Medicaid cut

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Medicaid cut means less for kids at risk, state officials say

By Warren Wolfe, Star Tribune

Last update: December 11, 2007 - 9:57 AM

After waiting most of the year for a restrictive new Medicaid rule, Minnesota counties got the bad news late last week.

The rule apparently will cut about $50 million in federal Medicaid money for an innovative service that helps 70,000 troubled, abused or foster children and their families in Minnesota.

It also may cut deeply into $38 million that counties receive from Medicaid for 20,000 adults and children with mental health problems and 7,000 retarded adults.

"It looks like all of that [child welfare] money is gone," said Deborah Huskins, the county's director of children, youth and families. "I'm quite worried about what we'll have to do."

State officials have known for a year that some restrictions were likely. Many counties cut services this year in anticipation. But the rule appears to cut deeper than they expected.

The service is called targeted case management, which has been used by counties to revamp a cumbersome social service system in which people with multiple problems often had to deal individually with myriad complex public and private agencies.

In targeted case management, social workers may assess needs for the whole family, develop a comprehensive plan and then coordinate medical and psychological help, housing, jobs, education, parenting help and other services.

The new rule appears to narrow the range of services covered to just medical and psychological care. It also requires states to bill Medicaid for each 15-minute increment of service instead a flat monthly payment of $400 or so for multiple services.

When he signed the law in February on which the rule is based, President Bush said this and other cuts would bring needed restraint to Medicaid spending. The administration wants to cut $25 billion from Medicaid over the next five years. Next year, the federal portion of Medicai



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