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 nor 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 Inclusion, 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.
Adopted by ANCOR Board of Directors on February 7, 2003; revision adopted
March 15, 2003.
