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Northern Ky. Expected To Be First Area Affected By New Medicaid Work/Training Requirement

Alexander Korzh 123rf Stock photo

  A top Kentucky official says northern Kentucky will likely be the first area where Medicaid enrollees will have to meet the state’s new ‘community engagement’ requirement, starting July 1.

Kristi Putnam, program manager for the Medicaid changes in Kentucky, said the state sent out post-cards this week.

“It went out to individuals in northern Kentucky to give them the 90 day notice that they may have community engagement requirement starting July 1,” Putnam said.

She added that she expects to finalize details with officials in northern Kentucky next week.

As part of Governor Matt Bevin’s approved Medicaid waiver, Kentucky will start making some Medicaid enrollees work, volunteer, take classes or train for jobs at 80 hours a month in order to keep health care coverage.

Credit Lisa Gillespie, WFPL
This slide presented on April 5, 2018 shows the state’s planned roll-out of the Medicaid community engagement requirement.

After the first roll-out in July, tentatively planned to affect Northern Kentucky, the community engagement requirement will be rolled out in the next round of counties in October. That includes Jefferson County, a 16-county area surrounding Louisville and some counties in northeast Kentucky.

In November, much of western Kentucky will follow. Then, in December, the community engagement requirement will also apply to most of the counties in the central part of the state around Lexington.

Eight counties in southeast Kentucky will be waived from the community engagement requirement until 2019.

Exceptions To The Rule

But Putnam also said there will be exceptions if the state finds a particular county doesn’t have enough jobs, training or volunteer opportunities for Medicaid enrollees to fulfill the requirement.

“If there’s an area where we’re concerned about, or leadership comes to us and says, ‘we have a real concern about this county,’ we can look at it on county-by-county basis,” Putnam said. “There’s flexibility in the plan.”

Some Medicaid enrollees will be exempt from the community engagement requirement, including pregnant women, people who a disability, live in a nursing home, are a former foster care youth or are deemed ‘medically frail.’

An enrollee might meet this status if they have a physical or mental condition that limits daily activites, or are chronically homeless. Refugees and domestic violence survivors will also be exempt the community engagement requirement.

“Refugees will be considered ‘medically frail’ upon date of entry to allow them to access immediate care,” Putnam said. That designation will last for one year.

New Systems

The state is building many systems to support this change to Medicaid.

One of those is an online portal: that’s where some enrollees will take classes, which will help them earn “dollars” for vision and dental services. Putnam said the state is initially using online educational classes from Kentucky Educational Television, but the initial soft launch did not go as well as she’d hoped.

“We had some technical glitches in translating their information and content over to our learning management system platform,” Putnam said.

There are currently 600 certified assisters to help Medicaid enrollees with possible changing benefits or requirements. Putnam said an organization can apply to become an assister on the state’s website.

Lisa Gillespie is WFPL's Health and Innovation Reporter. Most recently, she was a reporter for Kaiser Health News. During her career, Gillespie has covered all things health — from Medicaid and Medicare payment policy and rural hospital closures to science funding and the dietary supplement market.
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