Talking Points

on the State’s application to amend the 1115 Medicaid waiver

(a.k.a. the Super Waiver)

General comments on Stakeholder Engagement Process

• Commenting on an overview document, not the actual application
• Drafts of the applications should be posted before the application is finalized and sent to CMS, with adequate amount of time for public to comment before it is submitted
• The online survey tool must be fully accessible (readable by electronic readers, and available in multiple languages)
• How will the Medicaid Member Focus Groups be formed?

Overarching themes

• Overview document very medical in nature; need much more focus on promoting community-based organizations and services that keep people well and living in their homes
• The state should be building on and supporting existing, successful community-based programs
• Communities must be involved in shaping health care and services in their own communities; funding would encourage collaboration and integration, but seems only to be encouraging hospitals as the architects
• State investment must abide by the Olmstead decision; emphasize elements of Olmstead that are often ignored, like appropriateness of placement, comprehensive planning, assuring that recipients do not oppose placement, maintaining a waiting list that moves at reasonable pace, and more
• No mention of addressing disparities; wealth of recommendations from the MRT Health Disparities Workgroup still not enacted or implemented
• Distribution of funding must be transparent
• Entities receiving funding must be accountable for how they spend it
• Consumer/community education crucially important; need to support consumer assistance, navigation, and both individual and systems advocacy services

The entire talking points document is available here.