CKSN UPDATE for February 1, 2004		ABC for Health, Inc.


IN THIS ISSUE:

1. CASE TIP:  Dilemma of Dual Coverage:  Katie Beckett and Private Insurance 
2. Bullying Issue Brief
3. Helping Children Cope with Crisis
4. Presidential Candidate Forum on Health Care Issues
5. Coming Together for Children with Disabilities
6. Mental Health Parity Extended through December 2004
7. Web Site for Families in the Military who have CSHCN
8. Election 2004 Issue Spotlight
9. HealthWatch Updates



1. CASE TIP:  DILEMMA OF DUAL COVERAGE: KATIE BECKETT AND PRIVATE INSURANCE

Brenda has health insurance coverage through a HMO with her employer.  Her son, Kyle, is also on Katie Beckett.  Brenda wants Kyle to see a pediatric specialist that is out of network for the HMO.  Brenda feels that this pediatrician is more experienced with special needs children than the in-network pediatricians offered through the HMO. Besides, Kyle also has Katie Beckett, which is fee for service Medicaid, so he should be able to go to the pediatrician of choice, right? Wrong! 

Medicaid will not automatically pay for services that were covered by private insurance.  Medicaid, including Katie Beckett, is the payer of last resort and therefore any available private insurance must be billed first. Consequently, Brenda must follow the HMO's procedure for pursuing an out of network provider before Medicaid will consider paying the bill.  If Brenda took Kyle to the appointment with the particular pediatrician without following the HMO's out of network guidelines, Medicaid will likely deny the claim.
	
The HMO can argue that many of their in-network pediatricians have the same qualifications that the out of network pediatrician has.  Brenda could end up with an unexpected medical debt.

The bottom line:  Parents should not assume that if they bypass their private health insurance that Katie Beckett (Medicaid) to pick up the bill for services.

2. BULLYING ISSUE BRIEF

Bullying has been proven by numerous studies to be a serious problem nationwide. Harassment of youth with disabilities in particular has been steadily increasing. Whole school anti-bullying/anti-violence programs are necessary to address this problem effectively. This NCSET (National Center on Secondary Education and Transition) Issue Brief provides clear definitions of bullying, teasing, and disability harassment. It also outlines research about bullying and harassment, and describes two effective, comprehensive, whole school, anti-bullying programs. Finally, this brief offers recommendations and resources for further action.
http://www.ncset.org/publications/viewdesc.asp?id=1332


3. HELPING CHILDREN COPE WITH CRISIS

This activity book for African American families from the National Institute of Child Health and Human Development and the National Black Child Development Institute describes activities and resources to comfort children and help them feel safe when they are upset by events in their lives or repeated media coverage of terrorism, war, and violence.  http://www.nih.gov/news/pr/jan2004/nichd-12.htm


4. PRESIDENTIAL FORUM ON HEALTH CARE ISSUES

AARP Wisconsin is cosponsoring a Presidential Candidate Forum on Health Care issues.  Our co-sponsor is the National Health Policy Council.  At this time, all of the Democratic candidates have committed to attend.  President Bush is likely to be represented by Congressman Green or Ryan.  The Forum is Sunday, February 15 at UW Milwaukee, Zelazo Center for the Performing Arts, 2419 Kenwood Boulevard, Milwaukee.  

For more go the AARP Wisconsin website at:
http://community.aarp.org/n/mb/display.asp?webtag=rp-wi&msg=40.1

For free tickets go to the National Health Policy Council website at:
www.nationalhealthpolicycouncil.org


5. COMING TOGETHER FOR CHILDREN WITH DISABILITIES:  STATE COLLABORATION TO SUPPORT QUALITY, INCLUSIVE CHILD CARE

Families with children with disabilities have difficulty finding high-quality, appropriate child care for their children-and this is particularly true for low-income families. This report from Center for Law and Social Policy (CLASP) and Easter Seals discusses the challenges these low-income families face; presents the findings of a survey of administrators of state child care and Individuals with Disabilities Education Act programs; explains the importance of collaboration among these programs; and suggests policy recommendations for federal and state governments. To download the full report, go to: www.clasp.org/DMS/Documents/1071511692.1/ccdf_idea_rpt.pdf
(Source: Center for Law and Social Policy)


6. MENTAL HEALTH PARITY EXTENDED THROUGH DECEMBER 2004

Group health plans and insurers who offer both medical/surgical benefits and mental health benefits must continue to provide parity in annual and lifetime dollar benefits for mental health care through December this year, under final regulations issued by the U.S. Department of Labor January 26.  Parity in benefits is required by the Mental Health Parity Act, which became law in 1996, and which Congress reauthorized last year. The law does not require plans and insurers to offer mental health benefits, but says that if
they do, the mental health benefits must be equal to those for medical/surgical care.
(Source: Wisconsin Council on Children and Families)


7. WEB SITE FOR FAMILIES IN THE MILITARY WHO HAVE CSHCN

The Exceptional Family Members Connections web site, at www.EFMconnections.org
has been designed to give military families with special needs access to information on a variety of military, federal and local programs available to families.  The site also provides a mechanism for families to exchange information.


8. ELECTION 2004 ISSUE SPOTLIGHT

Kaisernetwork.org, the Kaiser Family Foundation's health policy news and information website, introduces a new online resource that provides easy access to the candidates' positions on critical health policy issues, as well as election-related news and analysis. 

Access the Election 2004 Issue Spotlight at
http://www.kaisernetwork.org/spotlight/election2004
Features include:
-- Candidate profiles, including issue statements, speeches, audio/video
interviews and transcripts, news coverage, and additional resources on
all major candidates.
-- A searchable archive of public opinion questions on health issues
related to the election.
-- A reference library of election websites and publications.
-- Multimedia resources, including web casts of interviews, discussions,
and debates.
-- Election-related health news headlines.

The Election 2004 Issue Spotlight will be updated regularly to include
new information and developments throughout the campaign cycle.


9. HEALTHWATCH UPDATES



The Western Regional Center held their HealthWatch meeting on January 13, 2004 at the Chippewa County Courthouse.  Speakers for this meeting were Jill Thrurow and Laura Plummer from the Center for Independent Living for Western WI.  The next HealthWatch meeting is scheduled for March 9, 2004.  Speakers are scheduled to present on the Children's Redesign Waiver.  For more information and to RSVP, please contact Rose Marsh at Chippewa County Public Health, 1-800-400-3678 ext. 2132 or e-mail rmarsh@co.chippewa.wi.us

The next Brown County Area HealthWatch meeting is scheduled for Thursday, February 12th from 9:00AM - 11:00 AM, at Bosco Hall, Green Bay Catholic Diocese.   Please RSVP to Sgerczak@stvgb.org or by phone at (920) 433-8154.  We will meet to develop a plan for the next year.   The first year of the Brown County Area HealthWatch was successful and very informative. Now it is time to discuss what this committee can address in the next year. 

If you are interested in joining your regional HealthWatch committee, or want more information about their work, please contact the following people:

Southern Region:  Barbara Katz, ABC for Health, Inc., 608.261.6939 ext 207, barbk@safetyweb.org Southeastern Region:  Brad Holman, Children's Hospital of Wisconsin, 414.266.3189,
bholman@chw.org or Brad Montgomery, 414.449.4777, opwindows@aol.com
Northern Region:  Deb Blackstone, Family Resource Connection, 715.365.8030,
dblacks@shsmh.org
Northeastern Region:  Steve Gerczak, St. Vincent Hospital, 920.433.8154,
sgerczak@stvgb.org
Western Region:  Rose Marsh, Chippewa County Dept of Public Health, 1-800-400-3678, rmarsh@co.chippewa.wi.us

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SUGGESTIONS OR TIPS FOR THE UPDATE?

We need your help to develop content and tips for our CKSN Update. Please let us know about your ideas or success stories.  Email your suggestions to barbk@safetyweb.org 

The CKSN Update is a bi-weekly electronic newsletter of the Covering Kids with Special Needs project that ABC for Health, Inc. is implementing with its partners, the Title V Children with Special Needs Regional Centers and Family Voices - Wisconsin.  If you would like to submit news and information in future CKSN Updates, please send it to the attention of Barbara Katz.  All submissions should be limited to 150 words.

ABC for Health is a Wisconsin-based, nonprofit public interest law firm dedicated to linking children and families, particularly those with special health care needs, to health care benefits and services.  ABC for Health's mission is to provide information, advocacy tools, legal services and expert support needed to obtain, maintain and finance health care coverage and services. 

We invite you to join with us in celebrating our 10th anniversary of helping families throughout the state of Wisconsin secure adequate health care coverage and financing resources!  Thanks so much for your ongoing support.

Barbara Katz, moderator
Parent Consultant
ABC for Health, Inc.
608.261.6939 ext. 207
barbk@safetyweb.org