Robert Hayden, DC, PhD, FICC
It may be apparent from my articles, my blog, or my rants that I tend to be conservative on a lot of issues. Simply put, I think if you teach a man to fish (rather than giving him a fish), you are a lot closer to conquering hunger. We uplift our fellow man when we encourage and foster independence.
When I first encountered the Griffin Area Resource Center (GARC), I saw an institution dedicated to teaching people to fish. I saw people with physical, mental, and perhaps emotional disabilities being assisted in a journey toward independence. People who once would have been considered wards of the state, hopeless, and trapped in bodies or minds that did not function well were learning job skills and going to work. I saw dependence and helplessness turned to self care, dignity, respect, and self-worth as people learned to fish.
I also saw families better able to function. While an afflicted family member may become the major focus of concern and disproportionate recipient of the family’s resources, GARC helped make those family members functional participants within their families instead.
Independence and freedom are blessings many of us assume, but imagine for a moment how a disability might limit or remove those blessings. Because the GARC exists, people with disabilities are able to make decisions about their lives, work for wages, choose their friends, engage in commerce, and many other things that comprise life. In short, they are achieving the highest attainable quality of life and enjoying it to the fullest extent possible.
In late September, Executive Director Lisa Sassaman of GARC received notification from Georgia Medicaid that an audit of 44 records of people served through a Medicaid Waiver for the period of March 1, 2013 - February 28, 2014 had determined that Georgia Medicaid made overpayments in the amount of $452,761.19.
GARC appealed this very negative decision and went to a hearing. The Medicaid representatives conceded about $300, which was an insult at best. If this penalty stands, not only is GARC finished as an institution after 60 years of service here in Griffin, but other such institutions that serve 12,000 people in Georgia will likely fall as well. The 8000 more who are waiting for services will also have lost hope. The families of these 20,000 Georgians will be very negatively impacted. Jobs will be lost. Independence, dignity, and self-worth, purchased at great price with the help of dedicated professionals, will be damaged or lost.
There was never any question that services had been rendered by GARC to those it serves, but technicalities were found on some signatures that created an opportunity for an auditor to disallow services on a large scale. For example, Ms. Sassaman herself signed some of those charts, but was elevated to the executive director position, and used that title on some of her signatures. That title change cause an auditor to disallow reimbursement for services.
The private sector engages in a similar subterfuge. Two of the largest private insurance companies have been known to do retroactive denials dating back two years, sending the providers a bill for everything they have been paid for the previous two years. If providers paid the money back to the insurance companies, the funds would be distributed to other providers so the insurance companies had no liability at all, thus higher profit. If the provider refused to pay the money back that was earned in good faith under the contract, the insurance company would merely subtract it from future earnings. Either way, the providers themselves would be stuck with the bill for taking care of the patients. Obviously, there is no way for providers to do business under these circumstances. It appears that Medicaid is using similar tactics now.
There is no doubt that the pressure on Medicaid dollars must be tremendous. Obamacare has been disastrous. Rural hospitals are closing nationwide, but disproportionately in the South, due to reduced Medicare payments and reduced reimbursement for uninsured patients as a result of the Affordable Care Act. In Georgia, there may have been additional pressure on Medicaid because our state did not expand Medicaid services under Obamacare.
Whatever the motives on the part of Medicaid, there is an ongoing fight to save GARC. Obviously, there is much at stake, but for GARC, but it is not a matter of money or saving jobs. GARC is fighting for the quality of lives gained by their participants. They are fighting for the families they serve by helping those with disabilities.
GARC needs your help. When you are besieged by a bureaucracy, sometimes it helps to bring those with influence to your cause. This is such a time. If you will add your name and your sphere of influence to helping save this great institution here in Griffin, call Lisa Sassaman or Connie Moody at 770-228-9919. Ask what you can do, who you can call, where you can write a letter to make a difference. We just cannot let this stand.
For more information on the GARC and what it does, check out http://griffinarearesourcecenter.com/.