News & Press: Public Policy

New Legislation Would Establish a Demonstration on Home- and Community-Based Services

Tuesday, February 28, 2017   (0 Comments)
Posted by: Kim Hollingshead
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On February 6, Senators Chuck Grassley (R-IA) and Ben Cardin (D-MD) introduced S. 309, a bill to establish a Community-Based Institutional Special Needs Plan demonstration program to target home- and community-based care to eligible Medicare beneficiaries.

If enacted, the bipartisan bill would establish a new Community-Based Institutional Special Needs Plan (CBI-SNP) demonstration program that would target home and community-based services for low-income, Medicare-only older adults who need assistance with two or more activities of daily living (ADLs). The goal of the demonstration is to target community-based services and supports for at-risk older adults so that they do not deplete their assets and become Medicaid dependent.

The demonstration would be operated in no more than five states building on Medicare Advantage (MA) plans that have experience caring for this population. The US Dept. of Health and Human Services (HHS) Secretary would determine the appropriate long-term care services and supports to be covered under the demonstration such as:

  • Homemaker services
  • Home-delivered meals
  • Transportation services
  • Respite care
  • Adult day care services
  • Non-Medicare-covered safety and other equipment

The five-year demonstration seeks to generate evidence to support an alternative payment methodology that could produce savings for both the federal government and states. Additionally, the demonstration seeks to provide evidence of improved patient care; reduced hospitalization or re-hospitalizations; reduced or delayed Medicaid nursing home admissions and lengths of stay; reduced spend down of assets for becoming eligible for Medicaid; and improved quality of life for those older adults participating in the program.

The bill has been referred to the Senate Committee on Finance for hearings and consideration. AASC encourages its members to contact their Senators to recommend that they co-sponsor this bipartisan legislation.