This Started with You –
CMS Administrator informs ADAPT of the progress to end the institutional bias in Medicaid.
(WASHINGTON DC, Feb. 27, 2005) In front of the Old Executive Office Building, with ADAPT blocking the rush-hour traffic in downtown Washington DC was the first time Mike McClellan says he spoke with ADAPT. Referring to a successful action back in May of 2002 when ADAPT demanded that the Office of Management and Budget review the savings of MiCASSA, Mark McClellan was the ranking bureaucrat charged with negotiating with ADAPT.
“The first time I met Bob Kafka and most of you, it wasn’t in a nice, warm hotel ballroom like this one,” said CMS Administrator McClellan. “It was in the middle of 15th Street, at rush hour, in the rain and I had the chance then to sit down and start talking with you about what you are trying to accomplish, about making progress on this road toward dignity and independence. The more I listen to you, the more I knew that Bob and the rest you were right.”
Since that meeting, Mr. McClellan has become the Administrator of the Center for Medicaid and Medicare Services (CMS). Also since that time, ADAPT has been essential in keeping the focus of the Medicaid program on people rather than facilities.
“I want to know more about how the Medicaid program works, the way all of our health-programs work,” said McClellan, “the more I realize the best ideas come from the people that have the most direct experience.”
The CMS Administrator met with the whole contingent of ADAPT, over 400 people. He was introduced by Samuel Mitchell from Georgia who called Mark McClellan a “friend of ADAPT.” Most activists were delighted to hear a ranking Medicaid figure use the same language that ADAPT has used for years. The ADAPT group; however is skeptical of everything said by government officials, even those who use our language.
“With two decades of experience behind us,” said McClellan, “with the Olmstead decision behind us, with overwhelming evidence that properly implemented rebalancing works to serve more people and get better outcomes we just can’t stand to wait anymore from the standpoint of the lives of people with disabilities. … It is time to end the institutional bias in the Medicaid program.”
“I was tired of hearing a written response,” said Randy Alexander who, after about 15 minutes, shouted out: “What do we do today? What about Harry, who lives in a nursing home in Tennessee, a state with no attendant services and no waiver?”
But Mike Oxford said: “I was thrilled to hear Mark McClellan talk about changing the Medicaid language. I’ve been talking about this since Bruce Valdic was the Administrator of CMS (then HCFA). The legislative language in Title IX lists ‘mandatory services’ of which nursing facilities are one. Just delete ‘nursing facilities’ and insert ‘long-term services and supports’.”
“Based on what we know now, if you were to design Medicaid today,” said Mark McClellan, “you would design it so you didn’t have to go through all the extra work, such as getting a waiver in order to have a Medicaid benefit, in order to get around the Medicaid benefit that is in an institution only. It should be the other way around. If you want to have the institution only, you ought to have to jump through all the hoops and go through all the waiver options.”
- Tim Wheat