Question on provider vulnerability to Medicaid cuts

[Guest guest]

Migrant Health Research Group-

I have a couple of questions on Medicaid reimbursement of Migrant

Health Providers. Any help would be greatly appreciated. I would

also be glad to call anyone who would be able to provide me with more

information on this.

Questions on Medicaid reimbursement of Migrant Health Providers:

Please correct me if I am wrong but as I understand it states are

required (in order to receive federal matching funds) under federal

Medicaid guidelines to provide reimbursement to FQHC-designated

migrant health centers. My questions are:

1. Are there significant numbers of migrant health providers out

there that are not FQHC designated, yet do receive Medicaid

reimbursement as optional services provided by state Medicaid

programs.

2. If so, might these providers be vulnerable to cuts in state

Medicaid programs as states attempt to address budget concerns? One

question I had was whether the majority (assuming there are

significant numbers) of non-FQHC providers are informal, such as eye

exams provided by the local church, etc... and would not be eligible

for Medicaid reimbursement anyway?

3. If there are significant numbers of non-FQHC designated migrant

health providers, are they mostly located in urban or rural areas?

4. Specifically, my question is: What migrant health providers could

be hurt if states cut Medicaid programs?

Relevant literature would be really helpful. Thanks.

M.R.

[Guest guest]

I have been asked by many workers both in Los Angeles and other southern

california cities about help with obtaining working visas

Does anyone know of any reliable lawyers in the southern california

region(especially los angeles) who sepcialize in immigration law??

THANK YOU!

Kun

Doctoral Candidate of Population and International Health

Harvard School of Public Health

921 10th Street #219 Santa , CA 90403

310 779 2223

hkun@...

[Guest guest]

,

Here's some comments from Don Villarejo in California related to your questions -- Alice Larson

-------------------------------Gov today (May 14, 2003) announced the 'May Revise' for the 2003-04 budget (this is the final revision of the proposed budget submitted to the legislature). The revise would not cut MediCal (California's version of Medicaid) eligibility as he had originally proposed. The earlier budget plan would have limited MediCal eligibility to households with incomes at 60% of federal poverty or less. Today's revise would keep eligibility for households at 100% of federal poverty incomes or less, the current level.Nothing has yet been said about 'emergency MediCal' which is the program that provides services for undocumented, pregnant California women from pre-natal through four months after the birth. I expect that we'll be able to protect emergency MediCal from any cuts.MediCal is not especially significant for current hired farm workers in California. Fewer than 2% of hired farm workers interviewed in the CAWHS (California Agricultural Workers Health Survey) who had received health care services during the preceeding 12 months had been covered by MediCal. The decline from the share covered a decade ago is largely the result of limitations on MediCal that exclude most undocumented workers, whose share of the California farm labor force increased sharply between 1992 and 1999. This factor was a component in the decision by some former migrant clinics, e.g., the Olivehurst clinic near Sacramento, to cater primarily to non-farm workers who are legal residents. On the other hand, we found that roughly one-fifth of CAWHS household members, mostly spouses and/or kids, had received services supported by MediCal during the prior 24 months. It's the workers themselves who are not covered.Nevertheless, even under the May revise, services for vision and dental would not be supported. Of course, all of this is subject to legislative whim.In regard to the question about non-migrant health centers serving significant number of migrants, Doctors and Martha Sablan, who operate the private Sablan Clinic in Firebaugh, are the folks who were found through the CAWHS to be serving a large number of hired farm workers on the west side of the San Joaquin Valley.----- Original Message -----

From: Rudolf

Sent: Wednesday, May 14, 2003 8:23 AM

Subject: [ ] Question on provider vulnerability to Medicaid cuts

Migrant Health Research Group-I have a couple of questions on Medicaid reimbursement of MigrantHealth Providers. Any help would be greatly appreciated. I wouldalso be glad to call anyone who would be able to provide me with moreinformation on this.Questions on Medicaid reimbursement of Migrant Health Providers:Please correct me if I am wrong but as I understand it states arerequired (in order to receive federal matching funds) under federalMedicaid guidelines to provide reimbursement to FQHC-designatedmigrant health centers. My questions are:1. Are there significant numbers of migrant health providers outthere that are not FQHC designated, yet do receive Medicaidreimbursement as optional services provided by state Medicaidprograms.2. If so, might these providers be vulnerable to cuts in stateMedicaid programs as states attempt to address budget concerns? Onequestion I had was whether the majority (assuming there aresignificant numbers) of non-FQHC providers are informal, such as eyeexams provided by the local church, etc... and would not be eligiblefor Medicaid reimbursement anyway?3. If there are significant numbers of non-FQHC designated migranthealth providers, are they mostly located in urban or rural areas?4. Specifically, my question is: What migrant health providers couldbe hurt if states cut Medicaid programs?Relevant literature would be really helpful. Thanks.M.R.

[Guest guest]

,

Based on my experience in the Mid-Atlantic states, here are some answers to the

questions you pose:

Yes, states typically reimburse federally qualified health centers (FQHCs),

including migrant health centers, under federal Medicaid guidelines.

Yes, there are significant numbers of providers who are not FQHC designated, and

who accept Medicaid reimbursement. FQHCs do not exist in all communities, so

migrant farmworkers as well as other very low income residents rely on private

providers who accept Medicaid, and more importantly, offer sliding scale or

reduced fee payment. You understand, migrant children often do not have

Medicaid coverage, due to restrictive and cumbersome eligibility processes, and

lack of portability of Medicaid coverage from state to state.

Yes, private providers are vulnerable to cuts in state Medicaid programs. You

are also correct in assuming that care for migrant farmworker families is often

provided as a charitable effort through free clinics, or special clinics relying

heavily on volunteer or student staffing. These services typically are not

authorized to file for Medicaid reimbursement, but would still feel the pinch of

Medicaid cuts, as people who have lost Medicaid coverage seek health care at

such clinics.

Private providers providing care to migrant farmworkers are usually in rural

areas, since that's where most farmworkers reside, at least during the growing

season. However, there are instances where farmworkers are picked up as day

laborers from urban areas, and returned to the city at the end of the day.

These workers would, of course, seek health care in urban areas.

Finally, cuts in Medicaid would affect all health care providers who accept

medicaid payment, as well as those who volunteer their time, and will see a rise

in the need for their services.

I am not an expert on Medicaid, but share these observations, for what they are

worth.

Best Regards,

Dawn

-----Original Message-----

From: Rudolf [mailto:mrudolf@...]

Sent: Wednesday, May 14, 2003 10:23 AM

Subject: [ ] Question on provider vulnerability to

Medicaid cuts

Migrant Health Research Group-

I have a couple of questions on Medicaid reimbursement of Migrant

Health Providers. Any help would be greatly appreciated. I would

also be glad to call anyone who would be able to provide me with more

information on this.

Questions on Medicaid reimbursement of Migrant Health Providers:

Please correct me if I am wrong but as I understand it states are

required (in order to receive federal matching funds) under federal

Medicaid guidelines to provide reimbursement to FQHC-designated

migrant health centers. My questions are:

1. Are there significant numbers of migrant health providers out

there that are not FQHC designated, yet do receive Medicaid

reimbursement as optional services provided by state Medicaid

programs.

2. If so, might these providers be vulnerable to cuts in state

Medicaid programs as states attempt to address budget concerns? One

question I had was whether the majority (assuming there are

significant numbers) of non-FQHC providers are informal, such as eye

exams provided by the local church, etc... and would not be eligible

for Medicaid reimbursement anyway?

3. If there are significant numbers of non-FQHC designated migrant

health providers, are they mostly located in urban or rural areas?

4. Specifically, my question is: What migrant health providers could

be hurt if states cut Medicaid programs?

Relevant literature would be really helpful. Thanks.

M.R.

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[Guest guest]

Dawn,

Thanks for the helpful responses. If you have any citeable literature that

support you please let me know. Thanks.

Regards,

--On Saturday, May 17, 2003 11:20 AM -0400 Dawn Burtt <burttd@...>

wrote:rrr

> ,

>

> Based on my experience in the Mid-Atlantic states, here are some answers

> to the questions you pose:

>

> Yes, states typically reimburse federally qualified health centers

> (FQHCs), including migrant health centers, under federal Medicaid

> guidelines.

>

> Yes, there are significant numbers of providers who are not FQHC

> designated, and who accept Medicaid reimbursement. FQHCs do not exist in

> all communities, so migrant farmworkers as well as other very low income

> residents rely on private providers who accept Medicaid, and more

> importantly, offer sliding scale or reduced fee payment. You understand,

> migrant children often do not have Medicaid coverage, due to restrictive

> and cumbersome eligibility processes, and lack of portability of Medicaid

> coverage from state to state.

>

> Yes, private providers are vulnerable to cuts in state Medicaid programs.

> You are also correct in assuming that care for migrant farmworker

> families is often provided as a charitable effort through free clinics,

> or special clinics relying heavily on volunteer or student staffing.

> These services typically are not authorized to file for Medicaid

> reimbursement, but would still feel the pinch of Medicaid cuts, as people

> who have lost Medicaid coverage seek health care at such clinics.

>

> Private providers providing care to migrant farmworkers are usually in

> rural areas, since that's where most farmworkers reside, at least during

> the growing season. However, there are instances where farmworkers are

> picked up as day laborers from urban areas, and returned to the city at

> the end of the day. These workers would, of course, seek health care in

> urban areas.

>

> Finally, cuts in Medicaid would affect all health care providers who

> accept medicaid payment, as well as those who volunteer their time, and

> will see a rise in the need for their services.

>

> I am not an expert on Medicaid, but share these observations, for what

> they are worth.

>

> Best Regards,

>

> Dawn

>

> -----Original Message-----

> From: Rudolf [mailto:mrudolf@...]

> Sent: Wednesday, May 14, 2003 10:23 AM

>

> Subject: [ ] Question on provider vulnerability to

> Medicaid cuts

>

>

> Migrant Health Research Group-

> I have a couple of questions on Medicaid reimbursement of Migrant

> Health Providers. Any help would be greatly appreciated. I would

> also be glad to call anyone who would be able to provide me with more

> information on this.

>

> Questions on Medicaid reimbursement of Migrant Health Providers:

>

> Please correct me if I am wrong but as I understand it states are

> required (in order to receive federal matching funds) under federal

> Medicaid guidelines to provide reimbursement to FQHC-designated

> migrant health centers. My questions are:

>

> 1. Are there significant numbers of migrant health providers out

> there that are not FQHC designated, yet do receive Medicaid

> reimbursement as optional services provided by state Medicaid

> programs.

>

> 2. If so, might these providers be vulnerable to cuts in state

> Medicaid programs as states attempt to address budget concerns? One

> question I had was whether the majority (assuming there are

> significant numbers) of non-FQHC providers are informal, such as eye

> exams provided by the local church, etc... and would not be eligible

> for Medicaid reimbursement anyway?

>

> 3. If there are significant numbers of non-FQHC designated migrant

> health providers, are they mostly located in urban or rural areas?

>

> 4. Specifically, my question is: What migrant health providers could

> be hurt if states cut Medicaid programs?

>

> Relevant literature would be really helpful. Thanks.

>

> M.R.

>

>

>

>

> To Post a message, send it to: Groups

>

> To Unsubscribe, send a blank message to:

> -unsubscribe

>

>