SOUTHERN INDIANA – Changes to Medicaid benefits in Indiana over the past two years, including the state’s transition into the PathWays for Aging program, have left many Hoosiers feeling frustrated and confused.
Some Southern Indiana residents over the age of 60 are struggling to adjust to the new system, with some saying the case management they have experienced through managed care entities has been lacking in more ways than one.
Event attendees at a town hall at Ivy Tech Community College in Sellersburg on Tuesday said some of their case managers won’t take their calls. Others said they have been stuck on Medicaid waiver waitlists for years. More said they felt they had been incorrectly assessed and deemed ineligible for benefits.
There are three managed care entities (MCEs) contracted to case manage Medicaid benefits in Indiana: Anthem, Humana and United Health Care. LifeSpan Resources, the Area Agency on Aging (AAA) for Clark, Floyd, Harrison and Scott counties, is a non-profit entity that also offers case management and services for aging Hoosiers and those with disabilities.
Medicaid benefit recipients ages 60 and older are automatically enrolled in the PathWays program and prompted to choose between the three MCEs. LifeSpan used to have a contract with Humana and United Health Care that allowed the AAA to take on some of those two MCEs’ case management load.
But Humana and UHC did not renew their contracts with LifeSpan after the first two years, and LifeSpan eventually lost two-thirds of its case management client base, town hall moderator and Indiana University Southeast professor of public and applied sociology Melissa Fry said Tuesday.
“They went from more than 3,000 clients to just over 1,000 clients,” Fry said. “This effectively represented a divestment from the AAA services and made it impossible for them to maintain the full services they were providing outside of case management.”
Around 60 people attended the town hall Tuesday, and several of them described situations where their case manager through an MCE was unable to help them or answer questions.
Michelle Brantley is a case management supervisor for LifeSpan. She cares for her mother, who is on PathWays and receives care through MCEs. Brantley said her mother has had five different case managers in the past two years.
The only reason she was aware her mother’s case manager had changed, Brantley said, is because she works for LifeSpan and could use her connections to figure it out.
Brantley said she has reached out to her mother’s current case manager to ask about her benefits several times to no response.
“When we do have communication with her, the communication we get is, ‘I’m overwhelmed, I’ll get to it when I can,’ or we just don’t get a call back,” Brantley said.
In the meantime, her mother has had a stroke, broke a femur and became wheelchair bound.
“She needs the help,” Brantley said. “She doesn’t want to go into a nursing home. So, I’m going to do everything I can to help keep her at home.”
Where many aging and aged Hoosiers are facing struggles managing their existing Medicaid benefits, some younger Southern Indiana residents are stuck on years-long waitlists to receive Medicaid waivers.
Kerissa Humbert said Tuesday she has a 5-year-old, legally blind son who will never be able to drive. As he gets older, she said she is starting to worry about his schooling situation and the accommodations he will need.
Humbert said her son has been on a waiver waitlist for three years, and that when she called to ask for an update two months ago, the Family and Social Services Administration said they were still in the year of 2022.
“He is delayed,” Humbert said. “He has to take Genotropin injections every day because he doesn’t produce growth hormones on his own … It’s very worrisome.”
State Representatives Wendy Dant Chesser and Ed Clere were present at the town hall Tuesday to answer questions from a legislative perspective.
“Let’s not dance around it,” Clere said. “It’s unacceptable to have waiting lists that leave a family such as yours waiting literally years to receive critical services and supports. This is part of a much broader crisis in health and human services in America, and Indiana is certainly part of it.”
A prevalent question asked multiple times by event speakers and attendees was who exactly is accountable for the issues with the PathWays program and Medicaid waiver waitlists.
“Where does the buck stop?” Fry asked.
Clere and Dant Chesser conveyed that the state legislature does not have control over the PathWays program, and that it was a project undertaken by former Gov. Eric Holcomb’s executive administration.
Now that Holcomb is no longer governor, and there is a “lack of appetite” for disability and aging related issues within the state legislature, Clere said, nobody is willing to take accountability for the programs’ lack of oversight.
Clere, who focused on disability-related issues and authored much legislation on the matter, is not running for re-election to the statehouse and is leaving the Republican party. Dant Chesser is trying to take up the mantle in his stead, he said.
With it being an election year, Clere encouraged town hall attendees to take their frustration to the polls, and elect people who campaign on improving PathWays oversight. Dant Chesser agreed, saying it will take a “harmony of voices” to raise reported failures as an issue.
“Find those positive solutions, and then make sure we’re all singing from the same tempo,” Dant Chesser said.
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