Michigan Ssi Programs\/internetSSI- Related Disabled Children and Medicaid. U. S. Department of Health and Human Services. Marilyn Rymer Ellwood. Syste. Metrics/Mc. Graw- Hill. June 1. PDF Version. This report was prepared under contract between the U. S. Department of Health and Human Services (HHS), Office of Family, Community and Long- Term Care Policy (now the Office of Disability, Aging and Long- Term Care Policy) and Syste. Metrics. For additional information about the study, you may visit the DALTCP home page at http: //aspe. Humphrey Building, 2. Independence Avenue, SW, Washington, DC 2. His e- mail address is: John. Drabek@hhs. gov. With the implementation of the SSI program in 1. The Supplemental Security Income (SSI) program pays benefits to disabled adults and children who have limited income and resources. SSI benefits also are payable to people 65 and older without disabilities who meet the. SI CHI00830.416 - (MI) Michigan Adoption Subsidies (RTN 377 -- 10/2005) - 02/02/2009 Batch run: 02/02/2009 Rev:02/02/2009. With the 2014 SSI Summer Program in Michigan complete, we took some time in our latest newsletter to look back at the summer and celebrate the successes, express our gratitude to everyone who helped, and make a few important. MSQC is a collaborative of Michigan Hospitals dedicated to overall surgical quality improvement, including better patient care and lower. Enhanced Recovery Program: Making the Surgery Experience Better From Beginning to End. Scuba Schools International (SSI) is a world-wide leader in diving education that is dedicated to provide The Ultimate Dive Experience. SSI - Serious Diving, Serious Fun. Student Statesmanship Institute 877-464-6388. Summer Program; Ambassador League; Register; Students. Check out this short VIDEO about how awesome the SSI summer program really is! SSI State Supplementary Payments / Optional State Supplements and Eldercare. Page Reviewed / Updated - Mar. Michigan Social Security Disability Field Offices. 1040 S Winter Street Suite 2401 Adrian, MI 49221 Phone: 1-517-263-7873. 111 N 4th Ave Alpena, MI 49707 Phone: 1-989-354-4140. SSI (Scuba Schools International). SSI and the authorized SSI Partners are dedicated to provide >The Ultimate Dive Experience< with a focus on flexibility. Freediving Freediving Program Freediving Instructor Programs. Employment; Education; Housing; Transportation; Health; Benefits; Technology; Accessibility; State Programs & Services; Civil Rights; Complaint. Michigan Rehabilitation Services Michigan.gov Home. Medicaid program- -disabled children in low- income families. Prior to SSI, severely disabled children generally had qualified for cash assistance and Medicaid only if their families were eligible through the AFDC provisions. With SSI, children became eligible for Medicaid in their own right if: 1) their disabilities were severe enough to satisfy the SSI disability criteria, and 2) they (or their families) were poor enough to meet the program's financial requirements. Adult disability determinations for SSI are largely based on whether a person is capable of work. For children, SSI disability assessments until recently focused on whether a child suffered from a condition included in (or equal to) a listing of medical impairments promulgated by the Social Security Administration. As will be discussed later in the paper, a recent ruling by the Supreme Court (Sullivan v. Zebley, February 2. SSI program to implement new standards for child disability determinations. The new standards will include individualized functional assessments for children which will focus on the impact of a child's handicap on his/her normal daily activities. It is generally believed that the new standards will result in a much higher approval rate for disabled child applicants. This paper presents available data on the Medicaid experience of disabled children, with disabled children defined as those who met the (pre- Zebley) disability test of SSI. The study population includes disabled children eligible for Medicaid and SSI cash assistance, as well as other optional groups of children who meet the disability test of SSI, but only qualify for Medicaid (not SSI cash assistance). The analysis focuses on the Medicaid patterns of disabled children in California, Georgia and Michigan, using Tape- to- Tape data for 1. This is the most recent readily available data on this Medicaid population group. The research questions addressed by this study include: What are the Medicaid enrollment, utilization and expenditure patterns of SSI- related disabled children? What proportion of overall child Medicaid enrollment and expenditures do disabled children represent? How do disabled children fit into the overall disabled Medicaid population and expenditures? What are the disabling conditions of SSI disabled children and how do these conditions relate to Medicaid expenditure levels? What differences are seen among selected subgroups of disabled children on Medicaid, including SSI children (noninstitutionalized), disabled children not receiving SSI benefits (noninstitutionalized), and institutionalized disabled children? What impact might the Supreme Court's Zebley decision have on Medicaid patterns for disabled children? DATA SOURCESThe data for this study were drawn from the Tape- to- Tape data base. Tape- to- Tape is a multi- state Medicaid data base developed by the Office of Research and Demonstrations at HCFA. The Tape- to- Tape data base includes information on every Medicaid enrollee and every claim processed by the Medicaid Management Information System (MMIS) in four States since 1. The data used for this study are 1. California, Georgia and Michigan. Table 1 shows the number of Medicaid disabled children and the level of Medicaid expenditures for the study population. These three States accounted for about 1. SSI children nationwide in 1. Medicaid programs. Disabled Child Medicaid Enrollees and Expenditures. California, Georgia and Michigan, 1. Number of Children. Expenditures. California 3. Georgia. 12,7. 15$3. Michigan. 11,2. 55$3. The study also made use of data from the SSI program which were linked to the Tape- to- Tape files. The SSI data came from the Characteristics Extract Record (CER), a 1. SSI recipients and applicants maintained by the Social Security Administration. The CER includes information on the major disabling condition for each SSI recipient. The disease categories used in coding the type of disability are based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD- 9- CM). MEDICAID ELIGIBILITY IN THE STUDY STATESThe study States varied somewhat in the groups of disabled children which they included for Medicaid in 1. All three States automatically enrolled SSI disabled children in their Medicaid programs. California and Michigan also covered disabled children under their medically needy programs in 1. Georgia did not. Medically needy disabled children are those who passed the SSI- related disability test, but had too much income or resources to meet the financial criteria for SSI cash assistance. Although Georgia did not cover medically needy disabled children, it covered two optional groups of the disabled who were institutionalized: those who would be eligible for SSI if they were not institutionalized, and those who were eligible under special income level for the institutionalized. The three study States varied substantially in the financial criteria which were used to determine Medicaid eligibility for disabled children in 1. The SSI program is federally administered and has a nationwide minimum benefit level for a person with no other sources of income. States also have the option to supplement the Federal benefit level (called the State supplementation payment). Among the study States in 1. California and Michigan elected to supplement the Federal amount, while Georgia did not. The monthly SSI benefit levels (including State supplementation) in 1. Table 2. Monthly Benefit Level, Including State Supplementation, for SSI Disabled Living Independently: California, Georgia, and Michigan, 1. California$4. 77. Georgia. 31. 4Michigan. Obviously, California's SSI benefit level was more generous than that of the other two States. The Federal poverty level in 1. Thus, the benefit level in California was above the Federal poverty level; the other two States used an income standard that was considerably less. The income levels for medically needy coverage used by California and Michigan are shown in Table 3. The medically needy level used by California was considerably higher than its SSI level (with supplementation), while Michigan's medically needy level was virtually the same as its SSI level. Thus, California potentially extended Medicaid eligibility to disabled children whose families had much higher incomes than either Michigan or Georgia. Medically Needy Income Level for One Person: California and Michigan, 1. California$6. 00. Michigan. 33. 9With a medically needy program, a State can allow persons to qualify for Medicaid through . The spend- down process allows applicants to deduct medical expenses from income in determining financial eligibility. Thus, disabled children from families of any income level could qualify for Medicaid, assuming their medical bills were large enough (and the disabled child satisfied the disability criteria). In all three study States, all- groups of disabled children were entitled to the same set of services. States have a mandatory set of Medicaid services, as well as optional services that they can elect to offer. Further, States can elect to set utilization limits on specific services, if they wish. As a result, the services included under any one State's Medicaid program can vary. There were some differences among the study States worth noting. Generally, the Medicaid program in Georgia was more limited than the programs in California and Michigan during 1. Georgia limited the number of outpatient hospital visits that could be reimbursed by Medicaid to 1. States imposed no limit. Georgia also limited the number of physician office visits during the year to 1. Neither California nor Michigan placed any restrictions on outpatient hospital or physician office visits. Although the restrictions in Georgia would not affect the utilization of the majority of disabled children, average measures of ambulatory services per enrollee may be affected. It should also be noted that Georgia did not cover inpatient psychiatric services for children during the study period. OVERVIEW OF MEDICAID DISABLED CHILDRENHCFA does not routinely collect data on the number of disabled child Medicaid recipients nationwide or their expenditures. The only nationwide data available on Medicaid disabled children is a count of the number of disabled children receiving Federally administered cash assistance benefits under the SSI program. According to the Social Security Administration, 2. SSI program in December, 1. This represented about 1. SSI disability enrollment. As shown in Figure 1, SSI child enrollment has remained generally flat since 1. SSI adult disabled population. Study data showed disabled children to be a small Medicaid group with regard to enrollment, but their expenditure levels are significant. Among the study states, they represented 2- 5% of child Medicaid enrollment, as shown in Figure 2. As expected, their expenditure levels were substantially higher than for other children on Medicaid. They accounted for 1. Medicaid expenditures. Disabled children can also be viewed as a subset of the disabled Medicaid population. Among the study States, they represented 8- 1. Medicaid enrollment, and about 8- 1. Medicaid expenditures (Figure 3). However, about 3. States were also enrolled in the Medicare program, thus reducing their proportion of Medicaid expenditures.
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