“The report on “No Paid Services” is extremely important and shows  such a critical need. This is very concerning for several reasons.

I fear  that this report will be used inappropriately by stating that those who reside  in the ICF/ID take more than “their share” of the funds and that is part of the  reason that there are so many on the “no paid services.” If this tactic is  taken, it only adds fuel a terrible fire which is not based on the  facts.

People may also take this to mean that those who do receive a  waiver receive all their needed services – this is again not true. There is a  huge difference between what an “allowed” service is and what is “approved.” In  our case having prescriptions from our son’s MD, referrals from his OT/PT,  hospital discharge recommendations were not enough for DDD to approve an  “allowed” service or piece of equipment or environmental adaptation. We were  told that DDD only paid for “needs” not “wants” yet why is DDD the one deciding  equipment or services MD, OT/PT and Psychologist prescribed were not needed?  This just mystifies me.

Another question that I have is that of medical coupons (I believe  they are called something else now – Provider One?) When our son was first  placed on paid services he had a CAP waiver (?) and with this he did receive  medical coupons which was not determined by our income. Where does this service  come in now? Do people on HCBS waivers automatically receive Provider One  Medical Coverage? Do those on the “no paid service” receive this?

As a family that has luckily survived – but only through the  finally allowed and approved services of the ICF/ID – I can tell you that the  two services that we had and were “approved” to use were Family Support funds to  pay for MCP and medical coupons which paid for diapers and the co-pay of very  expensive prescriptions, hospitalizations and medical costs. The services that  our son was “allowed” on his waiver were never “approved” and therefore he was  not able to access those services.

A study that I think would also be helpful is one of people on  waivers and if they are receiving the allowed services.

Again, thank you for undertaking this survey regarding the “no  paid service caseload” – I only ask that it be used without the biases attached  to differences in ideology. We all need to support a continuum of care which is  based on the assessed support needs of each individual to allow each person to  function optimally. “

Any  Comments or ideas?