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Family Leadership Institute-Live Sessions - Shared screen with gallery view
Melissa Suarez
19:23
I saw it
Kelly King
21:23
Thanks for your patience.
Melissa Suarez
23:18
LOVE TAHT
Betsy Winter-Hall
23:38
I am here but not able to talk -- sorry!
Melissa Suarez
23:53
That is super great
PEAL Staff
25:09
Hi everyone, If you are just joining us please remember to click on the globe to select your language.
PEAL Staff
27:37
Hi everyone, If you are just joining us please remember to click on the globe to select your language.
Melissa Suarez
27:43
Thanx everyone…this was a really fun exercise, and I really enjoyed reading everonyes memoirs
Danielle Hagenbuch
28:44
Is there information on that conference on the PEAL Facebook page?
Melissa Suarez
28:57
Yeah its in the listserv
Melissa Suarez
29:23
If she’s not a host, then she won’t be able ot share
Anya 2
30:34
The information about the conference will be posted on our Facebook page and will also be shared in our e-newsletter. If you would like to subscribe to our newsletter you can do so on PEAL’s website
Mary Hartley PEAL she/her
30:53
I'll get you the Eventbrite link!
Danielle Hagenbuch
31:12
Thank you!
Mary Hartley PEAL she/her
34:07
3 day health mini conference: March 22, 23, 24
Mary Hartley PEAL she/her
34:14
https://www.eventbrite.com/e/health-matters-healthcare-services-for-youth-with-disabilities-shcn-registration-262094440527
Jenny Chen
36:56
I am switching to my computer for better connection.
PEAL Staff
37:02
Hi everyone, If you are just joining us please remember to click on the globe to select your language.
Melissa Suarez
38:33
Was this earned income? Or all income
Melissa Suarez
41:03
When was the last time they updated the income limitations for SSI? It seemed sooo low when we had applied a few years ago. It was unlivable for our size family (all three children have a disability which wasn’t factored into the equation)
Melissa Suarez
43:47
This category was sooo helpful for our family, we always ended up making too much (barely) or we would go up and down with wages and it would mean eligibility was always being adjusted…. This was super helpful
Melissa Suarez
52:39
Unemployment disqualified us…I was on unemployment.
Tara Poe
01:01:19
I have had to fax over about 95 pages each year. One of the pages did not go through last year due to their fax running out of paper and they denied…..even though my son has had Medicaid for years. I unfortunately cannot load up all the documents in compass….there is not enough memory. I would love to not have to send so much every year, but i just don’t trust not too.
Melissa Suarez
01:08:50
Is that mobility to support ADLs or just any support of ADLs
Melissa Suarez
01:09:20
Summer camps?
Dom DeFino
01:09:46
Is there a limit on the amount of health services someone can access?
Melissa Suarez
01:09:48
Is that through a specific provider, or through state agency or is that any camp I pick as long as its related to a medical disability?
Melissa Suarez
01:10:49
We cannot get ABA or any type of therapy for mental health here in Philly…. EVERYONE has a waiting list, Ive called at least 12 places and nothing…they dont accept MA as a primary?
Kelly King
01:10:59
Melissa, you missed a word, these are Therapeutic Summer Camps.
Melissa Suarez
01:12:09
Right no, we tried to get my son into some ABA or autism summer camps and we could never ever afford it… but they could really benefit from the autism specific enrichments.
Melissa Suarez
01:14:56
What does it mean that they dont accept it as a primary?
Ferrara
01:15:34
So is it better to have other insurance rather than MA in order to get those services?
Melissa Suarez
01:15:38
Federal dollars would that mean they are able to just allow out of network or private services?
Melissa Suarez
01:15:59
Pretty much the poor on MA dont have other options so waitlist is the end of the line
Sylenthia Siebenlist
01:16:00
So if someone is in need of a wheelchair this is covered under the new MA guidelines, what steps should a parent go though in getting this approved? if it is denied, does your agency assist. thanks sylenthia
Tara Poe
01:16:50
Sylenthia do you have an ot? They can usually help you get started on this.
Tara Poe
01:17:40
My ot helped me get a specially modified trike for my son through Variety out of Pittsburg.
Sylenthia Siebenlist
01:18:04
Ive seen that form at a IEP meeting. They asked me to sign and I wasnt sure about it so thanks for this infor
Melissa Suarez
01:18:38
Is this the medical billing consent form?
Kelly King
01:19:03
To get any equipment you will need documentation from a provider that supports the medical necessity of the item. They will need to submit a prior authorization form.
Diane Perry (she/her)
01:20:06
Melissa the medical billing consent form is the form that school districts ask families to sign so they can get some of that reimbursement
Melissa Suarez
01:20:36
Right, is that the school based access program? Is that what the consent is for? @ Diane Perry
Diane Perry (she/her)
01:22:38
Yes, Melissa
Danielle Hagenbuch
01:22:47
We bump up on the dual insurance problem with limits for therapy services on our private insurance. They limit us to 75 sessions so once we get to 75 we cannot do anything else for the year.
Kelly King
01:22:48
The form signed for school is the School Based Medical Access [SBMA) form. This provides funds to the school to enable them to recover some their costs for things billable to Medicaid.
Melissa Suarez
01:23:28
They are the same
Melissa Suarez
01:23:32
? Is what im asking
Kelly King
01:23:39
If you do not sign the SBMA form, they cannot reduce or deny a necessary service as a consequence. These monies do not count toward lifetime limits for a child,
Tara Poe
01:24:30
Danielle….my old primary insurance was only 8 sessions a year for therapy and I picked the top tier through my employer…..we paid the rest out of pocket before we got Medicaid. $$$$$$$$$
Danielle Hagenbuch
01:24:49
To clarify … if a provider accepts the private insurance but not MA can we still utilize their services? I have heard conflicting information about that. I understand that I would have to pay the associated copays or deductible since MA wouldn’t cover that which is fine, but wanted to know if it was an option.
Melissa Suarez
01:25:24
Same situation Danielle…
Melissa Suarez
01:25:37
Its a ridiculous amount of money to pay out of pocket
Melissa Suarez
01:25:51
Where can we get more information on the HIPP?
Kelly King
01:26:29
HIPP https://www.dhs.pa.gov/Services/Assistance/Pages/HIPP-Program.aspx
Melissa Suarez
01:26:43
So there’s no extra out of pocket costs for having children added to private employment benefits? Since we cannot get services with MA alone, but cannot afford to add them because it more than doubles his deduction
Melissa Suarez
01:26:47
thank you
Kelly King
01:27:27
Not very many families are on HIPP.Melissa, I am not understanding your question.
Melissa Suarez
01:28:27
All MA providers we call have waitlists. So im looking for another avenue to get more options. WE cannot afford to have more taken out of his paycheck.
Melissa Suarez
01:29:28
Is it true that its almost unheard of to get anything through the waivers before the age of 21?
Kelly King
01:31:02
Melissa, call your Special Needs Unit and ask them for help finding a provider without lengthy waitlists. Also, ask to get on a cancellation list (if that is reasonable). If the Managed Care organization doesn’t have adequate participation of providers, you may want to call PHLP.
Kelly King
01:31:22
I know several children who have waiver funding.
Melissa Suarez
01:32:35
PHLP?
Sylenthia Siebenlist
01:32:46
that would be great to learn more about the waviers since its not advertised anywhere.
Kelly King
01:32:47
The waivers are generally provided for children when the EPSDT benefits (those hearty services that Janice has mentioned) are inadequate to meet the child’s needs.
Tara Poe
01:33:32
Thanks Kelly
Kelly King
01:33:48
PHLP is Janice’s organization. the PA Health Law Project t
Sylenthia Siebenlist
01:37:54
it sounds like they screening people who have MA ins.
Cindy Duch she/her
01:40:54
Maybe Melissa can contact Janice with her individual issue? Find contact info at www.phlp.org
Melissa Suarez
01:41:40
I can Cindy, thank you. I find all of the systems surrounding MA to be challenging to conceptualize.
Diane Perry (she/her)
01:43:30
Melissa you are right.... It is all very complicated. Thank you for Janice and the Health Law Project to help families navigate this. I know they helped me immensely when my son was younger
Melissa Suarez
01:44:29
Thank you!
Betsy Winter-Hall
01:44:42
thank you!
Cindy Duch she/her
01:44:44
Thanks Janice!!!
Nikki Herman
01:44:48
Thank you!
Dom DeFino
01:44:49
Thank you!
Ms Alana
01:44:54
thank you this was great info
Dawn Moschberger
01:44:55
Thank you very much@
Sylenthia Siebenlist
01:45:06
lol
Kelly King
01:46:46
If you’d like to discuss your Elevator Speech, feel free to contact me. kking@pealcenter.org. 866-590-4625 ext 207
Sylenthia Siebenlist
01:47:26
thanks everyone
Dawn Moschberger
01:49:13
Thank you so much! I need to run...have an ESY call with the ARC. :)
Melissa Suarez
01:49:24
SAME DAWN