As a result of the recession, the State was planning on exacting cuts to Medicaid providers, including home health agencies.  There were to be cuts in both Fiscal Years 2009 and 2010.  The Colorado Department of Health Care Policy and Financing (HCPF), which administers the Medicaid program, invited me and several providers around the State to discuss cuts.  There was talk about cutting services, establishing a waiting list or lowering provider rates.  The consensus among the providers was to lower rates and not impact services.  Staff members from HCPF asked if the providers wanted to lower home health rates equally among all the disciplines – HH Aide/CNA services, Nursing, OT, PT and Speech Therapy.  While the Home Care Association of Colorado (HCAC), a lobbying group representing home health agencies, wanted the cuts to be shared equally among all the disciplines, I strongly objected.  My objection was based upon rate settings over the last 22 years.  During that 22 year period, Nursing rates went up 74.4%, Physical Therapy rates went up 124.3%, Occupational Therapy went up 127.1%, Speech Therapy went up 162.9% and Home Health Aide/CNA rates went up 49.9%.  My feeling was that if the cuts should be equal, then the rates (percentages) should likewise be equal.  I believe many people at the meeting supported this, however the Association did not.  We all agreed that nursing homes needed to be cut since their rates are set in statute and they have actually seen a decrease in their clientele.  I was prepared for a battle, but we were all rescued by the President’s recent stimulus package.  While I don’t mind a good and fair fight now and then, I was elated that we would not be cut for this fiscal year at least.  I need to say that even if there was a cut, PASCO would not cut any staff member, CNA’s, Nurses, Therapists, etc.  At the moment, it’s as rough as it gets out there!

Lastly, I received a call from a parent who was midly panicked about her child getting cuty off from Medicaid.  The parent’s case manager hinted that due to changes in Medicaid, her child might be cut off.  It appears that the Colorado Dept. of Health Care Policy and Financing (HCPF) is concerned that there may be Medicaid clients receiving home health services when they should not be.  For sure there are some gray cases and as many of you know, PASCO has really tried to be judicious in making sure that clients receive the right amount of hours.  After getting the call, I met with Laura who then decided to go through efvery chart to make sure clients are getting the hours they need.  She estimates that 5% or less of the present cases are gray, but in most of these cases, some care has justifiably been provided.  We really try to balance the needs of each client/family with the rules/regulations and funding from Medicaid and overall, I think we do a great job in balancing this.

So in summary, the State will be looking at making sure services meet the need.  I will be attending a variety of meetings in the next few weeks and will keep you posted on what I learn.  In addition, I am in contact with Christy Blakely of Family Voices who lobbies on behalf of childeren with special health care needs and is aware of what is going on at Medicaid.

On a very sobering note, every one at PASCO was saddened to hear about the passing-away of a wonderful employee, Theresa Toriola, who had been with us for ten years.  Our most sincere condolences to her family and friends, she will be missed.

Looking forward to seeing everyone at the picnic, and have a wonderful spring.

Barry