The Continuing Care Leadership Coalition's (CCLC's) recommendations to the NYS Senate Task Force on Medicaid Reform focus on three areas: promoting personal responsibility in the financing of long term care (LTC) services, creating a more seamless continuum of services, and making better use of State resources. CCLC strongly opposes any reimbursement rate reductions for nursing homes or home health care services.
Personal Responsibility: With less than 10% of LTC costs in NYS funded by private sources, CCLC takes the position that there are not enough incentives in place to encourage residents to assume personal responsibility for meeting future LTC costs. To that end, CCLC recommends amending State law to discourage community spouses with substantial assets from executing spousal refusals (while ensuring protection against spousal impoverishment) while simultaneously encouraging the purchase of private LTC insurance policies through tax credits, tax deductions, and changes to encourage greater participation in the State's Partnership Program for LTC insurance.
Seamless Continuum: CCLC's recommendations focus on actions for strengthening and expanding managed long term care (MLTC) while promoting the right mix of community-based and inpatient service capacity. To that end, CCLC recommends that the State 1) issue a request for proposals to enable additional MLTC programs to come online; 2) significantly expand State resources to accommodate and promote MLTC growth; 3) review and remove regulatory barriers to MLTC growth; 4) consolidate State agency offices charged with overseeing all facets of the long term care system into a single entity to reduce system fragmentation; and 5) conduct an updated evaluation of where excesses and shortfalls exist in service capacity followed by a process to better align capacity and need.
State Resources: CCLC strongly recommends that the State increase efficiencies by rejecting a costly and administratively burdensome external utilization review process for home health care in favor of a system based on financial incentives. In addition, CCLC strongly recommends that the Patient Review Instrument used to assess individuals for nursing home placement be replaced by a single assessment, the Minimum Data Set, as a means of setting rates for both Medicaid and Medicare.