Sen. Barbara A. Mikulski
2008-03-13 08:00:00.0
Current rank: Not ranked

BALTIMORE -

I have a constituent in Baltimore, a 2-year old boy, who was diagnosed with a genetic disorder that leads to significant feeding problems, as well as cognitive, speech and motor delays without help in early life. He was referred to the Baltimore Infants and Toddlers Early Intervention Program, where he was assigned a case manger to get the care he needed and to make sure his family had someone on their side and to help them comply with the treatment plan.

This boy’s case manager discovered his mother had no family in Baltimore, so she connected her with a local support group. She arranged for the services the child needed — behavioral psychology for emerging self-injury problems, speech and occupational therapy, and nutrition services, since he was not gaining weight. This caseworker intervened and offered a helping hand that changed the 2-year-old’s life.

But if that 2-year-old had been diagnosed today, the federal government would not have helped him to receive a case manager or this treatment. On March 3, federal funding for case workers — generally social workers or nurses — who help adults and children with complicated problems, people with disabilities, complex medical problems, mental illness and children in foster care, was cut off by a new, harsh rule from the Centers for Medicaid and Medicare Services under the Bush administration.

I created legislation to delay implementation of this rule until April 2009, when we have a new president with a new attitude and sensible heads can prevail. I introduced the measure as an amendment to the Indian Health Care Bill (S. 1200), which passed the Senate at the end of February but did not become law before the funding cutoff deadline and is still pending in Congress. This means federal funding for these critical social workers and nurses has already been eliminated. As the Senate takes up the budget, I will also fight to include a provision to reverse this rule. In the state, Gov. Martin O’Malley has filed a lawsuit to halt the cut.

In Maryland, 200,000 of our most vulnerable residents will pay the cost of this cut — losing their critical case management services. As a social worker, I have provided these very services, and I realize what will happen if my constituents cannot get them.

The list of constituents whose lives have been dramatically improved — or even saved — because of their case managers is a long one. Eliminating the care means a 13-year-old boy with cerebral palsy would not have had access to a Medicaid ombudsman who helped him get a new wheelchair by overturning an insurer’s original decision to deny him one despite outgrowing his old one to the point of developing infected sores. A 6-year-old child exposed to lead paint in his home would not have had access to the caseworker who arranged for doctor’s visits and lead-free housing.

These human costs are far graver than the cost of providing such important services to the people who need it most. But, under the Bush administration, the CMS has said otherwise.

This is not about how we can control runaway Medicaid costs. It’s about how we can make sure the American people get the services they need to be able to lead independent lives. The Bush administration estimates that reversing this cut will cost $240 million over the next five years — however, this is not a new cost, but existing funding for services President Bush is eliminating. And there is no way to tell how much President Bush’s cut will cost taxpayers if we can’t provide these services for our most vulnerable citizens — will they have to go to emergency rooms for care or be admitted to hospitals if no one helps them coordinate their care?

I believe we give help to those that are practicing self-help. The families that are struggling need a government that is on their side. We must pass this measure as soon as possible to restore the funding before any more Americans pay the price.

Sen. Barbara A. Mikulski, a Democrat, represents Maryland in the U.S. Senate.