Background
For 4 years, Texas government has had a committee working on redesigning the services for Texans with IDD… while proceeding down the path to Medicaid managed care. (Read the document creating the IDD-SRACommittee and setting their priorities.)
Prior to 2015, Medicaid acute care and Long-Term care services (Waivers & ICFs) were managed by Texas HHSC, a government agency.
When managed care rolled in, Medicaid recipients switched from “traditional Medicaid” to Managed Care Medicaid – under the groupings called STAR, STARHealth, STARKids, STAR+Plus. Recipients had to choose between 3 MCOs (managed care organizations) and go to doctors and pharmacies based on contracts with their MCO.
And 2 long-term care Waivers were included in the move to Managed Care – MDCP & CBA (which became STAR+Plus Waiver).
Unfortunately, this did not result in better services. In fact, people died due to MCOs putting profit over care. (Read this award-winning investigative journalism series Pain & Profit in Dallas Morning news for details.)
The Redesign Committee
In January 2021, I sent a COVID-19 rule question to HHSC and I was told to submit my question the SARC. I did, and I was added to the agenda of the next meeting… which was online and 6 hours long.
I listened in while I worked, and became more and more intrigued. Subcommittees were making reports on how services in current Waivers were working and recommendations on how they should change in the future.
- The topic of changing “Day Programs”/“Day Hab” to “Meaningful Day Activities” was full of optimism and hope for better options.
- But the topic of dental comparing utilization in CLASS, HCS, and StarPlus’s limited $500 value-added service was inaccurate in the subcommittee’s knowledge of factors effecting utilization in the waivers.
The coolest part was that even as an observer, I was able to email in comments in real time and have my comments read to the committee.
Call to Action
We need to be listening and offering feedback as the Intellectual & Developmental Disability System Redesign Advisory Committee redesigns the services that shape our lives.
- Start by going to the IDD SARC page.
- Read the Implementation of Acute Care Services and Long-term Services and Supports System Redesign for Individuals with an Intellectual or Developmental Disability – 2020
- Go to the Meeting section and put a Webcast for a subcommittee on your calendar. Make notes and comment.
- Add a Reminder in your Task app to check the IDD SARC page at regular intervals.
Texas Medicaid Waivers Explained 