Full transparency needed for states' use of Medicaid stimulus $$
- von: Children's Disability Rights Education Association
- empfänger: U.S. Secretary for Health and Human Services Kathleen Sebelius
Millions of the weakest members of our society -- children and adults with disabilities, the elderly and others with special health care needs -- are being threatened with institutionalization while the states sit on $28 billion in stimulus money that can't be spent on anything except Medicaid.
The American Recovery Act mandates that the states cannot simply put the funds into a "rainy day" or general account.
Yet Medicaid-mandated services that enable children and adults with disabilities to live at home with their families are being particularly targeted for major budget cuts.
This is all made possible by a ruling of the Center for Medicare and Medicaid Services (CMS, the arm of the government that oversees each state's medicaid performance) on July 7, 2009. That document exempted state budget cuts in medicaid services from the Maintenance of Effort (MOE) requirement of the American Recovery Act.
The MOE basically said states couldn't receive their stimulus funds for Medicaid if they had made substantial changes to Medicaid programs since July 1, 2008. States that had made such cuts were supposedly required to restore them before they would get their first installment from DHHS.
State Medicaid Directors, however, wrote CMS asking them to exclude "medical necessity processes, level-of-care determinations and eligibility redetermination frequencies", along with service delivery, benefits and management of access to benefits, from the MOE requirements.
In other words, the states wanted the money but they didn't want anyone telling them how to spend it. They particularly didn't want to have to spend it on home support services for children and adults, including the elderly, with special health care needs. That's the primary focus of level of care determinations, and medical necessity "processes".
What the state Medicaid Directors called "processes" actually refers to federal Medicaid law which gives children (under 21) on Medicaid a special civil right to any health care a doctor says is "medically necessary."
Since CMS bowed to the state Medicaid Directors on July 7, 2009, the states have been cutting away at the services that enable Americans with disabilities and other special health care needs to stay at home with their parents and family caregivers.
These budget cuts have led to at least three states being under federal investigation for violating the civil rights of people with disabilities, six more states facing civil suits alleging similar ADA violations, and a seventh (just that we know of) in the process of putting such a civil suit together.
Violating the civil rights of children and adults with disabilities is becoming a national epidemic that must be stopped at the federal level.
Please think of visiting our website, www.childrensdisabilityrights.org
The American Recovery Act mandates that the states cannot simply put the funds into a "rainy day" or general account.
Yet Medicaid-mandated services that enable children and adults with disabilities to live at home with their families are being particularly targeted for major budget cuts.
This is all made possible by a ruling of the Center for Medicare and Medicaid Services (CMS, the arm of the government that oversees each state's medicaid performance) on July 7, 2009. That document exempted state budget cuts in medicaid services from the Maintenance of Effort (MOE) requirement of the American Recovery Act.
The MOE basically said states couldn't receive their stimulus funds for Medicaid if they had made substantial changes to Medicaid programs since July 1, 2008. States that had made such cuts were supposedly required to restore them before they would get their first installment from DHHS.
State Medicaid Directors, however, wrote CMS asking them to exclude "medical necessity processes, level-of-care determinations and eligibility redetermination frequencies", along with service delivery, benefits and management of access to benefits, from the MOE requirements.
In other words, the states wanted the money but they didn't want anyone telling them how to spend it. They particularly didn't want to have to spend it on home support services for children and adults, including the elderly, with special health care needs. That's the primary focus of level of care determinations, and medical necessity "processes".
What the state Medicaid Directors called "processes" actually refers to federal Medicaid law which gives children (under 21) on Medicaid a special civil right to any health care a doctor says is "medically necessary."
Since CMS bowed to the state Medicaid Directors on July 7, 2009, the states have been cutting away at the services that enable Americans with disabilities and other special health care needs to stay at home with their parents and family caregivers.
These budget cuts have led to at least three states being under federal investigation for violating the civil rights of people with disabilities, six more states facing civil suits alleging similar ADA violations, and a seventh (just that we know of) in the process of putting such a civil suit together.
Violating the civil rights of children and adults with disabilities is becoming a national epidemic that must be stopped at the federal level.
Please think of visiting our website, www.childrensdisabilityrights.org
We the undersigned call on DHHS to put an end to state-authorized violations of the rights of Americans with Disabilities.
States are taking advantage of a portion of the July 7, 2009 CMS ruling, and placing millions of our weakest citizens at risk of institutionalization. By specifying that budget cuts would not violate the ARRA Section 5001 MOE requirement, you have given the states carte blanche to violate federal Medicaid law in the name of budgetary constraints.
Meanwhile DHHS has given the states more than $28 billion in stimulus funds that can only be spent for Medicaid.
Where is this money being spent? Why are states continuing to make cuts that can literally tear children out of the arms of their parents, while the number of those on waiting lists for these services continues to expand?
DHHS must require the states to disclose fully how these Medicaid-destined funds are being allocated and spent, while ensuring that priority is given to restoring previous budget cuts to home and community based services. Moreover, there is no reason for caps on Medicaid participant numbers which leave millions on waiting lists while an additional $28 billion is siting in state bank accounts.
This state-approved medical abuse of our population of children and adults with disabilities needs to end now.
Petition unterzeichnenPetition unterzeichnenStates are taking advantage of a portion of the July 7, 2009 CMS ruling, and placing millions of our weakest citizens at risk of institutionalization. By specifying that budget cuts would not violate the ARRA Section 5001 MOE requirement, you have given the states carte blanche to violate federal Medicaid law in the name of budgetary constraints.
Meanwhile DHHS has given the states more than $28 billion in stimulus funds that can only be spent for Medicaid.
Where is this money being spent? Why are states continuing to make cuts that can literally tear children out of the arms of their parents, while the number of those on waiting lists for these services continues to expand?
DHHS must require the states to disclose fully how these Medicaid-destined funds are being allocated and spent, while ensuring that priority is given to restoring previous budget cuts to home and community based services. Moreover, there is no reason for caps on Medicaid participant numbers which leave millions on waiting lists while an additional $28 billion is siting in state bank accounts.
This state-approved medical abuse of our population of children and adults with disabilities needs to end now.
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