On December 13,
2011, the Medicaid Redesign Team met to hear remaining workgroup
recommendations for a full report that is due to Governor Cuomo on December
31. Advocates remain skeptical that the redesign
process can reduce overall spending on long-term care without jeopardizing
access to community-based services for individuals with disabilities. Individuals with disabilities are entitled to
receive health, employment, and education services and supports in an
integrated setting appropriate to their needs according to Title II of the
Americans with Disabilities Act.
Typically, people prefer their own home, yet New York State has
developed a Medicaid funding priority that favors institutional settings. Neither the Governor nor Medicaid Redesign
Team members have directed legislative action that is necessary to correct this
situation.
The Medicaid Redesign Team was created by Governor
Cuomo earlier in the year to develop strategies to bring the Program’s spending
to more sustainable levels and to improve patient health outcomes. Many reform recommendations
are already being implemented across the
state under a global spending cap set in the state’s 2011-2012 budget process. Previous cuts to homecare providers of 2% this
past year, also threaten access to long-term care services for individuals with
disabilities as agencies struggle to meet the needs of patients and
workers. Some highlights of the Medicaid
Redesign workgroups and their recommendations to date include:
· Program Streamlining – creation of a state
insurance exchange, centralize eligibility and enrollment, establish asset verification
system, and phase-out local share of Medicaid responsibility
·
Behavioral Health – will transition slowly
to managed care, increase use of health information technology, create of
specialty behavioral managed care organizations, and payment incentives based
on health outcomes
·
Managed Long-term Care Implementation and
Waiver – principals have been developed
for a new care coordination model, development of statewide quality measures to reduce admissions
·
Health Disparities – establishment of
data collection standards and improving access to language services
·
Basic Benefit Package – align state
coverage to federal grading mechanisms and eliminate non-evidence-based
benefits
·
Workforce Flexibility/Scope of Practice –
promote the consumer directed personal assistance program and define the scope
of practice for healthcare professionals
·
Payment Reform and Quality Measurement – Integrate Medicaid and Medicare service
delivery and financing for dual eligibles, adopt state-wide performance
measures
·
Affordable Housing – new investments in
affordable housing, creation of a formal mechanism to direct savings from
redesign to housing, stream-lining of assisted living to improve access, a
de-linking of nursing home bed reduction with the creation of assisted living
beds.
-
Donna G.
