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Questionnaire NameKentucky Health - Proposed Modifications to Application
DescriptionOn August 24, 2016, Kentucky submitted an application for a five year section 1115 demonstration, entitled "Kentucky HEALTH." On July 3, 2017, Kentucky submitted modifications to the pending HEALTH demonstration application, which removes their request to expand presumptive eligibility sites, removes the graduated hour requirements for the community engagement and employment requirement, and requests authority to implement a lockout for failure to report a change in circumstance. The federal public comment period will be open from July 3, 2017 through August 2, 2017.
Response FromID: #228925 on Jul 14th 2017 4:50 pm
Kentucky HEALTH - Proposed Modifications to Application

Kentucky HEALTH - Proposed Modifications to Application

We encourage the public to submit their comments on Medicaid.gov as they relate to demonstrations open for public comments. In support of transparency and open government, all public comments received are immediately posted and are in the public domain. Center for Medicaid and CHIP Services staff will review all public comments posted and we reserve the discretion to delete comments that are generally understood as any of the following: obscene, profane, threatening, or otherwise inappropriate.

Refer to the Application

Open for Public Comment – 7/3/17 – 8/2/17

Please provide your comments here and/or attach below:

Kentucky has not described the way these changes will be operationalized. For those of us that work in healthcare and recognize the current holes in the system, I find it hard to believe that adding layers of change on top of the current system will lead to improved healthcare outcomes for our patients. Additionally, I find it very concerning that those that have presented refuse to answer questions on these issues. So my questions/concerns are as follows.
1. What if I become ill and can not meet the volunteer hours for a week will I lose coverage?
2. Health care has been defined as a human right. Knowing that, the work requirement seems to mirror the United Nations definition of human trafficking. Specifically: Article 3, paragraph (a) of the Protocol to Prevent, Suppress and Punish Trafficking in Persons defines Trafficking in Persons as the recruitment, transportation, transfer, harbouring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation. Exploitation shall include, at a minimum, the exploitation of the prostitution of others or other forms of sexual exploitation, forced labour or services, slavery or practices similar to slavery, servitude or the removal of organs as the the mandatory volunteer hours specifically lead to unpaid labor services with the plan endorsed by many businesses.
3. Who will track the hours? The businesses?
4. If a business can meet their needs with all volunteers, how does that impact the job market in Kentucky? Knowing that the volunteers are providing a service for free, they will not be contributing to the tax base of the Commonwealth were as a paid worker would. This seems to impact the economic state of Kentucky.
5. If the value of the volunteer hours is $7.50/hr then the mandatory volunteer requirement has a financial value of $600/month. This exceeds the cost of the service (Medicaid) that they are receiving. Thus, the exploitation as defined in #2 is reality.
6. The Secretary mentioned that points can be used to purchased dental, vision and screenings. She provided the specific examples of cancer screenings and cholesterol screenings. Does this waiver obliterate preventative care? Evidence to support?
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