From the Wall Street Journal:

Members of Congress are expressing concern and scheduling hearings about a Medicare plan to use competitive bidding for products such as wheelchairs and walkers, in a sign that lobbying by medical-equipment companies is gaining traction.

Currently, companies receive a government-set fee to distribute such equipment for patients’ home use. Under the competitive system, companies bid on how low a fee they would be willing to accept. Medicare then limits distribution rights for a particular geographic area to several low bidders.

… Officials at the Centers for Medicare and Medicaid Services say competition could ultimately save $1 billion a year … Critics in Congress and elsewhere say service for the elderly will suffer if the bidding system drives some operators out of business. “We are very concerned about a decrease in quality and access and choice of provider,” says Peter W. Thomas of the Consortium for Citizens With Disabilities.

Son qualifies, but Missouri has no money for services

St. Louis Post-Dispatch columnist Bill McClellan writes again about Richard and Donna Schnurman, who are trying to get adult services for their son Brent. Despite the assistance of a state representative, the Schnurmans are caught on a “journey into the rabbit hole of the Missouri mental health system where nothing is quite as it seems.”

After many phone calls, the Schnurmans get some good news: Brent qualifies for “crisis” services under Medicaid waivers. But there is also bad news: he won’t receive the services because funds are not available.

Another parent tells McClellan he was in a similar situation and successfully sued for the Medicaid services. “I’ve been lied to so many times I don’t trust anybody in state government. The Department of Mental Health should be my son’s advocate, not his adversary,” he says.

Meanwhile, the Schnurmans are tired, and desperate for help. “It does not speak well of Missouri that we have no help to give,” McClellan writes.

Earlier column here.

Associated Press story on Fox News:

At least 20 disabled activists, most of them in wheelchairs, were arrested outside Sen. John McCain’s offices Tuesday after being refused a meeting with the GOP presidential nominee-to-be over a bill to expand Medicaid coverage to more people who want in-home care.

“If he should be president, it would be ironic that he comes from a party that talks a lot about family values,” said Bob Kafka, national organizer for ADAPT, a group advocating for passage of the bill. Without the legislation, many disabled and elderly people don’t have the choice to apply coverage to anything other than institutional care, he said.

“Families are devastated because they don’t have a choice to keep people at home,” Kafka said.

Earlier, from the Los Angeles Times: John McCain gets tax-free disability pension

From the Kansas City Star:

An estimated one in 26 American families is raising children with disabilities, yet more than 80 percent of parents of these children have not established a special-needs trust.

A special-needs trust provides financial protection to those with disabilities, and also preserves their eligibility for Medicaid, Social Security income and other need-based benefit programs.

Experts say such a trust could preserve medical benefits worth hundreds of thousands of dollars over the life of the individual. The trusts help people get services they are entitled to receive through government programs.

The story contains tips for doing financial planning for children with disabilities, as well as resources for more information.

Waiting for help that’s not coming

‘Judge a society by how it treats its weakest?’

From the Annapolis Capital, an extended feature on people with disabilities in Maryland who qualify for services that would allow them to live more independently, but cannot receive them because the services have not been funded.

Four years ago, there were 9,697 people waiting for help. There are 17,250 today. Ninety-four percent of those on the list need help immediately, said Michelle Hart, co-director of public policy initiatives for the Maryland Developmental Disabilities Council. She estimates it would take hundreds of millions of dollars to solve the problem.

“It is at a crisis stage,” said Robert T. Ireland, executive director of a group that serves about 450 people with developmental disabilities. “I turn people away every day. It’s the saddest part of my day.”

See related posts here and here and here.

From the Norfolk Virginian-Pilot:

In Virginia, the list of people with disabilities waiting for services is growing faster than the services available.

Brandon Christie of Virginia Beach needs round-the-clock care. He is one of 270 people in his community who are on a waiting list for 27 available Medicaid-funded slots, with at least 99 people ahead of him. Statewide, 4,000 people are waiting for services.

The Virginia General Assembly this session provided funding for an additional 600 people with intellectual disabilities like Christie to live more independently in the community, but the list is not keeping pace with the growing need. Without new slots, people on the list must wait until someone with a Medicaid waiver no longer needs it because he or she has moved out of state or into an institution or has died.

Christie, 24, lives with his parents. If they became too old or sick to care for him, he could move up on the list.

From the Nashville Tennessean:

The state of Tennessee ranks last in the nation in funding for nursing home alternatives. As a result, nursing homes have remained virtually the only option for Tennesseans who are elderly or have disabilities and cannot function entirely on their own.

AARP and other advocacy groups have been urging the state for years to provide more balance. This year, Gov. Phil Bredesen has gotten on board, inspired by his 86-year-old mother. While she occasionally needs assistance, she is generally healthy and has no intention of moving from her home, he says.

Bredesen has called for shifting more of the Medicaid dollars Tennessee receives into community and home care.

… As it is now, access to community and home care in Tennessee is fragmented and fraught with red tape — just the wrong note when the patient in question is elderly and needs help. There are individual programs around the state that can show how it should be done, if only the legislature and health-care community will take the challenge.

The governor’s bill should be just the beginning to put this state on the right path — homeward.

Related columns:

• Enable people to live where they thrive
• Change must be more than shift of funds