Alliance between disability advocates, Bush administration officials helped develop program to encourage home care for Medicaid beneficiaries

Sep 20 2006

NPR's "Morning Edition" on Friday examined how an "unlikely alliance" between a group of disability advocates and Bush administration officials resulted in a major change to federal funding for long-term care of Medicaid beneficiaries (Shapiro, "Morning Edition," NPR, 9/15).

HHS in July announced plans to award $1.75 billion in grants to states under a five-year program that would allow Medicaid beneficiaries to reside in their homes or in their communities, rather than in nursing homes.

Under the program, states for one year will receive a higher rate of federal Medicaid matching funds for beneficiaries whom states move from nursing homes into their own homes or communities.

States also can use the funds to make modifications to the homes of Medicaid beneficiaries to allow their continued residence and to provide respites for family caregivers.

States must agree to continue to provide Medicaid beneficiaries with home or community care for at least one year after the higher rate of federal Medicaid matching funds ends.

HHS said that the program could reduce costs because nursing home care is more expensive than home or community care (Kaiser Daily Health Policy Report, 7/27).

According to NPR, the relationship began in 2002 when 200 protestors in wheelchairs blocked traffic at an intersection near the White House and started discussions with Mark McClellan, current CMS administrator and a member of the president's Council of Economic Advisers at the time.

Since his appointment to CMS, McClellan met four times annually with Bob Kafka, executive director of the American Disabled for Attendant Programs Today.

Although some health care and disability advocates criticize some of the program's provisions, such as one allowing states to change benefits and charge copayments, McClellan said the Money Follows the Person program is the "biggest change in long-term financing in decades" and that his work with ADAPT is one of his proudest accomplishments from his tenure.

According to NPR, 30 states have told McClellan that they would like to participate in the program, which began accepting grant applications two weeks ago.

The NPR segment includes comments from Kafka and McClellan ("Morning Edition," NPR, 9/15).

The complete segment is available online in RealPlayer. Expanded NPR coverage, including a transcript of the segment, additional audio from ADAPT members and photos, is available online.