NC Innovations Waiver: Not So Unbiased. It Matters the Disorder!?
There is a waiting list for the Innovations Waiver. I don’t know about you, but when I go to the grocery store and I am in line to check out, if someone butts in front of me without my permission (because they have one item) I call that “cutting in line.” Apparently “cutting in line” is allowed in the Innovations Waiver.
The North Carolina Medicaid Innovations Waiver 1915 (b)/(c) Medicaid Waiver for MH/DD/SA Services supposedly set in place to serve those Medicaid recipients suffering from mental health, substance abuse, and developmental disabilities (MH/DD/SA).
Basically, if you are a woman in NC and have the possibility of having a baby, go ahead and apply for the NC Innovations Waiver at age 15. Since there is a 7-10 year waiting period, if you happen to give birth to a developmentally disabled child within 7-10 years, then your child will be covered by the Innovations Waiver.
On the other side, if you do not apply pre-pregnancy, your developmentally disabled child will be 7-10 BEFORE the child would be covered by the Innovations Waiver.
On CNN today, I heard that treatment for an autistic child runs approximately $80,000/year. That number is astronomical. If I made millions, MAYBE, $80,000 would be nothing to me. But let’s be realistic. How are these families with autistic children paying $80,000/year for health services? I know for a fact, I would not be able to fund that amount.
So, what if you have a “moderately” autistic child with limited funds? You would think that if you place your child on the Innovations Waiver at age 0, that your child would receive Waiver services within 7-10 years, according to the “wait list,” right?
Wrong. The Innovations Waiver waiting period is not based on date. As in if you file your application in 2001 and another person files in 2005, the 2005 applicant may be bumped above you depending on subjective ideas on what determines “moderate” or “severe.”
Let someone intricately involved with the waiver explain:
A wonderful woman with an adult, mentally-handicapped child emailed the following to me:
“I was quite surprised to learn that the Registry of Unmet Needs (waiting list) for the NC Innovations 1915(c) waiver is NOT a date based, first come/first served, list by each of the 11 LME/MCO’s. It is a date based listed by each and every one of the 100 NC Counties. I learned this at the SMC (Smoky) Board of Directors meeting last Thursday (3/28/2013.)
If you are FIRST ON THE LIST in a County that is “over-served” based on “per capita” allocation of waiver slots, then you will not get one of the slots that were just allocated to your LME/MCO.
Think about that. Here in Alexander County or Caldwell County a lot of people (that is who the “per capita” is: people) have lost jobs and moved away. Those of us with slots, didn’t move. It now looks as if Alexander County and/or Caldwell County are over-served! And, think about this, those of us with slots CANNOT move because the slot belongs to the LME/MCO and not the person.
I will never understand how people with power can make such hateful decisions. Who would have decided 100 lists is the correct way to get services to IDD people who are waiting for those services and who are eligible for “institutional level of care?” I am begging you all to be the “truth speaking to power.” I have argued repeatedly that the only list that should exist is a statewide list that is date based WITH exceptions for URGENT severe needs or emergencies.
Truth Speaking to Power: Call the Governor! Constituent Services: 919.733.5811. I called. I said: “I have an urgent Medicaid issue I would like to make the Governor aware of.” I explained the problem with 100 lists. I asked the Governor to find out who the actual live human being was that made such a hateful, mean spirited decision. I asked for an opportunity to speak with the Governor. I also explained that I was going to send an email and I hoped other people would call, too.”
Posted on April 2, 2013, in Division of Medical Assistance, Health Care Providers and Services, Medicaid, Mental Health, Mental Illness, NC DHHS, North Carolina and tagged CNN, Innovations Waiver, Medicaid, North Carolina, United States Department of Health and Human Services. Bookmark the permalink. 13 Comments.