MISSOULA, Mont. — NBC Montana brought you the stories of some Montana families that are struggling to secure care for their disabled loved ones through the Medicaid waiver program.
The Medicaid waiver waitlist is years long.
We are looking into how the waiver waitlist affects one medical community and the efforts they make to help this vulnerable population.
Logan Health in Kalispell is gearing up to host its Cycle Montana event to raise funds for Montana youth impacted by medical hardship. Many of these young people are likely on the waitlist for a Medicaid Home and Community-Based Services waiver.
“Having an extra source of money like through Cycle Montana, that would be very helpful, because the Medicaid Waiver list is so long to get on and certain medical needs are just not being met in many of these kids,” said Dr. Ken Graham, a pediatrician at Logan Health Children's Primary Care Clinic.
The fundraiser is a stationary bike relay event taking place on Mar. 11 and aims to raise $100,000 to help kids with complex medical needs cover some of the out of pocket expense gaps that Medicaid or traditional insurance will not cover.
Graham has been a pediatrician for 30 years and has seen first hand the challenges families face with the ongoing waitlist for a Medicaid Home and Community Based Services Waiver.
“Sometimes it takes multiple attempts to get on waiver, sometimes 3 or 4 applications and it’s really a frustrating thing for families,” says Graham.
The Logan Health pediatric team has felt the strain on their end as well. The time consuming process required for them to help kids apply for the waiver and still have time to see patients put them in a tight spot, so they had to recruit some help.
“We actually have a complex care navigator person that is now helping us to do all this work because we just can’t keep up with it.” explained Graham.
He also tells us that connecting waitlisted patients with specialist resources is not as simple as writing a prescription to get services covered.
“It’s very time consuming for the medical community too, just because we have to try and dig and find ways to help patients.”
Graham spends time each day calling therapists and other service providers and working with the complex care navigator to jump through hoops to secure services.
He also says the elephant in the room needs to be addressed,
“We need to go to our legislators and say, we need help,” say Graham.
He tells us there are pediatricians knocking on doors in Helena asking for change and that getting the word out is vital.
“Until we get stories out like what you’re doing that show people and real lives and real needs, and to see how many numbers of kids there are that have these medical issues, until we see the real life of it, I don’t think things are going to change," said Graham.
Follow this link to learn more about Logan Health's Cycle Montana event.
We’ll be following up soon about current legislation and how it may affect the Medicaid waiver program.