Thursday, May 10, 2018
State-imposed work requirements for Medicaid recipients will make obtaining health coverage harder for the homeless, especially those who live outdoors, Arkansas advocates for the homeless say.
On June 1, Arkansas will be the first state to implement a requirement that people between the ages of 30 and 49 work at least 80 hours per month, or engage in other approved activities, in order to receive government-funded health care. Work requirements will be phased in for recipients ages 19 to 29 after this year.
Gov. Asa Hutchinson said in a March 5 news release that the work requirement will "go a long way to create opportunities for able-bodied working-age Arkansans to enter into training or employment and ultimately climb the economic ladder."
Indiana and Kentucky are preparing to initiate similar requirements. Both states have included exemptions for the homeless; Arkansas has not.
Those in the homeless population are more likely to experience violence, infectious disease and chronic illness than people who have homes. Homeless people have a mortality rate between four and nine times higher than people who have homes, according to the U.S. Centers for Disease Control and Prevention.
Advocates for the homeless spoke out at a meeting Wednesday about the difficulties they foresee in getting that population qualified under the work requirement.
"It's so hard to really see being able to get the folks that are in the camps and maybe can't read or write to a computer," said Sandra Wilson, president of the Arkansas Homeless Coalition. The coalition is a group of advocates for the homeless that meets monthly.
At the meeting, Arkansas Department of Human Services officials explained to coalition members how to apply for exemptions and log work hours, and they fielded questions about Internet access and transportation for the homeless.
Medicaid recipients must certify online that they meet the work requirement or are exempt.
People who don't have places to shower or wash clothes have difficulty getting and keeping jobs, said Caleb Alexander-McKinzie, the coalition parliamentarian and a volunteer with The Van. The Van provides food, hygiene products and clothing for unsheltered homeless people in central Arkansas by driving out to encampments.
The most recent census of the homeless in central Arkansas showed that there were 990 homeless people in the four-county region; about 55 percent of those were living outside.
"I'm against this," Alexander-McKinzie said. "I'm against requiring the most vulnerable in our society to work to receive emergency benefits they need."
Volunteer work is another option to satisfy the requirement, but another attendee questioned how to get people who are homeless to jobs or volunteer obligations.
The meeting was the first step in an outreach effort by the Human Services Department to inform advocates and others about the coming changes. Officials plan to meet with about 20 other groups in the coming weeks, said Amy Webb, the department's spokesman.
"This is a unique program," Webb said. "Arkansas is going to be the first state in the country that is actually going to implement it, and we want to be sure that people are successful."
There are several exemptions to the new rule, including for anyone who is caring for a minor or someone with a disability, who receives unemployment benefits, who is in a drug or alcohol treatment program or who is medically frail.
The homeless are likely to qualify for an exemption under the "medically frail" category, especially if they have been in and out of inpatient treatment for behavioral health issues, said Robert Williams, assistant director in the department's Division of County Operations.
One in five people who are homeless also have substance abuse disorders or severe mental illness, according to the federal Substance Abuse and Mental Health Services Administration.
Advocates at the meeting expressed particular interest in the registered reporters program, which will allow people receiving Medicaid benefits to sign paperwork so someone else can fill out their exemptions or work forms for them.
Webb said the ideal registered reporters would be hospital workers or insurance carriers, but that homelessness service providers could sign up.
Wilson said she anticipated her group "leaning heavily" on the program. She said advocates will also be collaborating more to connect available services and fill in gaps, such as providing showers earlier in the morning so people can go to work clean.
After the presentation, the group discussed job fairs and other ways to connect the homeless with work. At last month's coalition meeting, Little Rock city officials presented a plan that, if implemented, would hire people from the streets to do city jobs a couple of days a week.
But Wilson said she was still apprehensive about how the requirements would affect their health care.
"It's scary," she said.
A Section on 05/10/2018
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