National Council on Medicaid Home Care Reports on Most Recent MACPAC Public Meeting on Long-Term Services and Supports
March 18, 2014 03:49 PM
The National Council on Medicaid Home Care – a NAHC affiliate – policy director Michelle Martin recently attended the latest public meeting of the Medicaid and CHIP Payment Access Commission (“MACPAC”). The Commissioners heard a panel on assessments in long-term services and supports (“LTSS”) titled “Assessment of Need for Medicaid Long-Term Services and Supports.” The panel was introduced by MACPAC Senior Analyst Angela Lello and included three presenters:
Lisa Alecxih, Senior Vice President, The Lewin Group
Charles Moseley, Associate Executive Director, National Association of State Directors of Developmental Disabilities Services
Jennifer Mathis, Deputy Legal Director and Director of Programs, Bazelon Center for Mental Health Law
The goal of the panel was to highlight the role that functional assessments play in service planning, and eligibility determinations, and how assessments are used to identify individuals with LTSS needs. The chapter on LTSS that will be included in MACPAC’s June 2014 report to Congress is intended to be only foundational, instead of including recommendations for Congress. However, the MACPAC staff offered the panel regardless so that Commissioners would have a greater understanding of the role Medicaid plays in providing LTSS.
The presentations centered on the value of developing a uniform assessment tool to be used in all states; the panelists took opposing positions on the value of such a tool. Lisa Alecxih offered support of a standardized assessment, perhaps with various portals to create a more refined outcome based on a person’s disability. The point of a standardized assessment would be, ideally, to have all individuals measured for services in the same way and allow for the same outcome in any setting or state.
For example, if a person receiving LTSS moved from Florida to Iowa, the standardized assessment tool would allow that person to receive the same type and level of service in each state because the assessment would reveal the same needs in both locations. Charles Moseley and Jennifer Mathis, on the other hand, supported a person-centered approach to assessments, asserting that a universal assessment would cause individuals to go through unnecessary questioning while a person centered assessment would be specific to a person’s need level. The example offered was that a universal assessment could first ask “Do you need help going to the toilet?” an unnecessary question to an adult seeking services allowing him to continue working.
The Commissioners spent about 30 minutes asking questions of the panel, clearly wanting to have a greater understanding of the pros and cons of the different assessment ideas offered. The Commissioners favored using the assessments together to create a functional assessment that is both person-centered and has universal applicability. By the end of the question and answer period, it was clear that the Commissioners are interested in learning more both about the assessment process and LTSS as a whole.
At the end of the scheduled panels, a time for public comment was offered. Ms. Martin took that opportunity to introduce the Council to the commissioners and thanked the Commission for including LTSS on their agenda. Ms. Martin offered the Council as a resource and encouraged the Commission to continue to explore LTSS, beyond the assessment issue. The Chair of the Commission, Diane Rowland, agreed that LTSS is a very important issue that is deserving of the Commission’s attention and one that they will continue to focus on in future reports to Congress. Following the meeting, Ms. Martin spoke with several commissioners. They thanked her for her comments and asked her to continue sharing her thoughts on LTSS when it was discussed during public comments.
Ms. Martin assured the commissioners that she would continue to attend MACPAC meetings and that the Council would always be available as a resource to MACPAC staff.