LINCOLN — State officials have found a way to continue Medicaid-funded services for some children with disabilities who lost coverage this year.
The option may help children like 4-year-old Claire Aschoff of Blair, who was dropped from a special Medicaid waiver program for disabled children and adults on Aug. 1. She lost coverage after state officials determined she did not meet new eligibility standards.
Now the Nebraska Department of Health and Human Services is offering to transfer Claire, and children like her, to a different Medicaid waiver, one designed for people with developmental disabilities.
Bridget Aschoff, Claire’s mother, called the offer “huge” for the family and its finances. But she’s not celebrating until her daughter is approved for the new coverage.
“I’m excited but I’m also nervous,” she said. “Until it actually happens, I’m going to be a little cautious.”
The offer is open to children who have been covered by the waiver for disabled children and adults but who no longer qualify under the standards that took effect Jan. 1.
Courtney Miller, director of developmental disability services at HHS, said funding will follow those children from one waiver to the other. That means they will not cut in line ahead of people currently waiting for developmental disability services.
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Both waivers are intended to keep adults and children out of nursing homes and other institutions. They can pay for health care services and long-term supports, such as respite care, special formulas and home modifications, that may not be offered under traditional Medicaid.
Under both, children must be disabled enough that they could be admitted to an institution — a pediatric nursing facility for one waiver, an intermediate care facility for the developmentally disabled for the other.
Miller said state officials began exploring the transfer option a few months ago. It took time to ensure it was allowed under state and federal laws and regulations and would not affect the developmental disability services waiting list.
She said she has offered the option to families of the 28 children found ineligible for the waiver for disabled children and adults so far. Others are expected to be found ineligible in the coming months as the state resumes eligibility reevaluations.
The state has reevaluated 210 children so far this year but the evaluations were suspended for six months because of the widespread spring flooding.
Edison McDonald, executive director for the arc of Nebraska, praised the state’s action.
“It’s going to be great news for a whole bunch of them,” he said. “This determination will definitely save some lives.”
But he cautioned that not all children who lose eligibility for one waiver will qualify under the other.
He estimated that, of children found ineligible for the waiver covering disabled children and adults, about 20% to 30% would not meet the state’s definition of developmental disability.
Nor will the transfer option help future children who have disabilities that are not severe enough to qualify for the waiver covering disabled children and adults. Those children will have to get on the waiting list for developmental disability services.
More than 2,300 people already are on that list, with the oldest application dating back to 2012.
“There are huge gaps and holes in our Medicaid system and this is one of the gaps,” McDonald said. “It’s a temporary solution and a short-term fix.”