Program to Help Those With Special Needs Stay Out of Nursing Homes Included in Health Care Reform Bill

The Medicaid program has long had a bias in favor of housing those with special needs and the elderly in nursing homes. Many people end up in institutions when all they really need is the help of an attendant in their home. An amendment to the Senate Finance Committee's health care reform proposal encourages states to offer greater access to in-home attendant services for people with disabilities. The amendment, which incorporates many elements of the Community Choice Act, passed its first legislative hurdle when Finance Committee Chairman Sen. Max Baucus (D-MT) accepted it as part of the Chairman's Markup of the committee's health reform bill.

The amendment, which was proposed by Sen. Charles Schumer (D-NY), is called the Community First Choice Option, and it serves as a less stringent substitute for the Community Choice Act, which appears to have stalled in committee. As currently written, the Community First Choice Option would provide partial federal Medicaid reimbursement to states that establish community support programs for people with disabilities. The programs must be designed for people with disabilities who require an institutional level of care, thus offering them the chance to leave facilities and institutions for their own homes and communities with appropriate services and supports. Importantly, the program would not allow caps on the number of individuals served or allow waiting lists for services.

The Community First Choice Option is not as comprehensive as the Community Choice Act, and unlike the Act, it does not require states to develop community support programs. Furthermore, the amendment funds the new programs only for five years. However, given the Community Choice Act's uncertain prospects, advocacy groups are viewing the Community First Choice Option as a very important step forward for people with disabilities seeking increased care in their communities, and provides much-needed support to get these important programs off the ground.

To read about the Community First Choice Option on the National Council for Independent Living's Web site, click here.