Sen. Chuck Schumer (D-NY) introduced a bill in Congress that’s designed to ensure that Medicaid-eligible people who are aged or have disabilities can receive their necessary services out in the community through the Medicaid Home and Community Based Services program (HCBS). Aging in Place is what it’s all about. The bill is S-2427 and here it is. The bill has been referred to the Senate’s Committee on Health, Education, Labor, and Pensions.
Sections 2 and 3 state the problem succinctly: “(2) While Congress expected that the [Americans With Disabilities Act of 1990] ADA’s integration mandate would be interpreted in a manner that ensures that individuals who are eligible for institutional placement are able to exercise a right to community-based long-term services and supports, that expectation has not been fulfilled. (3) The holdings of the Supreme Court in Olmstead v. L.C., 527 U.S. 581 (1999), and companion cases, have clearly articulated that individuals with disabilities have a civil right under the ADA to participate in society as equal citizens. However, many States still do not provide sufficient community-based long-term services and supports to individuals with disabilities to end segregation in institutions.”
State Medicaid Programs to date may choose the extent to which they offer home and community-based services. While the percentage of dollars being spent on HCBS has been growing, waiting lists in some states are tremendous. In New Jersey, an eligible person often has to really fight to get sufficient hours of home health aide services. ALso, in New Jersey the MLTSS Medicaid HCBS Program will not provide 24/7 home health care. ABD_2016_Overview
Coordinating care in the community is clearly more complicated than arranging for care in a one-stop-shopping nursing home setting. There can be a need for transportation to shopping and medical appointments, prescription delivery, grocery delivery, home health aides, meals on wheels, housekeeping, and more. Nevertheless, the federal government has been promoting aging-in-place initiatives for years, such as NORC (Naturally Occurring Retirement Communities). S-2427 confirms the proposition that individuals have a RIGHT to receive their care in the least restrictive setting available, which is what Olmstead was all about.
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