This letter to Gov. Sandoval, suggests three ways to stop unnecessary institutionalization in Nevada.  It also addresses some bullying from Medicaid administrators.

What is the Independent Caregiver Home Care option?

Are you an attorney or newsperson who is willing to help?  Please read your introduction note and the latest update.

On February 22, 2012 Gov. Sandoval received a letter detailing ongoing discrimination by Nevada Medicaid.  He promised his prompt attention. He has not responded nor asserted any corrective action.
Please follow us on twitter to be updated. Gov. Addresses Nevada Medicaid Issues

Below are other related letters sent to, (or forwarded to), the Governor:

Recommend this site.

Are you a media person? Please  look into doing an in-depth story including these questions to uncover ongoing discrimination.

If you have any questions or comments,
Please Contact Us.

Other Nevada Medicaid Issues:

Wage Proportionate Disbursements…
What Are They?
Why Implement Now?

Creating a Truly Workable "Money  Follows the Person" system…
Stop Wrongful Institutionalization.


Dear Gov. Sandoval,

Below, are listed three Medicaid policy changes that will cost effectively – 1. Improve and expand self-directed home care, 2. Bolster the availability and quality of caregivers, and 3. Open up a way for many unnecessarily institutionalized people to go home.  Also, these changes, (if properly implemented), will by and large, bring Nevada into compliance with the federal requirement to end the related discriminations.  

Medicaid administrators have deflected the responsibility to make such changes that would have cost effectively benefited many people.   Since mid-January, I have been petitioning your office about these changes, (addressed in the letter to Mr. Willden).  Now, your staff is beginning to use the same phraseology that Medicaid administrators are using.

The Division has become hardened in its position and brazen about it's threats*.  (Why are you permitting Medicaid staff to put unfair pressure on me?)  Please don't allow their methods nor go along with them in suppressing the validity of these changes.  Shouldn't we rather do whatever we can to save money and help people? 

Please allow me and other stakeholders, especially the people who are directly affected by the policies, to have an open channel to a CMS representative.  The expertise of national disability leaders should also be drawn from in laying out these changes.  Would you assign one staff person to oversee the proper implementation of these three corrections/innovations?

1.       That the Independent Caregiver Option be improved and that all eligible recipients have fair access to it.
2.       In order to bolster the availability and better quality of at-home caregivers, encourage reasonable wages for them by, implementing a viable wage proportionate payment system, (a tiered payment system, not to exceed the allocated budget).
3.       That Nevada Medicaid would adopt policies, (especially, a more sweeping Money Follows the Person program), adequate to achieve a minimum 50-50 balance of HCBS and institutional care expenditures.  (This is required by CMS to receive a 2% increased FMAP.)

I have patiently petitioned the state Medicaid and Gov. to redress a discrimination grievance and to better respect the human dignity of those affected by Medicaid policy.  *For that, Mr. Willden, Mary Liverratti, and Mr. Charles Duarte, are threatening to revoke allowance of the Independent Caregiver Option. 

That elimination of my current care system, would cause extreme personal harm.  Also, such a response/retaliation, (asserted because I am pushing these issues before you, and the Department of Justice), tramples my First Amendment rights.  Is this also the "fix", for a discriminatory policy**, that you endorse?  **(An ongoing discrimination occurs against other Medicaid recipients who are now unfairly deprived access to the Independent Caregiver Home Care Option.)

Respectfully at your service,

Rick Cline