State holds steady on care for disabled

Disabled individuals on Medicaid need not worry about being forced to join a Medicaid managed-care health plan -- at least not in the near future.

Members of the subcommittee of the Legislative Committee on Health Care all seemed to be in agreement Tuesday that the state should continue to provide health coverage for an estimated 17,000 disabled people. The cost ran close to $169 million this fiscal year.

Of these 17,000 individuals, about 750 were institutionalized and cost the state the biggest chunk -- $50 million -- of its expenditures for the disabled.

Beginning Oct. 1, all other Medicaid patients throughout the state will be required to abandon their present fee-for-service system, where they chose a physician of their choice, and sign with a health maintenance organization (HMO).

"The state will not prepare a budget to move disabled into managed care," said Christopher Thompson, administrator of the state's Division of Health Care Financing and Policy. "I am skeptical that capitated managed care will work for the disabled."

Thompson said the state will study the disabled-care problem for the next two years, and it won't be brought before the 1999 Legislature.

Several disabled people testified both in Las Vegas at the Grant Sawyer State Office Building and in Carson City that HMOs aren't designed to deliver the personalized care disabled individuals need.

New technology and in-home services are important things to be considered, said Paul Gowins of the State Independent Living Council.

"The whole gatekeeper policy (of HMOs) doesn't work with the disabled," Assemblywoman Barbara Buckley, D-Las Vegas, said. "I won't support moving the disabled into any kind of managed care."

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