State hopes to shift Medicaid spending to feds

WASILLA — Finding new ways to pay for services is becoming a big deal in Alaska, where looming budget deficits have forced state officials to get creative when it comes to finances. One idea currently being touted by the Department of Health and Social Services would rely on a tried-and-true method of getting money into Alaska.

Let the feds pick up the tab.

The department’s Senior and Disabilities Services division wrapped up a tour of Alaska cities on Friday night at the Wasilla Senior Center, where division director Duane Mayes laid out a complicated plan to restructure the way Medicaid services are financed in the state.

“That’s the key to the presentation is bringing in more federal dollars,” Mayes told a crowd of about 30 people who attended the evening event.

Mayes said the state is exploring the option of participating in the Medicaid 1915 (k) Community First Choice and 1915 (i) Home and Community-Based Services. If the state were to participate in these programs, Mayes said the federal government would likely pay for more Medicaid services in the state.

Mayes, along with consultant Shane Spotts of Health Management Associates, told the crowd that the options would serve those individuals needing an institutional level of care who currently are eligible for the 1915 (c) waiver. The options could also serve those who don’t qualify for the waiver but are among targeted populations such as people with Alzheimer’s disease, traumatic brain injuries, severe mental illness or developmental disabilities not covered by the waiver.

Spotts said one advantage of the 1915 (k) program is that the federal government would provide 56 percent of the funding — compared to 50 percent under the waiver.

“It doesn’t seem like a lot on the surface, but these programs come to hundreds of millions of dollars in Alaska,” Spotts said.

Mayes said the restructuring would likely help his department, which was forced to lay off 24 employees last year.

“We are in a fiscal crisis,” he said.

Shifting more of the funding burden to the feds, he said, could help get better care to Alaska’s disabled and senior populations.

“If we do nothing, we’re putting the state at risk,” he said. “We’re putting those populations at risk.”

The intricacies of health care law are infinitely complicated, and the men said the meetings are simply a first step toward possible implementation of the plan. They’ve gathered input from residents across the state, which will be delivered to an 11-member implementation council.

“We wanted to be able to hear what people had to say about this,” said Spotts, whose company was brought in by the state to help explore the idea.

Most of those who commented at Friday’s meeting said they’re most concerned with making sure the level of care they’re currently getting is either met or exceeded in the future. Mayes assured them that’s the plan.

“I want to make this a smooth transition so people would not feel a change,” Mayes said.

Now that the public meetings have been held, the next step is a review of state and federal regulations, followed by a review of current operations. Other steps that need to happen include determining who would be eligible for the programs, how much it could cost and coming up with a plan for implementation.

Mayes said anyone with questions about the proposed changes can visit the division’s website at dhss.alaska.gov/dsds/pages/default/aspx. There is a link to a website that’s been set up specifically to provide information about the plan, which includes a short video explaining the proposal, a frequently asked questions link and a forum to ask questions.

If all goes according to plan, the new funding structure could be in place by July 1, 2017. Spotts said his intent is to save money for the state while also ensuring those on Medicaid continue to receive quality care.

“If we’re successful there should be no disruption to anyone receiving services,” he said.