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Suggestions made for customized Medicaid

September 01, 1998|By KERRY LYNN FRALEY

MARTINSBURG, W.Va. - Until his mother-in-law died in April, Martinsburg resident E.J. Saville didn't have to worry about who would care for his brother-in-law, Johnny Morgan, who requires round-the-clock help because of muscular dystrophy

When she got sick and could no longer care for him alone, she paid $630 a month for private insurance to cover someone to come in to help, Saville said.

After a lifetime at home with his mother, Morgan, 40, didn't want to move into a nursing home after she died and the insurance coverage limit was exceeded, said Saville, who took over his brother-in-law's care full time.

Knowing how Morgan feels, he said, he has kept fighting with the West Virginia Department of Health and Human Services to bend its rules and cover his brother-in-law under the state's Medicaid program.

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It disqualifies Morgan from needed services because he requires a ventilator to breathe, Saville said.

On Monday, Saville pressed agency officials for a time line on a decision during a community meeting on the state's customized Medicaid coverage at the Comfort Inn in Martinsburg.

The agency has been holding a series of meetings around the state to guide what services will be included in the state's special waivers to federal Medicaid guidelines for the next five years, said Steve Wiseman, one of the panel of four officials answering questions at the meeting.

"The idea is to get as much firsthand input as possible, what's working, what's not working," said Wiseman, director of the agency's Division of Developmental Disabilities.

The meeting addressed two different waivers, one for the aged and disabled and the other for people with mental retardation and developmental disabilities, he said.

People need more flexibility in choosing the medical and support services they need to be covered by the special Medicaid waivers, said Ken Ervin, an activist for people with disabilities based in Morgantown, W.Va

Trustworthy respite services should be added, said Bunker Hill, W.Va., resident Nellie West, who told a horror story of her 77-year-old mother being bound to a lawn chair while she was visiting a doctor.

Middleway, W.Va., resident Reba Canby, 64, said she came to the meeting to let state officials know how well she's being treated under the system.

Morgan said he came hoping agency officials would understand that his need for a ventilator shouldn't stand in the way of his eligibility for Medicaid services.

"All I need is a nursing assistant so my brother-in-law can go back to work, so my sister and brother-in-law can go back to a normal life," he said.

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