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AHCA Moving Forward In Medicaid Waiver Transition

Jul 27, 2017
Originally published on July 28, 2017 11:55 am

Earlier this year, the Florida Legislature amended state statutes to phase out waiver programs that allow people with special needs to get Medicaid who wouldn't normally qualify for services.

The state Agency for Health Care Administration is currently transitioning people with AIDS out of the Project AIDS Care waiver – known as PAC - into privately managed Long Term Care Program (LTC) and Medicaid Medical Assistance programs.

But critics of the transition say that means many patients will lose services.

The state has tried assuring case managers there won't be a loss of or gap in services for these patients, but there was still confusion in a call with the agency's Chantelle Carter-Jones in a conference call on Wednesday. (Editors note: A previous version of this story incorrectly attributed the reading of a question in the webinar to a statement by an agency representative.) 

Some case managers worried that their patients would no longer get services, as they thought it required them to be eligible for long-term care. Many of the patients with AIDS in the program don't meet those requirements.

And Carter-Jones said there is no plan currently to expand the Long Term Care criteria.

She said there will be no wait for patients with AIDS who do transition successfully. Future patients diagnosed with AIDS will be wait-listed for some Medicaid services, which is concerning, said Brandi Geoit, director of the PAC-funded West Coast AIDS Foundation.

“How is this going to prevent any new cases of HIV/AIDS?” Geoit asked.

The information came from the first of a series of monthly webinars about the changes to the PAC waiver. The next one is scheduled for Tuesday, Aug. 15 at 2 p.m.

Geoit said she felt like “there were more questions raised then answered during the webinar.”

“(One of them is) how and who will be determining that a client meets Long Term Care or hospitalization criteria in the future?   In order to do a Level of Care at this time, either nursing homes do them or their HCBS Waiver case managers have to fill out the paperwork and submit to the Department of Elder Affairs. If there are no longer case managers to be the people assisting with applying for these services, who will be completing these forms? “

The Agency for Health Care Administration previously said all Medicaid waiver programs are being phased out by Jan. 1, 2018, including those for adults with cystic fibrosis and people with traumatic brain and spinal cord injuries. Carter-Jones said there will also be webinars scheduled for these two waiver programs.

On Thursday, AHCA replied to questions about whether this transition includes a waiver for people who have developmental disabilities. Officials say the waiver program for people with developmental disabilities will continue.