>This just proves a point, that the powers-that-be do NOT get it.

Families of kids with certain medical issues have life-long costs. A lot of those costs occur within the first 5 years of life.

Because most of those powers-that-be do not have a child with medical issues, many do not realize that private insurance companies do not always pay for all the services Birth To Three offers. If they do, therapy sessions, for instance, are covered for a limited number of visits. When you are dealing with an infant, changes occur every week; yet, most private insurance companies will cover an average of 20 visists per year, which would mean that child would not even have therapy services every 2 weeks. In the timeline of a child’s development, the difference between weekly, bi-weekly or monthly visits is vast. Not only that, but so much can be missed between visits that, with weekly therapy sessions, could be quickly and easily remedied.

Add to that that the majority of insurance companies impose lifetime limits of coverage, and a child with severe issues could reach that limit before he or she reaches adulthood. Then what is that child to do?

Upper middle class families may not be affected by these changes, but for those of us who are squarely lower- to mid- range for “middle class” would be affected more profoundly. For some families, $20 a month would mean the difference in whether or not the family could purchase milk that month (no kidding, with milk averaging around $4 or more a gallon).

Uphill battles are hard and this is just ridiculous. Aboslutely, depressingly, mind-boggling.

From the Charleston Gazette, online here: http://www.wvgazette.com/News/200804150651

State Health and Human Resources Secretary Martha Walker said Tuesday she’s committed to continuing a cash-strapped program for developmentally delayed infants and toddlers, but parents might have to shoulder some costs to keep the program afloat.

Walker set a July 1 deadline to overhaul the Birth to Three program, which provides free therapy services to more than 5,600 West Virginia children.

“I want to look at every part of the program to see what opportunities there are for cost-sharing,” Walker said. “It’s a wonderful program, but there’s not a never-ending pool of money to fund it. Cost-sharing has to be part of the solution.”

Earlier this week, state officials said Birth to Three is expected to finish the fiscal year in June with a $3 million deficit.

The number of children enrolled in the program has increased by 2,000 during the past five years. But state and federal funding for Birth to Three hasn’t changed.

The state has fallen weeks behind in reimbursing nurses, therapists and counselors who work with children in the $22 million-a-year program.

In January, a task force suggested that the state consider reducing services, limiting eligibility and charging families a monthly fee to keep Birth to Three afloat.

Under a proposal, parents who make more than $150,000 a year, for instance, would pay a $100 fee each month for their children’s services. Parents who make more than $35,000 would pay $20 a month.

Birth to Three now provides free services to children, regardless of income.

State Health and Human Resources Secretary Martha Walker said Tuesday she’s committed to continuing a cash-strapped program for developmentally delayed infants and toddlers, but parents might have to shoulder some costs to keep the program afloat.

Walker set a July 1 deadline to overhaul the Birth to Three program, which provides free therapy services to more than 5,600 West Virginia children.

“I want to look at every part of the program to see what opportunities there are for cost-sharing,” Walker said. “It’s a wonderful program, but there’s not a never-ending pool of money to fund it. Cost-sharing has to be part of the solution.”

Earlier this week, state officials said Birth to Three is expected to finish the fiscal year in June with a $3 million deficit.

The number of children enrolled in the program has increased by 2,000 during the past five years. But state and federal funding for Birth to Three hasn’t changed.

The state has fallen weeks behind in reimbursing nurses, therapists and counselors who work with children in the $22 million-a-year program.

In January, a task force suggested that the state consider reducing services, limiting eligibility and charging families a monthly fee to keep Birth to Three afloat.

Under a proposal, parents who make more than $150,000 a year, for instance, would pay a $100 fee each month for their children’s services. Parents who make more than $35,000 would pay $20 a month.

Birth to Three now provides free services to children, regardless of income.

The task force also recommended that the state consider requiring some families to use private health insurance to cover some program services.

Walker said many states already have adopted those changes to keep similar earlier-intervention programs going.

“We’re going to look at what other states are doing,” Walker said. “We’re committed to this program, but there’s only a finite amount of money. We do need to make some changes in structure.”

Walker said the number of children in Birth to Three has increased sharply because pediatricians across the state have become better at identifying developmentally delayed infants and toddlers. Nearly 5 percent of all West Virginia children age 3 and under are enrolled in the program.

“We have to look at ways to make the program more efficient,” Walker said. “We have to figure out how to use the resources we have. We’re working as hard as we can to find a solution.”
State House Health and Human Resources Chairman Don Perdue, D-Wayne, said Tuesday he would consider a supplemental appropriation request at an upcoming special session, if Walker’s agency determines it needs additional funding for Birth to Three.

“This thing has been way under the radar,” Perdue said. “What’s striking is the growth of the program.”

In recent days, parents have flooded state officials and lawmakers with phone calls and e-mails, urging them to find more money for the program. Parents praise Birth to Three, saying it changes children’s lives for the better.

To contact staff writer Eric Eyre, use e-mail or call 348-4869.

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