Showing posts with label Medicaid. Show all posts
Showing posts with label Medicaid. Show all posts

Monday, March 19, 2012

Katie Beckett Continued

**The following post is documentation of a personal experience with applying for the Katie Beckett Deeming Waiver in the State of Georgia, Barrow County. This information is given only as an example and is in no way a guarantee of like experience. The author is not a representative of the State of GA, Barrow County, or DFCS. The forms and procedures listed can (and probably will) go out of date without any note on this blog.**

Since I wrote last it has been approximately 45 days. This was the turn-around-time estimate given to me by my DFCS caseworker. Sure enough, I received Alexander's letter of APPROVAL (yay!) yesterday via certified mail. My caseworker also called me with the good news. So now that I'm personally out of those particular woods (my to-do list actually just got bigger, not smaller, with this new development) I wanted to update my Katie Beckett (Deeming Waiver) Checklist. So I did that but now here is the rundown of the experiences that helped me remember what I didn't include before.

- I can't believe I forgot to include the Psychological Eval in my checklist AND in my packet! This would be the report you received/will receive when you got/get a diagnosis of Autism from your (insert specialist here: we used a Neurodevelopmental Pediatrician). I worked for months to get the diagnosis and waited with bated breath to receive the report and then when it came time to hand in Alexander's Katie Beckett packet, I left the thing out. But it obviously wasn't the end of the world. Even my caseworker forgot to include a request for it in his first round of "you left this out." So I got a call from him a few days later asking for it. I pointed out that he hadn't made any note about it being missing on my Verification Checklist and he apologized and said he'd be sending me a new Verification Checklist. (Which he did.)

- Realizing the above oversight also reminded me that I didn't really go over the fact that you can't just go to a regular pediatrician to get an Autism diagnosis. In my experience, there wasn't a single person (doctor, therapist, special ed teacher, etc.) who would even say the word Autism in my presence without me bringing it up first. And then they would either say they didn't think he had Autism (which I believe was their honest opinion) or explain that they didn't have the authority to make that call (in which case I wondered if that meant they thought he might have it). This is because of mal-practice lawsuits. The people around you are protecting their butts by not expressing opinions about what your child "has." You can't really hold this against them with the way lawsuits work today (I mean, even I felt compelled to write a disclaimer at the top of these checklist posts), but the knowledge you should take from this is as follows: Find yourself a Neurodevelopmental Pediatrician, Developmental Pediatrician, or Developmental Psychologist. These are the people who CAN make that call. (There may be other specialties that also have that "power" but I don't know what they are.)

- Somehow, I really don't know how (I was reeeeally OCD about this paperwork, so I totally don't get it), I missed a signature line on the Level of Care Statement before I sent it in. This meant that a couple weeks later I received a Technical Denial of Services. (ack!) A Technical Denial means just that, a technicality is holding up the proceedings and you won't be able to get approved until it's fixed. This letter came via certified mail with a photo-copy of my filled-out Level of Care Statement for me to sign and return. Really not a big deal but I actually almost missed picking the letter up at the post office before it was returned to the sender. See, you have to sign for certified mail and apparently I didn't hear the door both days they tried to deliver it, hence a trip to the post office. So, I guess there are two lessons here -

#1) Have a buddy (a fresh set of eyes) look over the paperwork before you send it in to make sure you dotted all the i's and stuff.

#2) When your waiting for your Deeming Waiver Determination, assume that all certified letters coming in the mail are probably going to be about that! I totally thought the certified letter was something for my husband and when he didn't seem to know what it was, I figured it wasn't very important and decided to not stress myself out about going to retrieve it from the post office - ! Man, I can be a ditz sometimes.


Tuesday, February 7, 2012

Katie Beckett (Deeming Waiver) Checklist

**The following post is documentation of a personal experience with applying for the Katie Beckett Deeming Waiver in the State of Georgia, Barrow County. This information is given only as an example and is in no way a guarantee of like experience. The author is not a representative of the State of GA, Barrow County, or DFCS. The forms and procedures listed can (and probably will) go out of date without any note on this blog.**

**Updated 3/17/2012**

I wanted to take a minute and reach out to those parents (in Georgia specifically) that are starting to navigate the process of seeking government aid for their child with Autism (or other disability). I am by no means finished with the road I'm on but, knowing the work it took even to get to this point, I want to help others on their way.
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Brief History (taken from CHOA Deeming Waiver Information)
The Deeming Waiver is a type of Medicaid that helps to cover the costs of medical treatment and therapeutic services for children with physical or developmental disabilities. Before the Deeming Waiver, the government would subsidize care for a disabled child ONLY if the child was placed in a state institution. In 1981, the parents of Katie Beckett fought to get financial assistance while caring for their child at home. Now, the Deeming Waiver is helpful to families who make “too much ” to receive financially based Medicaid, but who need expensive services for their special needs children. 
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Back at the beginning of January, I shared this post on my family blog about my son Alexander's diagnosis of Autism and some of the resources we were looking into. I included a link to the CHOA Deeming Waiver Checklist I was using (in addition to some other links). While that checklist has a lot of good information (you'll see it peppered through this whole post), it is also sorely out of date (which I had a suspicion it might be). I ended up turning in one form that wasn't even needed and leaving out 2 forms that were needed in Alexander's application. So, after all of that, our new case worker (who wasn't assigned to us until I made the initial application) sent me a new checklist and the forms I was missing.

The following checklist can be found online at http://dhr.state.ga.us by searching for "Katie Beckett Cover Letter." The cover letter itself is a .doc file that will instantly download when you click on it (at least that's what it did for me). Here's that instant download link: Georgia Department of Human Services: Katie Beckett Cover Letter. All of the forms listed in the checklist can be found by visiting http://dhr.state.ga.us and searching for them by name/number. I've also linked each form name to its appropriate instant download page.

(Don't click the links in the checklists if you don't want the forms to download right away.)

q  Medicaid Application, Form 700, (answer questions as if your child was completing)
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Other required forms/items (from the Verification Checklist):
□ Psychological (this is the report you got/will get from the specialist who gave/will give your child his/her diagnosis of Autism) **updated**
□ Health Insurance Information Questionnaire, DMA 285 (I was unable to find a link for DMA 285: see tips below)
□ GA Dept of Human Services - Notice of Privacy Practices (one for each household member over age 18)

Other required/helpful documents:
□ Copy of Child's Birth Certificate
□ Copy of Insurance Card - Front and Back
□ SSI Rejection Letter (see tips below for more info)
□ Copy of Child's IEP/IFSP (if applicable)
□ Therapy Notes?
Our case worker asked for Alexander's therapy notes to be sent with the new forms. He's in the Special Needs Public Preschool Program and he gets speech therapy there but he doesn't go to private therapy yet. So I just made copies of his school and ST progress reports and put those in as the notes. (I'm actually not quite sure if this is what they're looking for but it's all I have so we'll see.)
□ Social History?
I additionally completed and submitted a Social History for Alexander because it was listed on the CHOA Deeming Waiver Info Checklist with instructions on how to write it. I don't actually know if this was necessary because it's not mentioned anywhere on the paperwork I got back from DFCS. (I'll try to find out from my caseworker if I did that work for nothing and update this post when I know.)

A few more tips:
- **update** I don't think I made this clear before, although you may already know and if not you'll find out quickly: Your regular pediatrician will not be able to give you a diagnosis of Autism. Find yourself a Neurodevelopmental Pediatrician, Developmental Pediatrician, or Developmental Psychologist. These are the people who CAN make that call. (There may be other specialties that also have that "power" but I don't know what they are.)

- Swing by your local DFCS office to pick up the Medicaid application (they were in a rack by the door when I went). I included the link above in order to give you options but getting one from an office is really easier in the end. The application I got from the Barrow County DFCS office also contained the Health Insurance Information Questionaire, DMA 285 and the Notice of Privacy. You will need a Notice of Privacy signed by each household member over the age of 18 (so get extras if you need them). You also might want to try asking the rep at the desk if there is a "Katie Beckett Packet." The girl I asked didn't have a clue but maybe you'll get lucky and find all the paperwork I've listed laid out for you.

- Once you have your copy of the Medicaid application, write Katie Beckett/TEFRA at the top.

- To date or not to date? I've read in a couple of places online that you shouldn't date any of this paperwork before you turn it in. I then proceeded to forget and dated all my signatures. I haven't heard from my case worker if this will be a problem yet. I'll let you know what I find out. **update** Ok, what I found out: Didn't matter in my case. The caseworker never came back and said I needed to start over because I dated everything wrong, and we now officially have our APPROVAL (w00t!).

- The Verification Checklist (item #2 above) isn't really for you! It's part of the contact letter you'll receive from DFCS if you're missing things from your application. Not all the lines apply to all applicants. Here's an actual scan (with personal info cropped out) of the checklist they sent me after my initial application:

As you can see, I wasn't required to submit most of the things on that list.

- The instructions pages (for forms 706 and 6A) aren't for turning in, they're for instruction! Make sure you look them over carefully and use them to double check your work. It's just always good to read the instructions!

- (Taken and paraphrased from CHOA Deeming Waiver Information.) The Katie Beckett Waiver is not based on your family's income (it's based on the assets of the child only). So, you first must prove that you do not qualify for the Supplemental Security Income (SSI) Disability - Medicaid program which is based on your family’s income. The first step is to apply for SSI through your nearest Social Security Office. You may call them at 1-800-772-1213 to begin the application. If your child receives SSI, and, thus, Medicaid, you are finished at this point, as Medicaid provides the same benefits as the Deeming Waiver). If your child does not receive SSI and Medicaid through this program, SSI will send you a denial letter. This denial letter becomes a part of your Deeming Waiver Application (see my scanned Verification Checklist above). Make sure you do not lose it!  - - - My case worker also said that if I hadn't applied for SSI yet that he would have to do a budget to find out if I was eligible for SSI. So it's my understanding that you can do the needed work through DFCS without calling SSI first. But, that's not how I did it so I can't recommend that way. The SSI application process was all over the phone; and I got my rejection letter fairly quickly.

- If you have an appointment coming up with your child's Developmental Pediatrician (or whatever specialist gave/will give you the diagnosis) take your Katie Beckett paperwork with you. Maybe your doc won't be quite this helpful but ours took the papers out of my hands and filled out most of the physcian's parts. I still had to take them to be signed by Alexander's pediatrician (PCP) but it doesn't really matter who fills them out. And let me tell you, the pediatrician was about to burst with relief when I presented the DMA-6(A) already filled out, with his signature lines highlighted. He said most regular pediatricians don't really know what to write on those forms (which is exactly what the Dev. Ped. said while she was filling them out).

- Related ^^^ If you didn't already know this (cuz I sure as heck didn't) you can schedule an appointment with your child's doctor just for paperwork. Our pediatrician's office calls it a consultation. I much preferred doing this and leaving my boys with a babysitter rather than trying to finagle signatures out of the doctor during a well-check or something. I assume most doctors prefer this as well.

- **updated** Lastly, and yeah, probably leastly, It wouldn't be a bad idea to have a friend look over all the paperwork before you send it in to make sure you signed everywhere it says "Parent or Guardian," "Primary Care Giver," etc. I discovered it wasn't a big deal in the end but I did receive a letter from the Katie Beckett Review Nurse with a copy of a form I'd forgotten to sign. Which I promptly signed and put back in the mail.

- **updated** See my Katie Beckett Continued post

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I really hope this post will help someone out there who's trying to work through this process. Please remember that I'm not an expert and your experience may be quite different from mine. I don't even know if we're going to get approved based on what I've sent in and we might have to try again. (**updated** We got our approval!) I'm going to work at keeping a record going on this blog so that people can benefit from our example (both what to do and what not to do) as much as possible.

Good luck!