Re: ] Re: Deeming Waiver

[Guest guest]

Hi :

I am one of those parent who was turned down for Beckett..it seems out local offices know nothing about this waiver. I was not only turned down one time but twice. I had already applied for SSI been turned down,applied for KB and turned down,then I somehow managed to get on MC spend down...okay that was great something is better than nothing right ! WRONG,as soon as I got my son an appointment in Rome with ST,OT,and PT...guess what....they sent me a letter saying that he was NO longer covered by MC. Even though we had the amount in spend down already covered,he still was removed from the program when I ask why...well...she didnt know...she didnt make that decision....

I think something has to be done to improve the health care of the US...Insurance Companies need to help us with these matters,but ours like most these days, only pay for so many therapy visits,and then the ball is in your court. and as far as Autism they cover nothing !

Deborah Davdison Rockmart Ga

] Re: Deeming Waiver

, you did a GREAT job of explaining this. I most assuredly would notprovide bank statements and other such personal information to them. Iwould only provide an income amount to them to show that I would beineligible for SSI.On a different note ( not financial eligibility ) , another issue that Ihave been concerned about is the new families who are applying for thewaiver now and being turned down and also for the families that are beingre-evaluated and found not eligible anymore. I think we have to step backand realize that the KB waiver has not been administered in the pastexactly as it was Federally mandated. One of the stipulations is that thechildren who receive this waiver be eligible for an institutional level ofcare. This doesn't mean that we, as parents, would have put our children ininstitutions if we didn't get the waiver but it does mean that the childrenwho received it met the level of care required for a person in aninstitution. I personally know of many children who did not qualify forthat level of care who have been receiving the waiver for a long time . I amnot at all blaming parents for having applied for this waiver in the past toobtain many needed services for their children but, unfortunately, parentsare suffering now because it is now time to pay the piper so to speak.Eligibility guidelines ( not income guidelines ) are , I believe, going tobe adhered to more so than in the past ( in part due to Medicaid'sdetermination to reduce eligibilities to save money ) and, for that reason,many children will simply not qualify. Even for those people who do qualifyfor SSI , the entire Medicaid eligibility issue is one of concern in thisyear's budget in that it will also affect SSI or SSDI recipients - they areproposing to lower the amount of money someone can receive on SSI or SSDIand still be eligible for the Medicaid portion . On SSI or SSDI alone,many of these people will not be able to afford private healthcare.Reducing Medicaid eligibility will, of course, save Medicaid money but I amconcerned about the people who won't qualify for either the KB or for theMedicaid portion of SSI or SSDI,

[Guest guest]

We do not qualify for any of these- It is called husband works 3 jobs, mom works one. live in debt.

Until state employees receive the same coverage as those on Peach Care or Medicaid, this is the way it will stay.

My husband is up for state teacher of the year BTW- which actually win hurt us financially if he wins- as he will not be able to teach at the 2 colleges in the evenings as he does now. Basically, if he does win, he may have to turn it down.

-S GA

Reducing Medicaid eligibility will, of course, save Medicaid money but I amconcerned about the people who won't qualify for either the KB or for theMedicaid portion of SSI or SSDI,

[Guest guest]

Deborah,

When your child was denied KB- what reason was given? They must give a reason. Did you go thru the appeal process. You should have received details on how to go thru the appeal process. Again, first you need to look at the reason your child was denied KB- that is the first step.

Heidi Fernandez

[Guest guest]

,

You need to review the paper work and see what was the exact reason your child was denied KB? Your child can not be denied KB because the parents make to much money.

Parents need to be aware that their is an appeal process that you can go thru.

Heidi Fernandez

[Guest guest]

We do not make too much money- he does not meet the requirement for care in a facility.

Re: ] Re: Deeming Waiver

,

You need to review the paper work and see what was the exact reason your child was denied KB? Your child can not be denied KB because the parents make to much money.

Parents need to be aware that their is an appeal process that you can go thru.

Heidi Fernandez

[Guest guest]

All that was said is that he did not qualify...She needed to talk to her superior,and would call me back....dont you think that 6 months is enough time to wait.... She said that kb was for adults only... I dont think our county office knows anything about KB.

Deborah

Re: ] Re: Deeming Waiver

Deborah,

When your child was denied KB- what reason was given? They must give a reason. Did you go thru the appeal process. You should have received details on how to go thru the appeal process. Again, first you need to look at the reason your child was denied KB- that is the first step.

Heidi Fernandez

[Guest guest]

In a message dated 11/2/04 9:29:22 AM, drld959@... writes:

<< All that was said is that he did not qualify...She needed to talk to her

superior,and would call me back....dont you think that 6 months is enough time

to wait.... She said that kb was for adults only... I dont think our county

office knows anything about KB. >>

My advice to you is to call DFACS again and to work your way up the chain of

command until you get someone there that knows about the deeming waiver and

will help you apply. Be persistent - do not wait for someone to call you back!!!

Here is some information that may help you:

The Beckett provision is a statute--the Tax Equity and Fiscal

Responsibility Act (TEFRA) 134--added to Medicaid in 1982.

Beckett is the name of the child whose parents petitioned the Federal

government for her to receive Medicaid services at home instead of in a

hospital, and whose plight led the Reagan Administration to urge Congress to

enact

the provision. TEFRA 134 gives states the option to cover noninstitutionalized

children with disabilities. Prior to enactment of this provision, if a child

with disabilities lived at home, the parents’ income and resources were

automatic-ally counted (deemed) as available for medical expenses. However, if

the

same child was institutionalized for 30 days or more, only the child’s own

income

and resources were counted in the deeming calculation--substantially

increasing the likelihood that a child could qualify for Medicaid. This sharp

divergence in methods of counting income often forced families to

institutionalize

their children simply to get them medical care. TEFRA 134 amended the Medicaid

law to give states the option to waive the deeming of parental income and

resources for children under 18 years old who were living at home but would

otherwise be eligible for Medicaid-funded institutional care. Not counting

parental

income enables these children to receive Medicaid services at home or in other

community settings. Many states (including Georgia) use this option, which

requires states to determine that (1) the child requires the level of care

provided in an institution; (2) it is appropriate to provide care outside the

facility; and (3) the cost of care at home is no more than the cost of

institutional

care.