Public Comment Help – PASSE Model Phase I

DHS has released a manual/rule change for public comment until August 11, 2017. After that, you will not be able to get your comments on the record. In addition, they are hosting a public hearing on August 8.


You should read the manual for yourself to make sure you cover everything that concerns you. However, even if you read it, you might still wonder what to say. The comments below are an example of what one person plans to send in.

Use the form below. By choosing “Submit,” you will send an email directly to the appropriate DHS representative. Enter your information, and type your comments into the text box. You may copy/paste the comments listed at bottom into the comment section of the form, but don’t do so unless you have read it first and agree with it all. The following comments are just examples of one person’s opinions. Public comments are most effective when you make them more personal to you!


EXAMPLE | EXAMPLE | EXAMPLE | EXAMPLE | EXAMPLE | EXAMPLE | EXAMPLE

This is my public comment regarding PASSE-New-17up.doc:

Section 211.000 – It says that the PASSEs should begin October 1, 2017. I believe that this model is not ready to begin taking on clients for several reasons. Rules like this one still have to be sent through the legislature for their approval. The Insurance Department isn’t supposed to approve the PASSEs until mid-September, which will only leave them a couple of weeks before they start managing people’s care. We don’t know what the rules will be, and we don’t know who the PASSEs will be. If the PASSEs aren’t ready and don’t do a good job, they could make mistakes. This will hurt people. I want DHS to push the date back and allow us to keep things the way they are until the PASSEs have had adequate time to review all of the finalized rules and to hire and train people who understand the rules.

Section 214.000 – It says that people can choose another PASSE during the first 90 days and once every year. How will we know what the differences between each PASSE is? I want to pick the best PASSE, but I don’t understand all of the rules or what they all offer. (At this point, I have reason to wonder if the PASSEs themselves understand the rules, as they have not been finalized.) It also says “on the beneficiary’s annual anniversary of attribution to a PASSE.” Is this a single day to respond, or is it a week? You need to define how long that amount of time would be.

Section 214.000 D – It says a client can move because of “poor quality of care,” but how do we prove that? That is a relative term. Who determines what kind of care is poor? I believe that the patient should determine whether care is poor and what that means in their situation.

Section 215.000 – What if the abeyance is due to DHS/Medicaid’s fault in paperwork (and the client can prove that)? Will the coordinator help the recipient to know that their Medicaid eligibility is in dispute and help them to figure that out?

Section 222.000 G – “The right to be provided written notice of a change in the beneficiaries care coordination” should be at least 14 days, not 7 days. If you are relying on snail mail, half of the time can be used simply in sending the notification, leaving the receiver very little time to respond or make other arrangements. Why isn’t this policy the same as 223.000 B, allowing 30 days from the time it goes into effect?

Section 231.000 – The travel times and distances listed need to be cut in half, especially for DD and BH providers who are seen on a more frequent basis. For example, it is not in the best interest of a child or adult to have to travel an hour to and then an hour to return from a location to see a therapist multiple times per week.

Section 241 G, 242 A, & 243.000 – DHS needs to give the PASSEs enough money to have a qualified individual available to help me whenever I need them, as many times as I may need them. Many providers seem to be concerned that the amount announced at the AR Waiver Conference (in July 2017) of $177 is not enough. I want them to get what they need so they can give me what I need. After December 31, 2018, they should have a different funding source and should not use any money from recipients’ care for administrative funding needs.

Section 242.000 – It says in the document that care coordinators will be employees of the PASSE (241 B). However, it does not say where the care coordinators should be located. Because Arkansas is so rural, care coordinators located in the communities they serve would be most knowledgeable for their clients.

Section 254.000 – Will DHS be required to submit the data received from PASSEs, such as data that shows savings or lack thereof, for public viewing? We want to see that data as well.

Section 261.000 – This says that grievances must be resolved within 30 days of the filing date. What will happen in the meantime? If a person needs treatment, do they have to wait all that time to receive it?

Section 264.000 – This description needs more definition. Who may serve on a Consumer Advisory Council? I believe that beneficiaries or direct consumers should serve, but caregivers who speak in place of beneficiaries who can’t speak for themselves should also be able to serve.

Senate pulls All-night Session to Vote on Skinny Repeal

The Senate is set to vote on a newly written bill, referred to as the skinny repeal, barely released an hour ago. They will vote around midnight.

Read the full text.

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Even Senators dislike it, but they may still vote it through.
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Watch live as they vote:
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Track the votes.

Senate Voted to Proceed: Now What?

Earlier today, the Senate voted 51-50 to proceed with debate over the health care bill. With only 2 opposing Republican votes, just 1 shy of what was needed, plus a tie-breaking vote from VP Pence, the motion succeeded. We now move toward serious Medicaid cuts that can’t be reversed once set into motion, and it will take all of us standing together to prevent it.

Watch how each Senator voted.

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Data shows that any bill, amendment, or revision proposed so far will be detrimental to Medicaid recipients. We (MSL) oppose the per capita caps or block grants that have been proposed because they will shift great stress to state budgets and reduce the ability to give recipients the coverage they need. We oppose ending expansion because it will result in millions losing coverage. In addition, the aforementioned bills remove essential health benefits and pre-existing condition protections, which would be detrimental to all Americans, making coverage unaffordable if not unattainable for many.

As part of the AACF statement on how this vote will affect Arkansas, Arkansas Advocates for Children and Families said: “Today’s vote shows that we have more work to do. Despite an outcry from health care professionals, business owners, families, and even governors, many Senators have decided to move forward with legislation that will destabilize the entire health care system. Too much is at risk to continue down the current path. Children with special needs, elderly enrollees, and people with chronic conditions who rely on Medicaid will lose coverage. Health care for families that were able to purchase affordable coverage, many for the first time, is also at risk.

The people have spoken—any proposal that falls short of guaranteeing everyone affordable, comprehensive coverage, is unacceptable. Now, it’s time for Congress to listen. We ask that Senator Cotton and Senator Boozman commit to voting no on any bill that endangers the health of tens of thousands of Arkansans. Anything less is breaking their promise to all of us.”

Now that we understand the ramifications haven’t changed, here’s what will happen next:

  1. The Senate will debate for 20 hours. By rules, to be fair, Republicans and Democrats get equal time of 10 hours each.
  2. The Senate will probably vote a bunch of times on amendments and such.
  3. Then the Senate will vote on a finalized bill and send it to the House.
  4. The House will vote, and if it passes, they’ll send it to President Trump.

See a flow chart.

As you can see, if you oppose Medicaid cuts, you can’t give up. Not a single Democrat voted to proceed, and we only need a few Republicans to oppose to keep any bill from moving forward. We were only one opposing vote short. Take a breath, renew your determination, and communicate in any way you possibly can!

Contact your Senator!

Email your Senators’ legislative aids!

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Stand strong!

Take Action: Graphic to Share

The news changes like the wind. Are they voting or aren’t they? Repeal and replace or repeal without replace? No matter what’s happening with them, we need to continue to make our needs and wants abundantly clear.

Many are saying that they can’t get through to Senators via phone calls. Don’t stop calling because they are counting the calls. 866-426-2631

However, social media is a great way to publicly contact your Senators, especially since they won’t post their direct email addresses.

Share this graphic with them and tag them in your posts. Use hash tags like #BCRA or #ProtectOurCare to help others see your posts!

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Revised Senate health care bill: Where are we now?

A revision of the BCRA Senate Health Care   bill has been released, but what’s different? We have the one-stop-shop for understanding the bill for yourself.

Some reports say that they want to vote as early as Tuesday. Get to reading and then get to calling!

Every call matters. Here’s the number for Senators across the nation: 866-426-2631

Find your states US Representative & contact his/her office

Find your state’s US Senator & contact his/her office

Read the new revised bill to make sure you discover everything for yourself.
Check out these resources to guide you:
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What was the original bill?

Full text of the original bill. Click on the image below, and  use the resources above to help you.
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How the BCRA will affect you, even if you don’t receive Medicaid

The topic of health care is not only in some ways oppressive on our minds but also overwhelming these days. Months ago, the House wrote the American Health Care Act (AHCA) in an effort to repeal and replace the Affordable Care Act (ACA), and they passed it on to the Senate. Then, the Senate must have found fault with the AHCA because they wrote their own version of the bill called the Better Care Reconciliation Act (BCRA). If the Senate passes their bill, it will have to go to the House for their approval. We have seen months (years!) of coverage on the subject of health care, and it’s downright confusing at this point.

Let’s try to clarify some of the confusion by pulling a few articles together to show what will change with the Senate health care bill, the BCRA. (The AHCA doesn’t matter if the House approves the BCRA.) This research will show that nearly everyone who isn’t extremely wealthy will be affected negatively by the bill as it stands proposed today. If you care about, or are affected by, any of the following categories, you can expect changes to come to you and your family if this bill were to pass.

1. Medicaid Funding

“[T]he Senate bill would radically restructure all parts of Medicaid—not just the expansion provided under the Affordable Care Act.” 1

“The cumulative impact: a $772 billion spending cut over 10 years, versus current law, and 15 million fewer people enrolled in Medicaid in 2026.” 2

2. Essential Health Benefits

“But another change might have more far-reaching effects: eliminating the Affordable Care Act’s ‘essential health benefits,’ or EHBs. That shift could affect almost everybody, including the 156 million Americans who receive health coverage through their employers.” 5

Here’s a rundown of what they are: 4, 5, 6

  • Outpatient care — scheduled doctor visits, (outpatient care you get without being admitted to a hospital)
  • Emergency room trips — ER visits and ambulance trips.
  • In-hospital care — All care people get as hospital patients, such as surgery.
  • Pregnancy, maternity and newborn care — before and after birth
  • Mental health and substance abuse disorder services — (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative services and habilitative services – help recovering from an injury or illness, but also treatment (therapy) for kids with autism or cerebral palsy.
  • Lab tests
  • Preventive services — vaccines, cancer screenings, etc.
  • Pediatric services — including dental and vision care for children.

3. Pre-existing Conditions Protections

“The BCRA retains the popular ACA provision that people with pre-existing conditions cannot be charged more for insurance because of their health status. However, weakened essential health benefits would hurt people with pre-existing conditions.” 1

“The Senate bill would retain some limits. It wouldn’t, for example, allow states to waive the prohibition on discriminating on the basis of preexisting conditions. But it would allow states to remove caps on out-of-pocket spending for exchange plans.” 3

4. Subsidies & Taxes

“One major difference is that the Senate bill provides subsides only up to 350% of the federal poverty level starting in 2020; the ACA currently provides subsidies up to 400%. In other words, while individuals earning up to $47,550 qualify for help under the ACA, only those earning up to $41,580 would qualify under the Senate plan. This means far fewer people will qualify for aid.” 1

Sources:

1 4 Things to Know About the Senate’s Health Care Bill

4 ways you probably didn’t know the Republican bill changes Medicaid

3  Crazy Waivers

4 What Are ‘Essential Benefits’ in GOP Health Care Bill Debate?

5 The 10 ‘essential’ benefits that could be eliminated under the GOP health care plan

6 What Marketplace health insurance plans cover

Senate Healthcare Bill Released

Updated: 7/9/17 4:08 pm

By now, you’ve probably seen more than 10 different news stories about the Senate healthcare bill. Maybe 10 per day! But what’s the truth? Will it really cut Medicaid? Will it really affect everyone? Well, the only way for you to know is for you to read it yourself. And we can help you.

You need to read, but also, don’t stop responding. The Senate wants to vote on this bill as soon as they can come to an agreement. They’re having many negotiations behind closed doors. Let your voice be heard through those doors! These are the Arkansas Senators to contact:
Sen. John Boozman (202) 224-4843
Sen. Tom Cotton (202) 224-2353

If you’re not from Arkansas, this info pertains to you as well. Every call matters. Here’s the number for Senators across the nation:  866-426-2631

Find your states US Representative & contact his/her office

Find your state’s US Senator & contact his/her office

Contact information for all of AR Congressmen.

What’s truly in the bill?

Make sure to read the bill to form your own educated opinions. Click on the image below to access the full text, and  use the resources above to help you.
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