Community Long-Term Care
FUNDING COMMUNITY BASED LONG-TERM CARE
House Bill 1/Senate Bill 1 (appropriations issue)
Position: SUPPORT INCREASED FUNDING
Outcome: FUNDING INCREASED
Background and Purpose: Some people living with MS need long-term care services, such as assistance getting in and out of bed, dressing, preparing meals, or housekeeping. Most people want these services in their own home or other community setting, rather than in a nursing home.
Unfortunately, in Texas people still don’t have real choice when it comes to long term care. Currently over 110,000 people with disabilities and older Texans who want to remain in their own homes and communities are on waiting lists for community long-term services. Meanwhile, nearly 25% of nursing home beds are empty. The demand is for community services, not institutional services – and the proof is in the waiting lists. This is where legislators should invest available funds.
The National MS Society supported increasing funding for community long term services by 20% as part of a plan to eliminate the waiting list in 10 years. We believe this goal is realistic given the amount of funds available.
Legislators chose to increase funding by 10% as part of a plan to eliminate the waiting lists in 20 years. The National MS Society will continue to advocate for increased funding to reduce the waiting lists.
NATIONAL MS SOCIETY Action:
1. Advocates made personal visits
2. Staff visited all legislators on key committees prior to votes
3. Provided oral and written testimony in House Appropriations and Senate Finance Committees
4. Initiated call to action prior to committee votes
Partners: AARP; Coalition of Texans with Disabilities; Disability Policy Consortium
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MONEY FOLLOWS THE PERSON
House Bill 1867 (Naishtat/Zaffirini)
Position: FOR
Outcome: PASSED
Background and Purpose: In Texas, people who live in nursing homes can choose to return to their own home or move to an assisted living facility, using the same Medicaid funds already used in the nursing home. This option was made possible in 2001 through a temporary provision in the budget. This policy proved quite successful. Approximately 7,000 people have used this option to return to the community. In most cases, nursing home care costs more than providing personal assistance and other long-term services in the community. In 2003, legislators again approved this temporary measure but chose not to make it a permanent option by putting it in statute.
The intent of House Bill 1867 is to make sure this option continues to be available by changing the policy from a temporary budget rider that must be renewed every legislative session to a permanent provision in law.
NATIONAL MS SOCIETY Action:
1. Advocates made personal visits
2. Staff visited all legislators on key committees prior to votes
3. Provided oral and written testimony in the House Human Services Committee and Senate Health and Human Services Committee
4. Initiated call to action prior to committee votes
Partners: AARP; Coalition of Texans with Disabilities; Disability Policy Consortium
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FLEXIBILITY FOR LONG-TERM CARE COSTS
Senate Bill 626 (Zaffirini)
Position: FOR
Outcome: PASSED
Background and Purpose: As described above, people who live in nursing homes can choose to return to their own home or move to an assisted living facility, using the same Medicaid funds already used in the nursing home. The state adopted individual cost ceilings for this program, equal to the cost of serving an individual in a nursing home, to ensure that the program would be a cost-neutral alternative to nursing home care. Due to the nature of the disease, people with MS are likely to have variation in their health care needs over time.
Senate Bill 626 will permit the costs of those who have returned to the community to vary somewhat (up to 133.3 percent of an individual’s cost limit). This will prevent people in this program whose healthcare needs change from month to month from being forced to return to a nursing home. The four year history of this program shows that no one has ever exceeded 133% of their nursing home costs. This increase in the cost ceiling will not effect the “cost neutral” status of the program since most people have costs well below their previous nursing home expenses.
NATIONAL MS SOCIETY Action:
1. Advocates made personal visits
2. Staff visited members of key committees prior to votes
3. Provided oral and written testimony in House Human Services and Senate Health and Human Services committees
4. Initiated call to action prior to committee votes
Partners: AARP; Coalition of Texans with Disabilities; Disability Policy Consortium