Fw: HCBS Reductions? What Advocates Can Do

[Guest guest]

This bulletin is something to pay attention to...

Ellen

Ellen Garber Bronfeld

egskb@...

HCBS Reductions? What Advocates Can Do

stevegoldada@...

HCBS Reductions? What Advocates Can Do.

Information Bulletin # 324 (9/2010).

Has your State threatened to cut back or reduce Medicaid-funded home and

community-based services ? Has your State actually reduced HCBS Medicaid

services? What impact will these reductions have on people remaining in

the community?

What can advocates do about these reductions? What should CMS do?

In addition to how the ADA and integration will be impacted if the

reductions are implemented, another handle is the Medicaid statute itself?

To receive federal Medicaid funds, a State must have a written state plan

that has been submitted to and approved by the Secretary of the U.S. Dept

of Health and Human Services. CMS posts state MA plans and amendments at

www.cms.gov/medicaid/stateplans/

State MA plans must be amended to reflect changes in federal policy, Court

decisions, and " material changes " in policy, state law, or operation of

the program. 42 Code of Federal Regulations ' 430.12. Proposed State plan

amendments must be submitted to the CMS regional office which must

" consult with central office staff on questions regarding application of

Federal policy. " 42 C.F.R ' 430.14. CMS must make a " determination as to

whether State plans (including plan amendments and administrative practice

under the plans) originally meet or continue to meet the requirements for

approval are based on relevant Federal statutes [including the ADA] and

regulations. " 42 C.F.R ' 430.15.

Hmmm. The United States Supreme Court in 1999 in the Olmstead decision

found that unnecessary segregation in institutions violated the ADA - sure

sounds like a Court decision. CMS has issued several " Dear State Medicaid

Director " letters telling states that their State plans must comply with

both the Medicaid and the ADA statutes, and these letters sure look like

federal policy. Therefore, when your State proposes reductions in HCBS,

advocates must analyze what impact the reductions will have on causing or

preventing unnecessary segregation. Advocates must ensure that CMS will

disapprove the amendments based on Olmstead and its own policy requiring

compliance with the ADA.

Advocates for older and younger Americans with disabilities should:

1. Find out if your Governor has reviewed the proposed amendments, a

Medicaid requirement for State plan amendments?

2. Contact your regional CMS officials and obtain copies of documents

between your State and CMS regarding the amendment.

3. Unbelievably, there is no requirement for public hearing or even an

opportunity for public comment. Nevertheless, each State has a Medical

Care Advisory Committee that reviews and comments on proposed changes.

Get to them and make your voices heard.

4. Send your comments to the CMS regional office AND to the Secretary of

HHS. Tell them how the amendments will impact on people unnecessarily

being institutionalized.

Thanks very much to the National Health Law Program for their invaluable

suggestions and observations, many of which are the basis for and

incorporated in this Information Bulletin.

Steve Gold, The Disability Odyssey continues

Back issues of other Information Bulletins are available online at

http://www.stevegoldada.com

with a searchable Archive at this site divided into different subjects.

As of August, 2010, Information Bulletins will also be posted on my blog

located at http://stevegoldada.blogspot.com/

To contact Steve Gold directly, write to stevegoldada@... or call

215-627-7100.

----------------------------------------------------------------

Visit

http://chance.unh.edu

for information on home ownership for people with disabilities.

Housing & Disability Issues is a moderated informational listserv.

It consists of disability issues concerning but not limited to housing.

Since this is not a discussion list, you will not be able to send content

directly to the list. However, if you have information that you feel is

relevant, please send it to:

drv@ unh.edu

If appropriate, we will post it to the list.

To subscribe to this list, send an email to:

HOUSING.DISABILITY.ISSUES-request@...

with the word " subscribe " in the subject line.