Mikulski: Medicaid Must Not Cut Off Case Managers for Children in Foster Care, Other Recipients

Senator Barbara A. Mikulski (D-Md.) went to the Senate floor today to introduce an amendment to halt the Centers for Medicaid and Medicare (CMS) from implementing a new rule that would cut off funding for Medicaid case management by March 3, 2008, for children in foster care, and people with disabilities, mental illness and complex medical problems. Senator Mikulski introduced the amendment to the Indian Health Care Bill (S. 1200) with Senators Norm Coleman (R-Minn.) and Amy Klobuchar (D-Minn.), to delay the implementation of this rule until April 2009.

"This bipartisan amendment stands up for thousands and thousands of people all over the United States of America who are about to lose their social workers or their nurses because of a new, harsh punitive rule put out by the Centers for Medicaid and Medicare. I'm going to talk today as the Senator from Maryland who is standing up for my constituents, but also as a professionally trained social worker. As a social worker, I have provided these very services and realize what will happen if my constituents cannot get them," said Senator Mikulski. "This amendment would stop the CMS from implementing this new rule by delaying it until April 2009, when we have a new President and a new attitude. We object to the rule and we want to delay the rule until sensible heads prevail."

Under the new rule, 200,000 Marylanders may not receive case management services. These services help adults and children with complicated problems, people with disabilities, complex medical problems, mental illness and children in foster care. Senator Mikulski is a senior member of the Health, Education, Labor and Pensions (HELP) Committee.

Video of Senator Mikulski's floor statement will be available on Pathfire's Digital Media Gateway later today. Instructions to access Pathfire's content can be found at: www.mikulski.senate.gov/pdfs/pathfire.pdf.

To hear and/or broadcast a radio actuality of Senator Mikulski's floor speech, please call (800) 511-0763 and, when prompted, enter actuality number 2109 or go to http://demradio.senate.gov/actualities/mikulski/mikulski080214.mp3 to download a high-quality mp3.

Senator Mikulski's statement, as prepared, is below:

"I rise today to speak about an amendment #4023, cosponsored by Senators Coleman and Klobuchar. This amendment will stop the Centers for Medicaid and Medicare (CMS) from implementing a new rule that would end most Medicaid case management services for our most vulnerable citizens

"On December 4, the Centers for Medicare and Medicaid Services proposed an interim rule that would cut Medicaid funding for targeted case management (TCM) services. The final rule would go into effect on March 3, 2008. These are the services provided by social workers and nurses. These services help adults and children with complicated problems, people with disabilities, complex medical problems, mental illness and children in foster care. Targeted Case Management services help individuals get and coordinate necessary medical, social, and educational services. This means either states would have to provide these services on their own - passing costs onto state and local tax payers - or thousands of families would go without case management.

"In Maryland, this could mean 200,000 individuals may not receive case management services. The state could lose up to $66 million in federal dollars 1,400 Marylanders could lose their jobs, many of which are nursing and social work jobs. As a social worker, I have provided these very services and realize what will happen if my constituents cannot get them.

"This amendment delays the implementation date of this rule until April 2009. This amendment is the same as legislation introduced by Senators Coleman and Klobuchar, cosponsored by 19 Senators - myself, Senators Cardin, Corker, Dominici, Bingaman, Alexander, Salazar, Leahy, Casey, Clinton, Collins, Kennedy, Sanders, Wyden, Snowe, Brown, Voinovich and Byrd.

"Let me give you two examples of people who received these services in Baltimore, who now might be at risk of losing them. There was a two-year-old diagnosed with a genetic disorder that led to feeding problems because of difficulty swallowing and sucking. This disease could cause more severe problems without help early in life. The family got case management, early intervention services. The case manager helped the family get nutrition services since the baby was not gaining weight, as well as speech and language, and occupational therapy.

"And then there was a pregnant woman who lost a baby last year due to unsafe sleeping arrangements. She was referred to a family advocate this year when she was four months pregnant, had not received prenatal care and was smoking. The family advocate helped her get health insurance and find a doctor. The advocate provided education on the importance of prenatal health care and the Woman, Infants and Children (WIC) program. She explained the importance of a crib and helped her get one. She helped the woman stop smoking. And the woman went on to give birth to a healthy baby boy.

"This bipartisan amendment stands up for thousands and thousands of people all over the United States of America who are about to lose their social workers or their nurses because of a new, harsh punitive rule put out by the Centers for Medicaid and Medicare. This amendment would stop the CMS from implementing this new rule by delaying it until April 2009, when we have a new President and a new attitude. We object to the rule and we want to delay the rule until sensible heads prevail.

"This is not about how we can control runaway Medicaid costs. It is how do we make sure the American people get the services they need to be able to lead independent lives. I believe we give help to those that are practicing self-help. Those families that are out there struggling need a government that is on their side.

"I say to my colleagues from the other side of the aisle - let's be those compassionate conservatives that you once talked about. Join with us. Let's do this."

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