June 21, 2011
The Administrator of the federal Medicaid program came to Atlantis on Tuesday because of an invitation of former CPWD employee Dawn Russell. Dawn met the head of the Center for Medicare and Medicaid Services during an ADAPT Action in Washington DC and challenged him to speak with the disability community here in Colorado.
“I have been at Center for Medicare and Medicaid Services just about one year,” said Dr. Berwick to about forty people gathered at Atlantis, “and as I look back on the year, I will tell you that no experience I have had – not one – exceeds the chance to know ADAPT and the group of people I have come to admire so much.”
Dawn Russell told everyone that Atlantis has worked for 37 years to move people out of nursing homes, but even with the Colorado Medicaid program people have lost their jobs because the reimbursement is ineffective. She pointed out that people receiving Medicaid services in the nursing home one day, could not get Medicaid services in the community the next day because of a bureaucratic “coding” change.
Different than any other Medicaid program, Community Transition Agencies like CPWD are asked to serve individuals without a guarantee of their Medicaid eligibility and thus final payment. Likewise, reimbursement is only for successful transitions and only $850 regardless of the time and effort spent to make a successful transition.
There were many questions from the community on AT and other CMS issues. Alice Beasley, a Medicaid recipient was Medicaid eligible in Washington, but since she moved to Colorado sixty-four days ago, still is not found to be Medicaid eligible by our state. The result is that PASCO, who provides the care to keep her alive, has not been paid. Other Medicaid providers could have not accepted her as a client.
Julie Reiskin of CCDC told the Administrator of the unintended consequences of CMS punishment for state mistakes. She said the state in return looks to end the program or cut services rather than correct errors.
Tim Thorton the Executive Director of Atlantis said that the Medicaid rates for non-skilled services are too low, he pointed out that he loses about two dollars per hour to pay his employees for this covered Medicaid service and that does not include Administrative costs.
“What I say to you here, is that I will do my best. We need your voices,” Dr. Berwick said, “don’t put away your sledgehammer because this is still a struggle.”