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Thursday, December 31, 2015

Florida kicks 9,000 chronically ill, disabled kids out of healthcare system

by Joan McCarter
Sorry, Rick Scott. Nothing you can do now is going to save your soul.
Florida moron Rick Scott (R-of course) has once again demonstrated just how much he doesn't care if people—children, even—suffer and die in ways that are totally preventable on his watch. An investigation by the Miami Herald has uncovered how the state gutted its Children's Medical Services, a program designed to help chronically ill and disabled poor children. So kids are getting dropped.
The Miami Herald obtained thousands of pages of health department documents under the state's public records law, including nearly 800 emails and hundreds of memos and reports that detailed the state's plan to "restructure" CMS. They show that the elimination of children from CMS was the result of a plan to slash spending on sick kids at a time when Florida had a $635.4 million surplus. For the legislative session that begins next month, Gov. Rick Scott has proposed $1 billion in new tax cuts. The spending plan would eliminate an additional 718 health department positions. […]
The parents of one Palm Beach County infant learned on the eve of a critical craniofacial surgery that their 6-month-old son had been "screened out" of CMS. The little boy is profoundly disabled, records show, having been born deaf, without eyes, and with a disfiguring cleft palate. The child's mother called CMS in preparation for the surgery, only to be told "the screening is showing 'NO,' so they would not do anything."
"URGENT" read the subject line of a Feb. 2 internal email. "There is nothing that we can do?"
There was something they could do. Within a few days, the infant was re-enrolled. Thousands of other youngsters, though, did not fare as well.
Nine thousand kids have been dropped since May, even though the state was running a surplus, and possibly to help fund the tax cuts Scott wants. This program—for Medicaid-qualified children and for those whose parents make too much for Medicaid coverage but not enough for private insurance—provides more intervention with specialists and care devised for kids with special medical needs. Some of the activities of the CMS, like "providing care coordinators to help parents access therapy and medication, and organizing one-stop clinics for kids with sickle cell disease, HIV or cleft palates," just doesn't happen with Medicaid.
But there was too much need in the state for the program. It was getting too many enrollees and it became too expensive to treat these kids, so the state had some options. Not having $1 billion in new tax cuts was not among the options. Dropping 9,000 kids was what they settled on.
The way the state reduced the number of eligible children has caused a big stir, among academics as well as parents. Critics blamed the "screening tool," which consists of five questions asked of the parents of children with disabling illnesses. One of those questions, No. 3, is a trap, they say—one that exploits the yearning of every parent of a sick or disabled child to believe that their son or daughter can live a normal life.
The question: "Is your child limited or prevented in any way in his or her ability to do the things most children of the same age can do?"
Give the wrong answer—no—and your child is eliminated.
The designers of that screening tool, by the way, say it was created "for use in surveys, not for eligibility determination … to estimate the number of children with special health care needs in a population." The state found it a handy tool to start weeding out patients. Children.
Yes, we still need universal healthcare.

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