A Home And Community-Based Service System Reform Blueprint

Source: Rick Surpin, Paraprofessional Healthcare Institute (PHI), Independence Care System (ICS), July 2010

From the summary:
The ICS/PHI blueprint, issued on November 24, is a detailed plan to simplify and rationalize the home and community-based service (HCBS) delivery system in New York City, which consumes $4.4 billion annually in Medicaid expenditures — accounting for at least 80 percent of all HCBS spending in New York State.

Currently, New York City’s HCBS delivery system suffers from a highly inefficient, fragmented, overlapping complexity of programs that provide Medicaid-funded services to elders and people living with disabilities.

The ICS/PHI reform blueprint directly addresses these challenges by proposing four essential reforms to New York City’s Medicaid-funded long-term care services for elders and people with disabilities:
* contain Medicaid costs;
* simplify the delivery system;
* improve quality outcomes by providing care management for consumers with complex needs; &
* stabilize the core HCBS workforce by establishing parity in wages for home care aides.

The blueprint builds on the strengths of the Medicaid-funded home and community-based service system, rather than turning to large managed care entities — which have limited, if any, experience in long-term care.

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