Medical Resources
A friend recently reminded me how difficult it can be when you have a child with significant issues in a hospital. Remember to you can request a different Nurse or Doctor! Personalities do clash - and that's ok. Ask to speak with a Nurse Supervisor, Patient Representative or Hospital Social Worker to resolve your frustrations! It's about quality care for your child!
---------------------------------------------
Reminder: Your Forward card - HMO has Case Managers that are suppose to help you know what benefits you can access! They are also there to help to access/problem solve what your individual needs! If you don't know who your forward card HMO is, call the number on the back of the card!
Remember - Clinics also have people to help you understand benefits.
---------------------------------------------
Birth to 3 Program: Child Development
https://www.dhs.wisconsin.gov/birt.../family/development.htm
Birth to 3 Program Information for Families
https://www.dhs.wisconsin.gov/birthto3/family/index.htm
Children’s Long-Term Support Waiver Program
https://www.dhs.wisconsin.gov/clts/waiver/family/index.htm
--------------------------------------------------------------------
Latest Edition of Finding Your Way: A Navigation Guide for Wisconsin Families Who Have Children and Youth with Special Health Care Needs and Disabilities Available English and Spanish
An English-language version is available at https://ucedd.waisman.wisc.edu/fyw/
pdf version of the guide is available at https://go.wisc.edu/finding-your-way.pdf
A Spanish-language .pdf versions: https://ucedd.waisman.wisc.edu/encuentre-su-camino/
A printed versions are available at minimal cost.
Special Health Care Needs and Disabilities is designed to help families and professionals navigate the system of care in Wisconsin.
-------------------------------------------------------------------
Accommodating Patients with Disabilities During COVID-19 Pandemic Today, in response to the first federal complaint challenging discriminatory hospital “no-visitor” policies, the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services announced a resolution making clear that federal law requires hospitals and the state agencies overseeing them to modify policies to ensure patients with disabilities can safely access the in-person supports needed to benefit from medical care during the COVID-19 pandemic.
https://www.hhs.gov/about/news/2020/06/09/ocr-resolves-complaints-after-state-connecticut-private-hospital-safeguard-rights-persons.html
Strict no-visitor policies put in place at hospitals have prevented patients with disabilities from safely receiving support from family members or staff necessary for them to effectively communicate with medical personnel or otherwise receive equal access to medical treatment. No-visitor policies have disproportionately impacted Black people with disabilities, who have higher rates of infection and hospitalization. Accommodations to these policies are required by federal civil rights laws.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6918e1.htm?s_cid=mm6918e1_w
---------------------------------------------------------------
Wisconsin Department of Health Services Websites:
Birth to 3 https://www.dhs.wisconsin.gov/birthto3/index.htm
Children's Community Options Program https://www.dhs.wisconsin.gov/ccop/index.htm
Children's Long Term Waivers http://www.dhs.wisconsin.gov/children/clts/index.htm
What Services are Available?
https://www.dhs.wisconsin.gov/clts/waiver/family/services.htm
* What types of services are available?
https://www.dhs.wisconsin.gov/clts/spcs.pdf
Updated Manual: Medicaid Home and Community-Based Services (HCBS) Waiver for the Children’s Long-Term Services
(CLTS) Waiver Program https://www.dhs.wisconsin.gov/publications/p02256.pdf
Transitioning to Adult Waiver Programs
Items Covered in the Family Care Benefit Package
https://www.dhs.wisconsin.gov/familycare/benpackage.htm
Comparison Chart at:
https://www.dhs.wisconsin.gov/publications/p0/p00570.pdf
18-01 of the Medicaid Eligibility Handbook Published - http://www.emhandbooks.wisconsin.gov/meh-ebd/meh.htm
Coordinated Services Teams (CST) Initiatives – Children https://www.dhs.wisconsin.gov/cst/index.htm
Comprehensive Community Services (CCS) Children and Adults https://www.dhs.wisconsin.gov/ccs/index.htm
---------------------------------------------
Fact sheet on Children's Programs!
Visit~ Family Voices of Wisconsin https://familyvoiceswi.org/
Fact sheets https://familyvoiceswi.org/resource-library/
Children’s Long Term Waivers
Mental Health
Medicaid and Transportation / Medical Appointments
SSI
Mental Health
Where do I begin/Treatment/Waiting/Paying
Transition - Supported Decision Making
In the News grid tab https://familyvoiceswi.org/newsgrid/
Appealing a Medicaid Denial
Finding providers
---------------------------------------------
Do you have questions or concerns about your Wisconsin Badger Care or Medicaid SSI. Call 1-800-760-0001 and speak with an Ombudsmen. Help for: Grievance
Rights and Responsibilities
Represent enrollee rights
Help with covering services
Denial, Stopped or Reduces Services
Feel you are treated unfairly or disrespectfully
Or write to: BadgerCare Plus or Medicaid SSI HMO Ombudsmen, PO Box 6470, Madison, WI 53716-4070
---------------------------------------------
DOA Division of Hearings And Appeals https://doa.wi.gov/Pages/AboutDOA/HearingsAndAppeals.aspx
Originally created in 1978, the Division of Hearing and Appeals (DHA) is an quasi-judicial, independent entity created to conduct high quality, impartial, independent, and cost and time efficient hearings that serve customer agencies and the citizens of Wisconsin.
819 N 6th St Rm 92, Milwaukee · (414) 227-3818
5005 University Ave Ste 201, Madison · (608) 266-7709
---------------------------------------------
MetaStar is a quality improvement organization with 45 years of experience working alongside those in the health care system to improve the quality of health care for all patients. Our health care improvement and consulting services address the need for system-wide innovation and consistent, evidence-based approaches across all settings of care. All of our work is guided by our mission, to effect positive change in health and health care.
We work with communities, providers, and insurers to transform care with a vision of optimal health for all. MetaStar is an independent nonprofit based in Madison and represents Wisconsin in the Lake Superior Quality Innovation Network.
---------------------------------------------
From the Kaiser Family Foundation http://kff.org
Health Insurance Marketplace Calculator provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance. You can also use this tool to estimate your eligibility for Medicaid. As eligibility requirements may vary by state, please contact your state’s Medicaid office or Marketplace with enrollment questions.
http://kff.org/interactive/subsidy-calculator/?utm_campaign=KFF%3A+2015+October+Health+Reform+ACA+Open+Enrollment&utm_source=hs_email&utm_medium=email&utm_content=24040652&_hsenc=p2ANqtz-_XnyaqY44up-hhs8ySQNlJRYrxpRifMhO_TgW-waqGUXF_C6aI_7ZaDoOp9e9I5oS5K17OpZ4IDnEaZz2jl_mDhcfXkA&_hsmi=24040652
---------------------------------------------
Acronym Finder
Confused by educational and medical jargon? This web site allows you to enter the acronym or a subject, such as autism, and find out what the acronyms mean in plain English. http://www.acronymfinder.com/
---------------------------------------------------------------
GRANT
UnitedHealthcare Children's Foundation is a non-profit Section 501(c)(3) charity funded by contributions from UnitedHealth Group, UnitedHealthcare and its employees, as well as the generosity of individuals and corporations. http://www.uhccf.org/aboutus.html
Purpose: Children who have medical needs are sometimes not insured comprehensively to provide coverage for all of their medical treatments. There are few places for families who have gaps in their commercial health benefit plan coverage to turn to for funding medically necessary services for their children. Children may go without necessary treatment, or, they receive the care and families assume a large amount of debt. The Foundation understands these needs and is willing to help fill this void.
http://www.uhccf.org/
-------------------------
Kathy's House: A Home Away from Home -Kathy's House is a hospital hospitality house - for patients of all ages and their caregivers traveling to Milwaukee area hospitals for medical treatment. Located near Milwaukee County Zoo.
www.kathyshouse.org www.facebook.com/KathysHouseMilwaukee 414-453-8290 mail@kathy-house.org
-------------------------
American Cancer Society Hope Lodge in Marshfield cost free lodging during treatment!
Help spread the word about Hope Lodge. Please
https://www.facebook.com/HopeLodgeMarshfield
--------------------------
Affordable Care Act -ACA, check out Family Voices of Wisconsin. http://fvofwi.org/public-policy/affordable-care-act/
A friend recently reminded me how difficult it can be when you have a child with significant issues in a hospital. Remember to you can request a different Nurse or Doctor! Personalities do clash - and that's ok. Ask to speak with a Nurse Supervisor, Patient Representative or Hospital Social Worker to resolve your frustrations! It's about quality care for your child!
---------------------------------------------
Reminder: Your Forward card - HMO has Case Managers that are suppose to help you know what benefits you can access! They are also there to help to access/problem solve what your individual needs! If you don't know who your forward card HMO is, call the number on the back of the card!
Remember - Clinics also have people to help you understand benefits.
---------------------------------------------
Birth to 3 Program: Child Development
https://www.dhs.wisconsin.gov/birt.../family/development.htm
Birth to 3 Program Information for Families
https://www.dhs.wisconsin.gov/birthto3/family/index.htm
Children’s Long-Term Support Waiver Program
https://www.dhs.wisconsin.gov/clts/waiver/family/index.htm
--------------------------------------------------------------------
Latest Edition of Finding Your Way: A Navigation Guide for Wisconsin Families Who Have Children and Youth with Special Health Care Needs and Disabilities Available English and Spanish
An English-language version is available at https://ucedd.waisman.wisc.edu/fyw/
pdf version of the guide is available at https://go.wisc.edu/finding-your-way.pdf
A Spanish-language .pdf versions: https://ucedd.waisman.wisc.edu/encuentre-su-camino/
A printed versions are available at minimal cost.
Special Health Care Needs and Disabilities is designed to help families and professionals navigate the system of care in Wisconsin.
-------------------------------------------------------------------
Accommodating Patients with Disabilities During COVID-19 Pandemic Today, in response to the first federal complaint challenging discriminatory hospital “no-visitor” policies, the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services announced a resolution making clear that federal law requires hospitals and the state agencies overseeing them to modify policies to ensure patients with disabilities can safely access the in-person supports needed to benefit from medical care during the COVID-19 pandemic.
https://www.hhs.gov/about/news/2020/06/09/ocr-resolves-complaints-after-state-connecticut-private-hospital-safeguard-rights-persons.html
Strict no-visitor policies put in place at hospitals have prevented patients with disabilities from safely receiving support from family members or staff necessary for them to effectively communicate with medical personnel or otherwise receive equal access to medical treatment. No-visitor policies have disproportionately impacted Black people with disabilities, who have higher rates of infection and hospitalization. Accommodations to these policies are required by federal civil rights laws.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6918e1.htm?s_cid=mm6918e1_w
---------------------------------------------------------------
Wisconsin Department of Health Services Websites:
Birth to 3 https://www.dhs.wisconsin.gov/birthto3/index.htm
Children's Community Options Program https://www.dhs.wisconsin.gov/ccop/index.htm
Children's Long Term Waivers http://www.dhs.wisconsin.gov/children/clts/index.htm
What Services are Available?
https://www.dhs.wisconsin.gov/clts/waiver/family/services.htm
* What types of services are available?
https://www.dhs.wisconsin.gov/clts/spcs.pdf
Updated Manual: Medicaid Home and Community-Based Services (HCBS) Waiver for the Children’s Long-Term Services
(CLTS) Waiver Program https://www.dhs.wisconsin.gov/publications/p02256.pdf
Transitioning to Adult Waiver Programs
Items Covered in the Family Care Benefit Package
https://www.dhs.wisconsin.gov/familycare/benpackage.htm
Comparison Chart at:
https://www.dhs.wisconsin.gov/publications/p0/p00570.pdf
18-01 of the Medicaid Eligibility Handbook Published - http://www.emhandbooks.wisconsin.gov/meh-ebd/meh.htm
Coordinated Services Teams (CST) Initiatives – Children https://www.dhs.wisconsin.gov/cst/index.htm
Comprehensive Community Services (CCS) Children and Adults https://www.dhs.wisconsin.gov/ccs/index.htm
---------------------------------------------
Fact sheet on Children's Programs!
Visit~ Family Voices of Wisconsin https://familyvoiceswi.org/
Fact sheets https://familyvoiceswi.org/resource-library/
Children’s Long Term Waivers
Mental Health
Medicaid and Transportation / Medical Appointments
SSI
Mental Health
Where do I begin/Treatment/Waiting/Paying
Transition - Supported Decision Making
In the News grid tab https://familyvoiceswi.org/newsgrid/
Appealing a Medicaid Denial
Finding providers
---------------------------------------------
Do you have questions or concerns about your Wisconsin Badger Care or Medicaid SSI. Call 1-800-760-0001 and speak with an Ombudsmen. Help for: Grievance
Rights and Responsibilities
Represent enrollee rights
Help with covering services
Denial, Stopped or Reduces Services
Feel you are treated unfairly or disrespectfully
Or write to: BadgerCare Plus or Medicaid SSI HMO Ombudsmen, PO Box 6470, Madison, WI 53716-4070
---------------------------------------------
DOA Division of Hearings And Appeals https://doa.wi.gov/Pages/AboutDOA/HearingsAndAppeals.aspx
Originally created in 1978, the Division of Hearing and Appeals (DHA) is an quasi-judicial, independent entity created to conduct high quality, impartial, independent, and cost and time efficient hearings that serve customer agencies and the citizens of Wisconsin.
819 N 6th St Rm 92, Milwaukee · (414) 227-3818
5005 University Ave Ste 201, Madison · (608) 266-7709
---------------------------------------------
MetaStar is a quality improvement organization with 45 years of experience working alongside those in the health care system to improve the quality of health care for all patients. Our health care improvement and consulting services address the need for system-wide innovation and consistent, evidence-based approaches across all settings of care. All of our work is guided by our mission, to effect positive change in health and health care.
We work with communities, providers, and insurers to transform care with a vision of optimal health for all. MetaStar is an independent nonprofit based in Madison and represents Wisconsin in the Lake Superior Quality Innovation Network.
---------------------------------------------
From the Kaiser Family Foundation http://kff.org
Health Insurance Marketplace Calculator provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance. You can also use this tool to estimate your eligibility for Medicaid. As eligibility requirements may vary by state, please contact your state’s Medicaid office or Marketplace with enrollment questions.
http://kff.org/interactive/subsidy-calculator/?utm_campaign=KFF%3A+2015+October+Health+Reform+ACA+Open+Enrollment&utm_source=hs_email&utm_medium=email&utm_content=24040652&_hsenc=p2ANqtz-_XnyaqY44up-hhs8ySQNlJRYrxpRifMhO_TgW-waqGUXF_C6aI_7ZaDoOp9e9I5oS5K17OpZ4IDnEaZz2jl_mDhcfXkA&_hsmi=24040652
---------------------------------------------
Acronym Finder
Confused by educational and medical jargon? This web site allows you to enter the acronym or a subject, such as autism, and find out what the acronyms mean in plain English. http://www.acronymfinder.com/
---------------------------------------------------------------
GRANT
UnitedHealthcare Children's Foundation is a non-profit Section 501(c)(3) charity funded by contributions from UnitedHealth Group, UnitedHealthcare and its employees, as well as the generosity of individuals and corporations. http://www.uhccf.org/aboutus.html
Purpose: Children who have medical needs are sometimes not insured comprehensively to provide coverage for all of their medical treatments. There are few places for families who have gaps in their commercial health benefit plan coverage to turn to for funding medically necessary services for their children. Children may go without necessary treatment, or, they receive the care and families assume a large amount of debt. The Foundation understands these needs and is willing to help fill this void.
http://www.uhccf.org/
-------------------------
Kathy's House: A Home Away from Home -Kathy's House is a hospital hospitality house - for patients of all ages and their caregivers traveling to Milwaukee area hospitals for medical treatment. Located near Milwaukee County Zoo.
www.kathyshouse.org www.facebook.com/KathysHouseMilwaukee 414-453-8290 mail@kathy-house.org
-------------------------
American Cancer Society Hope Lodge in Marshfield cost free lodging during treatment!
Help spread the word about Hope Lodge. Please
https://www.facebook.com/HopeLodgeMarshfield
--------------------------
Affordable Care Act -ACA, check out Family Voices of Wisconsin. http://fvofwi.org/public-policy/affordable-care-act/
Who / What are your resources that can help you?http://www.co.wood.wi.us/Departments/Health/Doc/CYSHCN%20Medical%20Resources%20Fact%20Sheet.pdf
-------------------- Northern Children and Youth with Special Health Care Needs Regional Center (CYSHCN) 715-261-1906 800-642-7837 specialneedsinfo@co.marathon.wi.us http://northernregionalcenter.org. Medical providers: serving everyone Uninsured or Under- Insured Medical Supply Reimbursement rates (Forward Card) Medical Information and Resources Specialty Medical Support Program Medical Insurance Resource To find your CYSHCN Regional Center: http://www.dhs.wisconsin.gov/health/children/RegionalCenters/index.htm --------------------------------------- Katie Beckett Program Consultants Click on an area of the map, or on the name below, to get information about the Katie Beckett consultant in your area. https://www.dhs.wisconsin.gov/kbp/consultants.htm For additional assistance to families related to applying for Katie Beckett Medicaid coverage, contact the Katie Beckett Program Assistant at (608) 266-3236. (800) 362-3002. ------------------------------------- Katie Beckett Consultant for Wood County - Wisconsin's Katie Beckett Medicaid Program provides health care coverage to eligible children who have disabilities and long-term support needs. Who do we contact – when? Shana Berg The Parenting Place 1500 Green Bay St. La Crosse, WI 54601 (608) 397-1897 shana.berg@wisconsin.gov -------------------------------------- Bureau of Children’s Services See Childrens Services Specialists Wood Co is Keith Keller for CLTS 608-215-8968 Keith.Keller@wisconsin.gov CENTRAL OFFICE CONTACTS: Autumn Knudtson, Chief Children’s Program Operations and Partner Relations Section Bureau of Children’s Services Division of Long Term Care Phone: 608-267-3257 Email: Autumn.Knudtson@dhs.wisconsin.gov Susan Larsen, Chief Policy Initiatives and Program Integrity Section Bureau of Children’s Services Division of Long Term Care Phone: 608-267-9175 Email: Susan.Larsen@dhs.wisconsin.gov 715-292-9677 dennis.liphart@wi.gov --------------------------------------- DHS - info on children's long term care waivers- http://www.dhs.wisconsin.gov/children/clts/index.htm -------------------------------------- ABC for Health Care 1-800-585-4222 32 N BASSETT ST MADISON, WI 53703 · 608-261-6939 800-585-4222 · INFO@SAFETYWEB.ORG ---------------------------------------- BirthInjuryGuide.org. Birth Injury Guide is a comprehensive informational website on all types of birth injuries. Our goal is to provide helpful information and guidance to parents if their child was born with a birth injury. ----------------------------------- Tubie Friends www.tubiefriends.com Taking the fear out of feeding tubes, one Tubie Friend at a time Find Tubie Friends on Facebook! Communication Clinics - Brain UWSP Communicative Disorders Program Work: 715-346-3667 (Kaye at front desk) Fax: 715-346-4835 Work Address: 2100 Main Street Stevens Point, WI 54481 Waisman Center Communication Aids and Systems Clinic (CASC) 1500 Highland Ave. Room 327 Madison, WI 53705-2280 (608) 262-3039 Fax: (608) 265-9851 Call and ask them to send you an informational packet. They are unable to give you an appointment until you fill out the packet and send it back in. When you send it in, put a note on it and tell them that you will take any opening that comes up. Otherwise you may wait up until 16 months. It's easier to get in during the winter - driving may suck but it can open up sooner than you think. State of WI Department of Health and Family Services – Office for the Deaf and hard of hearing… 715- 842-7693 -------------------------------------- Vision therapist in the Woodruff/Wausau areas...http://www.optometrosts.org/buffington Kate Buffington JEFFREY BECKER OD VISION REHABILITATION SPECIALIST NEUROSENSORY CENTER OF EASTERN PA 570 763 0054 jbecker@keystonensc.com www.keystonensc.com ------------------------------------- Family Voices of Wisconsin - http://www.familyvoicesofwisconsin.com/ Three new fact sheets are now available on the Family Voices website at www.fvofwi.org/factsheets.html These fact sheets provide easyto understand information on LogistiCare and how to get help with rides or reimbursement for driving to a Medicaid covered medical appointments. The fact sheets include: Fact Sheet #1 - Medicaid and Transportation to Medical Appointments Fact Sheet #2 - Mileage Reimbursement for Medicaid Covered Appointments Fact Sheet #3 - Medicaid & Help with Lodging and Meals for Medical Appointments For more information contact Lynn at Lynn@fvofwi.org or call Family Voices at 608-220-9598 Family Voices Announces the Release of the Bright Futures Family Pocket Guide http://brightfutures.aap.org/3rd_Edition_Guidelines_and_Pocket_Guide.html You will also find Fact sheets on:
1/28/13 New Interpretation of FMLA Issued by the U.S. Department of Labor's Wage and Hour Division This week, the U.S. Department of Labor's (DOL) Wage and Hour Division issued a new Administrator Interpretation that expands the Family and Medical Leave Act's (FMLA) current language to include adult children who are unable to care for themselves because of a mental or physical disability and whose disabilities occurred before or after the age of 18. The previous interpretation of the law was unclear as it applied to adult children with disabilities. This Interpretation also clarifies FMLA-protected leave for a parent is not dependent on the age of the adult child and the onset of their disability, and broadens the definition of "disability" to reflect the Americans with Disabilities Act Amendments Act (ADAAA). Ultimately, this Interpretation means that more parents will be able to take FMLA- protected leave from their jobs to care for their adult children with disabilities. Learn more about the FMLA http://ucp.us1.list-manage.com/track/click?u=2a0f8e7077be7d116c18c3273&id=97eeabff48&e=1f600b3792>and this new Administrator Interpretation http://ucp.us1.list-manage.com/track/click?u=2a0f8e7077be7d116c18c3273&id=237b029f2b&e=1f600b3792> from UCP's Website http://ucp.us1.list-manage.com/track/click?u=2a0f8e7077be7d116c18c3273&id=4a83fa7f55&e=1f600b3792> *REFERENCE POINTS* is administered by PACER Center http://www.pacer.org/> as a technical assistance activity of the TATRA Project. The TATRA Project is funded by the Rehabilitation Services Administration. Elizabeth Hecht Outreach Specialist for Public Policy Waisman Center - UCEDD 608- 263-7148 ------------------------------ Videos Medicaid Video featuring Wisconsin residents: www.imperfectunion.org Brain Hero | 3-minute video. This new video (only 3 minutes long!) comes from the Center for the Developing Child at Harvard University. It depicts how actions taken by parents, teachers, policymakers, and others can impact child development and affect life outcomes for both the child and the surrounding community. http://developingchild.harvard.edu/resources/multimedia/brain_hero/ -------------------------------- Abstract: State Health Care Financing Strategies for Children with Intellectual and Developmental Disabilities By Sara S. Bachman, Margaret Comeau, Carol Tobias, Deborah Allen, Susan Epstein, Kathryn Jantz, and Lynda Honberg Intellectual and Developmental Disabilities, Vol. 50, No. 3, pp. 181 - 189 June 2012 Citing data from the 2005-2006 National Survey of Children with Special Health Care Needs, http://www.childhealthdata.org/) the authors note that about 40% of families raising children with intellectual and developmental disabilities (IDD) report that their health insurance is not adequate to meet their children's needs and 34.6% of families experience financial hardship. Title V, Medicaid, the Children's Health Insurance Programs (CHIP), and state agency supports, which all vary from state to state, provide some additional services that may help reduce financial stress. These researchers from the Catalyst Center at Boston University, the Boston Public Health Commission, and the U.S. Department of Health and Human Services conducted structured interviews with staff from state Title V Children with Special Health Care Needs programs, Medicaid program staff, and family leaders to identify additional strategies to close benefit gaps and pay for additional services. They also discussed provisions of the Affordable Care Act (ACA) that may help reduce variability between states and alleviate the financial hardship many families experience. Abstract: State Insurance Parity Legislation for Autism Services and Family Financial Burden By Susan Parish, Kathleen Thomas, Roderick Rose, Mona Kilany and Robert McConville Intellectual and Developmental Disabilities, Vol. 50, No. 3, pp. 190-198 June 2012 Previous research documents that children with autism spectrum disorders use more health services than children with other special health care needs. There is also evidence that Medicaid and families bear the primary financial responsibility for the cost of these services, as many private health insurers limit or deny services for children with this diagnosis. Using individual and state level data from the 2005-2006 National Survey of Children with Special Health Care Needs, (http://www.childhealthdata.org/) the authors examined the association between states with autism mandates or parity legislation and family financial burden. Their preliminary analyses, which support the case of many advocates for creating autism mandates, found that families living in states with autism mandates or parity legislation had fewer out-of-pocket costs for their children's autism services than families living in states without these requirements for private health insurers. --------------------------------------- A Look at State Medicaid Program Spending, Enrollment and Policy Trends Results from a 50-StateMedicaid Budget Survey for State Fiscal Years 2012 and 2013 http://www.kff.org/medicaid/8380.cfm |
Information on programs:
Covered Services in Wisconsin's Long-Term Care Programs
http://www.dhs.wisconsin.gov/publications/P0/p00088o.pdf Children's Community Options Program: CCOP Power Point from Circles of Life - http://www.circlesoflifeconference.com/.../Childrens... http://www.dhs.wisconsin.gov/children/index.htm - Children's Long Term (CLT) Waivers http://www.dhs.wisconsin.gov/children/clts/waiver/county/csscontacts.pdf - CLT - waiver contacts http://www.dhs.wisconsin.gov/ltcare/adrc/professionals/policyprocedures/opsguide/ch6/OpGuideChildrenAgingintoMLTCIRIS050610.pdf - Children to adult LTC http://www.dhs.wisconsin.gov/publications/P0/p00088o.pdf - covered services LTC programs - FC - Partnership- IRIS- MA http://www.dhs.wisconsin.gov/publications/p0/p00079.pdf - bench mark and Badger Care + BadgerCare Plus Premium and Copayment table beginning on page 12 and the Covered Services table beginning on page 33 of the Benefits and Enrollment Handbook: http://www.dhs.wisconsin.gov/em/impubs/pubs/p-00079.pdf There is also a BadgerCare Plus Core Plan Covered Services/Copayment table beginning on page 18. -------------------------------- Medicaid Waiver Manual: http://www.dhs.wisconsin.gov/bdds/waivermanual/app_a.htm. 7 programs for which the CLTS Functional Screen determines functional eligibility: Comprehensive Community Service Community Recovery Services Community Options Program Family Support Program Children's Waivers Katie Beckett Medicaid Program MH Wrap Around Becky Burns, MSSW, CISWCLTS FS Clinical Advisor / FAX 608-263-7861 E-Mail: Becky.Burns@wisconsin.gov ------------------------------ MA Prior Authorization Appeal to: Martha Maltke - Medicaid Pharmacy Benefit 608-266-9749 ------------------------------- Have you ever served in the Armed Forces? If so, you may want to contact your local County Veteran Service Officer to see whether you qualify for additional Wisconsin Veterans Benefits. • ADAMS David Guerin 608-339-4221 adamsvso@co.adams.wi.us • JACKSON Randy Bjerke 715-284-0225 veterans.services@co.jackson.wi.us • MONROE Margaret Garvin 608-269-8726 margaret.garvin@co.monroe.wi.us • PORTAGE Michael Clements 715-346-1310 clementm@co.portage.wi.us • WAUSHARA William Rosenau 920-787-0446 williamr.parkstreet@co.waushara.wi.us • WOOD Rock Larson 715-421-8420 rlarson@co.wood.wi.us ------------------------------- Community Services Locator: An Online Directory for Finding Community Services for Children and Families, 3rd Edition http://www.mchlibrary.info/KnowledgePaths/kp_community.html The Maternal and Child Health Library at Georgetown University May 2012 The Maternal and Child Health (MCH) Library at Georgetown University has developed a new edition of the Community Services Locator, an online directory for finding services for children and families in the communities in which they live. Service providers and families can use the locator to find available childcare and early childhood programs; education and special education programs; developmental assessment and learning services; family support; financial support; and health and wellness care. ------------------ If you are having difficulty with obtaining therapy - you may want to understand: “Essential Health Benefits” under the Affordable Care Act.2 and look at habilitative and rehabilitative services and devices This is a part of: The Essential health benefits are a set of health care service categories that must be covered by certain insurance plans,starting in 2014, under the Patient Protection and Affordable Care Act (the ASHA Leader, Jan. 18, 2011; Nov. 22, 2011). ------------------- Health Transition Wisconsin - Supporting Youth to Adult Healthcare healthtransitionwi.org Learn more about youth to adult transition - *Transition information and resources for youth and families, including youth transition stories *Transition tools and resources for health care providers, including: practice guidelines and CME opportunities healthtransitionwi@waisman.wisc.edu ------------------------------------------------------------------ Enrollment for Health Coalition - www.e4healthwi.org A new, non-partisan, non-aligned, one-stop-shop resource to support and coordinate trainings, regulatory updates, new sources of materials, meetings and conferences. New functions will soon be added that will allow for specific groups to have specialized chat rooms- for Navigators and Certified Application Counselors, Regional Enrollment Network members, and others. ---------------------- ------------------- The Patient at Risk Program is a free, web-accessible database for Emergency Information Forms (EIFs) for patients and families across Wisconsin. The program allows a parent or guardian to create, store, and manage their child's health information. In the event of an emergency, providers have fast access to the information about the child's health which may include:· Health problems or conditions
To learn more about the Patient at Risk Program please visit: http://wiaap.org/patient-at-risk.php. You will be able to review the program support tools for families, emergency responders and medical providers as well as a link to the enrollment database for families. ------------------------------ Financing the Special Health Care Needs of Children and Youth in Foster Care: a Primer http://hdwg.org/sites/default/files/Foster-Care-Primer.pdf States are expanding managed care to new geographic areas and to additional populations and linking payment to performance in an effort to improve delivery of care to individuals dually eligible for Medicare and Medicaid. Forty-four states are implementing care coordination activities. Some of the care coordination will occur through the Medicaid health home state plan option (section 2703 of the ACA), for individuals with chronic conditions. • Executive Summary • Foster Care: Then and Now Description of the foster care population and their special health care needs. • Foster Care Placement Description of the types of out-of-home placements children may experience. • Child Welfare System Synopsis of the funding, federal legislation and key players of the child welfare system. • Comprehensive Health Care for Children in Foster Care Description of important elements in providing comprehensive health care for children in foster care. • Federal and State Efforts to Improve the System of Health Care Highlights of steps that federal and state officials have taken to improve the system of health care for children in foster care. • Innovative Models of Health Care Delivery in Foster Care Summary of three different programs and their models of providing health care services for children in foster care. --------------------------------- Video provides quick answers to the questions you may have about:
Note: As of September 23, 2010, a separate provision of the ACA extended coverage for young adults, ages 19-26, on their parents' private health policies. Some insurers allowed parents to continue coverage for their young adult children with known medical conditions. Young adults with pre-existing conditions who were denied coverage under their parent's plan prior to 2014 should be able to be added to their parents' plan starting in January 2014 if they are still younger than 26. http://www.kaiserhealthnews.org/Multimedia/2012/November/andrews-q-and-a-covering-a-sick-child.aspx ------------- http://www.childtrends.org/Files/Child_Trends2012_10_01_RB_ChildDisabilities.pdf Children with Disabilities: State-Level Data From the A merican Community Survey --------------------------------------- Essential Health Benefits: Balancing State Flexibility with Consumer Protections By Sara R. Collins The Commonwealth Fund Stateline: State Policy & Politics http://archive.constantcontact.com/fs073/1101483160413/archive/1109075550170.html#Article1 December 20, 2011 The U.S. Department of Health and Human Services (HHS) had been working toward developing an Essential Health Benefits package that individual and small group health insurers, as well as all health plans in the state exchanges will have to provide as mandated by the Affordable Care Act (ACA). In a change of policy, on December 16, 2011, HHS issued an Essential Health Benefits Bulletin that says, rather than creating a one-size-fits-all essential health benefits package, states will have some flexibility to create a state-specific benefit plan, as long as each state covers services in the following ten categories:
or more of the 10 categories, states can pick a second plan to complete its health benefits package. This will allow insurers to continue covering a state's mandated benefits without the state incurring the cost of those services which fall outside of the HHS Essential Health Benefits package. See the 2010 list of each state's health insurance mandates. Public input to HHS is welcome about this process. The deadline for comments is January 31, 2012. Send comments to: EssentialHealthBenefits@cms.hhs.gov --------------------------------------- ------------------------------- |
A tribute to Katie Beckett - well written -!
Katie Beckett, Who Inspired Health Reform, Dies at 34 By
DENNIS HEVESI Published: May 22,
2012
Katie Beckett, who was 3 years old and
had been hospitalized almost since birth when President Ronald Reagan invoked
her case as an example of irrational federal regulation in 1981 — a crucial
moment in the movement toward government support for home health care — died on
Friday in Cedar Rapids, Iowa, in the hospital where she was born. She was 34,
more than three times the age her doctors had predicted she would
reach.
United Press International Katie Beckett, 3, in 1981
leaving a hospital in Cedar Rapids, Iowa, with her parents after a victory over
health care red tape.
The cause was a
digestive disorder not related to the brain inflammation that led to her
lifelong respiratory difficulties, her mother, Julie Beckett, said.
On Monday, the secretary of health and human
services, Kathleen Sebelius, called Ms. Beckett “an inadvertent pioneer in the
civil rights movement for people with disabilities” and the inspiration for
regulations that have allowed more than 500,000 disabled children to live at
home since 1981.
Four months after her birth
at St. Luke’s Hospital in 1978, Katie contracted viral encephalitis, leaving her partly paralyzed,
unable to swallow and barely able to breathe on her own. Her parents found
themselves in a bureaucratic trap. They wanted to manage her care at home with a
ventilator and began lobbying politicians and bureaucrats. The case led to what
is known as the Katie Beckett Waiver.
Katie
qualified for Supplemental Security Income, a Medicaid program run by the Social Security
Administration. Under the old rules, if she had been taken home, her parents’
incomes would have been counted against her, and she would have lost eligibility
for the aid. Yet her hospital care was costing $12,000 a month, six times as
much as home care would have cost.
President
Reagan heard about Katie from Vice President George Bush, who been told about
her by Thomas Tauke, a Republican congressman from Iowa. At a news conference on
Nov. 10, 1981, Mr. Reagan cited Katie’s case as an example of “hidebound
regulations” that caused “tremendous expense to the taxpayers.” The rules, he
said, forced her to stay in the hospital even though she would be better off at
home.
A day later, the secretary of health and
human services, Richard S. Schweiker, waived the rules to let Katie return home
without the loss of federal support. He also created a review board to handle
similar cases. When she left the hospital a week before Christmas in 1981, Katie
received a rag doll from the Reagans and a note wishing her and her family “the
loveliest holiday ever.”
Ms. Sebelius said
that “thanks to her mother, Julie’s, tireless advocacy, in 1982, Medicaid policy
fundamentally shifted” toward supporting home heath care.
Mary Katherine Beckett was born in Cedar
Rapids on March 9, 1978, to Julie and Mark Beckett. Besides her parents, she is
survived by a stepsister, Chelsea.
Home care
worked for Katie Beckett, her mother said. Although Ms. Beckett required nursing
care an hour a day, five days a week, and 12 hours a day on a ventilator, she
graduated from Mount Mercy University in Cedar Rapids in 2001 with a degree in
English and creative writing. She held several jobs over the years, including
one as a secretary in a homeless shelter.
There were extended hospital stays, but she
had applied to graduate school and was writing a novel. “She wouldn’t let me
read it,” her mother said, “but she loved young-adult romance novels.”
She added: “She lived a fairly normal life.
She wasn’t homebound.”
PIER is an informational site. It is not a legal services agency and cannot provide legal advice or legal representation. Any information contained on this site is not intended as legal or medical advice but only as an informational resource. This web site was created to inform and educate. The content should not be used as a substitute for professional medical advice, recommendations, diagnosis or treatment.
You are encouraged to confirm all information with other sources and a physician. If you have health concerns, please call or see a qualified health care provider without delay. .
We do not endorse any treatments, providers, or product information in this site.
As with any program - we strongly encourage you to thoroughly check out references.
You are encouraged to confirm all information with other sources and a physician. If you have health concerns, please call or see a qualified health care provider without delay. .
We do not endorse any treatments, providers, or product information in this site.
As with any program - we strongly encourage you to thoroughly check out references.
