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Concerned Parents Want State to Delay Healthcare Program

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October 17, 2016

By Erin Nichols, News 4 San Antonio
Source: http://news4sanantonio.com/news/local/concerned-parents-want-state-to-de...

SAN ANTONIO -- On November 1, thousands of special needs kids across Texas will transition from Medicaid to a new healthcare program called Star Kids.

Although state officials say the program is designed to help families and kids get better care, some parents are urging lawmakers to hold off on the change.

Out of the 180,000 kids switching to Star Kids, the group of concerned parents represents about 11%.

That 11% includes the children who are the most vulnerable, often requiring 24/7 medical care or specialists who are out of the state.

They want the program to be delayed by a year in order to iron out any kinks or problems that might turn up.

Parents including Jennifer Wendell who has a 5-year-old son with cerebral palsy.

“He doesn't talk but he does communicate with us in his own way,” said Jennifer Wendell.

Colton Wendell also has several other conditions including chronic lung disease.

“He’s completely dependent,” said Wendell. “100% dependent for someone to always be with him.”

The Wendells have private insurance and also use Medicaid, however, not all their doctors and specialists are enrolled in the Star Kids program.

‘”We lost his audiologist who provides his hearing aids and testing,” said Wendell. “They are not willing to contract with the managed care organizations so we will have to start over from scratch.”

Wendell and other parents asked a Star Kids advisory committee to hold off on implementing the program for a full year while they wait to learn more.

The committee agreed, but the Texas Department of Health and Human Services says it's moving full speed ahead.

“We don't feel that it's a good idea to put such fragile human beings into a system that is unknown and we don't know if it will work,” Wendell said.

There will be a phase-in period, where families will be allowed to keep their current primary care or specialty doctor for up to 1 year.

And doctors can still be enrolled in the program even after November 1.

But Wendell and other families don't like being in limbo.

“We've been calling all of our legislators and leaders and encouraging other parents to reach out and express their issues,” she said.

State Senator Jose Menendez (D - District 26) held a community meeting on Star Kids in August.

The program has been in the works since 2013 and was partially designed to help the state cut down on Medicaid fraud.

As part of the program, families are assigned a care manager who assesses each child’s needs as they relate to health and independent living.

Menendez says the manager can also work to monitor costs.

“We believe it's important people feel comfortable and secure they will have their healthcare in place,” said Menendez. “The purpose of this is not to kick people off of anything. It's not for doctors to lose the ability to serve the community. It's really to get a grip on what's going on out there and in some cases where there is potential for fraud, because resources are limited and their scarce. We need to identify all sources of fraud and waste.”

Menendez says his office is willing to advocate on behalf of parents to address their concerns.

Wendell says she's going to keep fighting and asking lawmakers to delay the program.

“We don't think they understand 100% what it takes to take care of one of these fragile kids,” she said.

In a statement, the Texas Department of Health and Human Services says:

“We are on track to launch the STAR Kids program on Nov. 1. The system is ready. Throughout this process we have listened to concerns and have made adjustments to the program, extending protections to families. In essence, we are phasing in this critical program. After implementation, all STAR Kids members will be able to continue seeing existing primary care and specialty doctors for one year even if the provider is out of network. This will maintain continuity of care. We are committed to making sure Texas children receive the high quality care they need.”

We also reached out to State Senator Carlos Uresti (D - District 19) who sits on the Senate Committee on Health & Human Services.

He said this:

"Taking care of our children should be the number one priority of our state. These medically fragile children need extra attention so there is no disruption of services during any type of change to their health care. I hope the department will give weight to the advisory committee's recommendation and only proceed when we are absolutely certain that no child will experience an interruption of vital services."

We also reached out to state Senator Donna Campbell’s office (R- District 25), but the office did not send a statement.

For more information on Star Kids, go here.