Dear Senator Flanagan:
I am writing to request that you support Assembly Bill 7598/Senate Bill 5535.
This bill addresses the transition of the Traumatic Brain Injury (TBI) and Nursing Home Transition and Diversion (NHTD) waiver populations into managed care. The TBI and NHTD populations are relatively small (TBI contains about 2,800 persons; NHTD contains about 2,000); consequently, the program’s budgets are relatively small, but the population’s needs are great and their stability fragile.
These individuals qualify for nursing home placement, but under these Medicaid waivers they receive specialized services that keep them safe and functioning in the community and avoid institutional placement. The Department of Health is planning on transitioning these persons to Medicaid managed care early in 2016, but there is concern that the transition plan is not being developed with adequate stakeholder involvement or in a way that will ensure that these populations do not end up in more costly institutional settings.
The bill would require that the transition be postponed until at least April 1, 2017. This would afford the Department of Health time to establish a stakeholder work group (including payers, consumer representatives, providers of services and the chairs of the assembly and senate health committees) to ensure a thorough and thoughtful discussion on how to best transition these very sensitive populations to managed care. The legislation would require the work group to consider several critical principles in developing a transition plan. The work group recommendations would be due to the Commissioner of DOH on or before December 31, 2016.
This legislation is crucial to the successful transition of these pop ulations into managed care in a way that would allow them to continue to live successfully in the community.
We urge you to contact [Senator Hannon/Assemblyman Gottfried] and [Speaker Heastie/Majority Leader Flanagan and Independent Democratic Caucus Lead er Klein] to convey your support of this important legislation.
Director, Systems Advocacy
Westchester Independent Living Center
White Plains, NY 10601
914.682.3926 ext 2112(office)