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	111 Washington Avenue, Suite 101 Albany, NY 12210 (518) 427-1060 Voice & TDD, (518) 427-1139 Fax 1(888) 469-7452 Toll Free (NYS Only) www.nysilc.org or nysilc@nysilc.org
For Immediate Release		For more information contact:

Medicaid Solution: It’s Time to Follow!

By Brad Williams, Executive Director,
New York State Independent Living Council (NYSILC)

The Governor's Budget identifies an $11.5 million deficit and proposes a $1.2 billion cut for Medicaid. These recommendations include a variety of adjustments that miss the mark toward serious Medicaid reform in this state.

Instead, the disability community wants the Governor to include a Medicaid waiver program for people with disabilities and seniors in the executive budget's 30-day amendment period. The establishment of such a waiver would not only save the state and counties hundreds of millions Medicaid expenditures, but it would put the state in position to pursue a new funding initiative announced by the Bush Administration last week.

New York State has saved considerable dollars through its two existing waiver programs. In fact, the Traumatic Brain Injury (TBI) waiver program saves Medicaid over $1,600 per person per month. A Medicaid waiver will allow an individual with a disability to live in the community with appropriate support services, as opposed to the expensive cost of institutional care. At a minimum, the program is set up to be "cost-neutral" on an aggregate basis. Savings will be realized because the overall average of those living in the community is far less than if they were in costly segregated settings.

Several advocacy organizations have been asking the state to transition just 1 percent (1,300 people) of the current nursing home population back into the community through a waiver program. This plan would reduce Medicaid expenditures by over $25 million in the first year alone. This savings continues to accumulate as new savings is added each year when more people are successfully transitioned into the community.

The total amount saved over a five-year period would exceed $380 million dollars (Federal saves $190 million - State saves $152 million - Counties collectively save $38 million) for 6,500 people. As an added incentive, the five-year cycle would coincide with a new initiative announced by the Bush Administration.

The President’s FFY 2004 Budget proposes $350 million ($1.75 billion over five years) for a "Money Follows the Individual" initiative. The Federal grant would pay the full cost of home and community-based waiver services for one year for individuals who transition out of institutions.

After one-year, the state would agree to continue care at the regular Medicaid matching rate. If funded, the program could vastly improve its Medicaid savings over five years to $380 million (State saves $304 million - Counties save $76 million)! However, New York must have a Medicaid waiver in place to take advantage of this opportunity.

There is an opposite side to saving money at the state or county levels and/or obtaining additional revenue from the Federal government. Severe cuts to the Medicaid program en masse could force many individuals back into segregated, institutional settings. Such an action would only incur greater Medicaid expenses!

Besides increased Medicaid expenditures, it would also boost the number of Office of Civil Rights (OCR) complaints and lawsuits filed against the state. Enacting a Medicaid waiver program allows the state to comply with its legal obligations under the 1999 Olmstead U.S. Supreme Court decision. It is consistent with the "Most-Integrated Setting" state law signed by Governor Pataki in September of 2002.

In this time of fiscal responsibility, how can our state leaders afford not to enact a waiver program for people with disabilities and seniors? One of New York’s "solutions" to Medicaid is simple. Let the money follow the individual. Let the Governor follow the President.

Brad Williams, Executive Director, New York State Independent Living Council (NYSILC), 111 Washington Avenue, Suite 101, Albany, NY 12210, (518) 427-1060 Office, (518) 424-8121 Cell, nysilc@nysilc.org <mailto:nysilc@nysilc.org>.