A proposal to cut Medicaid payments to assisted living facilities and limit the help the program provides to elderly and disabled Arkansans in their homes cleared the Legislature’s public health committees last week.
The action followed an exchange between Senator Missy Irvin of Mountain View and Legal Aid attorney Kevin De Liban.
The Northwest Arkansas Times reports the changes, affecting the 8,800 Arkansans served by the ARChoices program and 1,200 Medicaid recipients in assisted living facilities, are part of the state’s efforts to slow the growth of Medicaid spending by enough to save $835 million from the fiscal year that started July 1, 2017, through fiscal 2021.
The proposal would reduce the rates paid to assisted living facilities by nearly 22 percent and set annual, per-person caps on the in-home help provided to participants in the ARChoices program.
The House and Senate Public Health, Welfare and Labor committees’ vote during a joint meeting came despite complaints from providers and beneficiaries the changes will cause assisted living facilities to go out of business and more disabled residents to end up in nursing homes, where the cost of their care will be higher.
ARChoices provides in-home help with daily living tasks and other needs for low-income people with disabilities severe enough to qualify for placement in a nursing home.
The Department of Human Services proposal would cap ArChoices benefits at $30,000 a year for recipients with the greatest needs — those who require total or extensive assistance with moving from one place to another, eating and using the bathroom.
Enrollees who are currently receiving more than $30,000 would be allowed to continue receiving their current level of care in 2019 and 95 percent of that amount in 2020.
Legal Aid attorney Kevin De Liban says the new system would increase the hours of care recipients can receive from about five and a half hours a day to about six and a half hours.
Sen. Irvin noted the proposed system attempts to address criticisms of the state’s current method for awarding hours by giving Human Services Department nurses more discretion in awarding hours.
Irvin asked De Liban, “I’m starting to wonder if there’s ever going to be a solution, or are you going to just continually be against any type of an assessment tool that we have to use? At what point are you going to be satisfied?”
De Liban said the state could make adjustments, such as increasing the annual cost caps, that would provide recipients with the care they need.
According to the waiver authorizing the program, the current rate was the result of negotiations between the department and providers in 2002 and automatically increased each year.
In a voice vote, with no members objecting, the committee declared the proposed rate and rules “reviewed.”
The proposal will go to the Legislative Council’s Administrative Rules and Regulations Subcommittee for approval on Tuesday and the full council on Friday.
WebReadyTM Powered by WireReady® NSI