The Medicaid program plays a critical role in providing
necessary supports and services to 47 million Americans in 2002, including 11
million individuals with disabilities - 7 million of whom are under age 65.
Medicaid is the primary financing mechanism for health and long-term services
for people with disabilities. Through its Federal/State partnership in the financing
and delivery of services, Medicaid is also the major funding source for reimbursing
providers of long-term supports and services to people with mental retardation
and other disabilities. It is ANCOR's top priority to advocate for protecting
and strengthening Medicaid as the critical safety net for people with disabilities.
ANCOR believes that the following overarching principles
should guide any Medicaid reform:
The Federal government must maintain its historic role
financing the safety net for people with mental retardation and other disabilities
and must assure adequate reimbursement rates for long-term supports and
services.
Medicaid financing must not be cut not should reforms be
used as a means of balancing the Federal budget.
Any Medicaid reforms should be driven by the goals of enhanced
coverage, quality, and adequate reimbursements; increased efficiency; decreased
waste and fraud; and the delivery of services that meets the individual
needs of people with disabilities.
Neither people with disabilities nor their providers should
bear the burden of efforts to contain the costs of Medicaid, nor should
savings be exacted from Medicaid that place individuals or providers at
undue risk.
Medicaid waivers should not be used to diminish Federal
protections for individuals or providers.
Medicaid financing must not be cut nor should reforms be
used as a means of balancing state budgets.
In addition, ANCOR adheres to the following principles
regarding Medicaid reform.
Sound Infrastructure with Adequate Provider and
Workforce Capacities
Federal Medicaid policy must be based upon sound service
and support infrastructures that include: (a) coordination of natural, generic
and specialized supports as needed and desired by individuals; (b) adequate
provider capacity; and (c) a stable, quality, and competitively compensated
workforce.
Ensure Federal Entitlement with Comprehensive Benefits,
Adequate Financing and Quality
The Federal entitlement to Medicaid must be maintained,
guaranteeing a Federal definition of disability and Federal requirements
for eligibility, timely access to supports and services, quality standards,
individual and provider protections, and a private right to action.
Any revisions in current Federal law must maintain the
vital Federal role that Medicaid now plays in financing supports and services
for individuals with mental retardation and other disabilities.
The delivery of long-term supports and services must be
closely coordinated with the provision of primary and preventive health
care services to individuals with mental retardation and other disabilities.
Financing long-term supports and services for individuals
with mental retardation and other disabilities must remain a distinct, identifiable
role of the Federal-State Medicaid program in every state.
Federal Medicaid policy must ensure the safety and health
of individuals with mental retardation and other disabilities, including
adequate reimbursements based on actual costs to ensure that sufficient
funding for wages are available; cover the costs of quality enhancement,
recruitment, retention and training of a quality workforce; and Federal
oversight.
Individuals with disabilities must not be burdened with
inequitable and disproportionate costs that limit their access to supports
and services and any cost sharing must preserve the individual's ability
to meet the expenses of their other life necessities.
Individual Supports with Active Individual and Provider
Involvement
Long-term supports and services for individuals with mental
retardation and other disabilities must be tailored to each individual's
unique needs.
Individuals with disabilities and their families are essential
voices in determining the supports and services an individual receives.
Providers (and other stakeholders) must be guaranteed meaningful,
active participation in the design, negotiation, implementation, monitoring
and evaluation of Medicaid long-term supports and services.
Community Inclusions, Investment and Maximizing
of Resources
Medicaid must promote full implementation of the Olmstead
decision, self-sufficiency, broad opportunities for community inclusion,
and the exercise of full citizenship rights by individuals with mental retardation
and other disabilities.
The institutional bias in Federal Medicaid policy and financing
must be eliminated with home and community based services authorized as
a mandatory part of each state's plan and adequate financing to support
this policy emphasis.
Medicaid must be utilized to address the growing backlog
of unmet service needs and eliminate waiting lists.
Any reforms that produce Medicaid savings in long-term supports
and services must be reinvested to meet the unmet needs of individuals with
mental retardation and other disabilities.
States must maximize their state resources and increase
the proportion of total Medicaid expenditures devoted to community options.
