A person could get lost in the sea of Medicaid waivers and definitions. With titles like 115, demonstration and 1915(c), these waivers can be confusing — for legislators and the general public.
During the State Medicaid Waivers session, panelists were able to explain the need for waivers and the purposes they serve. These waivers often cover specific needs of various communities of people, like children and individuals with disabilities.
“The trend is absolutely moving toward home and community based,” said Tyler Dienes, director of Medicaid and Home and Community Based Services Policy at LeadingAge.
Dienes explained that the federal government is moving away from providing institutional care, as community-based and home care is preferred and yields better results.
“You start with your application with the federal government, what you want to demonstrate, how it will be budget neutral, 1915(c) waivers were designed to target home and community-based services, what you are proving in a 1915 is cost-effectiveness. You are proving that it’s the same cost or less than, than serving the person in an institution,” said Dienes.
Across the country, Medicaid providers are trying to support those in need of services and balance the states cost. In New Mexico, 4,000 people are on a list waiting to receive benefits.
“We had hoped to try alternative methods to clearing up that wait list, so we put in place a supports waiver that was essentially to allow the people on the waitlist, a subset of services, and they don’t need the entirety of supports services,” said Nicole Comeaux of New Mexico Centennial Care.
The idea of providing a subset of services would allow those waiting for full benefits to receive some care. The end result was several people able to receive necessary coverage without coming off the waitlist for full benefits.
Comeaux, who was also joined by Jami Snyder, the director of Arizona Health Care Cost Containment System, said she hopes that legislators would understand the process is one of planning and engagement with community members, legislators and federal partners.
Snyder said as waivers change in the future, the focus will remain the same.
“We are fortunate to have equity as foundational to the whole conversation,” she said. “What you will see going forward is creative ways going forward to align with those goals.”