State health care officials and other witnesses told the Senate Finance Committee Sept. 25 that there is "an institutional bias" in the Medicaid program that places people with disabilities and the elderly in nursing homes, instead of allowing them to live in their own homes with home and community based care.Click to read the rest of the article.
Speaking at a Sept. 25 committee hearing on "Home and Community Based Care: Expanding Options for Long Term Care," panelists urged support of the Community Care Act (S. 799) that would give Medicaid beneficiaries the choice of either going to a nursing home or getting personal care attendant services in their own homes.
Bill sponsor Sen. Tom Harkin (D-Iowa) told the committee that "there is a Medicaid bias where two-thirds of the money goes to nursing homes and a third goes to community care."
He added that home and community based services (HCBS) would provide personal attendance services that allow people to live independently and fully participate in their communities, goals he said were part of the Americans With Disabilities Act that became law 17 years ago.
'Mandatory' Option
Although Iowa and other states have Medicaid waivers to offer HCBS, Harkin said there are "bureaucratic entanglements" for participating in the services, including a Medicaid spending cap and long waiting lists.
"It is time to move beyond the waivers and have broad-based community care," Harkin said.
The deputy secretary of the Vermont Agency of Human Services, director of the Iowa Department of Human Services, and the director of Montana Fair Housing echoed the request that Congress pass a law making HCBS a mandatory option offered under the Medicaid program.
"By making HCBS a mandatory benefit it would greatly reduce the institutional bias," said Mitchell La Plante, associate professor at the University of California, San Francisco, Department of Social and Behavioral Science.
Panel Urges Broader Coverage
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