The State’s Medicaid Reform Advisory Group has met for the last six months in relative obscurity. That changed today (Wednesday) when more than 200 parents, doctors and physical therapists showed up to testify about a list of proposed “innovations” the group hopes will help curtail the growing cost of program. The message the group heard was that the reforms would have huge impacts on the people who rely on Medicaid for health services.
Jamie Robinson approached the microphone with an 11-month-old baby snuggled on her chest in a baby carrier.
Robinson’s second child, a first grader named Brooke, is one of more than 150,000 Alaskans who benefit from the state’s Medicaid program. Brooke has cerebral palsy and other developmental delays. Robinson became emotional as she said Brooke was born by emergency c-section:
“She’s my miracle child because she should have died,” Robinson said. “When she was born doctors didn’t know if she would walk or talk. We didn’t know anything, so we just had to wait.”
Robinson says Brooke is now walking and talking- and thriving in school. She says her daughter has benefited from frequent occupational, physical and speech therapy. One of the proposed reforms would limit the number of therapy sessions to no more than six per year, after that a patient would need to be reevaluated. Robinson says frequent evaluations would be harmful to Brooke and cutting back on therapy would be devastating.
“Brooke has to work really really hard. you gotta think of this as a gym membership right,” Robinson said. “If you go to a gym, if you go six times a year, are you going to see a result? No you are not, you have to go and you have to work your body and she works her butt off.”
Nearly everyone who testified in the morning talked about problems with requiring frequent evaluations for therapy. And it was a message Division of Health and Social Services Commissioner Bill Streur had heard even before the meeting began. He committed to revisiting the issue.
“It was excellent testimony and it helped us realize we need to focus on the person, on the kid, on the child, on the parent on the family,” Streur said.
Commissioner Streur says he was pleased with the level of public involvement at the meeting. He says he heard good recommendations on specific reform ideas. One of the things he took away from the meeting is that a cookie cutter approach to reform won’t work:
“Focus the treatment on the stuff that you preach about Streur and that’s right care, right time, right place for the right person,” Streur said. “So it has to be person specific. What we came out with are broad recommendations and folks have come back to us and said, ‘tailor it and we can live with it.’”
Commissioner Streur says he’s committed to getting a list of reform ideas to the governor by the deadline of Nov. 15. But he says that is just the start of the next phase of the process, which will involve more analysis on each reform.
Still, for committee member Sandra Heffern, the testimony highlighted how rushed the process has been. Governor Parnell announced he was creating the Medicaid Reform Advisory Group last November. Members were appointed in March and have been meeting monthly since April. Heffern, who is a health care consultant with a background in home healthcare services, says there hasn’t been enough time for deep discussion on the recommendations:
“The recommendations are these are things we need to further explore, but to say were going to do any kind of reform based on any of the innovations that are brought forward is well I don’t want to use the word ludicrous, but that’s what comes to mind,” Heffern said.
Several people who testified brought up new reform ideas for the group to consider, like paying for hospice care at the end of life to save on hospital costs and reusing expensive medical equipment like wheelchairs. That last idea came from Medicaid recipient Ric Nelson, who uses a wheelchair and serves on the Governor’s Council on Disabilities and Special Education. He is also getting a graduate degree in public administration. Speaking through an interpreter, he left the committee with this thought:
“Without these services or therapies, I wouldn’t be who I am today. So I urge you to please look carefully at what you’re doing- you might affect someone like me in the world.”