Efforts to improve care for seniors and people with disabilities across the country are speeding forward as states take advantage of funding and flexibility offered by the federal government. These initiatives to serve people eligible for both Medicaid and Medicare – the so-called dual eligibles – have great potential to improve the lives and independence of millions. Since the initiatives are also driven by a federal mission to contain health care costs, consumer advocates need to raise their voices to ensure the initiatives live up to their potential.
Fortunately, many advocates are already speaking up. Disability advocates from across the country have come together to produce a set of national advocacy principles to help guide their colleagues. The principles stress the importance of robust community-based long-term supportive services, such as help with daily activities including eating, bathing and dressing, managing medication, maintaining a residence, managing money, and getting out and about. These services are critical to enabling people to stay healthy, live well and maximize their independence.
The principles also emphasize consumer protections and control, and have broad applicability to work on Medicaid managed care and services for dually eligible seniors as well as people with disabilities. The principles are a joint effort of the Disability Rights and Education Defense Fund, the National Council on Independent Living, Tri-County Independent Living Center of Utah, Boston Center for Independent Living and Community Catalyst.
The principles are largely grounded in ongoing advocacy in Massachusetts, which has released its detailed draft proposal for the initiative, becoming the first of 15 states with federal planning grants to do so. Massachusetts disability advocates have testified at public hearings and submitted comments that are helping to shape the final plan. They have also issued specific suggestions on long-term supportive services.
Now is the time for advocates to get involved in all the states that are working on similar changes. Besides Massachusetts, the states that received federal planning grants are California, Connecticut, Colorado, Michigan, Minnesota, North Carolina, New York, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin More information on their initial plans can be found here. They are expected to submit detailed proposals to the federal Centers for Medicare & Medicaid Services this spring.
In total, 39 states are exploring new ways to finance care for people who are enrolled in both Medicaid and Medicare. You can find out if your state is involved by checking this list.
Please stay tuned for more news and resources.
–Alice Dembner, Deputy Policy Director