an
interview with Candace Hawkins Mouth asks, What's the big excitement about Missouri? Candace SAYS People are excited about what Missouri has -- and they should be. We changed the way our state delivers long term care. |
photographer unknown This interview first appeared in Mouth magazine in July 2000. |
For more about Olmstead, click
here to go to the Freedom Clearinghouse website. |
Events in Missouri |
It was really neat, how it happened. The appropriations chairman said, 'Folks, you know how we direct money -- through appropriations. Go down to Brad, and get it done.' Brad is the budget analyst, and he did it. The language was incredible -- so detailed and just exactly right. |
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But you want to say, first... |
Some people are getting the idea that we have the entire Olmstead plan in place. Not so. Not yet. What we have is, first, the law -- the Olmstead decision from the U.S. Supreme Court -- is on our side. Now we have $645 million on our side. No bureaucrat can wiggle out of it by saying they don't have the money. The legislative language says that it is the person's choice, that the money follows them. But, until state Medicaid writes the policy and the regulations and the procedures for it to happen, nobody wins. Nobody's free. That's our big push now, to get all of this in the Medicaid plan. But since the state now has the money, they can no longer say they can't do it for one reason or another. They don't have an excuse. [As Mouth went to press, two departments of the state of Missouri announced that they would be "ready to roll" with the law on July 1, this year.] |
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What is so
controversial |
The
money. And where the money goes. |
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Am I right that
Missouri |
If our state hadn't already had it demonstrated that it's less expensive for people to stay in their own homes, we probably would not have won the appropriation. In
other states, where they don't have the Personal Care
Option, everybody acts like, 'Oh, then we're hopeless." But
state Medicaid plans are not carved in stone. You just write
a new plan and say you want to do it that way. State plans
are a lot more flexible than the state agency people let on.
They just have to write them. And you can participate in
that process. Then HCFA (the U.S. Health Care Finance
Administration) has 90 days to approve or reject the plan.
The rep from HCFA told our state, "We're not here to tell
you what should be in your plan. We're here to assist
you." |
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How did Missouri
happen |
It's cheaper. I
think we got the personal care option back in 1993 -- and
for the simple reason that they realized it's cheaper to
have someone live at home, and age in place, than it is to
move them to a nursing home. The
sad thing is that the developmental disability community got
this same flexibility last year and they never implemented
it. The department says it was "waiting for Olmstead." |
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Couldn't you have done
it |
The whole idea of a Medicaid waiver is to eliminate the universality of a service. You could say, 'I'm going to waive the entitlement of anybody who's eligible for Medicaid to get that service.' That would be a waiver. With
Olmstead, as we have it in Missouri now, everyone who
is eligible for government-financed long term care services
is eligible to get them in the setting they choose.
Period. |
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What group is doing
the |
We call ourselves the Ad Hoc Group. We're
advocates, a lot of folks who worked last year to get a
small but I guess better-than-nothing waiver through. The
group grew out of that effort. |
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How did you get |
We would not have gotten the state's attention if HHS and HCFA hadn't come to that first meeting. They
dominated that meeting. They presented the background on
Olmstead and emphasized that it's one of the top five
priorities of HHS. We had two people come out from
Washington and at least seven came from the HHS regional
office. |
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What do you say to |
'What part of "ALL" do you not understand?' |
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Freedom Clearinghouse is enlisting advocates in every state and territory to do what Candace and the Ad Hoc Coalition have done in Missouri. To see who has signed on in your state -- and maybe join them to make yours a free state -- click here. To go to the Freedom Clearinghouse website, click here. |
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At right is the cover of the Mouth Chronicles issue where Candace SAYS appeared. Click here to link to it in our online Attitude Catalog store.
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