State works to lift moratorium on home health care admissions

Personal care assistance program not covered by Medicaid restrictions, feds say

Posted: Thursday, August 13, 2009

State health officials say they're working aggressively to address federal concerns about Alaska home and community health care programs offered under a Medicaid waiver, and are praising federal authorities' decision to exempt personal care assistant services from the moratorium.

"We're glad to have reached this understanding, and we will actively work to connect these Alaskans with services as soon as possible," said Bill Hogan, commissioner of the state's Department of Health and Social Services, in a statement after the federal announcement.

The personal care assistant program became eligible for new enrollments at 8 a.m. Wednesday, Hogan said. The moratorium persists on four Medicaid waiver programs. Federal money pays for most of the four programs.

The federal Centers for Medicaid and Medicare Services imposed the moratorium on new enrollments in the four home health care programs because of state compliance issues. The agency initially included the personal care assistant program - though it is not a Medicaid waiver program - in the moratorium "in an abundance of caution," said Sarana Schell, spokeswoman for the Department of Health and Social Services. They were unaware it was operated under the state's Senior and Disabilities Services Division, separate from the four other programs, Schell said.

Federal authorities also recently confirmed that individuals who have had their applications completed and accepted by June 26 - when the moratorium was imposed - are not affected.

At the time, the state had a backlog of 1,856 Alaskans waiting initial assessments or re-assessments for the programs. Those reviews allow new clients into the programs or provide existing clients with additional services. Re-assessments can also allow clients in nursing homes to move to home or community care, Schell said.

The moratorium did not affect clients already receiving services.

"This has the side benefit of being less costly for the sate, allowing the state to provide more services to more people," she said.

As of Tuesday, there were 3,678 Alaskans receiving services under the waivers and 3,232 receiving personal care assistance. The programs overlap with 1,358 receiving both.

"It is important to note that some people who have applied for the waiver program or PCA services are in facilities such as Providence Extended Care and are getting very good services while they wait," Schell said. "Others are being served through other programs."

Juneau's REACH, Inc., which serves people with developmental disabilities under one of the programs, reported that it had found other services for its three clients affected by the moratorium.

Schell said the department was very concerned about people who might experience a crisis while awaiting an assessment, and was working with the federal agency to find a way to provide emergency exceptions to the moratorium.

• Contact reporter Pat Forgey at 523-2250 or patrick.forgey@juneauempire.com.



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