One of the most favorable ways for states to cope with young people with disabilities who are aging from the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) is to move them into services at home and at the community level (HCBS) program. HCBS provides these newborn people with disabilities the opportunity to receive Medicaid benefits that can be used to pay for health care services both at home and in the private community dedicated to their particular types of disabilities. This has two main problems: it cannot cope with the existing situation, and it is in the middle of the reform process because it is already too expensive.
Waiting for health
Those erupted HCBS rejections pay only for a certain number of people; All others are on the waiting list. At first, it doesn't matter if you realize that waiting lists only move when someone is currently receiving HCBS coverage — and most of these places are filled with young adults who have decades of life ahead of them!
Currently, more than half of millions of Americans are expected on such lists, trying to figure out how to make ends meet until their coverage begins. In some states, you can get a child with special needs, which must be included on an HCBS adult waiting list on the day they turn 14 ... and then still make sure they wait 5 or more years after 19th birthday until they actually get the coverage they need, all the while paying for medical care from their pockets.
HCBS - Crazy Reforms
The HCBS system began to gain popularity in 1995 as a less costly alternative to institutional care (for example, nursing home care). This year, HCBS costs amounted to $ 5 million for the entire country. Since then, however, the cost has increased significantly every year, to $ 44 million in 2014. Medicaid administrators panic because they cannot grow. Since they do not want them to directly attack a community of persons with disabilities, their strategy of choice was to attack private communities that arose throughout the country to serve people with special needs.
They did this by massively expanding the definition of “institutional”, so thousands of non-profit communities that served people with disabilities and were paid through the HCBS bounce system are no longer eligible for these refusals. It is not a question of any young adult with special needs who cannot qualify for HCBS - it is a question of the government that systematically declares “community” services based on communities. no longer be officially-communities, but rather institutions. So now, when you get older from EPSDT, even if you are applying for Medicaid, you can be told that only people who are allowed to take care of you are members of your family.
According to the Medicare Services Center, Medicare / Medicaid will begin to consume 100% of federal revenues by 2050 if nothing changes, so these restrictions are absolutely necessary. But there is another option that gives much more fiscal sense, if only people open their eyes - we will discuss this in the next post.
