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REAL Medicaid Reform... NOT arbitrary Medicaid cuts!

ADAPT has identified proposals that contain Medicaid spending while supporting our right to live in the most integrated setting and control our lives:

Expand the use of community-based services. Studies have demonstrated that by reducing the over-reliance on institutions and nursing facilities and shifting toward more cost-effective community-based services, states can contain Medicaid spending. Despite the growing body of evidence showing that community-based services are more cost effective, the federal government still allows states to continue their wasteful, institutionally-biased practices.

Demedicalize services. By reducing the reliance on costly medical personnel to provide assistance by allowing attendants to perform these tasks, states could use the same amount of Medicaid funding to support more seniors and people with disabilities living in their own homes. Changes in state Nurse Practices Acts could save millions of Medicaid dollars. Many of the long term services that are widely perceived as “medical” become a basic part of daily life to a person with disabilities. States continue to require that medical personnel provide such services, unnecessarily increasing Medicaid’s costs.

Expand consumer directed service options. By empowering people to manage their own services and reducing the need for administrative overhead, states can also reduce Medicaid expenditures. Many seniors and people with disabilities can manage their services and supervise the people providing the direct care, reducing the need for agencies to provide supervisory and administrative supports like training and scheduling.

Reorganize Medicaid services to eliminate wasteful bureaucracy. The current system wastefully organizes services based on diagnosis and age even though people may have the same functional needs. By organizing services based on functional needs states can eliminate redundant and needlessly expensive bureaucracies and reduce Medicaid expenditures. A system based on functional needs also eliminates gaps in services and makes services easier to access, reducing the need for professional assistance in navigating the system we currently have in place.

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