Some people with disabilities will have more money in their pocket
at the end of each month if they are enrolled in a small but effective
state health program.
The Minnesota Disability Health Options Program, or MnDHO, is a managed
care program for people with physical disabilities. If you have Medical
Assistance and live in the Metro area, you can choose to sign up for
MnDHO. One of the perks of MnDHO, in addition to having a health coordinator
assist you in navigating the often confusing health care system, is
that you get to skip the co-payments for medications.
“UCare Minnesota has
chosen to waive the Medical Assitance Pharmacy co-pays for all MnDHO
enrollees, picking up those costs themselves,” said
Pam Parker, who oversees the MnDHO program for the Department of
Human Services. “That is an advantage for MnDHO enrollees compared
to people who stay in the regular fee-for-service Medical Assistance
Program.”
In 2003, lawmakers added $1 and $3 co-payments to prescription drugs
and some office visits for anyone enrolled in the Medical Assistance,
MinnesotaCare and General Assistance Medical Care programs. Advocates
for the disabled were able to cap the monthly prescription charges
for co-payments at $20, and were successful in exempting certain services
like physical and occupational therapy from the co-pay requirements.
Likewise, anti-psychotic drugs were exempted to benefit people with
certain mental health issues.
Those $1 and $3 charges
might not sound like a lot, “but many
of the people we talk to hit that $20 limit every month,” said
Chris Duff, CEO at AXIS Healthcare, the organization that coordinates
the health care for the 450 people now in the MnDHO program. “A
lot of these people are trying to make ends meet with a monthly budget
of less than $100. I’d challenge anyone to try and do that and
still have a good quality of life,” he added.
For anyone living in
a group home, or for the 3,000 working age people with disabilities
now living in Minnesota nursing homes, they can only keep about
$90 per month of their personal income. Whether their money comes
from a job or a Social Security check, in order to qualify for
Medical Assistance people with disabilities have to turn over most
of their monthly income to the state. What they get to keep – roughly
$90 every month – is called a ‘personal needs allowance.’ Out
of this budget comes all the everyday essentials like toothpaste,
clothes, the phone bill, and Metro Mobility tickets. Co-payments
must also come out of this monthly allowance.
“We hope that taking away the co-payments will make things a
little easier for people that often have to make very tough choices,” said
Parker.
Advocates are back at
the Capitol this year lobbying for an increase in the personal
needs allowance, “but it’s going to be
tough,” said Joel Ulland, public policy director for the National
Multiple Sclerosis Society-Minnesota Chapter. “It will cost the
state several million dollars to do this and there’s not a
lot of money laying around for lawmakers to spend.”
Lobbyists for the disabled are also calling for expansion of the MnDHO
program. A small provision in HF980/SF984 would ask the state to get
permission to bring the voluntary managed care program to rural Minnesota.
That might sound easy, but in order to do that, the Department of Human
Services would need to work with AXIS Healthcare and UCare, (the organization
that actually contracts with the doctors and other health care providers
and processes the claims), to make sure that good services are available
in smaller communities throughout the state.
Satisfaction surveys
show that MnDHO enrollees are very happy with their quality of
care and most say their health has improved since joining the program.
New research being done by the National Rehabilitation Hospital’s
Center for Health and Disability Research also show that hospital
stays and emergency room visits have significantly declined for
people in the program.
“More people need to know about the benefits of MnDHO, and that
it’s a choice they can make if they want to” Parker said. “We
hope by removing the co-payments more people might take time to learn
what MnDHO can do for them.”
For more information
on the program or to discuss enrolling you can visit the DHS website
and type “MnDHO” in the search
window www.dhs.state.mn.us or call AXIS Healthcare at 651-641-0887;
TTY 651-556-0860.
