Georgia STAR Action Plan

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STAR Representative:� Paula Klingman-Palk

Date:� November 11, 2003

Outcome Update:� June 5, 2004

  1. Issue:� Georgia

    is experiencing major cuts in Medicaid programs which will impact funding for SLP/A pediatric services throughout the state. As a result, it is anticipated that participants will need to rely more on private plans and personal resources to obtain services.

Outcome:� Parents of children who receive, or are eligible to receive, Medicaid benefits in Georgia will learn strategies for advocating for adequate coverage for services for their children.

Baseline Data:� Georgia Speech-Language Hearing Association (GSHA) Lobbyist is providing a draft of budget revisions from the Governor�s office for clarification of the extent of the impact on specific programs.

The current Insurance Commissioner is judged to be potentially effective in gaining exposure for our efforts if he is included in public forums as a part of our agenda.

1.      Strategy:� A meeting will be scheduled with the Insurance Commissioner in order to elicit the help of his office in promoting advocacy efforts for parents, paths of recourse, means for filing complaints, and clarification of insurance laws in Georgia.

2.      Strategy:� Workshops will be provided throughout Georgia for parents through the Georgia Parent Infant Network for Educational Services and the Interagency Coordinating Councils. The Insurance Commissioner will be invited to introduce these workshops.

3.      Strategy:� An informational session regarding changes in benefits in the Medicaid programs and assisting parents in becoming advocates will be presented at the GSHA state convention.

4.      Strategy:� The STAR representative will write an article in the Communication Lines GSHA newsletter.

Expense Statement:� Undetermined at this time.

  1. Issue:� Many, if not most, SLP/A�s are unaware of what type of SLP/A benefit their respective insurance plans offer. As individuals who provide the type of services that we expect to have if needed, as a group, we are able to be strong advocates to our Human Resources Departments.

Outcome:� Beginning with members of the GSHA Executive Council and the subcommittee for reimbursement issues of the SLP/A Healthcare Committee, descriptions of benefits will be provided to the STAR representative. A report of good vs. inadequate benefits will be made, including strategies for approaching Human Resources Departments, utilizing the Checklist from AHSA.

Baseline Data:� Approximately 5% of members of both groups are knowledgeable about their plans. An employee of Children�s Healthcare of Atlanta, largest pediatric provider in the state of Georgia, reports that their benefit covers an evaluation, only.

      1. Strategy:� Appeals have been made to the Executive Council and the Healthcare Reimbursement Subcommittee and the Checklist has been disseminated to both groups. Members will be provided timelines for obtaining information. A summary report will be generated by the Healthcare Subcommittee.
      2. Strategy:� The Healthcare Reimbursement Subcommittee will present a forum at the state convention to discuss advocacy efforts for providers of services, including the summary report from the two GSHA committees.
      3. Strategy:� The STAR Representative will write an article in the Communication Lines newsletter of GSHA.

Expense statement:� None.

  1. Issue:� Other states have effectively lobbied for mandated coverage of SLP/A services.�

Outcome:� The progress of other states in implementing mandated coverage will be monitored and the viability of pursuing such options in Georgia will be determined potentially for the 2005 legislative session.

Baseline Data:� The GHSA Lobbyist reports that the current legislative climate in the state is tenuous for pursuing such an agenda at the present time.

1.      Strategy:� Identify the states that have passed such legislation and remain in contact regarding progress in implementation.

2.      Strategy:� Pursue grassroots efforts in educating legislators in conjunction with GSHA Lobbyist and Insurance Commissioner.

Expense statement:� None.

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