Gov. Asa Hutchinson wants to use about $29 million in Medicaid funds to reduce the number of developmentally disabled Arkansans who are on a waiting list for help with daily living tasks.
The money would provide services for 500 to 900 of the more than 3,000 people who are on the waiting list, Hutchinson told the Arkansas Tobacco Settlement Commission on Tuesday. The commission monitors the use of Arkansas' share of the 1998 national settlement with tobacco companies.
The governor told the commission that he will ask the state Legislature to designate about $8.5 million from the state's annual settlement payment to provide services to people on the waiting list.
The federal government, which provides about 70 percent of the funds for most Medicaid services in Arkansas, would provide the remaining $20.5 million, Hutchinson said.
"This is a significant statement of the people of Arkansas that those that are suffering from disabilities, physical, intellectual, that we care about them, that we want to provide services for them, that we'll provide the level of care that's needed but also that we provide some level of independence as well," Hutchinson said.
State Rep. Julie Mayberry, R-East End, whose 14-year-old daughter has spina bifida, called Hutchinson's proposal a "huge, huge step" toward shortening the waiting list.
Although she is leaving the Legislature at the end of the year, Mayberry said she has asked for legislation to be drafted and will work to build support for it among other legislators.
"It's a first step, but it's a gigantic leap if we can make it happen," Mayberry said.
Because of budget constraints, the number of developmentally disabled Arkansans who can receive home and community-based services under a program created in 1989 is limited to 4,200, Department of Human Services spokesman Amy Webb said.
During the fiscal year that ended June 30, the state Medicaid program spent $215 million on the services, with $64 million coming from state revenue and the federal government providing the rest.
The money Hutchinson proposes using to pare the waiting list had been designated for the ARHealthNetworks program, which provided limited health benefits to about 20,000 Arkansans of up to 200 percent of the poverty level.
The ARHealthNetworks program ended in 2014, when Arkansas expanded its Medicaid program to provide more comprehensive coverage to adults with incomes of up to 138 percent of the poverty level: $16,394 for an individual, for instance, or $33,534 for a family of four.
Through federal tax credits, the 2010 Patient Protection and Affordable Care Act also made subsidized coverage available starting in 2014 to many people with incomes below 400 percent of the poverty level: $47,520, for an individual, for instance, or $97,200 for a family of four.
Webb said in an email that "the money that would have gone toward ARHealthNetworks has been carried over," but didn't say how much has accumulated.
Human Services Department officials in the past have said that savings from discontinuing programs such as ARHealthNetworks will help offset the cost of the state's expanded Medicaid program after Jan. 1, when the state will start paying a portion of the cost.
State projections released in June indicate the state's share of the expanded program will total $79 million next year, when it will be responsible for 5 percent of the cost, and increase to $200 million in 2020, when the state's share will reach 10 percent.
Arkansas has provided the expanded coverage primarily by using Medicaid funds to buy private coverage for enrollees under the so-called private option.
A law passed this year to make changes to the private option and rename it Arkansas Works directs spending reductions resulting from the revamped program to go toward "future obligations under Arkansas Works."
Asked whether the money once allocated for ARHealthNetworks should go toward paying for the state's share of the expanded Medicaid program is "a fair question," Hutchinson said, but he noted that the allocation of the tobacco settlement funds is set out in a law passed by voters through an initiated act in 2000.
Amending that law requires a two-thirds vote of the Legislature.
"The question remains: What do you do with this money that's consistent with the tobacco settlement, and what's going to garner a two-thirds vote of the Legislature?" Hutchinson said.
Under Arkansas Code 19-12-108, 34.2 percent of the state's annual payment from the settlement goes to programs that expand Medicaid coverage to more adults.
A law passed in 2002 also allows the money to be used to "supplement current general revenues" for the entire Medicaid program "as approved by the Governor and the Chief Fiscal Officer of the State for the Arkansas Medicaid Program."
Hutchinson spokesman J.R. Davis said the governor wants the Legislature to amend the law to ensure services for the developmentally disabled have a "dedicated funding" source.
Cindy Alberding, director of Independent Case Management, a nonprofit organization that serves the developmentally disabled, called the proposal "fantastic."
"I think it's a real testament to the people of Arkansas that this is an area they're going to try to take on," she said.
Hutchinson has also proposed hiring managed-care companies to provide benefits to disabled and mentally ill Medicaid recipients and using the savings the companies generate to cut in half the waiting list for services for the developmentally disabled within three years.
The managed-care proposal drew opposition from some legislators and health care providers, however, and Hutchinson agreed to take it off the agenda for a special session that was held in April.
Hutchinson said Tuesday that his latest proposal separates the effort to reduce the waiting list from the debate over managed care.
"That debate will continue on a separate track," he said.
He said he remains opposed to using enhanced Medicaid funding from a part of the Affordable Care Act known as the Community First Choice Option to reduce the waiting list.
Under that program, the federal government would provide 76 percent of the funding for home- and community-based services for the developmentally disabled, but Arkansas would be required to eliminate the waiting list.
"I'm wary of it because of the risk associated with it, and so I've directed DHS not to pursue that program," Hutchinson said. "I think there's a much more reliable, cost-effective means of addressing the waiting list."
A Section on 09/14/2016
Print Headline: Governor: Tap tobacco dollars for disabled