Idaho Eagle Forum 

Legislative Opinion - H0776 Medicaid Simplification

 

Idaho Eagle Forum urges a NO vote on H0776 - Medicaid Simplification Act. 

 

This legislation splits the Medicaid program into three different programs to serve three separate and distinct populations.  That is hardly simplification.  What it does do is to pave the way for different eligibility rules and benefit structures to be defined for each population. 

 

In November of last year, the Governor produced a report claiming ‘skyrocketing costs’ for Medicaid[1] but on the first day of the legislature, the budget report to the Idaho legislature stated that Medicaid costs were stable or had declined.  The costs that were in fact skyrocketing were for costs incurred by the medically indigent.

 

In the opinion of Idaho Eagle Forum, the legislature needs to call a halt to the implementation of both the Education and Medicaid legislation until they have taken the time to study the direction of the entire concept of the schools as the center of community (i.e. global village), schools being the coordinator and provider of health services for children and their parents, and the ‘Total Information Awareness’ computer information system (H752) integrated into the Workforce Development system that is planned for the students.    

 

 

H 776 - Medicaid Simplification Act Related to S 1341  

 

Though not specifically stated in this, the purpose of H 776 is to support the Early Childhood program as defined by Senate Bill 1341.  Children and working age adults must be segregated from the rest of the Medicaid population in order to provide benefits under the ‘Care Management System’ through the schools - which in turn gives the schools (see specific language below) the information to keep health records on students in the Student Information Management System (SIMS  H752).

 

Specifically:

 

 

Section 56-253 - Powers and Duties of the Director
 

 15  (3)  Each  state  plan shall include explicit policy goals for the covered
 16    population identified in the plan,  as  well  as  specific  benefit  packages,
 17    delivery system components and performance measures in accordance with section
 18    67-1904, Idaho Code.

 

 30  (6)  The director may, subject to federal approval, enter  into  contracts
 31    for  medical and other services when such contracts are beneficial to partici-
 32    pant health outcomes as well as economically prudent for the medicaid program.
 33  (7)  The director may obtain agreements from  medicare,  school  districts
 34    and  other entities to provide medical care if it is practical and cost-effec-
 35    tive.
 
Section 56-255 - Medical Assistance Program - Services To Be Provided
 
 27 (2)  Specific  health benefits and limitations for low-income children and
 28    working-age adults include:
 29        (a)  All services described in subsection (5) of this section;
 30        (b)  Early and periodic screening, diagnosis and  treatment  services  for
 31        individuals  under  age twenty-one (21) years, and treatment of conditions
 32        found; and
 33        (c)  Cost-sharing required of participants. Participants in the low-income
 34        children and working-age adult group are subject to the following  premium
 35        payments, as stated in department rules:
(3)  Each  state  plan shall include explicit policy goals for the covered
 16    population identified in the plan,  as  well  as  specific  benefit  packages,
 17    delivery system components and performance measures in accordance with section
 18    67-1904, Idaho Code.

 

Senate Bill 1341 - Early Childhood

 

Note: Early childhood is defined as ALL children - not just disabled children.   The intent is obvious by reviewing a few of the changes to existing law as defined in Senate Bill S1341.

 

Section 16-103 - Definitions

 

(67)  "Early childhood and early intervention system" means the management
 43    structure established in this chapter, comprised of the interdependent contin-
 44    uum  of  services  and activities for the provision of a statewide, comprehen-
 45    sive, coordinated, multidisciplinary, interagency program for  young  children
 46    who have a disability or are at risk from birth to eight (8) years of age.
 47        (8)  "Early childhood services" means services delivered by entities which
 48    meet current nationally recognized standards applicable to them, or other com-
 49    parable standards adopted by promulgated rules.
 
 52        (710) "Health and safety standards" means those  standards  which  address
 53    the  facilities  where early intervention young children receive services, are
 54    offered, excluding the child's home. Such standards may include, but  are  not
 55    limited to, the dimensions or size of a facility, communicable disease, social
 environment, nutrition, immunization, and fire codes.

 

 

 

 

See the attached analysis of S.1341 for more on the nature of this program and why they need to create three separate Medicaid programs to implement Early Childhood.

 

 

March 8, 2006