Slog

News & Arts

Monday, September 28, 2009

Health The Cantwell Amendments: Community Care

Posted by Eli Sanders on Mon, Sep 28, 2009 at 1:35 PM

DerrickT via Creative Commons

It costs Medicaid about $70,000 a year to keep an elderly American in a nursing home—and often, by the time that elderly American is eligible for a Medicaid-funded nursing home bed, his or her retirement money has already been exhausted.

What if there were a type of elderly care that saved money for both consumers and Medicaid—a program that kept dollars in the government's pockets and helped seniors hang onto their savings, all while keeping people out of nursing homes when they didn't need to be in them?

In fact, there is such a thing. Washington State has been a model in pushing it, and Senator Maria Cantwell has offered the idea as another amendment to the Baucus Bill. It's amendment #C1, to be specific, and its title, though wonky, pretty much explains the idea: Incentives for States to Offer Home and Community Based Services (HCBS) as a Long-Term Care Alternative to Nursing Homes for the Medicaid Population.

Essentially, this amendment would get the federal government into the business of providing matching funds to states that offer "community care" to the elderly—services like fall-prevention classes, nutrition classes, exercise classes, and occasional home health care visits for people for people who need them (for example, a nurse to come and visit a couple times a month to monitor a person's diabetes medications).

“It’s a quality of life issue," said Cantwell spokesperson Ciaran Clayton. "I think more people would rather get care at home, or through their primary care doctor, or at their community center, than in a nursing home.”

No doubt true, and the cost savings for Medicaid from paying for fewer nursing home beds could be significant. That's why Cantwell introduced the amendment in the Senate Finance Committee, and why the committee chairman, Democrat Max Baucus of Montana, has already accepted the idea into the latest draft of his bill.

The federal matching funds would be financed by a 1.45% surtax on short-term capital gains. Full summary of the proposed amendment in the jump.

Cantwell Amendment #C1 to America’s Healthy Future Act of 2009

Short Title: Incentives for States to Offer Home and Community Based Services (HCBS) as a Long-Term Care Alternative to Nursing Homes for the Medicaid Population.

Description of Amendment: This amendment provides a modest, targeted, 5-year-limited increase in federal matching payments (FMAP) for Medicaid covered home and community based services (HBCS). This FMAP increase will be available only to those states willing to undertake certain structural reforms in their Medicaid long-term care programs that have been proven to increase nursing home diversions and access to HCBS. The targeted FMAP increase is offered on a scale based upon the percentage of a state’s long-term care that is offered through HCBS, with lower FMAP increases going to states that will need to make fewer reforms.

This amendment also includes provisions which make it easier for states to provide HCBS under existing Medicaid waiver and option authorities. States will be able to offer HCBS through state plan amendments for targeted populations, including HCBS populations up to 300 percent of the maximum Supplemental Security Income payment.

This amendment reflects S. 1256, the Home and Community Balanced Incentives Act of 2009.

Offset: A 1.45% surtax on short-term capital gains.

Comments (8) RSS

Oldest First Unregistered On Registered On Add a comment

So basically, have day traders pay for home day care for the elderly they defraud?

Sounds fair to me.

Still, I'd rather have single payer national health care. It would be way cheaper and more effective.

Posted by Will in Seattle

on September 28, 2009 at 1:46 PM

death panels would be even cheaper.

man i'm in a foul mood today...

Posted by Max Solomon on September 28, 2009 at 1:49 PM

Look at Maria, getting in line with her constituency. I like to feel my constant e-mails made a l'il difference.

Posted by meowmeowkitty on September 28, 2009 at 2:02 PM

Eli, do you have a hard on over Maria Cantwell? Doesn't she have a PR office? Why are you regurgitating her shitty policies? Fuck Maria Cantwell and the health insurance industry who she whores for.

Posted by Maria Cantwell is not on our side on September 28, 2009 at 2:15 PM

5 Comment Pulled (Spam) Comment Policy

OMGDEATHPANELSBLARGHARGOBAMAHITLERMARXISMFLUBFLUBSPLUTTTT

Posted by matt! on September 28, 2009 at 2:33 PM

Death panels during the donut hole would mean our state budget would be in the black, cause we have no income tax in this state but we do have an estate tax.

Besides, maybe we wouldn't have to pay for the Billionaires Tunnel then ...

Posted by Will in Seattle

on September 28, 2009 at 3:35 PM

I have a friend who lived on her own until age 82 when she had a stroke. Mentally she's 100% there but she needs a wheelchair, help getting to the bathroom, etc., so she can't live on her own. She's in a Medicaid-funded place now because living in a private assisted-care facility burned through the $300,000 of retirement savings she still had (plus whatever $ she got for her house) in six years. I mean, Jesus.

Posted by this guy I know in Spokane on September 28, 2009 at 11:19 PM