Frequently Asked Questions about Brokerage Customers Losing Services Oct 1

by independencenw | Aug 3, 2011 | budget cuts

Effective October 1^st, 2011, brokerage customers who are not currently Medicaid recipients (or Oregon Health Plan/ OHP Plus as it’s often called) will be exited from brokerage services.

Why is this happening? Oregon has been dealing with a serious budget deficit for some time. The State of Oregon Department of Human Services was instructed to find areas to cut spending. The State chose to cut non-Medicaid* recipients from support services. When a customer in services becomes eligible for Medicaid, the state can access federal funding on their behalf. If a customer is on a Medicaid waiver, the federal government funds approximately 60% of their services, therefore saving the state money.

Somewhere around 800 people are losing services on October 1st, 2011. At Independence Northwest, we estimate between 35 and 45 people will lose services. Brokerage operational funding is also being cut since we are paid for the number of people we serve. This is the largest cut to support services in its ten year existence.

What happens when I am exited from brokerage services?
If you are exited from Independence Northwest, you will be referred back to your local Community Developmental Disabilities Program in Washington, Multnomah or Clackamas. There, you will be assigned a Case Manager/Service Coordinator.

Will I have access to paid supports after exiting the brokerage?
Unfortunately, this is not likely. If you are exited from the brokerage and referred back to the county, the probability of having any service funds is very low. Cutting your service cost is one way Oregon’s Department of Human Services is addressing its program budget cuts. Your county Case Manager/Service Coordinator will be available to connect you to resources in the community and during times of increased need.

What happens to my current providers?
Your brokerage plan will pay those providers you currently work with (domestic employees, independent contractors or provider agencies) through September 30^th, 2011. After that, the State of Oregon will no longer permit state funds to be used to pay for your services.  Effective October 1^st, 2011, all service agreements will be null and void. If work happens on or after this date, you should be sure you have alternate payment options.

Can I private pay for services?
You should speak directly with your providers to see if this is a possibility. Independence Northwest is unable to offer private pay case management.

My plan just started. I want to use my entire plan year’s funds before I’m exited.  Can I?
We have received direction from the State of Oregon Department of Human Services that customers exiting our services are to have their overall annual benefit amount reduced by the number of months left in the plan October 1^st forward. (For example, if your plan year is July through June, you would be eligible for a pro-rated plan amount for three months: July, August and September, thereby reducing your overall benefit amount.)  Were all non-Medicaid customers to spend all their funds between now and October 1^st, the State might be in a position to cut other services to make up for the unexpected loss. If you have questions about this, check with your Personal Agent. Since guidance in this area has been minimal and this is a time of unexpected change for all involved, we will likely refer you to the State for a direct answer to more complex queries.

These services are essential for my health and safety. This puts me at serious risk.
Please communicate as soon as possible with your Personal Agent about any health and safety issues related to this service loss. We need to connect you with county personnel and work together on a transition that addresses these concerns. Please do not hesitate to contact us – we want to work closely with you and your circle of support during this difficult time.

If I get on Medicaid in the future, can I re-enter brokerage services?
Everything we’re being told by the State indicates that you will be able to come back to brokerage services if/when your situation changes and you become Medicaid eligible. There will be many openings at brokerages throughout the state and for some time we are not expecting waitlists to be an issue. We know that this is not possible for everyone and are disheartened by this reality.

Where can I complain and/or voice my concerns about this change?
You may file a formal complaint by using this form or you can call the Department of Human Services or your legislators directly.

Think you might be eligible for Medicaid? Check out our FAQ sheet on Getting on Medicaid here.

Have additional questions not addressed in this FAQ?
Contact your Personal Agent or Independence Northwest’s Executive Director Larry Deal at larry.deal (at) independencenw.org or by calling 503.546.2950.

Click here for a PDF version of this FAQ document.