In a message dated 3/4/2009 10:04:08 A.M. Central Standard Time, [email protected] writes:
Excerpt from Henry Claypool's written testimony to the committee on CCA and CLASS. If you go to http://aging.senate.gov/hearing_detail.cfm?id=309028&; and scroll down you will see a list of people testifying. If you click on Henry's name you can get his full testimony, but here is the section on CCA: " To strengthen our country's financing for LTSS and increase the availability and accessibility of community living services, I recommend that Congress work with President Obama to enact comprehensive LTSS reforms such as those envisioned in the Community Choice Act and the CLASS Act 1. Advance the Community Choice Act As you know, Senator Harkin has long sponsored legislation that would address the institutional bias in Medicaid and give those in a need a real choice of community-based or institutional services. The most recent iteration of this legislation- the Community Choice Act - would advance this vital aim by providing states with additional federal resources to make community living services a mandatory part of the Medicaid benefit. In so doing, it would offer people that need such assistance a real choice between living in an institution or their community-enabling states to better meet their civil rights obligations under the Americans with Disabilities Act to provide people with disabilities with services - including Medicaid LTSS - in the most integrated setting appropriate to their needs. The cost to the federal government associated with this proposal has been cited as a barrier to its enactment in the past. There is evidence, however, that the original estimates relied on assumptions that are now out-dated. By using recently compiled data regarding states' spending on personal assistance services, a more refined estimate from the Congressional Budget Office may allow policy makers to better weigh the benefits associated with allocating resources toward making access to community-based personal assistance services an entitlement If the estimated cost of the Community Choice Act continues to discourage legislators from adopting this approach to address the need to make more community-based personal assistance services available through the Medicaid Page 6 program, an alternative approach should be included as part of health reform. Such provisions could include providing financial incentives to states to increase the availability of community-based personal assistance services and supports over a five- to ten-year period. The federal government could establish a series of annual benchmarks to set a target for each state to measure progress toward providing a level of personal assistance services that would support an increased number of beneficiaries to live in their homes and communities. Providing, for example, a states with a modest increase in their FMAP over a prolonged five- to ten-year period could help advance four key objectives: .. It could help states to measurably reduce and gradually eliminate service access disparities that currently exist within states, across different groups of beneficiaries, and throughout the country. .. It could provide states with a federal funding commitment to expand access to such services and to sustain such access even during one or more economic downturn. This is necessary to address the chilling effect that the countercyclical nature of Medicaid has upon state policy makers' decision-making that affects community living services in both good times and bad. .. It could provide states with the time they require to rebalance their LTSS systems and begin to realize some of the cost efficiencies and savings that can result from doing so. .. Such an approach also could provide the states and the federal government the time needed to experiment with and arrive at a consensus on what a fair and sustainable division of labor and funding responsibility for Medicaid LTSS should be. States' participation in such a program could be voluntary. However, if a state refused to participate or take good-faith effort to make meaningful progress in rebalancing its LTSS system, it could be compelled to comply with the integration requirements of the ADA and the Olmstead decision." NATIONAL ADAPT MAILING LIST - Adapt Community Choice Act List http://www.adapt.org **************A Good Credit Score is 700 or Above. See yours in just 2 easy steps! (http://pr.atwola.com/promoclk/100126575x1219957551x1201325337/aol?redir=http:%2F%2Fwww.freecreditreport.com%2Fpm%2Fdefault.aspx%3Fsc%3D668072%26hmpgID %3D62%26bcd%3DfebemailfooterNO62)
