Health Care Reform Long Term Services and Supports Information
October 7, 2009
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In the battle for health care reform the inclusion of long term supports and services are important to individuals with disabilities and their families. Below is a brief summary of both the Community First Choice Option and the CLASS Act as well as materials and resources avaliable for download for your use and information.
What is the Community First Choice (CFC) Option?
The CFC option was proposed by Senator Tom Harkin (D-IA), now Chair of the HELP Committee, as a way to get the key provisions of the Community Choice Act in the health care reform bill. The option would encourage states to provide Medicaid home and community based attendant services (rather than require them as the CCA would do). The core elements of the Community Choice Act (found in Section 101 of the bill) would be structured as an option for states to include in their Medicaid State Plans. The CFC Option would provide individuals with disabilities who are eligible for nursing homes and other institutional settings with options to receive community-based services. CFC would support the Olmstead decision by giving people the choice to leave facilities and institutions for their own homes and communities with appropriate, cost effective services and supports. It would also help address state waiting lists for services by providing access to a community-based benefit within Medicaid. The option would not allow caps on the number of individuals served, nor allow waiting lists for these services. A significant enhanced FMAP would be provided, depending on cost, to encourage states to select this option. The CFC option would be a major step in helping to end Medicaid's institutional bias.
The CFC Option is included in the Senate Finance Committee's health care reform bill. However, unfortunately, several governors are expressing their concerns about any expansion of Medicaid.
What is the CLASS plan?
The Class Act is a provision in the Senate HELP Committee bill that would create a national voluntary long term care insurance program. It was developed to help people better prepare for their long term care needs and to help take pressure off of the Medicaid program.
The CLASS Plan is in the Health, Education, Labor and Pensions (HELP) Committee's version of the health care reform bill. It has also gained approval from the House Energy and Commerce Committee and is supported by the Obama Administration.
Unfortunately, the insurance industry has recently launched a full scale attack on the CLASS plan (despite the fact that it will reduce the federal deficit by $58 billion). According to the American Council of Life Insurers, the CLASS Act will not adequately protect Americans who are in need of long term care, citing the high costs of nursing home care and round-the-clock home health care services as evidence.
By focusing on these extreme ends of long term care, the industry is mischaracterizing the typical needs of most people with disabilities and older Americans. What they most need is some assistance with things like getting up the stairs or getting dressed so that they can stay at home and not enter nursing homes or obtain full time care before they truly need it. The CLASS plan's cash benefit of about $27,000 per year (depending on functional needs) can go a long way to meeting this need by paying for things like ramps and railings or a few hours a day of a home health worker.
