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Ohio's Medicaid Buy-In Campaign

Advocacy Planning Guide

This guide provides basic information to assist citizens in advocating for a Medicaid Buy-In program in Ohio.

Using the information in this guide will help you create a positive impact on the legislative process. Pages may be duplicated and distributed.

Goals for MBI Campaign

  1. To have written into Ohio law that people with disabilities have the option of buying into a Medicaid Buy-In program.
  2. To have funding approved for an Ohio Medicaid Buy-In program no later than the next biennial budget, 2003-2005.

What we need to do:

  1. By spring 2002, convince the Governor to include a Medicaid Buy-In option in the next biennial budget.
  2. Convince members of the General Assembly to keep the Governor's Medicaid Buy-In option in the budget - or add the option to the budget if the Governor has not included it.
  3. Get commitments to support a Medicaid Buy-In option from the gubernatorial and General Assembly candidates in the spring primaries and in the November elections of 2002.

Why do working Ohioans with disabilities need Medicaid Buy-In?

What is a Medicaid Buy-In Option?

H.R. 1180, the federal Ticket to Work and Work Incentives Improvement Act of 1999 expands a Medicaid option under Section 4733 of the Balanced Budget Act of 1997.

This provision gives states the option of providing Medicaid health insurance coverage to working individuals with disabilities who do not qualify for Medicaid under existing income and asset rules. Currently, Ohio does not offer this option.

Why does Ohio need this option?

People with disabilities are often discouraged from working because increasing their earnings makes them ineligible for Medicaid and the coverage they need for acute and longterm support services. In order to keep their Medicaid eligibility, these people often stop working or reduce their work hours because they cannot afford to pay for all their medical services.

What are eligibility requirements?

States have the option of providing Medicaid health insurance coverage to people with disabilities, age 16-64, who would be eligible for Supplemental Security Income (SSI) - except that their income is too high. In the new option, states can change limits on assets and income that are used to determine Medicaid eligibility.

If Ohio agrees to provide Medicaid coverage to the individuals described above, it also may provide coverage to working people with disabilities whose medical conditions have improved but who continue to have severe medical impairments.

If Ohio adopts a Medicaid Buy-In Option...

people who are eligible may "buy into" Medicaid coverage by paying premiums or other state-established, cost sharing charges. These charges will be set according to a sliding-fee scale based on income.

Where are we now?

The Joint Legislative Ticket to Work Program Evaluation Committee recommended in its final report dated March 2001, that Ohio provide a buy-in program to Medicaid for people with disabilities who are working. Advocates were hopeful that the administrative start-up costs would be included in the 2002-2003 biennial budget bill. Unfortunately this did not happen.

The Ohio Department of Job and Family Services received a Medicaid Infrastructure Grant from the Centers for Medicare and Medicaid Services, formerly the Health Care Financing Agency. ODJFS will conduct two studies under this grant to evaluate the administrative changes required to implement a Medicaid Buy-In program in Ohio, and study the implication of adding personal care as an optional Medicaid State Plan Service. A consumer task force has been established to provide input on the design, execution and distribution of both studies.

What you should know about Medicaid Buy-In

  • Medicaid Buy-In is a federal initiative - requiring state endorsement - that removes a significant barrier to employment for people with disabilities.
  • It allows workers with disabilities to "buy into" or purchase Medicaid coverage - possibly in conjunction with private insurance.
  • It provides employers with a pool of employees previously unavailable.
  • It helps people with disabilities increase their disposable income and move from dependence to independence and self-sufficiency.
  • Twenty-seven states have pending legislation or significant advocate support to establish a Medicaid Buy-In program in their state.
  • Fourteen states have either a Medicaid Buy-In plan or approved pending legislation.
  • Proposed costs for implementing Medicaid Buy-In will vary according to the specific program that Ohio adopts.

The information on this page also is provided as a convenient card for you to carry with you. Keep it handy, so you can refer to it when talking with people about Medicaid Buy-In.

Tips for building relationships with legislators

  1. Identify your representatives for the Ohio House and Senate:
    • Name
    • Address, phone, fax, e-mail
    • District number
    • Party affiliation

  2. Earn and nurture your legislator's respect.
  3. Don't confront or challenge. Don't put him or her on the defensive.
  4. Show that you understand your legislator's busy schedule by providing summaries of lengthy reports.
  5. Get to know your legislator's aides. They are key to getting information to the legislator.
  6. Show interest in other issues on which your legislator is working-not strictly what you think is important.
  7. Compliment the legislator if he or she has done an effective job on an issue. Thank them when appropriate.
  8. If you can truthfully say you have discussed your issue with others from his or her district, then do so.
  9. Provide positive media opportunities. Invite legislators to take part in community groundbreakings, ribbon cuttings, annual meetings, etc.
  10. Honor your legislators at special events. Give unusual awards to attract special attention in their offices.
  11. Remember holidays, birthdays, etc. Send a congratulatory note if you hear anything positive about him or her.
  12. Treat your legislator as you would like to be treated.

The most important thing to remember is that these officials are people just like you-treat them with respect, understanding, flexibility, and a sense of humor.

If you don't get everything you want, thank them for what you did get, or even their willingness to listen. Stay in touch and try for more in the future.

Guidelines for visiting legislators

  1. Make an appointment:
    • Telephone or e-mail the legislator's office.
    • Be prepared to leave a message and get a return call.
    • Be pleasant and brief.
    • Tell why you are calling.
    • Be prepared to answer questions or provide information.
    • Ask for an appointment with your legislator's aide if your legislator isn't available.

  2. Arrive early. Be prepared to wait.
  3. Be informal, but not disrespectful.
  4. Identify yourself, state why you are there, and what you'd like him or her to do.
  5. Be brief and to the point.
  6. Be prepared to answer questions.
  7. Personalize the issue you're interested in and tell how it will affect you, your family, friends, businesses, your district, etc.
  8. Limit your visit to the amount of time you requested -or less.
  9. Leave copies of key materials.
  10. Write a thank-you note immediately following your visit.

Additionally:

  • Have others write letters to the legislator describing their personal experiences related to the issue.
  • If possible, have a picture taken with the legislator. Use it in local newspapers to provide publicity for the legislator and for the issue.

Writing letters

Writing letters to individuals is effective when you want to have your voice heard. Whether you have a problem that needs resolved, or whether you want to show your support or opposition to an issue, a personalized letter to someone who can make a difference is often vital. Writing letters helps build relationships with these individuals and opens the door for them to later consult with you about your issue.

  1. Write legibly or type on one side of stationery or letterhead.
  2. Use correct spelling and grammar.
  3. Date the letter and mail it the same day.
  4. Use plain, simple English to make your points and write as if you are talking to the person face-to-face.
  5. Clearly state your reasons for writing and if a bill is pending, state your position.
  6. Follow-up with 1-3 supportive statements on your position and talk about what you know.
  7. Focus on one issue per letter.
  8. Ask the person a question in the letter so he or she has a reason to get back to you. Or ask the legislator for a statement of his or her position on the issue in a written reply.
  9. Thank the person for his or her attention to the letter, and if you like, for continuing service to your district.
  10. Include your full name and address below your signature.

Addressing letters

It is important to use correct titles, addresses and spelling. Professionalism is key to getting your voice heard.

The Honorable (Full Name)
The State House
Columbus, OH 43215

Dear Governor (Last Name):

The Honorable (Full Name)
Ohio Senate
The State House
Columbus, OH 43215

Dear Senator (Last Name):

The Honorable (Full Name)
Ohio House of Representatives
The State House
Columbus, OH 43215

Dear Representative (Last Name):

Writing letters to the editor

Letters to the editor provide an outlet to publicly express your viewpoint on an issue or current event. They are an effective way to provide feedback and comment on issues that already have been raised in local media.

  1. Write your letter in a timely manner. It's critical to address issues while they are relevant to the publication's readers.
  2. Consider writing to not only local newspapers, but to newsletters of agencies, organizations, schools, etc.
  3. Know the requirements and deadlines of each publication. Guidelines may include:
    • Letters must be typed or written legibly.
    • Focus on one issue.
    • Limit length to not more than 200 words. Be short and to the point.
    • Editor will write a headline.
    • Newspapers generally limit how often they will print letters from an individual.

  4. Write in an interesting way that will attract readers attention. Use simple words and avoid jargon.
  5. Be as forceful and persuasive as you can by using your best arguments and by citing specific examples, statistics, and facts.
  6. Convey desired attitudes, a positive outlook, and respect for people with disabilities; use person-first language.
  7. Never lie, distort, or exaggerate. Avoid attacks on individuals.
  8. Keep a copy of your letter so you can refer to it if the editor calls to ask you questions.
  9. Include your complete name, address, and daytime phone number.
  10. In a brief cover letter, include a little background about you and/or your family as it relates to the issue you're addressing. Encourage editor to print your letter and thank him or her for considering your input.

Sending your letter

Mail your letter the same day you write it - or send your letter by fax or e-mail. Today, many publishers prefer receiving information by these methods. Call ahead and get the correct address or fax number.

If you have built a relationship with a reporter at the newspaper, it also may be helpful to send him or her a copy of your letter accompanied by a personal note from you.

Don't be discouraged if your letter does not get printed. Think about how you can revise.

Advocating for Public Policy Change (APPC)

One of the major roles of the Ohio Developmental Disabilities Council is to educate and influence policy makers. People with disabilities and other advocates are in the best position to cause this education and influence to be viable and to succeed.

To that end, DD Council in collaboration with seven regional APPC sites and a Medicaid Buy-In project are designing and conducting a variety of grassroots activities including: advocate training, information sharing, contribution to public policy debate, matching of advocates with federal, state and local policymakers, and a legislative event.

A map of locations and a list of contacts for each site are enclosed.

If you live in an area outside APPC boundaries,

contact the director of DD Council's Medicaid Buy-In project to find out how you can participate most effectively in Ohio's Medicaid Buy-In Campaign.

Contact:
Doug DeVoe
Ohio Advocates for Mental Health
5022 Sinclair Road
Columbus, OH 43229
(800) 589-2603 v/tty in Ohio
(614) 888-8912 v/tty
(614) 888-9478 fax
oamhddevoe@aol.com

Identify the APPC site near you and join its members in advocating for a Medicaid Buy-In program in Ohio.

APPC Sites

The Ability Center of Greater Toledo
5605 Monroe Street
Sylvania, OH 43560
Sue Hetrick
shetrick@abilitycenter.org
(419) 885-5733
(419) 882-4813 fax

The Advocates
2601 Fairport Ave.
Dayton, OH 45406
Fran Watkins
franwatkins1@msn.com
(937) 454-5008
Wynema Mebane
wattmebe@aol.com
(937) 276-3661

The Arc of Hamilton County
1821 Summit Road #030
Cincinnati, OH 45237
Deborah Taylor
speakup@queencity.com
(513) 821-2113 ext. 102
(513) 821-2141 fax

The Arc of Summit and Portage Counties
90 N. Prospect Street
Akron, OH 44304-1273
Stephanie Maric
smthearc@neo.rr.com
(330) 374-1594
(303) 762-0317 fax

Cerebral Palsy Association of Ohio
4550 Indianola Avenue
Columbus, OH 43214
Beverly Johnson
cpo@iwaynet.net
(614) 267-5071
(614) 267-4550 fax

Havar Inc.
P.O. Box 460
Athens, OH 45701-0460
Debbie Schmeiding
daschmieding@yahoo.com
(740) 592-4269
(740) 593-3894 fax

Ohio Brain Injury Association
821 Anola Street, Suite B
Dover, OH 44622-2075
Chris Curtiss
ccurtiss@biaoh.org
(330) 343-3668
(330) 343-3678 fax

Contact information

My State Representative:

Name
Address
District
E-mail
Phone
Fax
Aide's name
Notes and dates contacted

My State Senator:

Name
Address
District
E-mail
Phone
Fax
Aide's name
Notes and dates contacted

Contact information

Keep a record of people contacted during the Medicaid Buy-In Campaign. These may include:

  • County commissioners
  • Superintendent of County Board of MRDD
  • Job placement personnel
  • Director of Mental Health Services
  • Director of County Job and Family Services
  • President of Chamber of Commerce
  • Disability organizations
  • Social service organizations
  • Local employers
  • Unions
  • Transition coordinators
  • Media and reporters

Name
Title
Organization
Address
E-mail
Phone
Fax
Notes

Name
Title
Organization
Address
E-mail
Phone
Fax
Notes

Name
Title
Organization
Address
E-mail
Phone
Fax
Notes

Contact information

Name
Title
Organization
Address
E-mail
Phone
Fax
Notes

Name
Title
Organization
Address
E-mail
Phone
Fax
Notes

Name
Title
Organization
Address
E-mail
Phone
Fax
Notes

How a bill becomes a law

As introduced
As amended in committee
As amended on second reading
As enacted
As funded by joint budget committee
As implemented by thestate agency
As reported by the media
As understood by the public
What was actually needed
Drawings reprinted from the Legislative Handbook, a project of the Arc of Ohio, funded by the Ohio Developmental Disabilities Council, 1998.

How can you participate in the statewide campaign?

The Medicaid Buy-In (MBI) Project has identified four key areas where local advocacy efforts can make a difference. They are:

  1. Providing education and advocacy training for people with disabilities, their families, friends and co-workers.
  2. Educating local businesses about Medicaid Buy-In.
  3. Informing legislators and other policy makers of the problems of people with disabilities going to work and a possible solution.
  4. Creating public awareness of a Medicaid Buy-In program by involving the media.

Advocacy activities come in many shapes and sizes. Select one or two and get started eliminating a major barrier to the employment of people with disabilities.

Quite possibly the easiest way to defeat the advocacy effort is to "let those other people do it." Instead, why not commit whatever time and energy you can contribute?

Whether you make a phone call, provide training to businesses, write a letter, or mail fact sheets and personal stories - all efforts will help the statewide campaign reach its goal. Select an activity from the partial list, or develop one of your own.

Advocacy activities:

  • Learn about Medicaid Buy-In
  • Join an APPC site or start a collaborative group
  • Educate others about the need and benefits of MBI
  • Hold local meetings to keep advocates informed
  • Write personal stories about the long term health insurance needs of people with disabilities
  • Identify local legislators and other policy makers
  • Present topic of MBI at community meetings
  • Distribute fact sheets and other MBI information
  • Hold candidate nights/forums
  • Give presentations to businesses and Chambers of Commerce
  • Meet with legislators and aides
  • Create a special event
  • Develop a telephone tree or e-mail network to keep advocates informed
  • Write a letter to the editor
  • Write to the Governor and/or your state representatives
  • As a continuous show of support, wear your MBI lapel pin and give pins to people you talk with
  • Get on the agendas of local disability conferences and meetings
  • Keep campaign staff informed of your activities and progress

Questions?

Throughout the campaign you may direct questions and/or ask for assistance from the sources listed, as well as the APPC sites.

Keep these folks informed of your involvement in the campaign. Let them know what kinds of materials and information you feel would enhance your advocacy efforts.

MBI lapel pins

Ohio's Disability Policy Coalition has produced a quantity of MBI lapel pins for all people who are working toward a Medicaid Buy-In program. Encouraging supporters to wear the pins will increase awareness of this vital issue.

Pins will be provided at no charge to any individual or group that is advocating for MBI. If you would like a supply to distribute among citizens you are talking with, contact:
Disability Policy Coalition
(800) 429-8885
(614) 267-4550 fax
cpo@iwaynet.net

MBI buttons and magnets

Ohio Legal Rights Service is providing buttons and magnets to those who are supporting Medicaid Buy-In. For a free supply, contact:
Ohio Legal Rights Service
(800) 282-9181
(614) 644-1888 fax
webmaster@olrs.state.oh.us

DD Council's Medicaid Buy-In Project

Doug DeVoe
OAMH
5022 Sinclair Road
Columbus, OH 43229
(800) 589-2603 v/tty
(614) 888-8912 v/tty
(614) 888-9478 fax
oamhddevoe@aol.com

DD Council's Benefit Innovators Project

Beverly Johnson
Cerebral Palsy Association of Ohio
4550 Indianola Avenue
Columbus, OH 43214
(800) 796-8498
(614) 267-5071
(614) 267-4550 fax
cpo@iwaynet.net

DD Council's Employment Committee

Leslie Paull
ODDC
8 E. Long Street, Suite 1200
Columbus, OH 43215-2931
(800) 766-7426
(614) 466-5205
(614) 644-5530 tty
(614) 466-0298 fax
leslie.paull@dmr.state.oh.us

Resources/web sites

www.ssa.gov/work - Office of Employment Support Programs: The Work Site

www.wdsc.org/disability - Department of Labor One-Stop Website: disAbility Online

www.access.gpo.gov/nara - Federal laws, rules and regulations

www.ssic.org - SSI Coalition for a Responsible Safety Net

www.spiconnect.org - Virginia Commonwealth University - State Partnership Initiatives

www.hcfa.gov/medicaid/twwiia/twwiiahp.htm - Health Care Finance Administration - Ticket to Work and Work Incentives Improvement Act information

www.thomas.loc.gov - Copy of Ticket to Work and Work Incentives Improvement Act

www.uiowa.edu/~lhpdc/work/index/html - Comprehensive State Work Incentives Initiatives

www.epcubed.com/oddcrep.pdf - Ohio's Facts and Figures, Steven Howe

 

 

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