************************************** See what's new at http://www.aol.com
--- Begin Message ---
October 4, 2007
The Honorable Tom Harkin
731 Hart Senate Office Building
Washington, DC 20510
Dear Senator Harkin:
AARP commends you for your leadership in seeking to expand home and
community-based services. Your sponsorship of the Community Choice Act
(S. 799) shines light on the issue of Medicaids institutional bias and the
need to
expand home and community-based services.
Among individuals age fifty and older, 89 percent say they want to remain in
their
home for as long as possible. Yet Medicaid, the largest payer of long-term
care,
has an institutional bias individuals who meet specific eligibility criteria
are
entitled to care in a nursing home, but not necessarily to home and
community-
based services (HCBS). HCBS are optional, and in many cases, states seek
waivers to provide HCBS under Medicaid. Individuals should not be forced to
receive services in nursing homes when they prefer and are able to receive
services in a home and community-based setting that is generally less
expensive.
Over time, states and the federal government have begun to rebalance Medicaid
to bring greater attention, efforts, and resources into HCBS. This is due to
factors such as consumer demand, the Olmstead Supreme Court ruling, and the
desire to stretch Medicaid dollars further. The Community Choice Act (S. 799)
further expands access to HCBS by requiring states to provide community-based
attendant services and supports (assistance with daily activities) to
individuals
eligible for Medicaid who require an institutional level of care and choose to
receive community-based attendant services and supports.
Lessening and removing the institutional bias in Medicaid is an important part
of
long-term care reform. We also note that while most individuals prefer to
receive
services in home and community-based settings and this access needs to be
expanded, there will continue to be individuals who receive care in nursing
homes. High quality of care in nursing homes is vital and should be an
important
consideration as quality HCBS options are expanded.
Page 2
As the Congress examines ways to increase options for HCBS, it is also
important to consider other issues that must be addressed in order to truly
make
these services available to those who need them and enable individuals to live
in
the homes and communities they choose. The critical elements include: support
for family caregivers, an adequate workforce, financing options, quality
supports
and services, and livable communities.
Reforming long-term care must become a national priority, and we appreciate
your leadership in bringing these issues before the Congress. If you have any
further questions, please feel free to call me or have your staff contact
Rhonda
Richards of our Federal Affairs staff at (202) 434-3770.
Sincerely,
David P. Sloane
Senior Managing Director
Government Relations and Advocacy
cc:
Senator Baucus
Senator Grassley
NATIONAL ADAPT MAILING LIST - Adapt Community Choice Act List
http://www.adapt.org
--- End Message ---
