Nonprofit groups question Bevin’s plan to require ‘volunteer’ work from able-bodied adults who aren’t primary caregivers

Gov. Matt Bevin’s plan to require volunteer work from unemployed, able-bodied Medicaid members isn’t sitting well with the Kentucky Nonprofit Network, which represents nearly 600 of the state’s nonprofit groups, because it would mean tens of thousands of people would “need training, supervision and—in some instances—criminal-background checks,” John Cheves reports for the Lexington Herald-Leader.

As part of the state’s request for a federal waiver to tighten eligibility standards for the 440,000 Kentuckians covered by the 2014 expansion of Medicaid, Bevin wants to require “community engagement” for able-bodied adults who aren’t primary caregivers, requiring them to work, search for a job, be enrolled in classes or volunteer in their communities, eventually for 20 hours a week. “The state estimates these requirements could affect roughly 215,000 people,” many of whom live in rural areas, some with few volunteer opportunities, Cheves reports.

That’s one thing Danielle Clore, executive director of the Kentucky Nonprofit Network,  told Bevin’s office when it asked the group to support his proposal. In her letter, she included comments from her members:

“The bottom line is this will cost nonprofits money – money and resources we don’t have to spare.”
“It takes professionals to effectively manage volunteers. For the experience to be valuable for both the agency and the individual, volunteer efforts have to be managed. Is it worth the limited and precious resources of a nonprofit to manage a volunteer that is there because ‘they have to be,’ not because they want to be? Nonprofit employees are spread so thin as it is and I feel like a volunteer requirement for anyone not truly committed to the mission of the agency isn’t an effective use of anyone’s time.”
“I do not typically take people who are ‘required’ to volunteer, because they don’t make good volunteers. Also, 20 hours is A LOT OF TIME. We don’t allow people to volunteer that many hours because at that point they could be considered a part time employee, and you have potential legal issues to consider.”

In an interview, Clore said “members of her organization have limited budgets,” Cheves reports. “Many cannot afford to manage a much larger staff. Some do not have enough space or work for so many additional people, Clore said. In sparsely populated rural counties, only a handful of nonprofit groups operate, she said. And some groups that work with children or the elderly require volunteers to pass a criminal-background check, which costs money and raises questions for Medicaid recipients with legal problems in their past, Clore said.”

The issue arose at the Aug. 17 meeting of the legislature’s Medicaid Oversight Committee, Rep. Joni Jenkins, D-Louisville, asked administration officials if they had a plan for people in communities with few jobs or volunteer opportunities.

Meier said the waiver had been drafted to allow the administration to make a special request to exempt those counties, and that it would build partnerships with non-profits, churches and local governments to find ways for people to fulfill the requirement.

He said people could pick up trash or work in places that did not require background checks, like soup kitchens or Habitat for Humanity.

“We are going to keep it pretty open,” Meier said. “We don’t want to really mandate where they go we just want them to be engaged in the community.”

Emily Beauregard, executive director of Kentucky Voices for Health, told Kentucky Health News in an interview, “The majority of the people who are not working in the Medicaid expansion population are caregivers and students. . . . I think we better need to understand that population and what their needs are.”

Beauregard added, “We need to provide them with the support services that they need, but forcing people to volunteer in order to get health care doesn’t make anybody healthier. We know this. There are data to suggest that. In fact, sometimes these stringent requirements put people in a position where they are unable to get care and then they get sick, and they are unable to work.”

Meier told Cheves that some Kentucky school districts require students to do volunteer work to graduate from high school, and in some counties this year work or volunteer requirements for people who get food stamps.

Information for this story was also gathered by Melissa Patrick of Kentucky Health News.

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