Tag: medicaid

Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare is Needed

autisticadvocacy:

Content Note: institutionalization, violence

“More than half of the 48 states providing [Medicaid assisted living] services couldn’t tell us the number or nature of critical incidents in assisted living facilities.”

Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare is Needed

withasmoothroundstone:

bittersnurr:

clatterbane replied to your post: “Finally got in to see a new PCP. They told me they don’t treat chronic…”:

I think “losing” applications is SOP, unfortunately. Not just the SSA, I lost food stamps and Medicaid coverage for at least 2 or 3 months a year over that. Every year. Existing file? They never heard of you before. Sorry you got that, and the rest

I’ve actually never had issues with medicaid I don’t think but I did lose cell service because I have a subsidized phone and they screwed my application up (I lost my phone number too)

This is my second denial for ss they apparently didn’t use the old files or the new files so i have no idea what the fuck they were even doing for the last 6 months. I get to talk to my therpist/social worker on monday and hopefully they can help me avoid it happening again

I lost Medicaid this year because of bullshit like that.  I got it back and got retroactive Medicaid for the time I was without it, which is good because I’d never have been able to pay the hospital bills without it, not in a million years.  But it was a serious hassle, and all happened for really stupid reasons.  I’m just glad I have a case manager who was capable of doing all the legwork to get it back, because I’m not even remotely capable of dealing with Medicaid bureaucrats.

In my case, also, Medicaid has tried to deny me on the grounds of income before, even though I’m in a protected category of people (in my case, Disabled Adult Children, there are other categories treated the same as well) who are supposed to be considered equivalent to SSI recipients for Medicaid purposes (meaning that I have no income limit for Medicaid).  I would call them up (back when I could use the Internet for relay purposes, before they required all kinds of bullshit to be able to do that) and tell them “Turn to page ____ of the Medicaid manual” and they’d just repeat at me “You have too much income.”  No matter how many times I told them to just open the frigging manual and what page to open it to.  Then I got Legal Aid’s lawyers to call them and tell them the exact same thing, and it was fixed with one phone call.  That happened to me at least twice.

This time though it was something related to a change of address or something like that.  But it seems like they’ll drop you for practically any reason.

And I’ve found that any bureaucracy whose basic goal is to save the government money by shutting as many people out of the program as possible, will do blatantly illegal things, including losing files on purpose (or pretending to have lost files), basically hoping that you won’t fight back.  And then half the time if you fight back even a little they’ll cave in.  They’re just banking on the fact that, statistically, most people aren’t going to have the time, energy, knowledge, and/or ability, to fight back, so they can save a lot of money by just ignoring people’s applications until they send in the equivalent of Legal Aid. 

California’s Regional Center system is notorious for pulling stunts like that.  In my case, for instance, they simply did not notify me when I was accepted as a Regional Center client.  The time for the notification came and went and they simply did not return phone calls asking if I was accepted.  The moment my mother sent them a letter by way of Protection and Advocacy, they suddenly sent me a letter saying I’d been accepted.  They were just hoping that we’d give up and go away when we didn’t get a response out of them.  And that’s because a large number of people wouldn’t know to contact P&A, and would either continue making fruitless phone calls, or give up assuming they’d not been accepted to begin with.

People tell me it’s too cynical to believe that places like the Regional Center exist in order to save the state money by denying people services, but that really seems to be their actual role in the world, as seen by themselves.  And Social Security, Medicaid, and the like are no different that way.  They’re all about making it as hard as possible to get benefits.  And that includes people who absolutely do qualify, who are even acknowledged by the state as qualifying, who simply aren’t told that they qualified in the hopes that they’ll assume they didn’t and go away.  And for things like Disabled Adult Child benefits and Medicaid, in states where DAC recipients automatically get Medicaid no matter what our income… they’ll basically pretend that they don’t know the law, because it’s so easy to pretend given how small and obscure the groups are that qualify in this way.

All of which adds up to a nightmare for anyone trying to get any kind of benefits or services anywhere, whether they technically were approved or not.

A little more context, in case anybody missed that link in the last post.

clatterbane:

The app is refusing to upload commentary again.

http://withasmoothroundstone.tumblr.com/post/126729442395/bittersnurr-clatterbane-replied-to-your-post

I recall that I think it was Florida got caught with internal memos and stuff years ago, with an “unofficial”-official policy of automatically denying applications regardless of eligibility in hopes that people would just go away and not be able to appeal. And that was stuff like TANF, where they knew full well that little kids were bearing the brunt. :/

That was just one case where it was documented and they faced scrutiny over it. I am sure that other states (very much including Virginia, where I was–and it’s at least as bad as Florida in a lot of ways) are doing the same crap, besides all the paperwork “losing” and “oops, you’re just not in our system!”. Besides similar bureaucracies at the federal level.

The only reason I had any kind of disability or medical benefits for years was because my mother knew her stuff and was persistent. A lot of people just don’t have the knowledge or the ability to keep chasing after them and making effective threats. I just don’t have the ability, at all, and never have. If something happens to my partner, I’m just screwed now.

It struck me as particularly ridiculous how they kept dumping me off Medicaid, which I shouldn’t have even had to submit a full application for since SSI makes you automatically eligible. Because they did have to cover the gap with back payments every time. (Unlike the food stamps, where they did actually save money.)

But, I was temporarily very limited in the medical care I could get, though thankfully my grandmother could temporarily cover any regular prescriptions that the doctor couldn’t make up in samples. (My main doctor was a good guy and would see me anyway, but you can bet pharmacies aren’t giving stuff out and billing later. And a lot of medications are bad to stop suddenly…) A lot of other people wouldn’t have that kind of backup available. I was lucky.

It was disruptive, and I suspect that was the main point. Besides the fact that it would have been hard for Social Services to claim they’d never heard of me to avoid paying out the huge $25/month in food stamps, without also dumping me off Medicaid–with their administering both programs. 😐

Reminded of this again, with the most recent Medicaid fuckery. Glad I found an earlier post I thought I remembered, not to have to repeat.

Haven’t been running across much discussion of this crap as an additional goal with the application changes. When pretty much anyone who has dealt with the system has already run into enough deliberate obstructionism as things stand already. Just another way to try to weed people out–and generally the ones who need it the most.

It does frustrate me, how many people who have not needed to rely on these programs want to assume they’re working fine now.

(Including with the “Medicare For All is the only way!!!” crowd. If you truly think that, you probably haven’t dealt with Medicare yourself or had people you care about harmed by the system as it exists in reality. Let’s fix it to be fit for purpose, and then maybe we can consider the rest. Yeah, some coverage in theory is way better than nothing at all. But, I am not going to pretend that’s ideal in practice. Those are not the only choices.)

I had to think about that a while back, when something else about seriously unequal access to dental care in the US (and how dangerous that can be) came up.

Hopefully the ABLE accounts can help for at least some of the people who are eligible, and actually have some way of getting the extra savings at all. Covering otherwise difficult medical and dental expenses (besides educational) was part of the idea behind that, to begin with.

Shame this is only an option in a minority of states, and only for people who became officially disabled before 26. Not to mention, as already said, that the vast majority of people relying on SSI are unlikely to be able to put away much/any money without the help of family and friends. At a maximum of 75% of the poverty line? :/

But, it’s particularly nasty how Medicaid does not cover dental care for disabled adults.

Besides the basic issue of finding the money at all, there’s also the $2000 individual asset limit with SSI. One root canal is liable to cost more than that. Some of us are also dealing with conditions which directly affect our teeth. It’s a mess.

That’s actually one of the reasons I ended up with a bit of a dental pileup, after I moved into a better financial situation. When I was on SSI, I got one badly needed filling done for $20 through a free clinic volunteer dental program with an extremely long waiting list. (And was glad for the opportunity, I tell you what.) That was the full extent of dental access over nearly 10 years. It would probably still be that way if I were on SSI. My mouth has needed a decent bit of catch-up work as it is, maybe not too surprisingly.

And I know I’m far from the only one to have ended up in a situation like that. It’s unconscionable that Medicaid does not have to provide any dental coverage, for people who are quite deliberately kept that poor. It’s unconscionable that anybody is kept away from dental/medical care, period. It just adds a few extra layers of nastiness, setting people up in that position because they are disabled and needing to rely on SSI/Medicaid.