Come Out to Support Home and Community Based Long-term Care Services!!!

Cross-posted as it is a topic of importance to our members and partners

NH Elder Rights Coalition

Contact: Carolyn A. Virtue

Telephone:(603) 848-7345

May 15, 2015

Follow The Law!

PRESS CONFERENCE:Tuesday, May 19th, 2015 at 9:00 AM

The NH Elder Rights Coalition (ERC) will be hosting a press conference onTuesday, May 19th, 2015 at 9:00 AMin theLegislative Office Building Lobby, 33 North State Street, Concord, NH.

The ERC members are concerned about certain legislative and budget activities and the detrimental impact upon our frail elderly and adult disabled citizens who choose to utilize community based care in lieu of nursing home placement.

On May 5th, the Governor announced a plan to provide "nursing homes with an immediate payment totaling $3.9 million representing the total that they would have received through a rate increase for Fiscal Year 2014, while using alarger-than-expected surplusfrom the Choices for Independencefor the Elderly and Chronically Ill (CFI) program for 2014 and 2015."

The Community response is this-the "surplus" from the Choices for Independence (CFI) program is not "unexpected," nor is it a surplus. A surplus is excess above what is needed. The CFI "surplus" was needed-instead it was not used for what it was appropriated for. This is not a "surplus," it is a failure to carry out the home and community-based carepolicy of this State.This "surplus" should not belarger than expected.The Elder Rights Coalition and others have repeatedly brought these issues to the attention of State policymakers, including the Governor, the Commissioner, and both chambers of the Legislature.

The "surplus" exists not because people do not need the care or because the system is exceptionally efficient, but rather it is there because people cannot access the care they need. System failure is not a "surplus." Many CFI enrollees go without authorized services because there is no one to provide services. New Hampshire's long-termcare infrastructure has lost and continues to lose manyproviders because of inadequate reimbursement rates. Long-term care providers that remain often cannot get enough people to work at the very low wage which must be paid under State reimbursement rates. Under the Affordable Care Act, many providers have been forced to reduce the hours of the staff they have, from full-time to part-time, because they cannot afford the insurance mandate under the current rates. Others have provided health insurance at the added expense, but do so under significant financial risk.

This access issue, for the elderly and adult disabled populations, is not an issue for Medicaid recipients only. Destroy the long-term care infrastructure for the Medicaid recipient and the State destroys it for everyone. Figures nationally show that Medicaid pays 62% of all long-termcare spending (21% out-of-pocket; 12% other private; 5% other public). As a result, Medicaid is the primary driver in long-term care. If we destroy the option of lower cost community-based care, more people will be forced into more costly, institutional alternatives and they will spend down their assets more quickly and enter the public system sooner.

The State had the opportunity and failed in rebalancing long-term care spending away from costly institutional care. As a participant in the Federal Balancing Incentive Program (BIP), New Hampshire was required to increase the share of Medicaid home and community-based long- term services and supports expenditures to demonstrate a shift away from costly institutional care. An enhanced federal share for community-based services was the incentive. Despite a queue of waiting applicants, community-based spending went down. Moreover, the State has submitted a "sustainability plan" for this performance.

Applicants are waiting months and months for eligibility determinations, applicants have gone without care, waiting for the services and supports needed to stabilize their lives. Unable to wait any longer, applicants instead enter nursing homes for care or, sadly, they die. Neither institutionalization nor death is "surplus."

When providers have not been paid in accordance with applicable laws, money owed and not paid is not a "surplus." Where the State has violated payment methodology statutes and/or ignored payment rates set in the State budget, restitution should be made to the impacted providers before a surplus is declared. The survival of our community based care system is dependent upon a sound provider system.

There is a simple solution ...FOLLOW THE LAW!

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