PETITION

From: Georgia Parents of special need kids
To: Georgia Pediatric Program (GAPP)

In summary, we are requesting that parents of children with special needs be given the permanent option to be their child's paid caregiver through the GAPP program. This was approved temporarily in the state of Georgia during the rise of covid but is due to expire on April,  2022. Please note, that this option request is not something that is new to other states. Currently states such as New York, California, and Florida allow for this option. 

The details: 
To the Department of Public health (DPH), Medicaid Program and centers of Medicare and Medicaid services (CMS) and all Members of the 
Legislative Assembly of Georgia.

     We, the parents of special needs children of Georgia, are requesting the Department of Public health and the GAPP program, which is founded under the Medicaid state plan to extend the approval for parents and other relatives to deliver personal care support services (PSS) through the Gapp program under a 1935 state plan authority which is planned to end shortly after the end of the declared public health emergency (PHE) on January 16th , 2022. 

     We are requesting CMS to permanently allow parents pf children with disabilities the option of being their child's paid caregiver. We, as parents of special needs kids were able under this temporary approval to be paid caregivers  and were able to provide personal support services/PSS or unskilled nursing to our children through the GAPP program, however, this will end on January 16th 2022, and we are requesting to continue providing paid services to our special needs children. This has allowed parents and family members the opportunity (which we've never had) to be able to work, receive training, and provide a service that we have been able to see benefit our special needs children. Again, we are only asking this to be an option.
 
     Currently, the GAPP program under the Medicaid state plan is not part of the Medicaid waiver programs that follow appendix K, which allow other parents to be paid for a more extended time than parents of children who received GAPP, and this is not something that the state had proper planning and equal opportunity for our special need kids. The Medicaid waiver program allows one to provide the services for their children on their Appendix K, which is extended six months after the public health emergency ends; however, this is not the case for the GAPP program, which provide the same services (PSS) for special needs kids under Medicaid as well.
 
     The GAPP program and other Medicaid waivers under the Medicaid state plan allow parents of children with special needs to receive care via PSS, with in-home caregivers. These unskilled nurse services by way of parents or family aid are only temporary due to Covid. Before this temporarily Covid PHE allowance, parents were not qualified to become caregivers and be paid. However, in many states such as New York, Florida, California, etc., they allow for parents to permanently work as caregivers for their special needs children, but Georgia does not allow that. If Georgia parents were given the same opportunity as other states, this would definitely help many of those homes that have staffing shortages. It would also help many of the companies that provide PSS services improve retention rates and care for those children that need these services. 

     Georgia is the only state that restricts parents from becoming a paid caregiver and only allows caregiver services from someone outside the home. As Covid arose, the fear of having a caregiver coming in and out of the home and potentially infecting the child became a big issue. The Medicaid state plan and Medicaid waivers under Appendix K temporarily approved parents and family members to become paid caregivers to help bridge the gap allowing parents to provide the care their child needed w/o the fear of their child being infected by outside caregivers.
 
     During our state's current economic and health issues due to covid and omicron, parents have had to leave their jobs in order to take care of their special needs child/ren. Moreover, the lack of available caregivers has led to inconsistent reliability, i.e. no shows and with the lack of higher income has led to caregivers searching for other jobs. This leads to parents having to call off from work, resulting in loss of income for their family.
 
     Therefore, this temporary approval has allowed parents to get paid to become caregivers and minimize the loss of income due to the lack of caregivers' availability and willingness to do the job with minimum pay.
 
     Based on the upcoming increase in disability benefits and Medicaid of 5.9% starting January 2022 due to the cost of living adjustments, a lot of the caregivers are not willing to provide GAPP PSS services since there has always been an increase in the paying rates for registered nurses RNs and LPN's who are skilled but not for the unskilled PSS workers. The PSS workers who provide these caregiver services haven't had a pay increase in the last five years. Therefore, there has been a lack of caregivers willing to come in and assist in these services.
 
     Therefore, we ask you to hear our petition and allow families and relatives the option to permanently provide paid PSS services to their child and be paid through the GAPP program under the Medicaid state plan
 
 

 
https://dch.georgia.gov/office-inspector-general/georgia-oig-exclusions-list
https://medicaid.georgia.gov/organization/about-georgia-medicaid/medicaid-state-plan
https://medicaid.georgia.gov/sites/medicaid.georgia.gov/files/related_files/site_page/GF%20Contract%20-%20Generic%20%28002%29.pdf
 
https://law.gsu.edu/2017/10/20/georgia-pediatric-program-an-introduction-to-gapp/