#Expert Conversations
WITH is pleased to present Expert Conversations, an ongoing series that will feature conversations with experts in the fields of healthcare, disability, digital health, and philanthropy.
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Today’s Expert Conversation is with Amy Westling, Executive Director, Association of Regional Center Agencies (ARCA).
The Association of Regional Center Agencies (ARCA) represents the network of 21 non-profit regional centers that coordinate services for, and advocate on behalf of, California’s over 300,000 people with developmental disabilities.
Health Insurance programs for people with disabilities have been threatened in the past few years. What are the most misconceptions about these programs, and about the people that need them?
When people hear the term “Medicaid” (“Medi-Cal” here in California), they often only think about people who access these services due to low socioeconomic status. It doesn’t occur to many people that these same programs provide critical support to people who are eligible for them as a result of a significant disability.
An additional misconception is that these public health insurance programs fund only medical services. Medicaid dollars allow California to fund a variety of other critical services, ranging from In-Home Supportive Services, to regional centers, to school nurses.
What are your thoughts about proposed work and other new requirements for Medicaid?
The federal government isn’t proposing work or “community engagement” activities for Medicaid eligibility but has indicated its willingness to approve states’ requests to impose these requirements on “able-bodied” adults. Kentucky is the first state to get approval for such measures, with a few other states also considering such proposals. Only one state with a Democratic Governor (Louisiana) has expressed interest in pursuing this. California is not likely to pursue any work requirements for its Medi-Cal recipients. Here’s a good article on this:http://thehill.com/policy/healthcare/368823-five-things-to-know-about-medicaid-work-requirements.
What are your ideas about safeguarding MediCal/Medicaid going forward?
There are still proposals at the federal level that we cannot lose sight of. While the federal Budget was recently passed, there was immediate discussion afterwards about pursuing a “recissions” bill that would dial back some of the domestic funding levels in the recently-approved Budget (https://www.politico.com/story/2018/04/10/mcconnell-senate-federal-spending-balanced-budget-amendment-512475).
On the statewide level, there are questions about which Medi-Cal rates are sufficient to ensure access to critical services. While this year’s Governor’s Proposed Budget includes significant increases for some services (i.e., 50% rate increases for in-home nursing), there are no enhancements proposed for rates for many other services. One example of such a service is for care provided by Pediatric Day Health Centers, which provide skilled nursing care to individuals under the age of 21 to make it possible for children who are medically fragile or technology dependent to live in the community with their families.
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The mission of WITH Foundation is to promote comprehensive and accessible healthcare for adults with developmental disabilities.