We are failing Maryland's most vulnerable citizens who need specialized care. We are also failing the caregivers of that care, be they professionals or loved ones. That's because the State keeps operating services like it is a business. When it comes to people, it cannot. Business deals with the bottom line cost of providing services and  that comes down to money. With many government services the bottom line is measured in people's lives. 

I experienced a case of incompetence in how our elderly and disabled are treated when Long Term Care under Medicaid is applied for. Medicaid is a joint federal-state program established by Title XIX of the Social Security Act, 42 USC sec. 1396. The program provides health care to financially and medically needy individuals. Ehrlich v. Perez, 394 Md. 691, 701 (2006); Reese v. Dep’t of Health and Mental Hygiene, No. 514, Sept. Term 2006, 2007 WL 3227549, at *2 (Md. App. Nov. 2, 2007); see 42 U.S.C. §§ 1396 et seq. Beneficiaries include low income adults and children, the elderly, and mentally and physically disabled individuals. Reese, 2007 WL 3227549, at 2. State participation in Medicaid is voluntary. Each participating state is given some flexibility in devising its Medicaid program, but the state’s plan must be approved by the federal Centers for Medicare and Medicaid Services (“CMS”).1 42 U.S.C. § 1396a. If the state’s proposed plan is approved, the state is eligible for federal funding, and the plan becomes mandatory. 42 U.S.C. § 1396a(a)(1); Ehrlich, 394 Md. at 702; Reese, 2007 WL 3227549, at 2. Maryland has elected to participate in Medicaid. The State’s Medicaid plan, known as the Medical Assistance Program (“MAP”), is administered by the Department. Md. Code (2005 Repl. Vol., 2007 Supp.), § 15-103 of the Health General Article; Reese, 2007 WL 3227549, at 2. Maryland City administers the program for the City.  We need to improve this process altogether. We need to reduce the time that it takes to approve applicants and for procedures performed under the treatment plan. We owe the proper respect to our elderly and disabled to get this done.

By participating in Medicaid, Maryland has agreed to abide by federal statutory and regulatory requirements and to provide financial assistance to qualified recipients for seven broad areas of medical treatment. See 42 U.S.C. § 1396a(a)(10)(A); Alexander v. Choate, 469 U.S. 287, 289 n.1 (1985); Jackson v. Millstone, 369 Md. 575, 595- 96 (2002); see also Ehrlich, 394 Md. at 701 (stating that, “[i]f a state chooses to take part in the federal Medicaid program, it must comply with the requirements set forth in Title XIX and its implementing regulations in order to receive federal matching funds”). The areas of treatment include nursing facility services for eligible persons, age twenty-one and over. 42U.S.C. § 1396d(a)(4)(A). This does not mean that we can't make it work in the favor of the People.