Your State Too Can Have an Effective MCAC

How can I make sure that consumers are on my state?s Medicaid MCAC?
Federal laws require strong consumer representation on the MCAC. You should encourage your state to adopt laws that strengthen that requirement and include broad, effective representation. Vermont requires that a third of the members are Medicaid or SCHIP beneficiaries. In Maine, the MCAC must have at least 51% Medicaid beneficiaries or representatives of beneficiaries. In Oklahoma, the MCAC must include representatives of these groups: children, elderly, poor people, and people with a mental illness, a developmental disability, or alcohol or substance abuse problems.

A good, representative MCAC should also include a racial and ethnic mix and people from both urban and rural areas of your state. You can work to make sure that actual Medicaid beneficiaries are on the MCAC, in addition to people from groups that represent the interests of beneficiaries. If you think that the MCAC doesn?t have enough Medicaid consumers on it, say so! Legal aid and welfare rights organizations or disease? or condition specific groups can be good places to contact for interested consumers and consumer representatives.

Who else should be part of the MCAC?
Some states, like Maryland and Louisiana, require that a few state legislators be on the MCAC. This can be a good thing. Since state legislators make decisions about Medicaid policy and decide how to spend Medicaid money, the MCAC is a good place for Medicaid beneficiaries to tell them how the program really works in practice.

Your MCAC should also include some health care providers and people concerned about health care like doctors, nurses, union officials, and hospital administrators. Consumers should have strong representation so that groups with other interests don?t take over the discussions. Extra meetings or subcommittees just for consumers may be useful. Remember: just because they are ?professionals? doesn?t mean that you don?t also have important and helpful things to say about your state?s Medicaid program!
What kind of support should my state give the MCAC?
Your state?s Medicaid agency should make staff available to the MCAC to help with meetings and activities. In Idaho, the state agency must help with new member orientation, keeping minutes of meetings, putting together and mailing out packets of information to members, and other administrative duties. If your state agency says that it does not have the money, you can remind it that the federal government will pay half of the state?s costs.

When the MCAC needs more technical help, the state can send a staff person to help the MCAC understand more complicated issues. Your state should help your MCAC work and understand the issues too. Many local legal aid and national health advocacy programs can also give you information on difficult issues.

What kinds of things do MCACs in other states do?
MCACs are supposed to help the state decide important Medicaid policy and administration questions. Some states give their MCACs specific responsibilities. The Ohio MCAC helps set Medicaid budget priorities. The Vermont MCAC reviews and comments on the
Medicaid budget early in the budget process and helps the state figure out the best decisions on eligibility, benefits, and financing. Before the state tries to get waivers from the federal government, the Vermont MCAC gets the chance to give its comments.
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