Some residents who receive Medicaid may only have 10 days to appeal a state decision that could cut their funding by as much as $40,000.
United Way of Palm Beach County, 2600 Quantum Blvd., is urging those who receive a letter from the Agency for Persons with Disabilities to file an immediate appeal.
Those affected by the cuts have received, or will receive, a letter notifying them that they have been placed in one of four tiers that places a financial limit on the services they can receive.
Someone placed in Tier One has no cap, while those placed in Tier Two, Three or Four will receive $55,000, $34,000 or $15,000, respectively.
Scott Badesch, United Way of Palm Beach County's president and CEO, said the letter is extremely confusing, even to him.
“I have a master’s degree and 30 years of experience, and I don’t fully understand the letter,” he said.
Badesch said the most important thing for a resident to do is to file that appeal within the 10 days because if that is done, the Medicaid will not be affected until after the appeals process in late October.
He said if filed after the 10 days, he does not know what could happen.
The new funding tiers are scheduled to take place Oct. 15.
He also pointed out the fact that the criteria for the four tiers is not being shared with clients. He even said there have been some inconsistencies with tiers.
For example, there are cases occurring where individuals with similar needs are being placed in different tier levels. In many cases, health and safety are comprised.
The state legislature mandated the APD to implement a Medicaid waiver called tiers. The four tiers establish financial limits on the services that a person with disabilities can receive.
In many cases, these amounts will not cover the tremendous costs for medical and residential care.
United Way has heard from some clients who used to receive $55,000 a year, and have been notified they will now receive just under $15,000 for services.
Badesch said the change in funding has put some families into a tailspin.
“Some families have to adjust how they care for their loved ones and this does not happen overnight,” he said.
For many the reduction in funding may mean a loss of nursing care, medical equipment, day care or socialization programs and therapies, said Linda Roman, community impact director for the United Way.
For information about the tiers, visit http://www.apd.myflorida.com/.
For information about the United Way of Palm Beach County, call 561-375-6600.
Mike Rothman can be reached at mkrothman@tribune.com.
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