Medicaid bill aims to end nursing-home bias

MiCassa reintroduced Aug., 2001

WASHINGTON, D.C. Nov. 16 -- The Medicaid Community Attendant Services and Supports Act,. designed to to reform the Medicaid program by allowing people a choice to remain at home rather than go to a nursing home, was introduced in the Senate by Sen. Tom Harkin (D-IA) and co-sponsored by Senator Arlen Specter (R-PA). The bill number is S-1935.

In 1998, Medicaid spent $44 billion in reimbursements to nursing homes and other institutions, according to figures from the Health Care Financing Administration, but only $14 billion on home and community-based services, or just 25% of its total long-term care expenditures. According to data gathered by the University of California/San Franciscošs Disability Statistics Center, the average yearly Medicaid expenditure for a person using community-based services is $7,276, compared to a taxpayer cost of $23,225 for a person receiving Medicaid services in a nursing home.

MiCASSA is the result of years of work by ADAPT, a national grassroots disability rights group. A number of ADAPT activists have been in nursing homes and other institutions.

"ADAPT's goal is to reform the institutionally-biased Medicaid long term care system by giving people with disabilities a real choice to live in the community. Nobody should be forced into a nursing home in the 21st century because of a lack of options," said ADAPT organizer Bob Kafka.

"We all know that given a real choice, most Americans who need long term services and supports would rather remain in their own homes and communities than go to a nursing home," said Sen. Harkin on introduction of the bill. Under the current system, he said, "a person has a right to the most expensive form of care, a nursing home bed, because nursing home care is an entitlement. But if that same person wants to live in the community, he or she is likely to encounter a lack of available services, because community services are optional under Medicaid.

"The deck is stacked against community living, and the purpose of our bill is to level the playing field and give people a real choice," said Harkin.

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