Government Waste and Inefficiencies
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 reference # 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 paperwork or tell them resources they can utilize to find answers instead of yes and no answers which lead to n o assistance in filling out paperwork or meeting criteria.
- Have more explicit instructions on how to fill out all the forms.
- Change renewals from every year to every 3 years (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 DFCS 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 for 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/clearinghouse for issues and feedback for the Director of Medicaid. This panel should be composed of families whose children have moved from Katie Beckett Waiver to another waiver program given their child is now over 18 and parents that are currently under various waivers as well. 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 not to 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.
- Having a live person to deal with would save huge amounts of aggravation, stress and anxiety, which directly affects many families.
(Please note: Many of the suggestions above 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 the 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 emails a day so please understand that I cannot 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. Wee 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 look around our website for even more information about why this issue is so very critical to all citizens of Georgia.
UNITED....WE WILL MAKE A DIFFERENCE!
Sincerely,
Heidi J. Moore
Rally Founder and Director
