National
Advisory Council on Migrant Health (NACMH) Recommendations
- 2004 (second letter)
November 24, 2004
Mark McClellan, M.D.
Administrator
Centers for Medicare and Medicaid (CMS)
Humphrey Building, Room 314G
200 Independence Avenue SW
Washington, D.C. 20201
Dear Dr. McClellan:
Each
year the National Advisory Council on Migrant
Health (NACMH) presents a set of recommendations
to the Secretary of Health and Human Services.
These recommendations include issues that the
Council feels are critical to improving the
health status of migrant and seasonal farmworkers
in the United States. In his response to our
2004 recommendations, contained in a letter
dated August 3, 2004, the Secretary noted his
"interest in the forthcoming report from
the Centers for Medicare and Medicaid Services
(CMS) on Medicaid portability for farmworkers
(the 404 Study)." As we anticipate the
forthcoming report, we wish to convey our concerns
to you.
For decades, States have been reluctant to admit to their Medicaid rolls migrant farmworkers and their families who are working temporarily in that State, even when they are eligible for or enrolled in Medicaid in their home State. This has continued despite federal mandates codified at 45 CFR 233.40 which prohibit States from imposing residency requirements. The Council believes that States' failure to comply with the law constitutes a significant barrier to migrant farmworkers' ability to access health care.
This reluctance to recognize the Medicaid eligibility of qualified temporary residents has persisted for decades. It is the firm belief of the Council that absent a concerted effort on the part of the Federal Government to compel States to adhere to Federal mandates, Medicaid & SCHIP-eligible farmworkers and their families will continue to be without health care when they are working out of their home State. Accordingly, to reverse this decades-long practice of denying health care to these migrant farmworkers and their families, the NACMH urgently counsels CMS to include as a central tenet of the 404 Report a viable mechanism whereby the Federal Government compels States to follow Federal law. The Council is certain that without such a mechanism, migrant farmworkers and their children will continue to be without health care coverage when they are away from their homes, toiling in the fields and orchards of our country.
The Council will meet again in January 26 and 27, 2005, and we are hopeful to obtain a response from you regarding this concern by the date of that meeting. We thank you in advance for your time and consideration in this matter. Please feel free to contact us with questions or concerns.
Sincerely,
/signed
Bruce E. Gould, M.D.
Chair, NACMH
(860) 679 - 4322
gould@adp.uchc.edu
/signed
Guillermo Martinez
Chair-Elect, NACMH
(269) 621 - 3176
MartinezG2@michigan.gov
cc: Secretary Tommy G. Thompson
Dr. Elizabeth M. Duke
Dr. Samuel Shekar
 |
