Medicaid change will lead to better care

My daughter Katie was the recipient of the first Medicaid home- and community-based waiver in the country. In many ways she was the first person to recognize the need for health care reform.

When Katie came home from the hospital in 1981, we really did not know how she would do after three years in a pediatric intensive care unit recovering from the effects of viral encephalitis that left her ventilator dependent. Even some of the nurses who had cared for her had their doubts.

The waivers were created to help people who had used up all of their major medical coverage and became eligible for Medicaid based on Supplemental Security Income under Social Security. It 'waived” the eligibility for Medicaid based on an outdated regulation that did not allow states to use Medicaid funds for home care purposes. Since it was a regulation and not part of the law, I was asked to speak before the Federal Regulatory Reform Commission chaired by then Vice President George H.W. Bush. In my testimony I fully endorsed the idea for case management services and the importance of care coordination to fully benefit children and their families who had complex medical needs and implementing home care for them. Just like the help we were able to receive so Katie could come home, ventilator and all. We also endorsed waiver programs requiring a plan of care and service availability to allow these children to be served at home.

Now that managed care is coming to Iowa's Medicaid program, I know we can make it happen because we have learned so much over the years in how to improve 'systems of care” for Medicaid-eligible individuals, especially those with disabilities. I know that many are concerned about what the future may hold, but change can be a great thing. Waivers were a quick fix to a huge health care issue but were not designed to last forever. Never did I believe that they would last 34 years, they thought Katie would not live past 10 years of age. Who knew?

I believe that private managed care programs know how to serve this population and as they discuss value added services it convinces me more that we are on the right path. I was recently hired to consult with one of the managed care programs to serve in the capacity of sharing knowledge I have built up over the years on disability issues, especially here in Iowa. Expertise based on firsthand experience. I thought that was very insightful of them and I feel honored to continue to help families and their children live a purpose- driven life that helps others to succeed in their homes and communities.

Even though change is imminent, we can learn from these times and empower individuals with disabilities and special health care needs about what their community can offer them. Care coordination is the key and community asset mapping will help identify what further communities can do and plan for in the future. I am impressed with what we know and what we are planning for the future. These are important times and I understand change is not always easy, but I also believe we can bring better coordinated care, individualized services and improved health outcomes to our state. Join me!

' Julie Beckett, of Cedar Rapids, is the proud mother of Katie Beckett and an Amerigroup consultant. Comments: waivermom@earthlink.net