Family Cost Participation in Georgia - PowerPoint PPT Presentation

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Family Cost Participation in Georgia

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4.8% PeachCare (S-CHIP) Georgia Demographics ... Source: GA Kids Count 2003. Why does FCP Work for Georgia? Consistent policies & procedures ... – PowerPoint PPT presentation

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Title: Family Cost Participation in Georgia


1
Family Cost Participation in Georgia
  • Part C/Babies Cant Wait Program

2
Why FCP in Georgia?
  • Precedent
  • Initial Planning
  • Stakeholder Involvement

3
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)

4
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

5
Why does FCP Work for Georgia?
  • Consistent policies procedures
  • Same criteria is applied to all families
  • Scheduled updates revisions

6
Ongoing Monitoring
  • Demographics
  • FCP scale is reviewed and updated annually to
    include most current Federal Poverty Guidelines
    and other necessary changes

7
Modifications are Based on Ongoing Monitoring
  • Local monitoring site reviews
  • Complaints
  • Identification of new fund sources

8

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
9
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

10
Revisions that Occurred in Response to Ongoing
Monitoring
  • Revised 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

11
Revisions that Occurred in Response to Ongoing
Monitoring
  • New Funding Sources Coordination
  • Private Insurance provisions
  • Expansion of FCP to Title V

12
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

13
Why does FCP Work for GA?
  • Consistent Policies
  • Determination of inability to pay
  • Ongoing Monitoring
  • Widespread acceptance expectations

14
Family Cost Participation -Whats Next in GA?
  • Changes in Political and Economic Context
  • Look at FCP fee scale, levels
  • Infrastructure Changes
  • Data system enhancements

15
What Does It Take to Get the Job Done?
Consider this as you study FCP in your
state
  • Stakeholders
  • Data
  • Other options
  • Authority needed

16
Any Questions???
  • Georgias FCP forms are available for your
    reference.
  • Contact me at skmoss_at_dhr.state.ga.us
  • or
  • 404-657-2721
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