Centers for Medicare and Medicaid New Proposed Rule
“Ensuring Access to Medicaid Services”
Patricia Larkins Hicks, Ph.D.
Thefollowingisanoverviewoftheproposed rule,EnsuringAccesstoMedicaidServices. Thisruleincludesrequirementsthatareintendedto advancetheCentersforMedicareandMedicaid Serviceseffortsto:
• improveaccesstocare,quality,andhealth outcomes;
• betterpromotehealthequityforMedicaid beneficiariesacrossfee-for-service;(FFS)
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Ensuring Access to Medicaid Services Rule
How Does the Rule Propose to Strengthen Direct Care Workers?
Current Reality
• Directcareworkerstypicallyearnlowwagesandreceivelimitedbenefits contributingtoashortageofdirectcareworkersandhighratesofturnover inthisworkforcewhichcanlimitaccesstoimpactthequalityof HomeCommunity-BasedServices(HCBS).
• WorkforceshortagescanalsoreducethecosteffectivenessofservicesforState Medicaidagenciesthattakeintoaccounttheactualcostofdeliveringservices whendeterminingMedicaidpaymentrates,suchasrelyingonovertimeand temporarystaff,whichhavehigherhourlycoststhannon-overtimewagespaid permanentstaff.
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Ensuring Access to Medicaid Services Rule
How Does the Rule Propose to Fix Waiting Lists?
Current Reality
• Statesvaryinwhethertheymaintainwaiting listsforsection1915(c)waivers, andifawaitinglistismaintained,howindividualsmayjointhewaitinglist.
• Statessetenrollmentlimitsorcapsonthenumberofindividualsservedina waiver,andmanyStatesmaintainwaitinglistsofindividualsinterested inreceivingwaiverservicesonceaspotbecomesavailable.Whilesomestates requireindividualstofirstbedeterminedeligibleforwaiverservicestojointhe waitinglist,otherstatespermitindividualstojoinawaitinglistafteran expressionofinterestinreceivingwaiverservices.Thiscanoverestimatethe numberofpeoplewhoneedMedicaid-coveredHCBSbecausethewaitinglistmay includeindividualswhoarenoteligibleforservices.
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Ensuring Access to Medicaid Services Rule
How Does the Rule Propose Underserved Populations Get Access to Services?
• CentersforMedicareandMedicaidServices(CMS)defineshealthequityas“the attainmentofthehighestlevelofhealthforallpeople,whereeveryonehasafair andjustopportunitytoattaintheiroptimalhealthregardlessofrace,ethnicity, disability,sexualorientation,genderidentity,socioeconomicstatus,geography, preferredlanguage,orotherfactorsthataffectaccesstocareandhealth outcomes.”
• CentersforMedicareandMedicaidServices(CMS)isworkingtoadvance healthequitybydesigning,implementing,andoperationalizingpoliciesand programsthatsupporthealthforallthepeopleservedbyCMSprograms, eliminatingavoidabledifferencesinhealthandqualityoflifeoutcomes experiencedbypeoplewhoaredisadvantagedorunderserved,andproviding thecareandsupportthatallindividualsneedtothrive.
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TheOhioAllianceofDirectSupportProfessionalsishostingitsannual LeadershipLAUNCHpad(LLP),July19-21,2023
Majoroutcomesparticipantscanexpecttoachieveinclude:
• Learningandunderstandingone’sownleadershipperceptionthrough OADSP’sLeadershipPerceptionProfile™process
• Exploringthe“powerskills”ofleadership
• Developingandimprovingconflictmanagementresolutionskills
• Creatingaprofessionaldevelopmentandaccountabilityplan
LeadershipLAUNCHpadempowersparticipantstoconcentrateon personaldevelopment,exercisenetworkingskills,andre-enterthe day-to-daywithaclearersenseoftheirleadershipidentities.Itisopento everyone-DSPs,FrontlineSupervisors,ProgramDirectors,QIDDPs, ExecutiveDirectors,stafffromCountyBoardsandstatedepartmentsof developmentaldisabilities,andotherinterestedprofessionalsfromanyfield.
EARLYBIRDRATE ENDSJUNE16TH. Learn more and Register Now!
IT'S AVIRTUAL CHALLENGE!
Co-HostedByDr.PatriciaHicksandShariCooper
Monday,June12th,2023
6:30-7:30 pm
LearnMore!
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