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