

“There will be cuts,” Newman stated emphatically. “The budget for the department of health is being cut by four percent in 2014.”

The presentation was offered in an effort to collect public comments and opinions, and to educate the public about the impending cuts to budgets and services, and the redesign of the waivers. The agenda for the presentation stated the purposes of the meeting were to explain the process for handling the waiver redesign, review how the changes came about, detail the waiver design changes and take public comments and questions.

Under the proposed changes there will be no flexibility in the budget amounts for individuals receiving assistance, though no basic amounts have been set at this time. The new waiver system will create three separate waivers. There will be support, comprehensive and acquired brain injury waivers after the changes are implemented. Only the acquired brain injury waivers stay the same. Budgets are to be figured and set on an individual basis, but present budgets for individuals will be reduced and fixed once the changes to the system are in place.

The reduction in federal funds to the state and from the state level to counties and municipalities was brought about by the passage of SEA 82, the federal Medicaid Reform Bill.

“Current individualized budget amounts (IBA) will be reduced,” literature handed out at the presentation read. “[It is] impossible to serve more without reducing current IBAs.”

One of the most contentious items discussed during the presentation was case management. Under new rules, it is stated the new case management system will be free of conflicts of interest. Though this sounds straightforward at first reading, what it actually means is no case manager will be allowed to be employed by any provider of services on a person’s plan.

“Had I known you were going to interpret the legislation in this way, I never would have voted for it,” local state senator Paul Barnard said at the meeting. “This was not the intent of what we voted for, and the interpretation will be corrected.”

Under current programs, case managers for individuals do work for the various providers within existing systems. This is the way providers make certain the individuals are receiving the care and services they need, and that the individuals are living within their existing budgets. The new rules would require case management be handled by outside sources, and taken out of the hands of local providers.

The timeline for implementation of the new waiver system starts now and runs through June 30, 2015. The existing waiver system ends on June 30, 2015, as reflected by the new legislation. This means the state has little time to have a new waiver system in place.

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