In Pa.- off topic up date

[Guest guest]

Next year will be a very tough budget year. The Bush budget

will cut over 2 billion dollars out of Pa. Medicaid system.

The current govenor in Pa wants to place co-pays for parents

of children with disabilities and now see below (most issues

are adult but still cause for concern)...Let them hear from

you, if not services will suffer....

Persons with Disabilities, their families and friends

From: Pennsylvania Protection & Advocacy & Disabilities Law

Project

Re: PENNSYLVANIA'S PROPOSED MEDICAID CUTS TARGET PERSONS WITH

DISABILITIES

Governor Rendell's proposed budget includes major changes to

Medicaid that, if implemented, will place people with

disabilities in serious jeopardy. While DPW has given its

assurances that 80% of the population will be unaffected by

these cuts, it is people with disabilities and chronic health

conditions that will shoulder the burden of these cuts. There

is little doubt that as a result of these cuts, people will

go untreated. If adopted, these cuts would make

Pennsylvania's hospital coverage among the worst in the

country. The proposed changes include:

.. Adult in-patient hospital stays will be limited to two per

year for most; only 1 per year for some others ( " GA "

category).

.. Adult in-patient rehabilitation stays will be limited to

one per year.

.. Adult out-patient visits to professionals will be limited

to 18 per year. This includes physicians, chiropractors,

optometrists, and podiatrists. We also understand that this

cap may include physical, occupational, and speech therapy

visits.

.. Adults will be allowed a total of $5,000 worth of durable

medical equipment (such as wheelchairs and augmentative

communication devices) per year.

.. Adults will be allowed no more than six prescriptions per

month, for most; only 3 per month for some others ( " GA "

category)regardless of whether the prescriptions relate to

physical or mental health issues.

.. Adult mental health benefits in the fee-for-service areas

will be cut -- from 60 to 30 in-patient hospital days per

benefit period; from 720 to 540 hours of partial

hospitalization per benefit period; and from 7 to 5 out-

patient visits per month.

.. Parents of youngsters with disabilities will be charged

significant premiums for Medicaid services if their incomes

exceed $40,000 per year.

.. Co-payments will be imposed for more services and

significantly increased for other services.

State officials, forced to defend these horrendous limits on

Medicaid, have attempted to downplay the significance of

these cuts. Officials have said that the limits on medical

care only affect discretionary care and not " emergent "

(emergency) care. But what that means is that if a person

has used up two hospital visits, he can go to an emergency

room for stabilization but will not be admitted to the

hospital for treatment.

Officials have indicated that some exception process will be

developed. But such a process likely would be inadequate to

protect persons with disabilities who are most at risk of

harm, in part because any exceptions process will require

already overburdened physicians to take time away from

treating their patients to fill out paper work or make phone

calls to justify to some state bureaucrat the care they

believe their patients need. Most importantly, many

medically necessary benefits will still be denied. Coverage

under Medical Assistance is already limited to medically

necessary services. In order to realize the cost savings

projected from these cuts, many exception requests for

medically necessary services will have to be denied.

Medically necessary heath care should not be an exception!

There is still time to stop these changes. The Pennsylvania

Legislature must approve the cuts, in principle, for them to

go into effect. It is critical for consumers, families, and

advocates to make their voices heard by contacting their

local state representatives and senators, and the media. Let

them know that these Medicaid cuts will severely harm persons

with disabilities and that the human costs for people with

disabilities are not worth any cost-savings DPW claims it

will get.

Please share this Alert with others and encourage them to

express their opposition to these proposed Medicaid changes.

We need to use every opportunity to fight these changes.

On March 7th PP & A will be cosponsoring a briefing on these

cuts with the PA Health Law Project. The briefing will take

place at 10:30 in PP & A's conference room at 1414 N. Cameron

St, burg. For more information contact the Health Law

Project at 717-236-6310.

Following our briefing on March 7th, you are invited to

attend an important hearing on these cuts held by the State

Senate Appropriations Committee. The hearing will start at

1:15 pm and will be held in the Majority Caucus room in the

Main Capitol.

The State House Appropriations Committee will also hold a

hearing on these cuts on March 9 at 2 pm in Room 140, Main

Capitol.

You are encouraged to contact members of the appropriations

committees with your concerns.

Come to the hearings and use the opportunity to talk to the

media about how these cuts will affect people with

disabilities.