Congress considers alternatives to long-term care

Monday, June 30, 2003

WASHINGTON - Congress is considering legislation that would fund community-based attendant services programs as alternatives to institutional care.

The Medicaid Community-based Attendant Services and Supports Act of 2003 (MiCASSA) offers a choice in long-term care for individuals eligible for nursing facility services.

For HME companies, the consequences of MiCASSA are plain: Fewer patients in facility-based care means more home care.

“It’s the No. 1 consumer issue,” said Dave Williams, director of government relations at Invacare. “Our industry should get behind (MiCASSA) 1,000%.”

The bill would allow individuals to choose a level of attendant care, depending on the assistance needed, without being placed in a nursing home or other institutional care facility. The outcome would ultimately bring down state costs for nursing home care and place individuals back into society, while receiving professional outside care.

Williams said over the past decade, Medicaid spending for nursing home care has risen 49%. “The problem is that people are living in a nursing home that don’t need to be there. They just need help,” he said.

The average nursing home costs $64,000 per person annually. With MiCASSA in place, Williams said, states could save approximately $21,000 for every person transitioned from a facility.

MiCASSA would put in place a service and support system to assist in activities ranging from eating, bathing and dressing to managing finances and health-related functions. It also covers transition costs, such as rent and utility deposits, from an institutional care facility to a home setting.

Also outlined is an enhanced match - up to 90% federal funding - for individuals whose costs exceed 150% of the average nursing home costs. If the bill becomes law, additional matches of around 10% would be made available for states which change over their long-term care systems to MiCASSA. HME