The end of two significant medical funding programs for Libby asbestos victims has been confusing and frustrating for patients who must now tap into the “Libby Provision” of the federal health-care reform law.

“It’s been madness for sure,” said Tanis Hernandez, outreach coordinator for the Center for Asbestos Related Disease or CARD clinic in Libby. “It’s so complicated.”

The Libby Asbestos Medical Plan, known as Lamp, ended on June 30.

The state program had been in effect since 2003, using money provided by W.R. Grace & Co. as part of a lawsuit settlement with the U.S. Environmental Protection Agency. Grace operated the Libby vermiculite mine that is blamed for widespread death and illness from toxic asbestos exposure.

Robert Underwood, a former Libby resident and disabled veteran with severe asbestos disease who now lives in Pablo, said he relied on LAMP funding for his oxygen and has been without it since the program took back his oxygen tank and equipment in early July.

“Without oxygen, I’m not doing so good,” he said.

Those who depended on LAMP can sign up for Medicare Part B for continued respiratory care, but Underwood is reluctant to do that because he has been told Medicare will put liens on his portion of a proposed settlement by the state of Montana to asbestos victims.

“They’re pushing me into a corner,” he said. “I guess I’ll go without oxygen and if I die you can print the story.”

Hernandez said the CARD clinic has contacted the lawyers representing asbestos victims and haven’t gotten a clear answer about whether or not victims’ settlements will be affected by Medicare liens.

But Underwood said he spoke to a Medicare representative who confirmed that the federal agency does intend to attach liens to asbestos settlements.

“They told me with their own lips they’ll take the money back,” he said.

Hernandez said the dissolution of LAMP affected roughly 70 to 80 patients on oxygen, but LAMP and the other crucial program that ended — the Federal Libby Asbestos Specialty Healthcare, or FLASH program — together served 1,200 people with asbestos disease.

“FLASH used to be the Cadillac of asbestos health care,” Hernandez said.

A secondary federal program called FLASH 2 will continue for six months to one year, offering prescription drug coverage and home assistance. But when the money is gone that program, too, will go by the wayside.

“FLASH was intended to be a bridge” until a long-term medical funding solution could be found for asbestos victims, she said.

That long-term solution is expected to be found in the Libby Provision of the federal Affordable Care Act passed last year.

Asbestos victims can use the Libby Provision in three ways.

First, the bill provides traditional Medicare coverage for Libby asbestos patients even if they’re under 65.

Second, victims can seek assistance through the Medicare Pilot Program for Asbestos Related Disease. The program offers home-care services, medical equipment, help with travel to receive care, counseling, nutritional supplements and prescription drugs not covered by Medicare drug plans, according to Noridian Administrative Services, the Medicare contractor in Montana and claims processor for the pilot program that began July 1.

To be eligible for the pilot program, participants must have both Medicare Part A and B and must live in Lincoln or Flathead counties.

“That’s a contentious issue,” Hernandez said, referring to the residency requirement. “There are many people who have moved out of the area for work.”

About 40 percent of the CARD clinic’s patients live outside Lincoln County, she noted.

More than 300 deaths have been linked to asbestos disease, and the CARD clinic currently serves close to 3,000 patients with various stages of asbestos disease.

The third prong of the Libby Provision is access to competitive grants for ongoing screening. The CARD clinic applied for a grant and was awarded funding July 1 to continue screening.

“The rate of new screening participants is still steady,” Hernandez said. “CARD sees an average of 40 to 50 brand new patients each month.”

Sen. Max Baucus, D-Mont., who fought to keep the Libby Provision in the federal health-care reform bill, lauded the special help for Libby victims when the bill was passed. He said the EPA’s public-health emergency declaration for Libby, along with the new legislation, “has triggered over $300 million [in health aid for Libby] over the next 10 years.”

For more information about the Libby Provision and asbestos health-care resources, go online to www.noridianmedicare.com/ard or 222.libbyasbestos.org.

Features editor Lynnette Hintze may be reached at 758-4421 or by email at lhintze@dailyinterlake.com.