Under the sweeping health reform bill passed by House Democrats last weekend, CHIP would cease to exist at the end of 2013, instead shuffling those kids into Medicaid or private insurance plans on a proposed insurance marketplace, called the exchange.Supporters of that strategy — including many House Democratic leaders who have championed the program for more than a decade – argue that it will promote expanded coverage by allowing entire families to join the same insurance plan. But critics, including some children’s welfare advocates and policy experts, maintain that the proposal would shift an additional cost burden on millions of low-income families, thereby discouraging them from buying coverage at all.

Stan Dorn, senior health policy researcher at the Urban Institute, said there are certain advantages to scrapping CHIP. Both Medicaid and exchange plans, for example, would never require congressionalreauthorization — a process CHIP is subjected to every few years, he pointed out. But due to CHIP’s affordability, Dorn said “it’s clear” that kids “are much better off” under CHIP than they would be under private exchange plans.

“It’s not even a close question,” Dorn said during a children’s health care forum on Capitol Hill Friday.

Studies suggest Dorn’s concerns are valid. One analysis, conducted by Watson Wyatt Worldwide, an actuarial research firm, found that families living between 175 and 225 percent of the federal poverty level pay just 2 percent or less of treatment costs under CHIP. Under the proposed exchange plans, researchers found, those same families would pay up to 35 percent of their children’s health costs.

Nate Checketts, director of Utah’s CHIP program, noted that the move to more expensive exchange plans would only discourage low-income families already pinching pennies in the economic downturn. “Unless there’s a mandate, I don’t think those low-income families will sign up for it,” saidChecketts.

CHIP was created in 1997 with broad bipartisan support and renewed for five additional years last February. The popular program is designed to cover children in low-income families that are ineligible for Medicaid. The House bill would both expand Medicaid and dismantle CHIP, sending some kids currently covered under the program into Medicaid plans and others into private plans on the exchange.

The Senate Finance Committee also initially proposed to terminate CHIP when it unveiled its legislation in September. However, the committee last month approved an amendment, sponsored by Sen. Jay Rockefeller (D-W.Va.), to reauthorize the program through 2019.

Supporters of the House proposal argue the advantages of centralizing control over CHIP coverage. Because CHIP is managed by states, there is a fear among some lawmakers that lean economic times could lead to sharp CHIP cuts in some spots, leaving those kids without any coverage at all. Those fears were almost realized earlier this year when California, facing a severe budget squeeze, temporarily froze new CHIP enrollment. Some health policy experts have pointed out that it’s probably not a coincidence that many House Democrats pushing the CHIP repeal are from California, including Speaker NancyPelosi, Rep. George Miller, who chairs the Education and Labor Committee, and Rep. Pete Stark, who heads the Ways and Means health subpanel.

Rep. John Dingell (D-Mich.) has also defended the plan to terminate CHIP, arguing in a recent email that “enrollment of kids increases when the entire family can be enrolled under one plan.”

Checketts agrees, pointing out the difficulties that can arise when family members’ health coverage is scattered across different programs. “It is a good goal,” he said, “to get families on a single source of coverage.”

Yet some analysts have concluded that affordability is the more significant factor to ensuring coverage.

The advantages of providing families with low-cost access to health coverage for their kids, Dorn said, “significantly outweighs the benefits of putting parents and kids in the same health plan.”

Other children’s health care advocates are agnostic. Jocelyn Guyer, co-executive director at Georgetown University’s Center for Children and Families, said Friday that, while CHIP has proven “a great success,” getting affordable coverage for kids is more important than what program provides it.

Ron Pollack, executive director of Families USA, a consumer health care group, also indicated that affordability is more critical for ensuring children have health insurance. “What are the out-of-pocket costs, and what is the care that they’ll receive?” Pollack asked, without endorsing either the House or Senate approach to CHIP.

If an analysis by the Congressional Budget Office is correct, the Senate’s plan to salvage CHIP is the more affordable option. Examining the Senate Finance Committee’s initial proposal to repeal CHIP, CBO Director Douglas Elmendorf noted last month that “some of those children would be eligible for subsidized coverage in the exchanges but would not be enrolled in an exchange plan.”

The reason, Elemndorf explained, is “at least in part to the higher premiums and higher out-of-pocket costs that they would typically face in such a plan.”

The Medicare supplement insurance standards were originally set by the NAIC in 1979 and have been advised numerous times since then. The recent changes to the standards include changes to the Medicare Supplement plan options that were believed to be confusing and duplicate benefits that are available in the Medicare Part B – physician and outpatient services – plan. These include the following:

- The addition of hospice benefits to each Medicare Supplement plan option – The elimination of preventative and at-home recovery benefits for all Medicare Supplement plan options

More About Medigap Insurance

Medigap insurance, also known as supplement insurance, is an insurance policy that Medicare subscribers can take out in order to cover healthcare expenses that are not already covered by Medicare. Medigap insurance policies are offered by private insurers and are available for all Medicare subscribers that are interested in enrolling in such programs.

All Medicare subscribers should be aware of how Medigap insurance policies work with their existing Medicare policies. For example, some Medicare subscribers that have Medicare Plan D may be able to have Medigap insurance cover the cost of prescription medications that are not covered by Plan D.

Other Medicare Changes

In addition to the addition of hospice benefits and the elimination of preventative and at-home recovery benefits to the Medicare program, the system will undergo several other changes in 2010. These additional changes include the elimination of four Medicare Plans and the addition of two new plans.

All Medicare subscribers should review their existing plans and learn more about the changes that will impact them. Medicare subscribers may want to make changes to their Medicare accounts after they learn more about the option available to them. These changes need to be made during the open enrollment period from November 15 to December 31, 2009 in order to be applied to the 2010 Medicare year.

More Information about Medicare

Medicare is a federal healthcare program that is available to all U.S. citizens over the age of 65. Individuals under the age of 65 are eligible for Medicare coverage if they have a qualifying disability or if they have End-Stage Renal Disease – a disease in which an individual has permanent kidney failure and requires a kidney transplant or dialysis treatments.

Individuals that are enrolled in a Medicare program receive coverage for many healthcare-related expenses, including healthcare services and supplies. However, there are healthcare expenses that are not covered by Medicare, including co-insurance, copayments, and deductibles. Some prescription drugs and treatments are also not covered by the Medicare program.

Medicare Subscribers have many options when it comes to selecting the right plan for their needs. Subscribers are required to select from four plans: Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. In some cases, they can combine these plans in order to get the right coverage for their needs.

In the event that a subscriber selects a plan that does not cover some or all of their healthcare needs, the individual may elect to purchase Medigap insurance. Medigap insurance is designed to cover the cost of many healthcare expenses that are not already covered by Medicare. Coverage options vary based on the plan and the plan provider that an individual selects.

Often, when an individual has Medicare Part B coverage, the individual will purchase Medigap coverage as well. Medicare Plan B covers 80 percent of the medically necessary healthcare charges that an individual may incur as a result of treatment by a physician or a hospital. When bills are high, Medigap insurance can cover all or some of the remaining 20 percent that is not covered by Medicare.

Medicare also does not generally pay for preventative services, such as routine exams. Medigap insurance plans may cover the cost of these non-covered services, depending on the plan that a subscriber purchases.

Under the agreement, which is on the verge of being approved Thursday by the Senate, Nebraska is permanently exempt from paying for its expansion of Medicaid, shoving that cost onto taxpayers in every other state.

Mr. Nelson was able to exercise such leverage because in exchange, he was providing the magical 60th vote that Democrats needed to advance their health care bill.

The deal has enraged other Senators, especially those from red states, whose Republican Senators didn’t bring home any pork at all because they were not part of the negotiations with Democratic leaders. Several other Democratic senators did get concessions for their states, but no deal has hit the nerve struck by Mr. Nelson’s.

Attorneys general in at least 10 states held a conference call late Tuesday to consider how they might challenge the deal, which they call federally subsidized vote-buying.

Some say it is certainly unfair and may be unconstitutional.

Troy King, the attorney general in Alabama, told MSNBC on Wednesday that the Constitution was not written to allow “the subsidization of a backroom deal.”

The Constitution, he said, was written to protect citizens from arbitrary and capricious decisions by Congress, not “for Congress to force Alabama to subsidize vote-buying.”

Bob Shrum, a Democratic strategist, defended the Nebraska deal on MSNBC. He said that brokering legislation was a long American tradition and said there was nothing unconstitutional about it. In fact, he said that Mr. King of Alabama had been “incoherent” in trying to back up his assertion that it was unconstitutional.

Could the growing backlash threaten passage of the health care bill? Mr. Nelson has said that he would vote for the bill only if nothing in it were changed. That makes it seem unlikely that Democratic leaders would try to undo the bill before the Thursday vote because doing so could threaten final passage.

But if anger builds — and especially if it spreads to Democratic senators — it may be harder for the Senate and House to keep the Nebraska deal intact when they meld their two bills in January.

Recently, as sourced from www medicare gov, the healthcare program has added two additional core benefits called the Advantage Plan and Long-Term Care Plan corresponding to Medicare Part C and Part D, respectively. With the Medicare Part C, purchase of the Medigap policy is no longer necessary as the package has a relative more comprehensive coverage, including prescription drug coverage which is lacking in the original two Medicare benefits packages. The Medicare Part D is meant to provide aid in paying for skilled nursing services such as those in nursing homes.

All of the Medicare Plans have premiums and higher premiums are assigned with plans of wider coverage. The Medicaid premiums are paid in the form of taxes deducted monthly from an individual’s salary and the standard allotment is set at 2.0%- the value or payment is shared between the worker and the employer. Individual contributors pay this percentage in full. State subsidy or premium payment exception is given to individuals who do not have the means to pay for the premiums and applications for state subsidy is made tot e local social security agency.

Last year, Mr. Ryan’s article stated that Wisconsin Governor Jim Doyle needed to slash the state’s Medicaid budget by 0 million. However, the Governor took a different approach than most politicians in defining what budget cuts to make. Past efforts to cut entitlement programs have usually been ineffective since it involved sitting politicians attempting to make the cuts without endangering their political futures and careers, or in Mr. Ryan’s words, “programs like Medicaid cannot be cut without political bloodshed.” Usually what happens when politicians have to make difficult decisions is they make suboptimal decisions since their actions are guided by their political careers and fortunes, not what is best for the citizens they represent.

Governor Doyle took a different approach in this case. Rather than rely on politicians to make the decisions on cutbacks, people that are mostly ignorant of how operations like Medicaid work and thus, are least likely to identify root causes of problems, the Governor turned to the people that that ran Wisconsin’s Medicaid program and asked them to come up with the 0 million in savings. The result: Wisconsin Medicaid officials found the necessary changes with the following positive effects:

- The 0 million target was met with a mix of new contracts and new procedures that steer customers to lower cost but just as effective treatments.

- Lobbyists lost influence since elected politicians were taken out of the loop and thus, lobbyists lost all of their leverage.

- Politicians were happy since they did not have to take any courageous but unpopular positions relative to budget cuts, preserving their political careers.

- Knock down, drag out political battles were avoided and changes were identified quickly rather than compromised, ineffective answers that took forever to agree on.

- Best of all, according to the article, voters are also happy.

Wow, a government entity that reduced itself in an effective and efficient manner, saving taxpayer money. How did it happen? It allowed the experts in the field, not politicians in the legislature, to identify the root causes and then solved the problem by attacking the right causes. Compare this behavior of the Federal political class that passed health care reform and financial regulatory reform where in each case, the politicians did not understand the root causes of the problems, resulting in idiotic legislation that will never solve the problems: the politicians never understood the root causes.

Since the Federal government usually pays at least fifty percent of the states’ Medicaid budget, you could assume that if the Wisconsin changes saved the state 0 million, it probably saved the Federal government about the same amount, resulting in the nation saving 0 million. Since Wisconsin’s population is about 1.9% of the country’s total population, a rough, rough estimate of national savings if the Wisconsin savings were rolled out coast to coast would be over billion a year. Taking it another step, what if those same types of changes were instituted in the bigger medical entitlement program, Medicare, on a national basis? Conservatively, at least another – billion could be saved just between Medicaid and Medicare.

This step is consistent with several steps outlined in the book, “Love My Country, Loathe My Government.” Step 1 would reduce Federal spending by 10% a year for five years in order to downsize the government out of inefficient and ineffective programs and departments. A major process for attaining these downsizing targets is to do exactly what the Wisconsin politicians did: allow the experts, i.e. the government employees who know the ins and outs of the government operations they are involved in, to identify and propose the necessary changes. The twist that “Love My Country, Loathe My Government” proposes is the implementation of a lottery system that would randomly pass on a monetary reward to employees that come up with true costs savings. Imagine what savings we could incur if similar savings were identified in all government departments.

Steps 26 to 29 would attack major issues such as reducing medical costs, instituting a national energy program, fixing public education, and implementing a comprehensive immigration reform
in the same manner. It would institute panels of experts, sans lobbyists and politicians, that would identify true root causes of each issue, just like they did in the Wisconsin Medicaid area, and develop cost effective solutions quickly, without the political infighting that is never good news for the American public.

Congratulations to the Wisconsin leaders, whose foresight and courage allowed their own expert state employees to solve their budget problem. We can only hope that the rest of the political class shows the same initiative. and show it quickly. Waiting for our Federal politicians to do the same has resulted in a national debt of over TRILLION.

There is another classic blunder that should be added to the list.  And I am sure that Vizzini would have added it had he not, just seconds after uttering these words, fallen over dead from unwittingly poisoning himself.  I am referring to of course the classic blunder of believing anything a government union tells you.  AFSCME, the American Federation of State, County and Municipal Employees, provides us a stark lesson as to why this is true.

The race is on for the House of Representatives seat once held by one of the most embarrassing and corrupt human beings to ever be called an American; the late John Murtha.  Spare me the false praise and silly defenses of the unindicted coconspirator of ABSCAM, the man who went to his grave having called our Marines in Iraq murderers and a man who secured so much unconstitutional pork for his district that he oinked.  I am not in the mood for it.

In PA-12 they are currently preparing for a special election to fill out the remainder of Murtha’s term and like Golem fearing that he is about to lose the One Ring forever the Democrats and their allies are plotting, lying, scratching, and even biting to keep that from happening.  The political intrigue aside about how Tim Burns was chosen by Republican elders as their official candidate by party insiders over Bill Russell who has already run in the district once held by the King of Pork, the left is up to their old tricks again.  Right now AFSCME is running ads on the radio which included a half truth that is twisted into a lie.

I know!  A real shocker right?

These ads start out proclaiming that Tim Burns supports raising taxes 23% through a national sales tax.  From there on the ads deviate from the tracks of reality even further and start asking questions about how the middle class, the poor and seniors will be able to afford such a tax on gasoline, food and medicine.  In the end you are left with the impression that Tim Burns wants to put grandma under his boot and crush her.

But then again, this is AFSCME we are talking about here.  I think we’ve seen this ploy before.

The facts?  Tim Burns’s stance on a national sales tax is a little murky.  He has spoke in favor of a specific plan called the FairTax and then turned around to later call it not practical.  I presume that this is because he simply could not speak intelligently enough on the subject and just decided to beat a hasty retreat.

So what is the FairTax?  This is a tax which is a national retail sales tax on new goods and services and not just a national sales tax.  Buy a home previously built and owned by someone else and you pay no sales tax.  Buy a used car and you pay no sales tax.  The FairTax also does not tax any money spent up to the poverty line through a prebate system where Americans are refunded each and every month the amount of taxes they would pay on that amount of money based on government tables of family size and poverty levels.  FYI, this is also one of my biggest gripes with the FairTax in that it makes the tax progressive and maintains a segment of our population who still would pay no taxes.  Thus they would still not interested in how tax dollars are spent and that is bad for a representative Republic such as ours.

The FairTax also does something else that AFSCME does not want voters in Pennsylvania’s 12th District to know because, well, it would really hurt their chances at slandering Tim Burns after all.  See, the FairTax actually replaces not just the personal income tax and the corporate income tax but also federal payroll taxes for things like Medicare and Social Security.  It does not however repeal the 16th Amendment because legislation cannot do that and leaving the possibility that liberal politicians who love to tax labor and spend our money could reinstate a new income tax on top of the FairTax.  This is why supporters of the FairTax, to a man, also support the repeal of the 16th Amendment.  But, as has been said, that has to be done separately.

So while there is a new national retail sales tax on new goods and services of 23% there is an elimination of all sorts of income taxes which strip money from your paycheck before you even see it and get to touch it.  It also, through the elimination of corporate income taxes, which are just rolled up into the final cost of the goods and services you buy anyway and, takes away about 19% to 30% of the cost you pay for those goods and services.  The exact rate depends on exactly what you are buying because different goods and services travel different paths to you, the consumer, and thus accrue a different level of tax burden passed on down the line.  Yeah, the reality is that companies do not pay taxes.  They just collect them from you and then transfer those dollars to the government.  So if you are middle class and paying a 25% marginal tax rate on your income (,000 – ,000 per year as a single person) plus all these rolled up corporate taxes on goods and services every time you purchase something it is pretty hard to explain how the such people will actually wind up paying more once you realize that direct debit from your paycheck each payday is removed.

Oh, and just in case you are worried about what will happen to people that rely on Medicare and Social Security if the FairTax were to be implemented and those payrolls taxes removed, the FairTax rate of 23% actually has been designed to include these taxes and maintain these programs.  In fact it maintains all these little fiefdoms of power over the people from Food Stamps to Medicaid. Yeah, that is another problem that I have with the FairTax too; it keeps the socialist nanny state rolling right along.

If you want to learn more about the FairTax you can visit FairTax.org.  Because taking AFSME’s word for what the plan involves would be a blunder too big to excuse.  Yes, even bigger than getting involved in a land war in Asia.  But hey, did you really expect the truth from a bunch of people that have made their lives off the government dole?

I am not saying run out and vote for Tim Burns if you are in Pennsylvania’s 12th Congressional District just because AFSCME is a bunch of lying cretins.  I am saying just make sure you are educated on the issues come Election Day.  Because an educated public is the last thing AFSCME wants for they fear that their own little piece of the government pie might be shrunk.  If it wasn’t, well then they would be telling you the truth wouldn’t they?  The facts are that too many people have a vested interest in a complicated, arcane and easily manipulated tax code like the one we have now and anything that threatens to simplify said system must be lied about and shot down by any means necessary.

And let’s be even more brutally honest here.  AFSCME would love Mark Critz to win in PA-12 because, well you know, he’s a Democrat and being an ex-Murtha staffer it would mean they can pretty much count on his vote in Congress to be just like Murtha was still there doing all the unconstitutionally things Murtha loved to do.  Besides, you know that Republicans are just evil S.O.B.s who would rather you, “die quickly,” not be able to ever retire and wallow in misery.  You know that right?  Right!?!

What do you mean you don’t know that?  What are you?  Some sort of troublemaker?  Ok, be that way then.  Some of AFSCME’s fellow travelers from the SEIU will be visiting you shortly to beat some sense into you.  Literally!

There are only three ways to pay for nursing home care:   Medicaid, your assets, or Long term care insurance coverage.  For people with low income and assets, Medicaid pays for nursing home care.  In most parts of the country 50% to 65% of residents of nursing home have their care paid by Medicaid.   It is probably not coincidental that nursing homes funded primarily by Medicaid (which offers a very low reimbursement rate) generally offer a lower standard of care when compared to other nursing homes. 

It should be noted that Medicare Insurance (as opposed to Medicaid) does not pay for assisted living expenses.  These policies only pay for a limited amount of skilled nursing care after a qualified hospitalization.  In addition, these costs must be for skilled care and not custodial care.  Three quarters of these costs (as opposed to custodial nursing home costs) are paid by the family.

It takes more than what most people have to pay for a typical stay in a long term care facility, and still leave enough for a surviving spouse’s living expenses and nursing home care. 

As the average retirement “nest egg” is slightly under 0,000, very few families can afford the cost of even one spouse requiring quality personal care, let alone two.  In many cases one spouse becomes ill and needs specialized care.  This can result in leaving the remaining spouse in poverty for the rest of their life.

Experts the need for Long Term Care insurance coverage both for estate preservation reasons and maintaining as high quality of life as possible for the longest period of time. 

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Yes, there are some people who will never use Long Term Care insurance – close to 30%.  Even so, the average long-term care insurance contract bought by a 65-year-old and held until death pays out 82 cents for every dollar of paid.  

Because Long Term Care plans are not standardized and there are such a wide variety of options available for coverage, it  is may not be a good idea to research and buy LTC without help.  It is important to understand which options each insured needs, and be able to able to give you good advice.   A long term care insurance agent is the best resource to compare contracts, coverage, and endorsements. An independent agent can make sure the policy you purchase is the best plan for you and your family.
The author recommends that you get prices and additional information about insurance for nursing home care and click here for Medigap rates” on his site.  Alston J. Balkcom is a veteran insurance professional with over 25 years of experience as a licensed agent.
There are many reasons why nursing home insurance or long term care is so important.  Approximately 70% of those reach age 65 will require some type of living assistance in their lifetime.  The average stay in a nursing home is 904 days, almost two and a half years.  The average cost of those 904 days is just under 8,000.  Can you write a check for this?  40% of us pay out of pocket.  50 percent of all couples and almost 3 quarters of individuals are impoverished in less than 12 months of entering a long term care facility.

There are only three ways to pay for nursing home care:   Medicaid, your assets, or Long term care insurance coverage.  For people with low income and assets, Medicaid pays for nursing home care.  In most parts of the country 50% to 65% of residents of nursing home have their care paid by Medicaid.   It is probably not coincidental that nursing homes funded primarily by Medicaid (which offers a very low reimbursement rate) generally offer a lower standard of care when compared to other nursing homes. 

It should be noted that Medicare Insurance (as opposed to Medicaid) does not pay for assisted living expenses.  These policies only pay for a limited amount of skilled nursing care after a qualified hospitalization.  In addition, these costs must be for skilled care and not custodial care.  Three quarters of these costs (as opposed to custodial nursing home costs) are paid by the family.

It takes more than what most people have to pay for a typical stay in a long term care facility, and still leave enough for a surviving spouse’s living expenses and nursing home care. 

As the average retirement “nest egg” is slightly under 0,000, very few families can afford the cost of even one spouse requiring quality personal care, let alone two.  In many cases one spouse becomes ill and needs specialized care.  This can result in leaving the remaining spouse in poverty for the rest of their life.

Experts the need for Long Term Care insurance coverage both for estate preservation reasons and maintaining as high quality of life as possible for the longest period of time. 

Yes, there are some people who will never use Long Term Care insurance – close to 30%.  Even so, the average long-term care insurance contract bought by a 65-year-old and held until death pays out 82 cents for every dollar of paid.  

Because Long Term Care plans are not standardized and there are such a wide variety of options available for coverage, it  is may not be a good idea to research and buy LTC without help.  It is important to understand which options each insured needs, and be able to able to give you good advice.   A long term care insurance agent is the best resource to compare contracts, coverage, and endorsements. An independent agent can make sure the policy you purchase is the best plan for you and your family.

In 1909, the problems facing children in America were recognized by the first White House Conference on Children. This, the first White House Conference on any subject, signaled a new era where government increasingly recognized its responsibility to its youngest citizens.  In fact, after a 38 year hiatus, legislation has been introduced to Congress this year that proposes a 2010 White House Conference on Children to mark the 100 year anniversary of this historic event and to renew our attention and focus on the problems faced by children and families in this new century.

The roots of Treatment Foster Care are found in the 1950s, 1960s and 1970s, when agencies began to train foster families to provide more than just a home to their foster children. This model has, at its core, evolved to believe that a foster family, provided with specialized training, supervision, and other clinical supports, can be a powerful agent of change for a child with special behavioral, emotional and/or medical needs. Unlike traditional foster care, where a child’s primary need is for placement, in treatment foster care, the positive aspects of a nurturing family environment are combined with active and structured treatment interventions.

From the initial experiments in small agencies around the country, the popularity of the model grew as the deinstitutionalization movement of the 1970s became the national policy of the 1980s. In the 1990s,research demonstrated that the model produced outcomes that in many cases were comparable to residential treatment and, when compared to traditional foster care, had 20 – 30% fewer disrupted placements. Many states used the Medicaid program to expand the availability and service intensity of  Treatment Foster Care. Today, Treatment Foster Care is widespread and a viable alternative to residential treatment, with foster parents receiving specialized, intensive training to help their foster children heal while residing in normalized family settings.

Ken Olson is a Foster Care and Family Services Regional Director for KidsPeace, overseeing treatment foster care programs in Maine, Georgia and North Carolina to help children with a multitude of emotional, psychological, social and behavioral needs. Having started out as a treatment foster parent in 1975, Ken has seen the system from both sides and always keeps the challenges faced by foster parents in mind when making decisions. He definitely understands when foster parents describe their work as “the hardest job you’ll ever love.” He relates when foster parents are having a particularly bad day or worrying about how the foster child’s meltdown will affect their biological children or how they will be able to do everything they need to do in a day and still take their foster child to treatment or for a supervised visit with the birth parents. Ken also has no problem explaining to foster parents that they will be held accountable for the safety and well-being of their foster children, and that they must never use physical restraint or punishment on their foster children. He refers individuals who want to learn more about foster care to www.fostercare.com provides information and resources on foster care for current and potential foster parents.

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According to 2005 U.S. Adoption and Foster Care Analysis and Reporting System (AFCARS) estimates, there were 513,000 children in our nation’s foster care system that year, with more than 114,000 waiting for adoption. Those estimates also indicate that, while 24% were in foster care in the home of a relative, 46% were living in foster homes with which they had had no prior contact. Quite obviously, more trained foster parents are needed.

“The federal mandate is to reduce ‘drift,’ which means kids being placed in home after home, which is very damaging to their ability to attach and their self-esteem. It is therefore the job of organizations such as ours to be extremely selective when interviewing potential foster families and providing them with in-depth training and support to deal with any crises that arise, 24/7,” Ken explained. “At KidsPeace, we pay close attention to the matching process and do everything in our power to make our placements successful. We want our kids to stay in one foster home until they are returned to their families or are adopted, often by their foster families.”

According to Ken, trends in foster care are to reduce the number of kids in the system and their time in the foster care system. This has resulted in an explosion of home-based services that were not available 10 years ago, allowing many kids to remain at home while receiving the treatment they need, even if that means counselors visiting a home three times weekly to work with the children and their families.

“At KidsPeace, we work with families during supervised visits on parenting and psychoeducational issues, medical problems and dealing with behavior disorders in order to get the kids back home as quickly as possible,” Ken said. “When reunification is impossible, we work to find the appropriate adoptive family, which is often the foster family that has grown to know and love the child. This is a blessing, but it also can reduce the number of trained foster parents available due to the number of children in the home.” Most states limit foster families to one or two foster kids unless the family takes a group of siblings, which all agencies strive to keep together.

The Past 25 Years

Ken discussed how treatment foster care has changed over the past few years. “It has become more focused on permanence as an outcome,” he said. “We are seeing kids who present with great emotional and behavioral acuity. This poses many more challenges in terms of finding and training foster parents. Additionally, Medicaid, which provides a source of funding for TFC in about 50% of our states, is under increasing pressure to cut the amount it spends, requiring higher standards to qualify for funding, which, in turn, creates a mountain of additional paperwork.”

Funding and some aspects of the model are different in each state, depending on whether treatment foster care is considered a  “mental health” or “child welfare” program. “What we have learned,” Ken explained, “is that best practices mean that services need to be integrated, and integrated services need to wrap around the kid and blend treatment with daily living.” Foster parents are seen as professionals in some states and volunteers in others. Regardless of how their roles are defined, Ken described foster parents as the most powerful agents for change in foster children’s lives.

Treatment foster families come from a wide variety of backgrounds and are by no means strictly defined. While the screening process to become a foster parent can be cumbersome, it is imperative to ensure the safety and well being of any child placed in the home. Home studies are conducted with all families to ensure that the right children are matched with the right family. There are background and criminal history checks, personal interviews about attitudes and prior experiences and comprehensive training. According to Ken, it can take anywhere from three to six months to become a licensed foster parent, and annual training is ongoing for the entire time one remains a licensed foster parent.

Aging Out

Ken said that one of the “huge problems” with the foster care system is that kids age out at 18 without the skills, resources or support to move on to independent living. He believes that, in this regard, the system has poorly prepared our foster kids socially. Ken said that studies have shown that few kids from any background are ready to live on their own at 18 or 19 years old. There need to be more programs that prepare foster kids to transition into independent living and help them avoid the pitfalls of homelessness, unemployment, dropping out of high school or not attending college, illegal activities and drug and alcohol abuse.

The Future

Finding new foster parents can be challenging, but, according to Ken, foster parents are the best recruiters, showing family and friends how rewarding foster parenting can be and being walking, talking advertisements for the program. “Friends visit their homes and see what goes on, and then they call us to see if they qualify to be foster parents, and the word of mouth just keeps spreading,” Ken said. “Our foster parents develop a fantastic support system for each other, and our staff go above and beyond to do everything possible to help our foster families stay together. The most difficult recruitment issue we experience is finding families for teens. They can be the most difficult age group to place because they can be the most difficult to control and reach and often have the greatest number of emotional and behavioral problems.”

Ken is optimistic by nature, and is hopeful about the future of foster care, predicting that it will continue to evolve. He believes that government agencies are getting better at understanding which kids are best served by the foster care model and that other foster care organizations will improve their matching processes. Ken also looks forward to permanency options improving for foster kids, with many states establishing policies to terminate parental custody after one year of foster care, freeing the children up for adoption sooner. Foster parents are also helping birth parents with parenting skills and becoming role models for parents, as well as for their foster children. Ken predicts that kinship foster care will continue to grow, especially with the assistance of technology that can help locate relatives who live far away from other family members.

Ken asked readers to “Call us. Let us show you how you can become a foster parent and how you can have a really positive impact on the life of a child. It is an extraordinary experience that will change you forever.”

For more information on KidsPeace Foster Care Programs across the country, please call 800-8KID-123 or visit www.fostercare.com.

KidsPeace is a private charity dedicated to serving the behavioral and mental health needs of children, families and communities. Founded in 1882, KidsPeace provides a unique psychiatric hospital; a comprehensive range of residential treatment programs; accredited educational services; and a variety of foster care and community-based treatment programs to help people in need overcome challenges and transform their lives. Visit our websites, KidsPeace.org, ParentCentral.Net, and Fostercare.com for more information. 

Social problem in Medicaid

Medicaid can be defined as a federal-state entitlement program  that is meant ot provide insurance coverage for low income indivdiauls and their families.  This programs is a part of the 1965 Title XIX act. It provides federal mathing funds to all states to  offset cost which are incurred paying healthcare providers  who serve all individuals covered under the program. Although state participation is voluntary, all 50 states have participated in Medicaid since 1982.

Medicaid provide medical benefits covering basic healhcer and also long-term healthcare services for all individuals who are eligible.  More than 50 percent of Medicaid spending usually goes to cover hospitial and acute care expenses. The remaining 52 percent of Medicaid expenses usually covers nursing home and long term care. Any state that chooses to get Medicaid has to offer the below given services:

Hospital care, provided for inpatient and outpatients
Nursing home care
Physical caser services
Laboratory and diagnostics services like X-ray services
Immunization
Family planning services
Nurse and midwife services
Physical assistant services
Health center and rural health  clinic

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States participating in the program may offer blow optional services and get federal matching funds:

a)      Drug prescription

b)      Institutional care for the mentally retarded patients

c)      Home or community based care

d)     Disabled personal care

e)      Dental and vision care

Since every state has the freedom to  design its own beneiftis package, so long aas the benefits meet the minimum federal requirements, Medicaid benefits there vary from state to state depending on state-specific design.

In eligibility, Medicaid covers about three major groups of low income individuals including:

(i)               All recipients including all individuals who qualify through the eligibility criteria

(ii)             Parents and their children who qualify under the different criteria – Medicaid covers more than one fifth of children in the United States. It provides coverage to more than 10 million low income adults, most of who include adults.

(iii)           Elderly individuals – Medicare provides coverage to more than five million adults aged above 65 yeas.  It is the single largest purchase of longer-term nursing care in the country

(iv)           Disabled individuals – More than 17% of Medicaid recipient include blind and disabled individuals.  Most of the receive Medicaid through Supplementary Security Income (SSI) program

For individuals to qualify for Medicaid, they must prove their resources and incomes fall below the federal specified eligibility levels. However, these levels varies from state to state and depend on the local cost living. For example in 2001, federal poverty levels (FPL) stood at ,630 for a family of three members. In Hawaii, it was estimated at ,830 in Hawaii and in Alaska it was ,290.  This shows that federal poverty level varies from one state to another.   To qualify under the specified criteria individuals must be citizens of the United States. Legal immigrants also qualify depending on the date they entered into the United States.  However, illegal immigrants are not eligible to Medicaid except in cases of emergency.  To receive Medicaid, individual are required to fit into the eligibility criteria, even if they are coming from low income families.  Childless couples and single childless adults also do not qualify for Medicaid unless they are disabled or elderly.  

In terms of cost, Medicaid is the most expensive welfare program. In 1965, it account for only 1.4% of the budget but today, it accounts for more than 10% of the federal budget. For both state and federal government, it account for 20 cents for every tax dollar. More than half of beneficiaries are children (54%) while more than 70% of the total cost goes elderly.  The cost of medical case has increased due to a number of factors include increase in the number eligible individuals due to increase in the number of  elderly  above 85 years, increase in cost of medical and long term care, increase  in use of services, and expansion of state coverage  from minimum benefits packages.

Medicaid historical antecedents

Medicaid was created by the same policy that created Medicare. Both programs were signed into law in 1965 after the government realized that there was a growing problem of increasing number of people without health insurance coverage.   Health insurance for the public was first proposed in 1945 but the legislation dragged with the government for a long time until it was realized that the cost of healthcare was becoming a heavy burden to most Americans. The Social Security Amendments of 1965 provided the ground for establishment of the two healthcare policies which have now become the backbone of U.S  insurance coverage for the low income people, retirees, and soldiers returning back from war.  

However wise it is to consider a long term care insurance (LTCI) policy for your future health care needs, you have to follow a certain process when negotiating for one. By doing so, you will definitely be able to clinch the type of LTCI policy that will be suitable for your future health care needs.

According to experts on the LTC field, nobody is 100 percent sure of what he will need in the future but everybody can determine how much he is willing to risk for a policy. For instance, upon checking with a reputable insurance company you find out that acquiring a policy with lifetime coverage will cost you ,000 on annual premiums. So, you back out from making the purchase when in fact you could’ve settled for a shorter benefit period.

Of course, you would rationalize that it is unreasonable to buy a policy with a shorter benefit period only to seek further care afterwards once your insurance benefits have been exhausted.

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Since we’ve reached that part of exhausting LTCI policy’s benefits, guess now is the best time to discuss LTCI policies under the partnership program. New York, Connecticut, California, and Indiana are four states responsible for implementing the partnership program in the country.

Long Term Care Insurance Policy Options

In hopes of getting every citizen of the country to plan his and her future health care needs, various state government agencies and private insurance companies that market LTCI collaborated and established the partnership program.

Anybody who owns an LTCI policy that complies with the guidelines of the partnership program can apply for Medicaid assistance should they need additional care after having exhausted their policy benefits.

Under the law, before a person can get Medicaid coverage he should deplete his assets first up to the program’s asset limit requirement which varies in every state. Fortunately, those individuals with a partnership- qualified LTCI policy are exempted from this spend down rule as they are allowed to protect a portion of their assets, or the total amount of their assets that is equivalent to the maximum benefit amount of their insurance policy.

Meaning to say, owners of an LTCI policy that qualifies under the partnership program get to enjoy both worlds — topnotch health care coverage and asset protection.

Another type of LTCI policy which is actually favored by the majority is the indemnity policy. With this type of policy, you will receive the exact amount of your maximum daily or monthly benefit regardless of your total expenses on care.

Since it allows you to be in full control of your cash benefits, an indemnity LTCI policy is more expensive but many people believe it’s worth investing your money into this kind of LTCI product.

The most common LTCI policy is the reimbursement type. It is the opposite of indemnity insurance as it would only reimburse to you the exact amount of your LTC expenses.

There is absolutely a lot to choose from but when out shopping for an insurance policy be sure to weigh your long term care insurance policy options very well to be able to get the best deal.