
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, May 26, 1993                   TAG: 9305260279
SECTION: VIRGINIA                    PAGE: C3   EDITION: METRO 
SOURCE: Associated Press
DATELINE: RICHMOND                                LENGTH: Medium

MEDICAID PAYMENT CHANGES COULD HURT CARE GIVERS, SOME SAY

Family members who are denied financial help to pay for nursing care for ailing relatives could become burdened to the point they can't care for themselves or their relatives, speakers at a public hearing said Tuesday.

The state Department of Medical Assistance Services held the first of four hearings on changes in the way its regulations on financial assistance are enforced.

The regulations require that people receiving Medicaid reimbursement for nursing care - either at home or in a nursing home - have a medical need as well as a functional need, said Betty Cochran, director of quality care assurance for the Department of Medical Assistance Services. That means that someone who needs help going to the bathroom but needs no medication would not be eligible.

Cathie Galvin, executive director of the Shenandoah Area Agency on Aging, spoke on behalf of the family of Ora Dove. Dove, 76, cares for his wife, Denna, who has Alzheimer's disease, and for his mentally retarded brother, Raymond.

Denna Dove was screened for Medicaid reimbursement for care at home, but did not pass because she did not have a nursing need.

Raymond Dove had been receiving care at home reimbursed by Medicaid but did not pass a second screening. On May 12, the daily three-hour helper visits stopped.

The family has hired a woman to come in a few hours a day and help Ora Dove, said his daughter-in-law, Cindy, but he still feels the stress of taking care of his wife and brother.

If Ora Dove's health deteriorates and he is unable to provide care, "the state of Virginia eventually will have to pay full cost for all three of these individuals," Galvin said.

Cochran said screening teams are not allowed to base their assessment on a diagnosis, such as Alzheimer's disease. "We look at their functioning ability and their medical needs."

Since 1977, the state has contracted with doctors, nurses and social workers to screen those needing assistance, Cochran said. But a few years ago, state officials realized some screening teams were not adhering to the guidelines.

Emergency regulations were passed in September 1992 clarifying the rules. The teams were trained and began following the new rules early this year. Permanent rules that could include proposals made at the public hearings are to become effective in September, Cochran said.

by CNB