Fee for Service is kicking in. There is much confusion about the
process. Some States, I have been
informed, have pulled out of it due to the complex nature of the program. Many Agencies are overwhelmed with the
mechanics of how to incorporate this new system into what they have mastered
for years with the old system based on Contracts.
This new system is much more tedious with allotting 15
minute chunks of time for accounting purposes.
It is a totally complicated system when dealing with so many
developmentally disabled individuals with specific needs. This makes for intricate accountability of
each program for each individual and for each staff member. A lot of time has to go into this.
There is speculation that things may get better with more
services available. Yet, so many
services have been removed before this came into play that it becomes a process
of filling in the gap. An example is the
personal training was terminated along with Gym memberships. Instead other therapies will now be allowed
like Speech, OT, and PT. I believe the
trick behind this is that you will need a doctor to attest to the need for such
services, whereas, going to a Gym is not considered a medical goal.
Everyone previously had the State paying for housing after
they billed what they could of the clients and their families. Now a variation of Section 8 Housing is
coming into play through various agencies.
So, every aspect of the disabled person’s life is being affected by this
change.
There is concern if the Agencies which run programs for the
disabled will survive this change; or, if Doctors would continue taking these
types of patients with the new system in place.
This is because this population is so vulnerable to not being able to make
it to appointments for therapies, education, habilitation, and doctor visits
that the concern is the payments will not take place and there will be a large
loss of income for these providers.
Also, the same holds true with people who work with these individuals
who are not very well paid at all to begin with. There may be a large loss of their income with
inconsistent pay that will result in a bigger loss of workers in the field.
As in the past with the Dept. of Human Service and the
Division of Developmental Disabilities, there have been so many programs
implemented and revoked throughout the years that it is stunning that by now
nothing solid has been in place. And,
with this program, which has many parents concerned with all the pressure on
them, their children, and the agencies they are involved with, who knows how
long even this will last or how it will evolve.
And with each change of the political environment, new ways of thinking
come into play. So it is a matter of
time before we are able to see the fate of Fee for Service.
