family cost participation in georgia part c/babies can’t wait program
TRANSCRIPT
Family Cost Family Cost Participation Participation
in Georgiain Georgia
Family Cost Family Cost Participation Participation
in Georgiain Georgia
Part C/Babies Can’t Wait ProgramPart C/Babies Can’t Wait Program
Why FCP in Georgia?
Precedent
Initial Planning
Stakeholder Involvement
GA Part C Demographics• Part C serving 4,457 children
(6/30/03) and over 7,000 per year• Moderate eligibility criteria
• 62.6% Medicaid eligible• 39.1% Private Insurance• 4.8% PeachCare (S-CHIP)
Georgia Demographics• Median Income of families with children
(2000) = $44,800 ($50,000 nationally)
• Percentage of Children Living in Poverty: 21% in 1990; 18% in 2000
• Percentage of Children in Extreme Poverty (below 50% Poverty level) = 8% (7% nationally)
Source: GA Kids Count 2003
Why does FCP Work for Georgia?
• Consistent policies & procedures
• Same criteria is applied to all families
• Scheduled updates & revisions
Ongoing Monitoring
Demographics:
FCP scale is reviewed and updated annually to include most current Federal Poverty Guidelines and other necessary changes
Modifications are Based on Ongoing
Monitoring
Local monitoring & site reviews
Complaints
Identification of new fund sources
Revisions that Occurred in Response to Ongoing Monitoring
Revised Policies:FCP & Medicaid-eligibility -
Provisions applied family cost participation to non-covered
services for all families
Revisions that Occurred in Response to Ongoing Monitoring
Revised Policies:“Spend Down” & Adjusted Income -
Revisions to refine, clarify, and define allowable and disallowed
“spend downs”
Revisions that Occurred in Response to Ongoing MonitoringRevised Criteria:
For families with multiple children enrolled in Part C -
Provisions to reduce FCP percentage by 5% for each child
after the first enrolled child
Revisions that Occurred in Response to Ongoing Monitoring
New Funding Sources & Coordination:
• Private Insurance provisions
• Expansion of FCP to Title V
Things we Considered but did not do in GA
• Out of pocket maximum costs per year for each family
• Separate scales for families who access insurance and those who deny access
Why does FCP Work for GA?
Consistent Policies:• Determination of “inability to pay”
Ongoing Monitoring:• Widespread acceptance &
expectations
Family Cost Participation -
What’s Next in GA?
Changes in Political and Economic Context:
• Look at FCP fee scale, levels
Infrastructure Changes:• Data system enhancements
What Does It Take to Get the Job Done?
• Stakeholders
• Data
• Other options
• Authority needed
Consider this as you study FCP in your state…
Any Questions???
Georgia’s FCP forms are available for your reference.
Contact me at [email protected]
or 404-657-2721