Sunday, June 5, 2016

Medicaid Waivers: Top Five things you need to ask!

For whatever reason, there will be times that you may want to see what else is available in Medicaid services. Or you may be just entering these services for the first time.  Here are the top five questions you need to ask when looking at disability service providers. 

The number one tip to remember is that you are in charge.  You are the contractor.  You receive Medicaid funding to support you in your pursuit of quality in life; the provider needs to meet your needs.  

On the other hand, doing the work up front will allow you to have reasonable expectations of your provider.  Medicaid providers enter this line of work because they have a vision and a style of working for people with disabilities.  They should not change who they are to meet your needs, instead find the right fit and it will make your world so much easier. 

Always meet with the Director of the agency directly.  This is the most important decision you will make regarding quality of life and safety so knowing the Director will give you a feel of where they are heading, and it will get you front and center if any issues arise in the future.  If they are too busy, then so are you because you have other agencies to contact. You can see more options here at

1.        How much of my services are you able to cover?
In the delivery of services the biggest obstacle is finding and keeping good staff.    In this industry the pay is low and it is difficult for people to view this as a long term career.  Spend time finding out how they plan to serve you, will it be with one staff, many, and will you know who is showing up each day?  Find out how the provider treats their employees and how committed they are to treating their staff well.  The better an employer treats their staff is also how they will treat you and your family.
On a side note, this should also be a top question you ask when speaking to any references. They’ll tell it to you honestly. 

2.       What is the worst thing one of your staff has done while on the job?
Keep in mind that this will be a tough question for a provider to answer.    Every agency has a “worst thing” someone has done on the job.  Agencies I have run have them, and some of them break my heart to this day.  See how open they are about any issue, see if they have had a series of the same issue.  Do they take responsibility?  Do they blame someone else or before their time?  Also follow up with what have you done to ensure it won’t happen again? 

3.       Do you currently serve anyone similar to me?
As the conversation around this question deepens you should feel as though the agency takes time to know who you are.  They don’t just say we have other people your age, your diagnosis or some other wild generality that has nothing to do with who you really are.  Instead the conversation should be about you, who you are, what do you like to do, who you think you are like, etc.  You want a
n agency that will attempt to know you before they attempt to describe you. 

4.       Have you ever terminated services with someone you were serving?
Follow up with a why?  This is important!!!  They should have some sort of policy around termination of services, but it would be good for you to hear as much detail about what issues they cannot handle.  You need this information to be able to gauge whether their style fits your needs. 
Three key points:
a.       Do they pick up everyone they can and determine fit later?  This happens more than you think. 
b.      Are they equipped to handle the issues or concerns you have? 
c.       Are they clear about who they are best at serving?  For instance do they take in someone with autism over 65 when they have a history of working with young adults with behavioral issues?  Or are they selling you on the fact they can serve an active adult when they typically serve a very different population? 

5.       In five years how will this agency look, feel or do business differently?
Every agency should have a vision, a place they are striving towards.  It should be a future you want to be a part of.  Sometimes the answer is more reactive, especially around the state, new federal regulations or reimbursement rates from Medicaid.  While it is an easy trap for a leader to feel this way they should be able to think beyond it and have a plan.     

Let me know if you have other suggestions for questions or stories about good interviews and bad interviews you have had with prospective services providers.  Comment below or email me at