New Information on the Katie Beckett Foundation: 

 

The Community Foundation for Greater Atlanta is pleased to provide an update on its partnership with the State of Georgia and the Department of Human Resources (DHR) to develop a statewide service delivery system for medically fragile children and their families. Established in the fall 2006, Champions for Children with Exceptional Needs Initiative (formerly Supporting Healthy Families Initiative) will map the existing services for medically fragile children and their families, identify where there are gaps, and develop recommendations to meet those gaps with an appropriate nonprofit or network of nonprofits across Georgia. This work is being guided by an Advisory Committee comprised of a diverse group of stakeholders. The Georgia Health Policy Center (GHPC) has been hired to conduct the research and outreach activities.

As an important stakeholder, The Community Foundation would like to update you on the Initiative’s progress:

 

·     Ongoing literature review on best practices for states delivering health services to medically fragile children. GHPC has not only researched best practices, but also reviewed how programs are structured.

·     Completed an analysis of CY 2005 Medicaid claims of children who received services through the Katie Beckett Waiver Program, including utilization and Medicaid payments. The analysis revealed that families use funds mostly to cover therapeutic services, prescriptions, and medical equipment, although families also used funds to cover home care and outpatient hospital services.

·     Conducted focus groups with family members of medically fragile children. The focus groups included families no longer eligible for the Katie Beckett Waiver Program and families still eligible for the Katie Beckett Waiver Program.

·     Ongoing key informant interviews with providers and leaders of nonprofit organizations, including representatives from organizations serving medically fragile children and representatives from the medical community (doctors, nurses, and therapists). In individual settings, participants have shared in-depth knowledge of the needs of medically fragile children and their families, systems (medical and nonprofit) that work to address their needs, and thoughts on how the funds set aside by the Legislature could be used.

 In the next two weeks will conduct two half-day Community Forums to gain feedback on results of the data gathering and outreach activities. The first Forum will be held in metro Atlanta on April 28 and the second Forum in the Savannah area on May 5. These forums will be open to the public and will provide all stakeholders an opportunity to give us additional feedback. The attached announcement contains details on the two Community Forums. Please forward t his email and the attached announcement to all parents, advocates, service providers (nonprofit, medical, etc.) and any other stakeholders you feel would be interested in attending the Forums.   For more information contact Lita Ugarte at champions@atlcf.org.

 

 

Q:  What is this transitional funding related to the Katie Becket Waiver? 

A:  During the 2005-2006 Legislative Session, $7.6 million dollars were allocated to help transition children and families who were removed from the Katie Beckett Waiver as of October 2005 or after as a result of re-alignment with the federal Katie Beckett (TEFRA) eligibility criteria.  

 

This one-time allocation of funds is intended to help families purchase some limited assistance.  Additionally, a portion of the funds is intended to provide resources for the establishment of a foundation to raise funds for assistance to families with children with disabilities.

 

Q:  Who is eligible to receive the funding allocated by the Legislature?

A:  Any child that was receiving services from the Katie Beckett Waiver program and was denied October 2005 or after due to a Level of Care (LOC) decision. 

 

Q:  What is Level of Care?

A:  Level of care is one of the factors that determine whether a child is eligible for Katie Beckett Medicaid.  Level of care for Katie Beckett Medicaid requires that the child need institutional (level of) care, such as a nursing home, if community-based care is not available.

 

Q:  Who determined which children would be eligible for the transitional funding?

A:  The Georgia Legislature determined who would be eligible, indicated by the language written in House Bill 1026 signed by Governor Perdue May 8, 2006.

“Add funds for the Katie Beckett waiver for families who don’t meet the new criteria used starting October 2005. This funding will be the sole funding for those families as they are not going to be eligible for Federal matching funds.” – Georgia HB 1026

 

Q:  Who decided on the October 2005 date?

A:  The Georgia Legislature determined the start date for eligibility in House Bill 1026 signed by Governor Perdue May 8, 2006.

“Add funds for the Katie Beckett waiver for families who don’t meet the new criteria used starting October 2005. This funding will be the sole funding for those families as they are not going to be eligible for Federal matching funds.” - Georgia HB 1026

 

NOTE: To view the full text, go to http://www.legis.state.ga.us/, select “Legislation”, and search for HB 1026.

 

Q:  How can I find out if my child is eligible to receive the assistance provided by the transitional funding?

A:  All children who were removed from the Katie Beckett Waiver after October 2005 will be screened by DHR-DFCS for eligibility.  Parents will receive an option letter in the mail if their child is deemed eligible.

 

Q:  How can parents check on their child’s eligibility for this assistance if they did not receive an option letter?

A:  Parents who think they should have received an option letter and did not should contact Brian Dowd at 404-657-3592 or by email at bddowd@dhr.state.ga.us           

 

Q: Will new applicants after October 2005 be eligible to receive the assistance?

A:  No.  New applicants who were denied after October 2005 are not eligible.  Only children who had previously been receiving Katie Beckett and whose cases were closed after October 2005 are eligible.

 

Q:  What about those cases closed prior to October 2005?

A:  Children whose cases were closed prior to 10/05 are not eligible for the transitional funding.

 

Q:  How will the assistance be provided to families?

A:  Assistance will be provided after receipt of a signed election form that is included with the option letter indicating that the family wishes to participate and receive the transitional funding.  A card will be issued to the family that is similar to a prepaid debit card.  Instructions will be included with the card when mailed.

 

Q: When will families be able to use the card to access this assistance?

A:  As soon as they receive the card.

 

Q:  How much assistance will be provided?

A:  A one-time amount of $2600.00 will be allotted for each eligible child.

 

Q:  How much assistance will be provided if there are multiple eligible children in the same family?

A:  Each child will receive $2,600, so a family that has 2 eligible children, for example, will receive a total funding of $5,200.

 

Q:  What about eligible children that need more than $2600?

A:  The limit per eligible child is $2,600 for this one-time financial assistance. 

 

Q:  What are the restrictions on the use of this assistance?

A:  The funding can be used for any medically necessary service.  In addition, the funding can be used to purchase respite care from participating non-Medicaid providers.

 

Q:  What is meant by medically necessary service?

A:  Specific billing instructions and guidelines will be provided with the card.  The card will be able to be used for medical supplies, pharmacies, hearing aids, optical needs, and dental needs.  It will be able to be used at hospitals, doctor’s offices, and medical labs. 

 

Q:  How is payment made to service providers that do not accept a debit card?

A:  Paper claims can be submitted for medically necessary services.  Instructions for reimbursement will be mailed with the card.

 

Q:  Can I be reimbursed for service or equipment I’ve already paid for?

A:  Yes.  Services are covered retroactive to 4/1/06.  So, a paper claim will need to be made with corresponding insurance explanation of benefits (EOB).

 

Q:  What is the present status of this funding?

A:  As of July 14^th 2006, 981 option letters have been mailed out to all children deemed eligible from the months of October 2005 to April 2006.  Option letters for children eligible from May 2006 will be mailed out by 7/19/06.  A computer generated report of children eligible from June 2006 is currently being produced. 

 

Q:  Does acceptance of this funding prohibit application for Medicaid benefits?

A:  Acceptance of this funding in no way prohibits an individual’s right to make application for any benefits.  If the child receiving this interim assistance becomes eligible for Medicaid the interim assistance will be cancelled.

 

Q:  How does receipt of this assistance impact the hearing process?

A:  If you are in the process of appeal and have continued your Medicaid benefits pending the appeal you are not currently eligible for the transitional funding. 

 

If you have not continued benefits pending the appeal’s outcome you will receive an option letter to participate.  If the hearing decision is in your favor and your Medicaid is reinstated, you will no longer be eligible for the funding.  If your hearing decision is not in your favor and your Medicaid is closed, you will receive an option letter, funds permitting.

 

Q:  I have heard that part of the transitional funding is being used to set up a foundation.  What is the status of this foundation?

A:  Planning for the foundation will begin in July 2006 with an anticipated completion date in spring 2007.

 

Q: What is the “foundation”?

A:  A condition of the transitional funding requires DHR to provide resources for the establishment of an independent, community-based foundation to administer special assistance benefits to families of children with disabilities. 

 

Q:  Who will be involved in planning and developing the foundation?

A:  The foundation development team will include families of children with disabilities, advocacy groups, Georgia legislators, as well as representatives from the Department of Community Health and DHR.

 

Q: Has the Community Foundation of Atlanta been selected as the home for the foundation?

A:  No.  DHR has contracted with The Community Foundation to provide technical assistance to the development team.  Stakeholders on the development team will make decisions about the organizational home of the foundation.

 

Q: How much of the supplemental funding is being used to set up a foundation?

A:  $2.4 million.  This funding will be used to capitalize the foundation and ensure its ability to administer some financial benefit to families after the interim assistance has expired.

 

Q:  Who will be eligible to receive assistance from the foundation once it’s established?

A:  The foundation, under the guidance of the development team, will establish its own eligibility requirements.

 

Q:  How can I apply for assistance from the foundation or get on the waiting list?

A:  Currently, there is no application process or waiting list for the foundation.   Once established, the foundation will create their application process.