CQ HEALTHBEAT NEWS
Oct. 26, 2004 – 5:27 p.m.

One Agency Should Head Disabled Programs, Report Says

By Mary Agnes Carey, CQ HealthBeat Associate Editor

Advocates for the disabled hope a new report from the National Council on Disability released on Tuesday will help create more programs that will enable disabled Americans to live independent lives.

The findings recommend that one federal agency be responsible for the programs and services dealing with disabled individuals. The report recommends that the Health Resources and Services Administration could handle this role for adults and elders as it does now for children with special health care needs.

The report urges opportunities for choice to be incorporated whenever possible, even in institutional settings. But that does not absolve agencies of responsibility for ensuring access and quality, nor should policy makers expect that so-called “consumer directed” health care programs will save money immediately, although it might over time, the report noted.

“Taken as a whole, (the council’s) recommendations imply a major shift in the way government, private agencies and even to some extent, consumer organizations think about organizing and locating and managing health care for people with disabilities,” the council stated.

At a news conference to announce the report, Dennis Smith, director of the Center for Medicare and Medicaid Services Center for Medicaid and State Operations, said that many aspects of the Bush Administration’s “New Freedom Initiative” has helped the disabled lead more independent lives.

More money has been spent in the past four years to support home- and community-based waivers than in the proceeding eight, Smith said. He also said that in fiscal 2005, the federal Medicaid program is budgeted to spend $90 billion on long-term care.

The administration has advocated a series of initiatives officials say will help improve the lives of disabled Americans. Such as a series of demonstration projects to help provide transitional services for Medicaid beneficiaries moving from institutions to home- or community-based centers or to provide respite services to caregivers of children and adults with disabilities.

But advocates for the disabled said that funding for such programs is far smaller than what the government spends on institutional care, and that alternatives must be proven to save money. “There are just so many hoops you have to go through,” said Carol Tobias, an assistant professor at Boston University’s School of Public Health who was the report’s principal investigator.

While disabled advocates noted that there have been some improvements in federal services, they said more must be done.

“This system is 40 years old. It is institutionally based,” said Bob Kafka of the group Americans Disabled for Attendant Programs Today (ADAPT), a group advocating more funding for programs that would allow the disabled to received care in their homes or in community-based settings rather than in institutions.

Kafka said he hoped the report could help reverse “that institutional bias” that he said favors federal funding for institutional settings, such as nursing homes, over other alternatives.

Source: CQ HealthBeat News