Thursday, August 28, 2014

Community care for the old and disabled: Koch-heads say no!

Posted By on Thu, Aug 28, 2014 at 9:43 AM

click to enlarge ADVOCACY: A group came to support the community option wearting this button.
  • ADVOCACY: A group came to support the community option wearting this button.
A huge crowd is on hand at a legislative subcommittee this morning for a discussion of the state's development of a Community First Choice Option program. It's simple: It provides money (mostly federal) for home- and community-based services for people with a range of disabilities as an alternative to more expensive nursing home and other institutional care.

 It is specifically intended for those individuals who, without services and supports, would be unable to care for themselves at home and would need to enter a nursing home or other institutional setting. The program will be available to all who are eligible – no more long waiting lists of people who need help!

Sounds great, right? Wrong if you're a follower of the Koch boys and their interlocking network of political groups such as Americans for Prosperity and the legislators who slavishly follow them — Meeks boys, Bell, etc.

Here's all you need to know about the Koch objection: It's part of Obamacare. It will cost money. The idea has broad support, particularly from advocates for the disabled on long waiting lists for  the services. It could be the legislature's next big Obamacare battle.

Coincidentally, I note this article circulated today about the "implosion" of the Republican Party's all-out battle against Obamacare. It's losing steam because Obamacare is providing demonstrable benefits to millions and producing promised efficiency in medical care delivery. Of course, Arkansas is always on the back end of societal bends toward justice so I expect no letup from the bitter-enders in the Arkansas legislature.

Notes from Benji Hardy:

Big turnout. Most everyone is wearing these stickers. Mostly families. The mood is intense When Republican Rep. Nate Bell asked a not-very-friendly question about federal spending, you could feel the temperature drop precipitously. You can tell people feel very passionately about this (obviously — thousands of people have been on a waiting list for years).

The agenda included a long list of organizations and individuals scheduled to speak for the program and the "against" heading says "to be determined." 

John Selig and DHS officials were up first, to endorse it. Selig: We're not taking anything from facilities. "It's just additional funding from the federal government. ... What CFCO does in a nutshell is...if you serve everybody who is eligible [in the state, to receive services] we'll increase your match by 6 percent". 

Selig says it would save the state $365 million over the next 12 years (that's $30 million a year or a savings of about $10 per person in the state per year). The savings come from the increased federal reimbursement and a reduction in the state's share if the state commits to serving all in need. He also says that if the state doesn't act to serve the thousands of people we currently have on our waiting list, we risk a lawsuit. He emphasized the savings are from state general revenues, not in federal money.

Bell: "I have a couple of daughters, and they occasionally go shopping. They'll come home and tell me how much money they saved me by buying things as a discount. And that's sort of what I'm hearing here today....what's the net cost to taxpayers?"

Said the head of the DHS agency that oversees this: "Citizens of Arkansas are going to pay in federal taxes. If we don't take advantage of it, those taxes are going to go to other states."

That didn't satisfy Bell, who continued to press for the state's net cost. Selig said the state will come out ahead.

Selig: One of big misunderstandings is that this is expansion..."people are worried 'what if it gets out of control?'" But, Selig says, this doesn't expand an entitlement...it just allows more federal funding to flow to pay for disabled people we aren't currently serving.

Some figures from a handout: 2800 developmentally disabled people currently on a waitlist. Currently, over 14,000 people are currently served by "home and community based waivers": 4,100 developmentally disabled, 7,300 elderly persons, 2,700 physically disabled adults. CFCO would provide more funds, allowing expansion of waiver cap.

Note that opposition is not strictly from those who oppose the federal spending that will flow to helping disabled people. Existing institutions fear being diminished, particularly advocates for the human development centers as a better treatment option for severely disabled. There are also peripheral services that fear a loss of support, such as Abilities Unlimited, cited by Bruce Maloch.

DHS said the CFCO program is just one of many in a wave of changes.

The Disability Rights Center presented this statement in support of the program.

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