Spring
2004 Newsletter click
for links to other newsletter pages
| See Family Voices of VT Links page
Dr. Dynasaur Premium Lead to
Significant Drop in Enrollment
Dr. Dynasaur-Vermont's
Medicaid program for children - was created to ensure that children of
lower-income Vermont families have access to comprehensive and
preventive health care. Vermont's Dr. Dynasaur program has been very
important to ensuring children's good health and avoiding later,
greater costs and consequences to children, families, and taxpayers.
Families with incomes below 185% of the federal poverty level pay no
premiums for their children's Dr. Dynasaur health care coverage.
Families with incomes between 185% and 300% of the poverty level pay
varying premiums (depending on income and availability of other health
insurance) that pay for health care coverage for all the children in
that household.
In 2003, premiums for families participating in Dr. Dynasaur were
increased between 25% and 46%. In addition, effective January 2004,
billing was changed to require that premiums be paid in advance.
This change also required families to make a one-time payment of two
months' of premiums in a single month. As a result of the cumulative
impact of these increases and premium payment provisions, families are
dropping or being dropped from the program.
While average enrollment in Dr. Dynasaur is down 6% from October 2003
to March 2004, in the higher premium categories enrollment has
decreased as much as 19%. This raises serious concerns about
whether families are being left without health insurance for their
children. Since we know that a high proportion of families in
those categories have a child with special needs, Parent to Parent is
concerned that this shift will significantly tax the budgets for such
programs as Children with Special Health Needs, Family, Infant and
Toddler, or schools' Special Education programs that would have billed
Dr. Dynasaur in the past for many expenditures for medical services for
enrolled children.
Provisions for keeping Dr. Dynasaur coverage despite a missed or
delayed payment, and provisions for reinstatement after losing coverage
have also become much more stringent. While the Agency of Human
Services has been a bit lenient as these changes have been implemented,
soon it will become more difficult to re-enroll if a payment has been
missed. Parent to Parent staff is concerned that even more
families will lose coverage.
If the changes to the Dr. Dynasaur premiums have been a particular
hardship or resulted in lack of insurance for your children, Family
Voices of Vermont would like to relay your experience to our policy
makers. Contact Kay Van Woert at 985-5668. Of course, you
can also directly contact your own legislator to talk with him or her
about your family and Dr. Dynasaur. If you need assistance in
enrolling or re-enrolling in Dr. Dynasaur, call Parent to Parent's
Family Support staff at 800-800-4005 for more information. ©
New
Organizational Structure Proposed for the Agency of Human Services
A
new organizational structure with potential to significantly impact
families of children with special needs has been proposed for The
Agency of Human Services (AHS).
The reorganization process was authorized by the Vermont Legislature in
May 2003. An inquiry phase, from July 2003 through Jan 2004,
gathered information from consumers, employees, contracted providers,
advocates and other partners to develop initial recommendations to
improve the human services delivery system. Surveys, focus
groups, regional meetings, and task groups were used to solicit
information.
Family Voices of Vermont, a program of Parent to Parent, sponsored two
parent focus groups, and submitted a great deal of feedback to the
agency reflecting the problems and successes families have experienced
with AHS programs like Dr. Dynasaur, Personal Care Services, High Tech,
Children with Special Health Needs, and the Family Infant and Toddler
Program.
Parent to Parent passed on families' concerns regarding lack of respite
opportunities, provider shortages, poor service coordination,
overwhelming paperwork, program inflexibility, illogical requirements,
and in some situations, lack of understanding or even respect for
families. Parent to Parent also relayed information about supportive
services and programs that families reported were working well.
As a result of input from citizens,
organizations such as Parent to
Parent, providers, and state workers, AHS identified 10 themes to
improve outcomes for Vermonters:
- Respectful
Service, Valuing the Assets and
Strengths of Clients
- Access to Services
- Prevention
- Effective Service
Coordination
- Flexible Funding to
Address Gaps in Services
- Services Provided
Before a Crisis
- Collaboration with
Key Partners
- Support for People
Through Transition
- Continuous
Improvement and Accountability
- Information Systems
and Communication
|
The
themes identified are certainly very reflective of the concerns and
wishes for improvement that families have shared with Parent to Parent
over the years.
In the past, programs for children with special health needs have been
split between several departments, with no one department having any
accountability for outcomes or knowledge of the "big picture" of the
issues families face. Families served by multiple departments in
particular, have faced conflicting requirements, overwhelming
paperwork, and lack of understanding. To better serve Vermonters, AHS
has proposed a new organizational structure.
Children's services would still be provided by a number of separate
programs with specialized expertise, though some might be
consolidated. But the programs would be realigned in different
ways, under re-formed departments that would hopefully have better
understanding of family needs and responsibility to ensure that those
needs are met. When families are served by more than one department,
the department providing the bulk of services would coordinate with the
others, and have accountability for meeting family needs and expected
outcomes. In addition, this AHS reorganization proposal would
strengthen and unite departmental district offices so that services are
better planned and coordinated at the local level.
For families of children with special health needs in chronic, long
term care situations, and for children and adults with developmental
disabilities, the majority of state programs would be managed by the
new Department of Aging and Independent Living. This should improve
transitions in programs from childhood to youth to adulthood to older
age. Nursing, personal care, and respite programs could be better
coordinated and provider shortages better managed, and hopefully
lessened. This departmental alignment is expected to help ensure that
supports for independent living and community based services are
emphasized and maximized for all individuals and families, regardless
of age or diagnosis.
State services for children and families would, in most cases, be
managed by a new Department of Children and Family Services. However,
the Children with Special Health Needs Program would remain in the
Department of Health due to its medical focus. Mental Health Services
would be transferred to the Department of Health, and the Office of
Health Access (Medicaid) would remain a separate office. All would
remain under the umbrella of AHS, and be well coordinated with the
Departments of Children and Family Services and Aging and Independent
Living. AHS hopes this new approach will reduce duplication and
fragmentation and lead to more efficient and effective family centered
services.
This proposed organizational realignment must be approved by the
Legislature. Many details need to be worked out, and putting these
changes in effect will take some time. Parent to Parent will
continue to advocate on behalf of families, so please continue to
contact us with your concerns and we will relay them to policy makers.
For more detail on the process and the current proposal, or to leave a
message for AHS, visit the AHS Reorganization web site at
http://www.ahsnet.ahs.state.vt.us/council/
Spring
2004 - In this Issue:
From
our Director
Family
Support Report
Family
Voices of Vermont
20th Anniversary Reflections
Family-Centered Care
Thanks
to David Stifler, MD
Interview with Don Swartz, MD
Books & Beyond
Heartfelt Thanks
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