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Champion Change for Special Needs Children: Sign the Katie Beckett Petition

Katie Beckett PeitionIn the early 1980’s a little girl named Katie Beckett was only 3 years old and suffering from a viral brain infection she caught a 5 months old that left her fighting for her life and permanently disabled. Her parents insurance was capped at one million dollars and they quickly surpassed that. Medicaid began covering her hospital stay. She was in the hospital for 3 years before her condition improved to where going home was even a possibility. BUT they faced a huge obstacle. While in the hospital Medicaid covered Katie’s needs. At home, her parents would not qualify. Her parents could not afford her care.

The dire situation of Katie Beckett got the attention of President Ronald Reagan. He too saw the absurdity. Her hospital stay was costing taxpayers more than providing Medicaid to her parents so they could provide her treatment at home. In 1981 Katie Beckett’s family was the first to receive the soon called Katie Beckett waiver and a week before Christmas Katie finally left the hospital with her new doll from the Reagan family in tow. In 1982 it was expanded to be a state plan option provision under Medicaid.

More than 30 years later, it is children in GA that now need help. Children who, like Katie, are severely affected by cognitive, developmental and physical disabilities. These children are in danger of losing the help they NEED and becoming wards of the state and institutionalized if they cannot receive the help their parents need to care for them at home. It is highly likely that Katie Beckett herself would not qualify for the waiver named after her if she were a child today living in the state of Georgia. Currently GA families are facing an unreasonable tightening and reevaluation of the requirements for those children receiving the Katie Beckett Medicaid Deeming Waiver.

The requirements are now stating that therapy/ nursing must be received 5 DAYS a week. While this requirement might not seem extreme, if enforced to this exact interpretation, thousands of children needing help would be denied and thousands of families would be forced with the agonizing decision of ripping apart their families and having their beloved children institutionalized in hospitals at great expense to the taxpayers of the state of Georgia. There is a provision in the guidelines that states that children with disabilities qualify regardless of ability to participate in therapy if they meet certain psychological testing guidelines.  This provision is being overlooked and children are routinely being denied. What are some of the problems?

NURSING:

  • It is very hard for families of medically fragile children to qualify and/or afford in-home nursing care for their children. In fact, the Department of Community Health is removing access to nursing care of these medically fragile, vulnerable children.
  • The majority of private insurance companies do not cover in home, private duty nursing care. In many instances, there are not enough nurses to staff the hours and days, particularly for highly specialized care.
  • A parent may choose to become their child’s unpaid 24/7 nurse for their child after being trained and given oversight by qualified personnel. Because they do not have “skilled nursing hours” they can be denied Katie Beckett with these stricter requirements.

THERAPY:

  • A parent may receive a prescription for therapy 5 or more sessions a week from their doctor which is the amount of therapy that is medically necessary for the child. Many times it is impossible for children to be able to receive it. Lack of availability of therapists and therapy centers.
  • There are not enough therapy centers or therapists to accommodate the growing list of children who now need 5 sessions of therapy a week in order to keep the Katie Beckett Deeming Waiver.
  • If a parent is lucky enough to find such a center, there is then usually a wait list for afternoon hours. Many children attend school during the day and many parents try to have therapy later in the day so the child misses the least amount of school.
  • Most primary insurance plans have limitations on amount of therapy or what type is covered. Many families cannot afford it and may not be enrolled in therapy when they apply for Katie Beckett. Medicaid rarely covers five days per week of therapy for any child, even the most severe.
  • Lack of therapy services and providers in the school setting. Across the state, the majority of children receiving therapeutic services at school through their IEPs are enrolled in group therapy. Many schools only offer this due to limited funding, time, and staffing. While there is NOTHING in the Medicaid guidelines stating that this type of therapy cannot be provided or counted, they are now not being allowed to count this as a session of therapy by the state of Georgia. Furthermore, the majority of these children are not able to continue their therapies at school over the summer and are getting penalized as not having enough therapies because of this.
  • Only physical, occupational, and speech therapies are being counted as counted therapies. This excludes other medically researched, peer reviewed proven therapies like Applied Behavioral Analysis (ABA) and music therapy that have greatly improved the quality of life and health of these children.
  • Stamina and health issues of medically fragile children: Some children are too immune compromised to attend a therapy center and/or miss therapy frequently due to hospitalizations, illnesses, medical procedures/appointments.
  • Many parents do not have the means to safely transport their medically complicated or child with severe physical disabilities 5 sessions a week, and parents have had an extremely difficult time finding therapists to come to their homes. They will be DENIED Katie Beckett for this reason.

Please help us to send a clear message to our lawmakers in GA, that we must help these children who cannot help themselves. Without this waiver, more children will be placed in the care of the state of Georgia and be placed in institutions at a cost that can be six times the cost of caring for the child at home which Georgia taxpayers will be paying!

The state of Georgia will be forced to place many of these children in pediatric facilities like Children’s Healthcare of Atlanta for long-term care creating a bed shortage, and ANY sick child across the state of Georgia will suffer due to a lack of treatment space. This policy will cost the state of Georgia more in the long run than any savings it may gain in the short term!

Please sign this petition and let us remind our Governor, Representatives, and those who oversee the Katie Beckett Medicaid Deeming Waiver that this vulnerable population of children matter. We must be the voice of these children who are unable to speak for themselves.

LETTER TO
Governor of Georgia Governor Nathan Deal (Governor of Georgia)
Chair Health & Human Services – Georgia House of Representatives Representative Sharon Cooper
Georgia House of Representatives Speaker Representative David Ralston
and 15 others
Leutenant Governor of Georgia Leutenant Governor Casey Cagle
Chair Senate Health and Human Services Committee Senator Renee Unterman
Department of Community Health – Office of Communications & Legislative Affairs Janice Abrams
Department of Community Health – Office of Communications & Legislative Affairs Jeremy Arieh
Department of Community Health – Director, Office of Communications and Legislative Affairs Lisa Marie Shekell
Department of Community Health – Constituent Services Constituent Services
CBS 46
WSBTV
Atlanta Business News – Atlanta Business Chronicle
AJC
Fox 5 News
11 Alive News
Newnan Times Herald
Georgia Advocacy Office
Children’s Healthcare of Atlanta CHOA Social Media

Please help Georgia’s children with disabilities and preserve the Katie Beckett Deeming Medicaid Waiver created by President Ronald Reagan! These children are in danger of losing the help they NEED and becoming wards of the state and institutionalized if they cannot receive the help their parents need to care for them at home. It is highly likely that Katie Beckett herself would not qualify for the waiver named after her if she were a child living in Georgia today. Currently GA families are facing an unreasonable tightening and reevaluation of the requirements for those children receiving the Katie Beckett Medicaid Deeming Waiver. Without this waiver, more children will be placed in the care of the state of Georgia and be placed in institutions at a cost that can be six times the cost of caring for the child at home which Georgia taxpayers will be paying! The state of Georgia will be forced to place many of these children in pediatric facilities like Children’s Healthcare of Atlanta for long-term care creating a bed shortage, and ANY sick child across the state of Georgia will suffer due to a lack of treatment space. This policy will cost the state of Georgia more in the long run than any savings it may gain in the short term! Please fix this problem started by President Reagan for the sake of these children and the taxpayers of Georgia.

Physicians’ Medicare Payments No Longer Tied To Economy

SRGAfter almost 20 years, Congress finally passed a law repealing the Sustainable Growth Rate (SGR ). Under SRG, Medicare payments to physicians were tied to the growth rate in the economy. Because of the sluggish economy during and after the Great Recession, the growth rate formula has resulted in either a reduction or inadequate increase in Medicare reimbursement rates. As a result, Congress recently passed last minute, short-term fixes to ensure that physicians receive the appropriate fees.

With the passage of the new law, physicians will finally see stabilization in Medicare payments. The statute provides for a 0.5% increase for the next five years. Then the government will transition to a new system in which payments will be based on quality, value and accountability – the Merit-based Incentive Payment System.

The repeal of SGR is good news for physicians treating Medicare patients. Because Medicare reimbursement rates have been so unpredictable for the last decade, physician practices  have had little opportunity to arrange for innovative care models. With the new law, physicians have the chance to come up with groundbreaking care delivery models while developing patient care protocols focused on quality and gearing up for the next phase in Medicare reimbursement.

If you are a physician with questions about Medicare reimbursement or enrollment, or need healthcare regulatory advice, please contact DJ Jeyaram at DJ@jeylaw.com or Danielle Hildebrand at Dhildebrand@jeylaw.com.