Shackleford: We cannot allow caregivers to be punished for GOP’s $1 billion Medicaid shortfall

Last December, a report from the Family and Social Services Administration (FSSA) revealed a massive forecasting error which resulted in a miscalculation of the funds needed to cover Medicaid expenses. The initial projection fell short of $1 billion dollars, forcing the FSSA to frantically to look for quick mitigation solutions. 

Republican lawmakers point to increased Medicaid enrollment during the COVID-19 pandemic, budget reversions and rising Medicaid enrollment as the reason behind the egregious error, though there is really no excuse that can justify this discrepancy. As a result of this blunder, $255.2 million will need to be appropriated prior to July 2024 to fund the program. In 2025, an additional $457.9 million will also need to be allocated. So, what does that mean for Hoosiers? FSSA is proposing to cut programs to save funding shortages created by an accounting error.

On Jan. 17, the FSSA released a statement proposing eight changes to help reduce costs. Among them is a plan to modify the Aged and Disabled Waiver. The proposal would forgo payments to Legally Responsible Individuals (LRIs) operating as Personal Care Attendants to those with disabilities. The consequences of this decision cannot be understated. Families across the state rely on the financial reimbursements offered through Medicaid Waivers to provide for those who need around-the-clock care. 

It is unconscionable that the FSSA is even considering halting financial assistance to caregivers. These reimbursements protect the most vulnerable in our state and punishing them for a GOP calculation error is no way acceptable. 

Families aren't the only ones pushing back. On Monday Jan. 29, the plan received pushback from the Intellectual and Developmental Disabilities Task Force including Lt. Gov. Suzanne Crouch who called on the Family and Social Services Administration to pause their cuts to the paid-family caregiver program. I applaud these bipartisan elected officials for offering their support to Hoosier families, and I encourage everyone to add their voice to testify against FSSA's plan. We’re glad to see leaders from all sides of the political spectrum joining the call for action Democrats have been pushing for months.

I have also taken steps to reduce the harm of this proposed action. On Tuesday, Jan. 30, I offered an amendment to House Bill 1386 during the Public Health Committee that would prevent Medicaid from reverting their funds, which was done and contributed to their budget shortfall. Of course, one could argue it could have been prevented if the reversion had not taken place. This would be especially effective during a budget year when funding is on the line.  As our population ages, we will see a rise in seniors who need care, which of course means the numbers for Medicaid enrollment will rise as well. By restricting the reversion of Medicaid funds, we will ensure that a healthy budget is protected from further reduction. 

I also am heartened to see Hoosiers speak out and refuse to take these changes lying down. On Monday, Jan. 22, parents with disabled children rallied at the Statehouse to protest these changes by the FSSA. Due to the current nursing shortage, many parents have been forced to take up the torch as full-time caregivers. This obviously means these parents cannot likely hold a full-time job, placing a financial strain on these individuals and their families. But these parents still need to afford food, housing and other basic costs of living. The funds distributed by the FSSA allow these parents to do right for their children and still receive an hourly income. 

Currently, the FSSA is encouraging parents to transition towards Structured Family Caregiving (SFC) as an alternative. SFC offers a daily rate ranging from $30-70 depending on the provider agency. But by contrast, currently LSI's can receive payments up to $15 an hour, which is clearly the more advantageous option.

It is imperative that we provide these parents with the support they need to keep their children alive. I find it ridiculous that these families are the ones paying for the mistakes made by Republican lawmakers. 

I encourage Hoosiers to stand up for the well-being of these families and advocate against the proposed Medicaid Waver changes. Comments on the proposal can be emailed to [email protected].

Alternatively, feedback can be sent via the following address: 
FSSA Division of Disabilities and Rehabilitative Services P.O. Box 7083, Indianapolis, IN 46027 Attn: Medicaid Waiver Amendments 

Public comments will be accepted until Feb 16, 2024. Together, we can show the FSSA that we will not accept the burden they wish to inflict on Hoosier families navigating medically complex health needs. I refuse to stand by while these families are thrown under the bus. I call on the FSSA to listen to Hoosier families and reconsider this ill-advised decision.