----- Original Message ----- From: Tom Emmons Sent: Thursday, January 17, 2008 12:22 PM Subject: Congressional Quarterly - Disabled People Want More Choice in Types of Care - Way to go Stephanie!!!!
Congressional Quarterly http://www.cqpolitics.com/wmspage.cfm?docID=hbnews-000002656258 CQ HEALTHBEAT NEWS Jan. 16, 2008 6:24 p.m. Disabled People Want More Choice in Types of Care By Emily P. Walker, CQ Staff Dozens of people with disabilities packed a House Energy and Commerce hearing room on Wednesday to support legislation that aims to give people with disabilities more choice about their care. Individuals with disabilities deserve care when and where they decide, said Jan Schakowsky , D-Ill., a member of the Health subcommittee, which held the hearing on Medicaids role in caring for people with disabilities. One bill, HR 1621, sponsored by Danny K. Davis , D-Ill., would mandate Medicaid coverage of community-based services. Currently Medicaid mandates that states cover nursing home care for people with disabilities, but makes coverage of community-based care optional. On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed regulation that the agency said would allow more Medicaid beneficiaries to be in charge of their own personal assistance services rather than relying on an agency to deliver them. CMS has requested public comment on how states could allow Medicaid beneficiaries who need help with the activities of daily living to hire, direct, train or fire their own personal care workers. Beneficiaries could hire qualified family members to perform the personal assistance services, CMS said. (See related story, CQ HealthBeat, Jan. 14, 2008) Medicaid only covers for community care for adults if the disabled person is transitioning into the community after being in a nursing home. For instance, Medicaid allows states to pay for case managers, but only to help transition Medicaid beneficiaries from a nursing home institution to the community. Medicaid is piloting another program that rewards states for transitioning people with disabilities into the community, but requires the person to have been in a nursing home for at least six months beforehand. You should not have to go in to get out, said Stephanie Thomas, an organizer with ADAPT, a grass-roots disability rights organization. Sixty-seven percent of Medicaid long-term funds go toward institutions, and just 33 percent are left for community services, she said. Shifting some funding away from nursing home institutions and toward community services could save money, Thomas said, because nursing home care cost is more expensive. We could be serving three people for every two we are serving now, and doing it more humanely, she said. Several of the witnesses at the hearing argued that most people with disabilities would rather choose what type of care they receive, rather than be required to be institutionalized to qualify for coverage. Many individuals living in nursing homes do not want to be there, nor would they need to be there, if attendant services and supports were available in a community-based setting, said Celine Fortin, associated executive director for The Arc of New Jersey, an advocacy organization for people with disabilities. Meanwhile, the American Health Care Association and the National Center for Assisted Living issued a joint statement following the hearing that said while they firmly back efforts in which care is available in the most appropriate, least restrictive setting for an individuals needs and preferences, they are concerned that HR 1621 may divert funding from nursing homes and other residential care settings and deny care for those with severe disabilities who may not be able to rely solely on community care. Other legislation discussed at the hearing included HR 3001, also sponsored by Davis, which would provide a national insurance program for adults with functional impairments, and HR 1279, sponsored by Lois Capps , D-Calif., that would amend Medicaid to enable states to pay disability support specialists higher wages. ----------------------------------------------------------------------------- --- Connect and share in new ways with Windows Live. Get it now! NATIONAL ADAPT MAILING LIST - Adapt Community Choice Act List http://www.adapt.org **************The year's hottest artists on the red carpet at the Grammy Awards. Go to AOL Music. (http://music.aol.com/grammys?NCID=aolcmp00300000002565)
