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OPINION: Medicaid eligibility expanded

by By Cecile Bledsoe, Capitol Report | September 27, 2022 at 7:00 a.m.

LITTLE ROCK – Over the next three years about 3,200 Arkansans with disabilities will be able to get Medicaid services at home or in their community, rather than in an institution.

The Legislative Council approved the expansion of eligibility, submitted by the state Division of Developmental Disabilities Services.

The division doesn't have sufficient staff to care for the additional 3,200 people. A provision in the new rules approved by legislators will allow the division to make up for the shortage of labor. Basically, Medicaid will now be able to hire, train and pay family members and legal guardians.

Currently, 5,400 children and adults receive Supportive Living services, which brings support staff to their homes and communities.

The program is called the Community and Employment Supports (CES) waiver. It costs about $300 million a year, with the federal government paying 71.62% and state government paying 28.38%.

During the 2022 fiscal session earlier this year, legislators voted to dedicate an additional $37.6 million for the CES waiver program, with the intention of eliminating the current waiting list for services.

The Legislative Council also signed off on a Department of Human Services proposal to add 200 more slots for children in foster care, and to increase the allowable bed capacity of group homes from four to eight.

The cost of the rule change will be $132 million next fiscal year. The state will provide $34 million and the federal government will provide $94 million, with a premium tax on care providers accounting for the remainder.

During a public comment period on the new rule, the division heard from a spokesman for a non-profit agency that provides care and services for people with disabilities. The spokesman said there is a "very real crisis in the home and community-based service system," specifically a shortage of direct care professionals.

He said the division should pay higher reimbursements to providers for competitive salaries, because "nothing short of that will fix the problem." He also asked for funding for training and workforce development of direct care staff.

Director of DHS Resigning

Cindy Gillespie, the secretary of the Department of Human Services, announced that she would resign after six years. Her final day is scheduled to be Oct. 7.

The department has more than 6,600 employees who administer a wide variety of social services.

Its annual budget is more than $10 billion in state and federal revenue. The largest program is Medicaid, a health care program for people with disabilities, senior citizens and low-income families. More than 470,000 Arkansas children benefit from Medicaid services. Statewide, more than 1.2 million Arkansans received some type of service through Medicaid.

The department subsidizes child care and runs meals programs for senior citizens. It also investigates allegations of abuse or neglect of children and elderly people. It finalized 732 adoptions last year. At the end of the year DHS was responsible for 4,854 children in foster care.

DHS also administers welfare and food stamps programs. It operates secure facilities for troubled youths and contracts with non-profit organizations that diagnose and treat abuse of alcohol and drugs.

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Editor's note: Arkansas Sen. Cecile Bledsoe represents the third district. From Rogers, Sen. Bledsoe is chair of the Senate Health Committee.

Print Headline: Medicaid eligibility expanded

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