Public Policy Capitol Hill Days, OAA, Medicare Option, & HCBS

April 23, 2016

As NADSA members prepare for the May 16th & 17th Public Policy Capitol Hill Days, it is helpful to keep in mind that despite the Presidential primary activities distracting from reporting of Congressional actions, there has been significant activity in both the House of Representatives and the United States Senate.

On March 21st the House amended and passed S.192, the long-awaited reauthorization of the Older Americans Act, which the Senate had passed in July 2015. The Senate and the President have concurred with the House amendments, thereby comple4ting a 6-year effort for reauthorization. NADSA worked within the Leadership Council of Aging Organizations (LCAO) to support reauthorization of the OAA.

The critical key to House passage was removal of the open-ended appropriations language that had been in the act since its inception in 1965. That language has been replaced with specific appropriation amounts, as is the case with nearly all other legislation. An increase of 6.777% over three years was included with this change. The reauthorization extends through 2019 and contains at least two provisions of importance to ADS.

First, the bill redefines Aging and Disability Resource Centers (ADRC) to emphasize Home and Community Based Services (HCBS). The bill also directs ADRCs to better cooperate and coordinate with Area Agencies on Aging (AAA) to provide HCBS information to individuals who are residing in, or at risk of residing in, institutional facilities.

Second, S.192 requires the Administration on Aging (AOA) to provide information and technical assistance to states, AAAs, and service providers, in collaboration with relevant federal agencies, on delivering efficient person-centered transportation services, including across geographic boundaries.

One of the messages NADSA carried to the House on Capitol Hill Days in 2015 was to have a House Bill introduced as a companion to Senator Chuck Grassley’s S.704, the Community Based Independence for Seniors Act, which would create a Medicare SNP demonstration to include adult day services. ADS friends Rep. Linda Sanchez (D-CA) and Rep. Patrick Meehan (R-PA) responded by introducing H.R 2704 and an amended version H.R. 4212. NADSA members who attend the May 16th & 17th Public Policy Capitol Hill Days, will advocate strongly for these bills to authorize a Medicare option demonstration that specifically includes adult day services.

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NADSA Public Policy Co-Chair Simon Ortiz Meets with Senator Cruz

On April 13th CMS approved Tennessee’s Medicaid HCBS State Transition Plan (STP). This is the first STP approved in final form by CMS and may prove illustrative for other states. Signed by Ralph Lollar, CMS Director of the Division of Long Term Services and Supports, the letter of approval enumerates specific items CMS is seeking in the STP. Additionally, CMS has posted guidance for Planned Construction of HCBS settings. This document contains information helpful to states for modification of existing settings and commits CMS to further guidance specific to settings for consumers with dementia. Use the highlighted links to view both of these documents.

Our friends at the Medicare Rights Center asked NADSA to join with several other national Medicare focused organizations to support Dr. Marilyn Moon, former Director of the Center on Aging for the American Institutes for Research (AIR), for nomination to the Medicare Payment Advisory Commission (MEDPAC). MEDPAC is a legislative agency to advise Congress and upon meeting with Dr. Moon, a former senior analyst at the Congressional Budget Office (CBO), we discovered that she is very knowledgeable and supportive of ADS, including a full Medicare Option. Whether or not Dr. Moon is nominated to MEDPAC, it will be helpful to NADSA to have her as a continuing ally.

As NADSA continues to move forward on legislative and regulatory issues such as the Medicare Option, the CMS Medicaid HCBS rule and the MLTSS rule, there is no better advocate than you for adult day services and the consumers you serve. We hope to see you on May 16th and 17th for May 16th & 17th Public Policy Capitol Hill Days!

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