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"content": "\u003cfigure id=\"attachment_21011\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/PhotoAnne-e1408992079757.jpg\">\u003cimg class=\"size-large wp-image-21011\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/PhotoAnne-640x478.jpg\" alt=\"Anne-Louise Vernon in front of her home in Campbell. (Photo: Pauline Bartolone)\" width=\"640\" height=\"478\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Anne-Louise Vernon in front of her home in Campbell. She recently enrolled in Medi-Cal then found out the state could use proceeds from her home to recover costs of her health care. (Photo: Pauline Bartolone)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Pauline Bartolone,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/August/28/Calif-Bill-Would-Protect-Estates-Of-Many-Receiving-Medicaid-Services.aspx\" target=\"_blank\">\u003cb>Kaiser Health News\u003c/b>\u003c/a>\u003c/p>\n\u003cp>Anne-Louise Vernon had been looking forward to signing up for health insurance under Covered California. She was hoping to save hundreds of dollars a month. But when she called to enroll, she was told her income wasn’t high enough to purchase a subsidized plan.\u003c/p>\n\u003cp>“It never even occurred to me I might be on Medi-Cal,\" she said, in reference to the state's version of Medicaid, \"and I didn’t know anything about it.\"\u003c/p>\n\u003cp>She says she asked whether there were any strings attached.\u003c/p>\n\u003cp>\"And the woman said very cheerfully, \"Oh no, no, it’s all free. There's nothing you have to worry about, this is your lucky day.'” she recounts.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Vernon signed up for Medi-Cal on the phone from her home in Campbell. But months later, she learned online about a state law that allows California to take assets of people who die if they received health care through Medi-Cal after the age of 55.\u003c!--more-->\u003c/p>\n\u003cp>“So I called Medi-Cal and asked specifically, 'Does this mean what I think it means?'” she says.\u003c/p>\n\u003cp>It means Medi-Cal managers can take part of her estate later for health care costs she’s accruing now. A \u003ca href=\"http://aspe.hhs.gov/daltcp/reports/estaterec.htm\" target=\"_blank\">1993 federal law \u003c/a>requires states to recoup Medicaid money spent on institutional care, such as nursing homes, and it gives states the option to recover all health costs from people 55 and over. California took that option.\u003c/p>\n\u003cp>Vernon says she’s panicked and worried. She doesn’t get a monthly bill –- so she’s not sure what she’ll be accountable for.\u003c/p>\n\u003cp>“I feel as though right now, if I could go to do the doctor and I felt I knew where I stood, there are a number of appointments that I’d be making right now,\" says Vernon. \"But I feel so unsettled about this whole estate recovery thing, that I’m afraid to go to the doctor.\"\u003c/p>\n\u003cp>The California law has now been on the books for two decades. Elizabeth Landsberg of the Western Center on Law and Poverty says it turns what was intended to be a safety net program into a long-term loan program. It undermines the security that families might pass on to the next generation.\u003c/p>\n\u003cp>“So in most cases it's modest family homes that we’re talking about, and so the state will most often come back and put a lien on that home, and unfortunately it does force the kids to sell the homes sometimes, ” says Landsberg.\u003c/p>\n\u003cp>Landsberg says the law is complicating Medi-Cal enrollment. Some people have refused to sign up, or have terminated enrollment for fear of losing their estate. She says it’s unfair because people buying insurance through Covered California aren’t subject to the same rules.\u003c/p>\n\u003cp>“For the first time people have to have health coverage. So it’s created an inequity where the lowest income people could lose their assets, and other higher income people who are also getting publicly-subsidized health coverage have no worries, ” says Landsberg.\u003c/p>\n\u003cp>Over the past 20 years, the state of California has recovered almost a billion dollars that paid for long-term care and basic health services through Medi-Cal.\u003c/p>\n\u003cp>Norman Williams of the California Department of Health Care Services says that’s just a very small fraction of the overall Medi-Cal budget during that time.\u003c/p>\n\u003cp>“The funds are collected and returned to the state general fund and along with federal matching funds, that’s used to provide care for members beyond what we have now,\" says Williams.\u003c/p>\n\u003cp>Williams says the average claim is about $95,000.\u003c/p>\n\u003cp>“But the average amount collected is about $15,000,\" he says. \"There are many exceptions available. Hardship exemptions for instance. If there are children who are living and under 21, there is no claim against the Medi-Cal member's estate.\"\u003c/p>\n\u003cp>A bill in the California legislature, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1124\" target=\"_blank\">SB 1124\u003c/a>, would eliminate state recovery for basic Medi-Cal services for older Californians. It would also require the state to provide health claim information for free, so enrollees can keep track of their expenses.\u003c/p>\n\u003cp>That’s something Anne-Louise Vernon is advocating for.\u003c/p>\n\u003cp>“I don’t understand why someone my age, in my situation has been singled out to be a cash cow for the state of California, when this is not required by the federal government,” says Vernon.\u003c/p>\n\u003cp>If the measure is approved by lawmakers, it might have a tough time getting the governor’s signature. The California Department of Finance says it would remove $30 million in revenue that helps pay for the health care of other low-income Californians.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca style=\"font-size: medium\" href=\"http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_recovery_FAQ.htm\" target=\"_blank\">Medi-Cal Recovery FAQ\u003c/a> (California Advocates for Nursing Home Reform)\u003c/li>\n\u003cli>\u003ca style=\"font-size: medium\" href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/E/PDF%20EstateRecoveryMediCal.pdf\" target=\"_blank\">Estate Recovery Under Medi-Cal \u003c/a>(California HealthCare Foundation)\u003c/li>\n\u003c/ul>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Vernon signed up for Medi-Cal on the phone from her home in Campbell. But months later, she learned online about a state law that allows California to take assets of people who die if they received health care through Medi-Cal after the age of 55.\u003c!--more-->\u003c/p>\n\u003cp>“So I called Medi-Cal and asked specifically, 'Does this mean what I think it means?'” she says.\u003c/p>\n\u003cp>It means Medi-Cal managers can take part of her estate later for health care costs she’s accruing now. A \u003ca href=\"http://aspe.hhs.gov/daltcp/reports/estaterec.htm\" target=\"_blank\">1993 federal law \u003c/a>requires states to recoup Medicaid money spent on institutional care, such as nursing homes, and it gives states the option to recover all health costs from people 55 and over. California took that option.\u003c/p>\n\u003cp>Vernon says she’s panicked and worried. She doesn’t get a monthly bill –- so she’s not sure what she’ll be accountable for.\u003c/p>\n\u003cp>“I feel as though right now, if I could go to do the doctor and I felt I knew where I stood, there are a number of appointments that I’d be making right now,\" says Vernon. \"But I feel so unsettled about this whole estate recovery thing, that I’m afraid to go to the doctor.\"\u003c/p>\n\u003cp>The California law has now been on the books for two decades. Elizabeth Landsberg of the Western Center on Law and Poverty says it turns what was intended to be a safety net program into a long-term loan program. It undermines the security that families might pass on to the next generation.\u003c/p>\n\u003cp>“So in most cases it's modest family homes that we’re talking about, and so the state will most often come back and put a lien on that home, and unfortunately it does force the kids to sell the homes sometimes, ” says Landsberg.\u003c/p>\n\u003cp>Landsberg says the law is complicating Medi-Cal enrollment. Some people have refused to sign up, or have terminated enrollment for fear of losing their estate. She says it’s unfair because people buying insurance through Covered California aren’t subject to the same rules.\u003c/p>\n\u003cp>“For the first time people have to have health coverage. So it’s created an inequity where the lowest income people could lose their assets, and other higher income people who are also getting publicly-subsidized health coverage have no worries, ” says Landsberg.\u003c/p>\n\u003cp>Over the past 20 years, the state of California has recovered almost a billion dollars that paid for long-term care and basic health services through Medi-Cal.\u003c/p>\n\u003cp>Norman Williams of the California Department of Health Care Services says that’s just a very small fraction of the overall Medi-Cal budget during that time.\u003c/p>\n\u003cp>“The funds are collected and returned to the state general fund and along with federal matching funds, that’s used to provide care for members beyond what we have now,\" says Williams.\u003c/p>\n\u003cp>Williams says the average claim is about $95,000.\u003c/p>\n\u003cp>“But the average amount collected is about $15,000,\" he says. \"There are many exceptions available. Hardship exemptions for instance. If there are children who are living and under 21, there is no claim against the Medi-Cal member's estate.\"\u003c/p>\n\u003cp>A bill in the California legislature, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1124\" target=\"_blank\">SB 1124\u003c/a>, would eliminate state recovery for basic Medi-Cal services for older Californians. It would also require the state to provide health claim information for free, so enrollees can keep track of their expenses.\u003c/p>\n\u003cp>That’s something Anne-Louise Vernon is advocating for.\u003c/p>\n\u003cp>“I don’t understand why someone my age, in my situation has been singled out to be a cash cow for the state of California, when this is not required by the federal government,” says Vernon.\u003c/p>\n\u003cp>If the measure is approved by lawmakers, it might have a tough time getting the governor’s signature. The California Department of Finance says it would remove $30 million in revenue that helps pay for the health care of other low-income Californians.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca style=\"font-size: medium\" href=\"http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_recovery_FAQ.htm\" target=\"_blank\">Medi-Cal Recovery FAQ\u003c/a> (California Advocates for Nursing Home Reform)\u003c/li>\n\u003cli>\u003ca style=\"font-size: medium\" href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/E/PDF%20EstateRecoveryMediCal.pdf\" target=\"_blank\">Estate Recovery Under Medi-Cal \u003c/a>(California HealthCare Foundation)\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Critics Say Covered California Ill-Equipped to Help Former Foster Youth",
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"content": "\u003cfigure id=\"attachment_15508\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>Former foster youth lined up at Covered California's last board meeting to complain about the hoops they have to jump through to enroll in Medi-Cal, the state's health plan for the poor.\u003c/p>\n\u003cp>“Navigating adulthood is challenging enough, let alone trying to find insurance to cover your medical needs,” said Vanessa Hernandez, who spent 14 years in foster care. She says her younger brother tried twice to sign up online before he gave up.\u003c/p>\n\u003cp>“Currently the process is very unclear, it’s hard to navigate, and it’s not very accessible,” she said.\u003c!--more-->\u003c/p>\n\u003cp>For most young people, The Affordable Care Act allows them to stay on their parents’ insurance until they turn 26. But when California foster youth \u003ca href=\"http://www.childsworld.ca.gov/res/pdf/AB12FactSheet.pdf\" target=\"_blank\">age out of the system\u003c/a> between ages 18 and 21, they often have no one. So federal lawmakers added a special provision to the health law that allows these young adults to stay on Medicaid -- called Medi-Cal in California -- until age 26, regardless of their income.\u003c/p>\n\u003cp>“Former foster youth are extremely vulnerable,” says Jessica Haspel a policy associate at the advocacy nonprofit Children Now. She says any obstacles or delays to enrollment are especially problematic for foster youth. Many have special health needs stemming from a history of abuse or neglect and may rely on important medication for things like diabetes or anxiety. \u003ca href=\"http://www.ncd.gov/newsroom/PolicyCorner/05062013\" target=\"_blank\">Studies show \u003c/a>nearly one in three former foster youth exhibit signs of post-traumatic stress disorder -- which is itself about twice the rate of American war veterans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160128590&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>“They may have been offered counseling when they were a child, but were not in a position where they were really able or ready to process it,” Haspel says. “As an adult, they want to take advantage of counseling and services to help them deal with everything that they’ve been through.”\u003c/p>\n\u003cp>She says the Covered California website isn't programmed properly to enroll former foster youth into coverage. And call center employees aren't educated about the new provision. As a result, some youth are being told they don't qualify when they do, or they are put in a queue when they should be fast-tracked into coverage.\u003c/p>\n\u003cp>“We are constantly working hard to resolve some of those issues,” says Anne Gonzales, Covered California spokesperson.\u003c/p>\n\u003cp>She says the agency is beefing up training and updating its guide for service center reps. Website fixes are scheduled for the winter.\u003c/p>\n\u003cp>“We are currently urging anyone who thinks they missed out on benefits to sign up now,” she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But youth advocates are advising young people to sidestep Covered California altogether, and to go to their county social services office instead to sign up for Medi-Cal in person.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15508\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>Former foster youth lined up at Covered California's last board meeting to complain about the hoops they have to jump through to enroll in Medi-Cal, the state's health plan for the poor.\u003c/p>\n\u003cp>“Navigating adulthood is challenging enough, let alone trying to find insurance to cover your medical needs,” said Vanessa Hernandez, who spent 14 years in foster care. She says her younger brother tried twice to sign up online before he gave up.\u003c/p>\n\u003cp>“Currently the process is very unclear, it’s hard to navigate, and it’s not very accessible,” she said.\u003c!--more-->\u003c/p>\n\u003cp>For most young people, The Affordable Care Act allows them to stay on their parents’ insurance until they turn 26. But when California foster youth \u003ca href=\"http://www.childsworld.ca.gov/res/pdf/AB12FactSheet.pdf\" target=\"_blank\">age out of the system\u003c/a> between ages 18 and 21, they often have no one. So federal lawmakers added a special provision to the health law that allows these young adults to stay on Medicaid -- called Medi-Cal in California -- until age 26, regardless of their income.\u003c/p>\n\u003cp>“Former foster youth are extremely vulnerable,” says Jessica Haspel a policy associate at the advocacy nonprofit Children Now. She says any obstacles or delays to enrollment are especially problematic for foster youth. Many have special health needs stemming from a history of abuse or neglect and may rely on important medication for things like diabetes or anxiety. \u003ca href=\"http://www.ncd.gov/newsroom/PolicyCorner/05062013\" target=\"_blank\">Studies show \u003c/a>nearly one in three former foster youth exhibit signs of post-traumatic stress disorder -- which is itself about twice the rate of American war veterans.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160128590&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>“They may have been offered counseling when they were a child, but were not in a position where they were really able or ready to process it,” Haspel says. “As an adult, they want to take advantage of counseling and services to help them deal with everything that they’ve been through.”\u003c/p>\n\u003cp>She says the Covered California website isn't programmed properly to enroll former foster youth into coverage. And call center employees aren't educated about the new provision. As a result, some youth are being told they don't qualify when they do, or they are put in a queue when they should be fast-tracked into coverage.\u003c/p>\n\u003cp>“We are constantly working hard to resolve some of those issues,” says Anne Gonzales, Covered California spokesperson.\u003c/p>\n\u003cp>She says the agency is beefing up training and updating its guide for service center reps. Website fixes are scheduled for the winter.\u003c/p>\n\u003cp>“We are currently urging anyone who thinks they missed out on benefits to sign up now,” she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But youth advocates are advising young people to sidestep Covered California altogether, and to go to their county social services office instead to sign up for Medi-Cal in person.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Feds Say Autism Therapy Now Covered As Children's Medicaid Benefit",
"title": "Feds Say Autism Therapy Now Covered As Children's Medicaid Benefit",
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"content": "\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/7/cms-guidance-says-autism-therapy-covered-as-medicaid-benefit-for-kids\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>CMS officials \u003ca style=\"color: #6d1618\" href=\"http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-07-14.pdf\" target=\"_blank\">released federal guidance\u003c/a> for states on Medicaid coverage of autism therapy on Monday, and that guidance indicates it is covered for beneficiaries under age 21.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"ABA therapy must be covered (by Medi-Cal). It's very, very clear.\" \u003c/aside>\n\u003cp>\"It's a good day. It's such a good day,\" said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, an advocacy group based in Tarzana. \"Whenever you get a decision that we've been seeking for years, that is a good day.\"\u003c/p>\n\u003cp>Applied behavior analysis treatment, known as ABA therapy, now is a benefit for those under age 21 under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision of Medicaid -- and therefore it also must be covered under Medi-Cal, California's version of Medicaid, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame.\u003c!--more-->\u003c/p>\n\u003cp>\"ABA therapy must be covered under EPSDT. It's very, very clear,\" Jacobson said. \"Any coverable benefit must be provided under the age of 21. If it's coverable in any way, then you have to provide it.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On top of that, CMS' new guidance says state officials don't need to file a State Plan Amendment to start coverage of autism therapy. \"It doesn't have to be in your state plan, it says it right there,\" Jacobson said.\u003c/p>\n\u003cp>State officials were a little more careful.\u003c/p>\n\u003cp>According to Norman Williams, deputy director of public affairs for the Department of Health Care Services, the health policy experts at DHCS need a bit more time to fully review the guidance.\u003c/p>\n\u003cp>Kornack acknowledged that \"lawyers are still dissecting the guidance and [that] there's some leeway here about how states will implement this.\"\u003c/p>\n\u003cp>\"But whether they implement is no longer a question,\" she said.\u003c/p>\n\u003cp>State officials previously have said they were awaiting federal guidance on the question of ABA therapy coverage -- and Kornack, for one, can't wait to hear the official word from the state.\u003c/p>\n\u003cp>\"I don't think we could ask for better clarification than what we just got,\" she said. \"There's some latitude for states in terms of how to augment the waiver, there will be complexities. But there's no latitude about whether they provide services. The question about whether they provide it is done.\"\u003c/p>\n\u003cp>Jacobson said now it's just a matter of the time of implementation till Medi-Cal children can access ABA therapy services.\u003c/p>\n\u003cp>\"When I look at as clarification of existing requirements, I don't know how much you could delay it,\" she said. \"They have to make it available and accessible, and make families aware that it's available and accessible. I'd say, if families already have medical necessity established, they should try to pursue coverage right away.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"BWwh2OirqqsTtzUNMv2viXsdoF50551A\"]\u003c/p>\n\n",
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"excerpt": "While Calif. officials are still reviewing the guidance, advocates say the federal decision is clear.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/7/cms-guidance-says-autism-therapy-covered-as-medicaid-benefit-for-kids\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>CMS officials \u003ca style=\"color: #6d1618\" href=\"http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-07-14.pdf\" target=\"_blank\">released federal guidance\u003c/a> for states on Medicaid coverage of autism therapy on Monday, and that guidance indicates it is covered for beneficiaries under age 21.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"ABA therapy must be covered (by Medi-Cal). It's very, very clear.\" \u003c/aside>\n\u003cp>\"It's a good day. It's such a good day,\" said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, an advocacy group based in Tarzana. \"Whenever you get a decision that we've been seeking for years, that is a good day.\"\u003c/p>\n\u003cp>Applied behavior analysis treatment, known as ABA therapy, now is a benefit for those under age 21 under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision of Medicaid -- and therefore it also must be covered under Medi-Cal, California's version of Medicaid, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame.\u003c!--more-->\u003c/p>\n\u003cp>\"ABA therapy must be covered under EPSDT. It's very, very clear,\" Jacobson said. \"Any coverable benefit must be provided under the age of 21. If it's coverable in any way, then you have to provide it.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On top of that, CMS' new guidance says state officials don't need to file a State Plan Amendment to start coverage of autism therapy. \"It doesn't have to be in your state plan, it says it right there,\" Jacobson said.\u003c/p>\n\u003cp>State officials were a little more careful.\u003c/p>\n\u003cp>According to Norman Williams, deputy director of public affairs for the Department of Health Care Services, the health policy experts at DHCS need a bit more time to fully review the guidance.\u003c/p>\n\u003cp>Kornack acknowledged that \"lawyers are still dissecting the guidance and [that] there's some leeway here about how states will implement this.\"\u003c/p>\n\u003cp>\"But whether they implement is no longer a question,\" she said.\u003c/p>\n\u003cp>State officials previously have said they were awaiting federal guidance on the question of ABA therapy coverage -- and Kornack, for one, can't wait to hear the official word from the state.\u003c/p>\n\u003cp>\"I don't think we could ask for better clarification than what we just got,\" she said. \"There's some latitude for states in terms of how to augment the waiver, there will be complexities. But there's no latitude about whether they provide services. The question about whether they provide it is done.\"\u003c/p>\n\u003cp>Jacobson said now it's just a matter of the time of implementation till Medi-Cal children can access ABA therapy services.\u003c/p>\n\u003cp>\"When I look at as clarification of existing requirements, I don't know how much you could delay it,\" she said. \"They have to make it available and accessible, and make families aware that it's available and accessible. I'd say, if families already have medical necessity established, they should try to pursue coverage right away.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"BWwh2OirqqsTtzUNMv2viXsdoF50551A\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Another Step Closer to Autism Therapy as Medi-Cal Benefit?",
"title": "Another Step Closer to Autism Therapy as Medi-Cal Benefit?",
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"content": "\u003cfigure id=\"attachment_18394\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/183682661-e1395966642552.jpg\">\u003cimg class=\"size-large wp-image-18394\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/183682661-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/6/california-may-be-pushed-to-offer-autism-treatment-as-medical-benefit#.U6NDpLXgICg.twitter\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>CMS officials last week approved a state plan amendment for the state of Washington that includes autism therapy as a Medicaid benefit.\u003c/p>\n\u003cp>It's the second state in a month to receive that go-ahead from the federal government, and it means autism coverage should be a Medi-Cal benefit in California, as well, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, a not-for-profit autism advocacy group.\u003c/p>\n\u003cp>The budget passed this week by the California Legislature omitted autism therapy as a Medi-Cal benefit.\u003c/p>\n\u003cp>Autism advocates hope one day soon CMS will make it clear that applied behavior analysis treatment -- known as ABA therapy -- should be a required benefit for all states receiving Medicaid, including California.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It looks as if that day is already here, Jacobson said.\u003c/p>\n\u003cp>The ruling by CMS in Washington state, and earlier in Louisiana, combine to \"clearly establish\" that ABA therapy is a Medicaid benefit, Jacobson said.\u003c/p>\n\u003cp>\"It shouldn't vary from state to state because it's a federal benefit. The feds have spoken by approving [the benefit coverage] in both Louisiana and Washington. It shows that the Louisiana approval is not somehow a unique situation,\" Jacobson said.\u003c/p>\n\u003cp>California health officials have said they're watching the cases in other states closely, particularly in Washington, since that state's rules around autism treatment are similar to California's.\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"AjurOcz0t2FwjHtorRejPFS96LEZfSuj\"]\u003c/p>\n\u003cp>When CMS gave approval of coverage to Louisiana, state officials here issued a statement about it:\u003c/p>\n\u003cp>\"California and other states are currently awaiting guidance on ABA services from CMS, which we expect to receive soon,\" said Norman Williams, deputy director of public affairs for DHCS. \"This guidance is what will be used to set policy direction for the inclusion of ABA therapy as a covered Medicaid benefit.\"\u003c/p>\n\u003cp>When asked if the Washington state approval was actually federal guidance, Williams said only that they \"continue to await forthcoming guidance from CMS as it relates specifically to California.\"\u003c/p>\n\u003cp>Over two days of inquiry, CMS officials declined to comment for this story.\u003c/p>\n\u003cp>All of that doesn't sit well with Jacobson.\u003c/p>\n\u003cp>\"I don't think any further guidance is necessary. It's a bit of excuse for them to say they need more guidance,\" Jacobson said.\u003c/p>\n\u003cp>\"If it's an approvable benefit, then it's a required benefit. … Washington asked for guidance and CMS told them. Louisiana asked for guidance and CMS told them. It's disappointing that the administration has still been so resistant and keeps wanting more guidance. At this point, they shouldn't need more,\" Jacobson said.\u003c/p>\n\u003cp>\"I don't think the families can keep waiting. That's not acceptable, and it's not legally compliant, either,\" she said. \"Given the state's position [acknowledging] the benefits of ABA therapy, it's unconscionable that they're not providing it to this population.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Louisiana and Washington approvals were prompted by lawsuits. \"I hope we don't have to do that, but we're not going to rule it out till we see them moving forward for this benefit,\" Jacobson said.\u003c/p>\n\n",
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"excerpt": "Advocates say federal approval of an autism therapy in two states means California must also offer it.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18394\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/183682661-e1395966642552.jpg\">\u003cimg class=\"size-large wp-image-18394\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/183682661-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/6/california-may-be-pushed-to-offer-autism-treatment-as-medical-benefit#.U6NDpLXgICg.twitter\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>CMS officials last week approved a state plan amendment for the state of Washington that includes autism therapy as a Medicaid benefit.\u003c/p>\n\u003cp>It's the second state in a month to receive that go-ahead from the federal government, and it means autism coverage should be a Medi-Cal benefit in California, as well, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, a not-for-profit autism advocacy group.\u003c/p>\n\u003cp>The budget passed this week by the California Legislature omitted autism therapy as a Medi-Cal benefit.\u003c/p>\n\u003cp>Autism advocates hope one day soon CMS will make it clear that applied behavior analysis treatment -- known as ABA therapy -- should be a required benefit for all states receiving Medicaid, including California.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Students and welfare recipients will feel in the pinch in the new budget that Gov. Jerry Brown and lawmakers announced on Thursday after a week of negotiation, according to news reports.\u003c/p>\n\u003cp>\u003ca href=\"http://latimesblogs.latimes.com/california-politics/2012/06/california-budget-agreement-welfare-education-courts.html\">Los Angeles Times\u003c/a> writes:\u003c/p>\n\u003cblockquote>\u003cp>One of the biggest barriers to a deal was disagreement between Brown and legislative Democrats over how to change the state’s welfare system. The agreement creates a 24-month time limit for unemployed recipients of CalWorks grants to find work. Those grant recipients currently have 48 months before they are at risk of losing cash assistance.\u003c/p>\u003c/blockquote>\n\u003cp>Among other cuts reported by the LA Times:\u003c/p>\n\u003cul>\n\u003cli>An 8.7% reduction in subsidies for child care, and a suspension in cost-of-living adjustments for child-care costs until mid-2015.\u003c/li>\n\u003cli>A merger of the Healthy Families Program for low-income children into Medi-Cal.\u003c/li>\n\u003cli>Reductions in the Cal Grants program for college students, starting in the 2013-2014 school year.\u003c/li>\n\u003c/ul>\n\u003cp>Not everyone loses, though. The newspaper said the budget includes a categorical block grant for charter schools.\u003c/p>\n\u003cp>Here’s the background, as sketched out by the Associated Press:\u003c/p>\n\u003cblockquote>\u003cp>Although Democrats passed the main budget bill on a majority vote last week, the governor pressed for deeper cuts to welfare and other social services amid a projected $15.7 billion shortfall. Brown has until Wednesday to sign or veto the main bill.\u003c/p>\n\u003cp>The Legislature passed a $92 billion budget Friday but several companion bills must still pass before the state’s spending plan can take effect. Many deal with some of the most contentious issues, including aid to the poor. The whole package hinges on voters approving an initiative in November to raise taxes.\u003c/p>\n\u003cp>In passing the main budget bill, lawmakers met the minimum requirement to keep their paychecks flowing under a voter-approved measure that blocks lawmakers’ pay if a budget is late.\u003c/p>\u003c/blockquote>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"description": "Students and welfare recipients will feel in the pinch in the new budget that Gov. Jerry Brown and lawmakers announced on Thursday after a week of negotiation, according to news reports. Los Angeles Times writes: One of the biggest barriers to a deal was disagreement between Brown and legislative Democrats over how to change the state's welfare system. The agreement creates a 24-month time limit for unemployed recipients of CalWorks grants to find work. Those grant recipients currently have 48 months before they are at risk of losing cash assistance. Among other cuts reported by the LA Times: An 8.7%",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
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