Bruce gave me permission to post this. While it is geared towards New Yorkers, anyone can do this, especially if you have senators and congressfolks who have signed on to MiCASSA, but not the Community Choice Act.
This excellant information piece on the Community Choice Act (H.R.1621, and S. 799) comes from Bruce Darling He says:
It was pointed out that people might like some talking points for calling their Representative.
Below, I’ve written a piece about how the Community Choice Act would be beneficial for New Yorkers and the state itself. Some people might think that we don’t “need” the Community Choice Act because we are in New York State. Indeed, you might even get asked that question. Well here’s the (not so short) answer.
I think the impact on actual people is really important. Let me list those first.
The Community Choice Act levels the playing field and assures choice in the long term “care” system. Right now, institutional “care” is mandated by the federal government. States MUST pay for nursing facility care. The Community Choice Act doesn’t create a new mandate, but it expands the existing mandate so that people who would be eligible for placement in a facility could have the CHOICE to live in the community with supports. The Community Choice Act would require that states have a community-based option for people who would otherwise be placed in an institutional setting. Until we get the Community Choice Act passed, institutional “care” will remain the standard/norm. As other states have run into financial problems, they have cut community based services in order to maintain funding for nursing facilities because the institutions are REQUIRED under federal Medicaid law and community services are not.
Even look at the language that is used. Home and Community Based Services are often provided through WAIVERS where the state is asking if it can use money that is designated for institutional placement to pay for community based services. These waiver programs are capped and may run out of slots, meaning that people would need to go into a facility until a slot becomes available. We haven’t had much of this in New York, but it could easily become a problem here as the state expands the use of waivers.
The Community Choice Act includes assistance with the instrumental activities of daily living. New York does have an extensive long term care system, but it hasn’t effectively served individuals with Alzheimer’s disease and other dementias. Although at one time these individuals were served under the personal care program, that changed with a court case and the personal care program (including the consumer directed personal assistance program) don’t assist with instrumental activities of daily living and supports like “safety monitoring”. Even now, this group of people (who desperately need services) have EXTREMELY LIMITED options in New York. Consequently families get burnt out meeting the individual’s needs and the person ends up in a nursing facility.
The Community Choice Act includes a maintenance-of-effort requirement. This means that states can not diminish more enriched programs already being provided in the state. Again, as we face uncertain economic times, this would be particularly important in a state like New York which has a wide range of programs.
And the Community Choice Act will also benefit our state.
The Community Choice Act provides an enhanced Federal match for the five years before the services become permanent. With this enhanced match states which begin planning activities for changing their long term care systems and include Community-based Attendant Services and Supports in their State Plan would receive an additional 10% in federal matching funds. That means New York would get 60 cents on the dollar rather than just 50 cents. A dime doesn’t sound like much but on the scale we are talking, it’s good money. And its NEW money! We could definitely use that to balance our budget.
The Community Choice Act also provides an enhanced match (up to 90% Federal funding) for individuals whose costs exceed 150% of average nursing facility costs. Okay, that one sounds too much like blah blah blah, but it’s really cool. It helps both the state AND our community. The cost of serving some people is just really expensive. We were concerned that this group of people might get “left behind” in nursing facilities because there would be a financial incentive to keep them there. This provision of the Community Choice Act means that the federal government would pay a higher Medicaid match (up to 90% of the cost) to support these individuals in the community. A state like New York, which provides a significant personal care benefit (up to 24 hours per day), would get extra federal dollars to serve these people. More federal Medicaid matching funds… the state likes that. Back to us and the people we represent. We like this aspect of the legislation because it takes the heat off of people with more extensive support needs (who for years have been under fire for costing too much) and it because it helps level the financial playing field, it FREES OUR PEOPLE!
A word about cost. Your representative may express concern about a Congressional Budget Office “score” or cost estimate of MiCASSA, the previous version of this legislation. That score was WRONG!
Use this line and you sound like a policy wonk on Sunday morning television:
“The CBO score included too many people, including people with less significant disabilities who wouldn’t have been eligible for institutional care and people who wouldn’t be income eligible for Medicaid. The CBO score also included a bunch of other services costs that were NOT in the legislation. The actual cost would be much smaller than what the CBO estimated. There’s a study I can send you that discusses this issue in detail.”
Then call CDR, and we’ll send you the study so you can send it out.
If they persist with cost, or talk about the “woodwork effect”, I think its okay to be annoyed with them. When confronted with this I ask, “What’s the appropriate price tag for my mother’s freedom to live at home?” And by the way, the “woodwork effect” is actually “unmet need” and represents people who NEED these services and don’t have them. They have just argued why we need the Community Choice Act. We are NOT cockroaches.
Remember that March 17th through 28th is the Spring District Work Period.
Our representatives will be in our home districts. So you can call them locally or even meet with them to talk about CCA. Although the action alert focused on six representatives who were previous cosponsors who aren’t currently on the legislation, we wanted to make it easy. The real goal is to get ALL of our representatives signed on. If you are curious where other NYS Representatives stand on the Community Choice Act, I’ve listed them below.
Ackerman, Gary L.; New York, 5th ……………….. Never signed on to any version
Arcuri, Michael A.; New York, 24th ……………….. Never signed on to any version
Bishop, Timothy H.; New York, 1st ……………….. Never signed on to any version
Clarke, Yvette D.; New York, 11th ………………… Never signed on to any version
Crowley, Joseph; New York, 7th …………………… Never signed on to any version
Engel, Eliot L.; New York, 17th ……………………. Previous cosponsor, not signed on
Fossella, Vito; New York, 13th …………………….. Never signed on to any version
Gillibrand, Kirsten E.; New York, 20th ……………. Never signed on to any version
Hall, John J.; New York, 19th ………………………. Never signed on to any version
Higgins, Brian; New York, 27th …………………….. Never signed on to any version
Hinchey, Maurice D.; New York, 22nd ……………. Signed on 9/6/2007
Israel, Steve; New York, 2nd ……………………….. Never signed on to any version
King, Peter T.; New York, 3rd ………………………. Never signed on to any version
Kuhl, John R. “Randy”; New York, 29th ………….. Signed on 3/3/2008
Lowey, Nita M.; New York, 18th …………………… Signed on 11/15/2007
Maloney, Carolyn B.; New York, 14th ……………. Signed on 2/25/2008
McCarthy, Carolyn; New York, 4th ………………… Signed on 10/9/2007
McHugh, John M.; New York, 23rd ……………….. Previous cosponsor, not signed on
McNulty, Michael R.; New York, 21st ……………. Previous cosponsor, not signed on
Meeks, Gregory W.; New York, 6th ………………. Never signed on to any version
Nadler, Jerrold; New York, 8th ……………………… Signed on 10/15/2007
Rangel, Charles B.; New York, 15th ………………. Signed on 10/25/2007
Reynolds, Thomas M.; New York, 26th ………….. Never signed on to any version
Serrano, Jose E.; New York, 16th …………………. Previous cosponsor, not signed on
Slaughter, Louise McIntosh; New York, 28th …… Previous cosponsor, not signed on
Towns, Edolphus; New York, 10th ………………… Signed on 1/15/2008
Velazquez, Nydia M.; New York, 12th ……………. Previous cosponsor, not signed on
Walsh, James T.; New York, 25th…………………. Signed on 5/14/2007
Weiner, Anthony D.; New York, 9th ………………. Never signed on to any version
In case you are wondering… both of our state’s Senators are cosponsors of the Senate version.
Senator Schumer was EXTREMELY SUPPORTIVE at the Senate Finance Committee Hearing and really deserves our gratitude.
Good luck with those calls and visits!
Bruce Darling
NYS ADAPT
You can also have people contact their representatives and send them a message about the Community Choice Act by using CDR’s CapWiz system. http://capwiz.com/rochestercdr/issues/alert/?alertid=10155901&type=CO&show_alert=1
