Guest guest Posted July 25, 2002 Report Share Posted July 25, 2002 >Dear Darin, > >In reviewing my email box, I came across your letter that I did not >respond to. > >I apologize. I did forward Dr. 's phone number to Freels in >order for him to contact the Dr. > >I did not want to just hand out his phone number across the web. > >So, please contact Freels to get the specific information that Dr. > has. HOpefully, has gotten all the specifics for us to chase >down and we will not have to keep bothering all Dr. for the same >items and information. > >Best wishes for you battles for your child! > >Warm Regards, > >Ed Nemeth > >At 07:57 PM 7/10/2002 -0400, you wrote: >>Who is Dr. and how do you get in touch with him. I have worked with >>Medicaid till im blue in the face. Yes she qualify's for the medicad waiver >>but here in Texas the waiting list is so long it takes the children that are >>on the list 8 to 10 years. We applied in 1998 and they tell us we still have >>another 4 to 6 years on the list. We are at # 675. We started at #800 Four >>years ago so you see the list does not move very fast. We are on a program >>called Chip's. It is for familys that dont qualify for medicaid but need >>insurance. Its a form of medicaid but is a HMO. you use there Dr.s and have >>to fight like a dog for everything. >> >>Darin >>Crandall Texas > > J. Nemeth >President, CEO >Spectrum Events >916-856-7044 x 339 Phone >916-856-7040 Fax Dear Darin/Ed and the list, Thanks for the note and I apologize that I haven't posted this earlier. I did speak at length with Dr. . He's actually a retired dentist who specialized in dentistry for children with disabilities and he also taught others how to do dental work on children with disabilities. He said the Medicaid waiver program(s) are designed to assure access to Medicaid coverage for children with disabilities because when Medicaid first began, disabled children often didn't have access to Medicaid services. However, just like every state is free to administer their Medicaid programs however they want, so too are the states free to administer their waiver programs however they want. As for SCHIP (State Children's Health Insurance Plan) coverage, according to the US Dept. of Health and Human Services [http://www.hhs.gov/news/press/2002pres/schip.html]: " Ensuring Meaningful Health Benefits. Under the program, states may choose to expand their Medicaid programs, design a separate child health program, or use a combination of both. States choosing separate child health programs must offer either the same or " equivalent " benefits as those offered under one of three benchmark plans: the standard Blue Cross/Blue Shield Preferred Provider Option offered by the Federal Employees Health Benefit Program; a health benefit plan offered by the state to its employees; or the HMO benefit plan with the largest commercial enrollment in the state. " Each state's SCHIP plan can be found at http://www.cms.hhs.gov/schip/chpa-map.asp . In Texas, the SCHIP program is administered by two sources (1) an expansion of Medicaid services and/or (2) coverage provided by the state employees health benefit plan. Now, what's happening for you in Texas, Darin is your child has coverage via the state employees health benefit plan and it's not equivalent to the Medicaid coverage because the state employees health benefit plan does not have a provision like " Paragraph 5 " . At the same time, your child is qualified to receive a Medicaid waiver (and thus Medicaid coverage via Paragraph 5). In short, you're getting screwed and you need to get yourself an attorney. There is such an obvious lack of equality here that any judge worth his/her salt would quickly amend the inequity. At least I hope so. If there are other Texas parents whose kids are also on SCHIP--or parents in other states whose kids are also on SCHIP--I encourage you to use this list to band together and make something happen. That's what this list is for. Back to Dr. --it turns out he's intimately aware of the specific details of Medicaid for children and in fact Dr. was part of the original panel of physicians, dentists, therapists and other caregivers of disabled children convened by the Lyndon White House when the Medicaid program was originally conceived. That's when I quizzed him on this LBJ statement: " The problem is to discover, as early as possible, the ills that handicap our children. There must be continuing follow-up and treatment so that handicaps do not go untreated. " (13 Congressional Record 2883. February 8, 1967). Dr. said when LBJ used the word " handicap " he was speaking specifically about children with disabilities. He was talking about our kids--yours and mine. Well, those " ills " are caused by hypoxia and the ONLY continuing follow-up and treatment that can overcome hypoxia is hyperoxia--which can only be achieved by administering oxygen at greater than normal atmospheric pressures. Once again, a well-intentioned government program (Medicaid) has failed to achieve its original goal. Of course, that failure was built on the failure of another government program--Medicare (via HCFA/CMS HBOT rules) to truly help people with brain-injury overcome brain-injury. After a little digging I dug up the home phone number of a noted presidential historian and Pulitzer-prize winning author on LBJ and left a request on her answering machine for some sort of written confirmation/documentation that LBJ was thinking of brain-injured children when he made that statement. That too will be posted on the medicaid/files/ page. Additionally, I believe it would be helpful to contact family members and see if they're interested in seeing President 's goals actually met. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ " Delight yourself in the LORD and he will give you the desires of your heart. " [Psalm 37:4] Freels 2948 Windfield Circle Tucker, GA 30084-6714 770/491-6776 (phone and fax) 509/275-1618 (efax, sends fax as email attachment) mailto:dfreels@... http://www.freelanceforum.org/content/portfolio.asp?ID=195 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 25, 2002 Report Share Posted July 25, 2002 >Dear Darin, > >In reviewing my email box, I came across your letter that I did not >respond to. > >I apologize. I did forward Dr. 's phone number to Freels in >order for him to contact the Dr. > >I did not want to just hand out his phone number across the web. > >So, please contact Freels to get the specific information that Dr. > has. HOpefully, has gotten all the specifics for us to chase >down and we will not have to keep bothering all Dr. for the same >items and information. > >Best wishes for you battles for your child! > >Warm Regards, > >Ed Nemeth > >At 07:57 PM 7/10/2002 -0400, you wrote: >>Who is Dr. and how do you get in touch with him. I have worked with >>Medicaid till im blue in the face. Yes she qualify's for the medicad waiver >>but here in Texas the waiting list is so long it takes the children that are >>on the list 8 to 10 years. We applied in 1998 and they tell us we still have >>another 4 to 6 years on the list. We are at # 675. We started at #800 Four >>years ago so you see the list does not move very fast. We are on a program >>called Chip's. It is for familys that dont qualify for medicaid but need >>insurance. Its a form of medicaid but is a HMO. you use there Dr.s and have >>to fight like a dog for everything. >> >>Darin >>Crandall Texas > > J. Nemeth >President, CEO >Spectrum Events >916-856-7044 x 339 Phone >916-856-7040 Fax Dear Darin/Ed and the list, Thanks for the note and I apologize that I haven't posted this earlier. I did speak at length with Dr. . He's actually a retired dentist who specialized in dentistry for children with disabilities and he also taught others how to do dental work on children with disabilities. He said the Medicaid waiver program(s) are designed to assure access to Medicaid coverage for children with disabilities because when Medicaid first began, disabled children often didn't have access to Medicaid services. However, just like every state is free to administer their Medicaid programs however they want, so too are the states free to administer their waiver programs however they want. As for SCHIP (State Children's Health Insurance Plan) coverage, according to the US Dept. of Health and Human Services [http://www.hhs.gov/news/press/2002pres/schip.html]: " Ensuring Meaningful Health Benefits. Under the program, states may choose to expand their Medicaid programs, design a separate child health program, or use a combination of both. States choosing separate child health programs must offer either the same or " equivalent " benefits as those offered under one of three benchmark plans: the standard Blue Cross/Blue Shield Preferred Provider Option offered by the Federal Employees Health Benefit Program; a health benefit plan offered by the state to its employees; or the HMO benefit plan with the largest commercial enrollment in the state. " Each state's SCHIP plan can be found at http://www.cms.hhs.gov/schip/chpa-map.asp . In Texas, the SCHIP program is administered by two sources (1) an expansion of Medicaid services and/or (2) coverage provided by the state employees health benefit plan. Now, what's happening for you in Texas, Darin is your child has coverage via the state employees health benefit plan and it's not equivalent to the Medicaid coverage because the state employees health benefit plan does not have a provision like " Paragraph 5 " . At the same time, your child is qualified to receive a Medicaid waiver (and thus Medicaid coverage via Paragraph 5). In short, you're getting screwed and you need to get yourself an attorney. There is such an obvious lack of equality here that any judge worth his/her salt would quickly amend the inequity. At least I hope so. If there are other Texas parents whose kids are also on SCHIP--or parents in other states whose kids are also on SCHIP--I encourage you to use this list to band together and make something happen. That's what this list is for. Back to Dr. --it turns out he's intimately aware of the specific details of Medicaid for children and in fact Dr. was part of the original panel of physicians, dentists, therapists and other caregivers of disabled children convened by the Lyndon White House when the Medicaid program was originally conceived. That's when I quizzed him on this LBJ statement: " The problem is to discover, as early as possible, the ills that handicap our children. There must be continuing follow-up and treatment so that handicaps do not go untreated. " (13 Congressional Record 2883. February 8, 1967). Dr. said when LBJ used the word " handicap " he was speaking specifically about children with disabilities. He was talking about our kids--yours and mine. Well, those " ills " are caused by hypoxia and the ONLY continuing follow-up and treatment that can overcome hypoxia is hyperoxia--which can only be achieved by administering oxygen at greater than normal atmospheric pressures. Once again, a well-intentioned government program (Medicaid) has failed to achieve its original goal. Of course, that failure was built on the failure of another government program--Medicare (via HCFA/CMS HBOT rules) to truly help people with brain-injury overcome brain-injury. After a little digging I dug up the home phone number of a noted presidential historian and Pulitzer-prize winning author on LBJ and left a request on her answering machine for some sort of written confirmation/documentation that LBJ was thinking of brain-injured children when he made that statement. That too will be posted on the medicaid/files/ page. Additionally, I believe it would be helpful to contact family members and see if they're interested in seeing President 's goals actually met. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ " Delight yourself in the LORD and he will give you the desires of your heart. " [Psalm 37:4] Freels 2948 Windfield Circle Tucker, GA 30084-6714 770/491-6776 (phone and fax) 509/275-1618 (efax, sends fax as email attachment) mailto:dfreels@... http://www.freelanceforum.org/content/portfolio.asp?ID=195 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2002 Report Share Posted July 28, 2002 remove me from the list. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2005 Report Share Posted October 26, 2005 What happened to the waiver for " cognitive disabiities " ? Our kids with autism fell under that before. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 18, 2008 Report Share Posted March 18, 2008 Holy Catfish, Lynn. Just a little typing... Okay, but, only within the Division of Developmental Disabilities State Operated Developmental Centers Nine of them around Illinois, an old, segregated, heartbreaking, and expensive model. Lincoln has closed, Howe is in the news now. Incredibly expensive places for people to be segregated because of their disability. Local Grant Funding - started with parent advocacy in the 1950's. " We're not going to institutionalize OUR CHILDREN! " Started with programs in church basements and were funded with bake sales and volunteer time. Eventually organizations asked the state for help. Many of these programs live on. Organizations receive funding for specific programs, typically a specific service, limited enrollment, sometimes well over taxed by well meaning providers. You've got to hope that you've got the right kind of disability or challenge, that there is no waiting list, and that once you're in they're able to offer services that are actually helpful because they're not stretched too thin. In short, these programs which can vary widely in quality, are not " Person Driven " . It's take it or leave it. A great way to identify providers of services in your area is to contact the Illinois LifeSpan Project at www.illinoislifespan.org. They are the 411 of disability services, have a HUGE website, trying to track everything. You can interact with the website only or contact them for real people help at 800-588-7002. ICF/DDS These are the typically large settings that are actually a nursing home model, but only for people with dd. They can be huge. State Ops are technically ICF/DDs. Or some people run them relatively small, between 8 and 16 people. Most ICF/DDs are downstate. Don't ask me why. There is probably some kind of historical answer. Interestingly, ICF/DDs are entitlements. But, who wants to live in a nursing home? In most ICF/DDs people don't have any choice about what they eat, when they go to bed, when they get up, and many of the other simple choices of life. Traditionally, once you are in an ICF/DD you have a very had time moving into a CILA (or waiver funded) group home. Medicaid Waivers These are programs that you know as the Adult and Children's Home-Based Support Services Programs, Community Integrated Living Arrangements (CILA, the supports adults receive typically in group homes), and the Children's Residential Waiver. Medicaid Waivers Charlotte, For those of us just joining the group, could you please give us a summary of the programs available to us? Thank you, Lynn Wetterberg ************ **It's Tax Time! Get tips, forms, and advice on AOL Money & Finance. (http://money. aol.com/tax? NCID=aolprf00030 000000001) Quote Link to comment Share on other sites More sharing options...
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