Under new co-payment guidelines in Pennsylvania for children with mental and physical disabilities, Kimberly Shank, of Quarryville, is afraid she won’t be able to pay for so-called “wraparound” services for Abbie, 7, right, and Allie, 5, including behavior and speech therapy. (Courtesy: Kimberly Shank)
Kimberly Shank just got a $3,600-per-year bill from Pennsylvania for care the state previously provided her two autistic daughters for free, putting a squeeze on the family and forcing choices between necessities.
“We are already living like the true definition of paycheck to paycheck,” Shank told FoxNews.com. “Do we have enough milk? How much gas do we have? Are we going to make it until the next paycheck? I have no idea where I can come with another $300 a month.”
The move by Pennsylvania’s Department of Public Welfare to require costly co-payments for behavioral services that were previously covered by the state could mean choosing between the necessities.
For Kimberly Shank, a mother of two young girls with autism, a move by Pennsylvania’s Department of Public Welfare to require costly co-payments for behavioral services that were previously covered by the state could mean choosing between the necessities.
Shank, an occupational therapist in Quarryville, said the change, which took effect on Monday, will cost her family just over $300 per month, or more than $3,600 annually. Shank and her husband, Dan, are now afraid they won’t be able to make ends meet and pay for so-called “wraparound” services for Abbie, 7, and Allie, 5, including behavior and speech therapy.
“We are already living like the true definition of paycheck to paycheck,” Shank told FoxNews.com. “Do we have enough milk? How much gas do we have? Are we going to make it until the next paycheck? I have no idea where I can come with another $300 a month.”
The new initiative was first announced in August, but sources close to the matter told FoxNews.com advocates and parents are involved in ongoing talks with Republican Gov. Tom Corbett’s office to delay implementation and find viable alternatives.
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According to the plan, families earning more than 200 percent of the federal poverty level will pay up to 5 percent of their gross monthly income for behavioral services previously covered by the state’s Medical Assistance program. For a family of four earning roughly $46,000, that equates to $2,300 annually. For the Shanks, who earn about $66,000 per year, it means scouring for other options, like trying to pick up extra hours.
“I acknowledge, my kids are expensive, they’re expensive to the state,” Shank said. “But this isn’t something they’ve chosen. They have a disability. It is impairing their quality of life.”
Department of Public Welfare Secretary Gary Alexander has said Medicaid services in this category for children with mental and physical disabilities cost taxpayers approximately $700 million per year.
“About 80 percent of these families have incomes above 200 percent of the federal poverty level and one in four have an income above $100,000 a year,” Alexander said in a statement last month. “Currently, no other state has criteria as generous as ours, and we will continue to maintain services for eligible participants. However, we cannot continue to do so solely at the expense of the taxpayer.”
Donna Morgan, a Department of Public Welfare spokeswoman, told FoxNews.com there has been considerable “pushback” from the state’s 48,000 affected families, many of whom said they simply cannot afford new fees.
“We’re asking people who have means to contribute their fair share,” Morgan said. “We’re spending over $700 million on them every year and we are not cutting services. We are asking for a fair share co-payment.”
The change is a “done deal,” Morgan said, but “everything is negotiable,” she acknowledged.
“Right now it is a done deal, but we’re in the land of politics, and everything is possible,” she said Wednesday. “And we certainly feel for the families as they work this into their budget. But we’re also trying to preserve the program for those families and make our program sustainable.”
Catherine Hughes, director of family support services for Family Behavioral Resources, a health care provider in Allegheny County, said the new co-pays will cripple families already teetering on fiscal ledges and questioned whether DPW officials are ready to implement the changes, particularly regarding collection of the premiums.
“This will devastate families,” she said. “It’s a huge impact.”
Call seeking comment from Gov. Corbett’s office on the status of any potential talks to delay implementation of the co-payment plan were not returned. House Resolution 879, which calls for a more detailed study of how the new regulations are being implemented, was introduced last month.
Jim Bouder, whose 17-year-old son Donovan suffers from autism, said every family affected by the change is willing to pay fair and reasonable cost-sharing contributions, but urged legislators to “take a step back and call a timeout” as families scurry to figure out how to afford the new charges. He claims the state also overestimated his income by $44,000, inflating his copay liability by more than 5 percent per month.
“[Donovan] needs these services in order to not only make gains, but also to maintain the gains that he’s made,” said Bouder, who will now pay roughly $400 per month for services that were previously covered.
Shank, meanwhile, said she’s now trying to figure out how she can “put the brakes” on the change. She’s also doing a lot of praying, she said.
“We don’t want a free ride,” Shank said. “But we all benefit from some state program one way or another.”
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