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WASHINGTON - Today U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) held a hearing to call for the inclusion of improvements to long-term care services and supports as part of emerging blueprints for national health reform.  A member of the Obama Administration from the Department of Health and Human Services (HHS) offered testimony as the Committee considers how to improve the country's current scattered system of long-term care services and supports, while also working to ensure that they are cost-effective.  In recent years, Medicaid payments have shifted from primarily funding nursing home care, to funding more home and community-based care for older and disabled Americans.  Witnesses called for targeted changes to Medicare and Medicaid, as well as broader changes in the context of national health care reform discussions.
"Our message is a simple one:  any serious health reform proposal must address long-term care.  With America aging at an unprecedented rate, and with the high and rising costs of caring for a loved one, it is crucial that long-term care services are addressed," said Chairman Kohl.  "My colleagues on the Finance and HELP Committees do not have an easy task ahead, but my hope is that the lessons we learn and the ideas we generate in this Committee will be a resource for them."
Thomas Hamilton from the Centers for Medicare and Medicaid Services shared with the panel an overview of the Obama Administration's programs and priorities for improving the delivery of services to older adults and individuals with disabilities.  HHS has a broad array of grant initiatives in its portfolio that states have used to build a more sophisticated array of community-based services.  Among these grant programs are the "Real Choice Systems Change" grants, "Money Follows the Person" grants, Aging and Disability Resource Center grants, "Rebalancing Initiatives," and Quality Assurance and Quality Improvement grants.  These programs break away from a one-size-fits-all approach, offering flexibility and choices tailored to an individual's needs. 
Karen Timberlake, Wisconsin's Secretary of Health and Human Services, offered testimony on the state's "Family Care" program, which is transforming and re-programming state and federal Medicaid funding to finance a broad array of long-term care services and supports, including hands-on personal care, adult day care, home-delivered meals, transportation assistance to get to doctor's appointments, and medical device assistance.  Wisconsin has been a model for getting its Medicaid costs under control.  Next, Florida Secretary of Agency for Health Care Administration Holly Benson discussed the status of programs that Florida has developed for providing long-term care services.
On the second panel, Henry Claypool provided an overview of the political and grassroots independent living movement among disabled adults over the last three decades, which has fueled legislative and policy reforms at the state level, and more recently at the federal level.  Claypool is the Policy Director of Independence Care System, a nonprofit-managed long-term care plan in New York, and a former senior advisor for disability policy at HHS.  Melanie Bella, Senior Vice President for Policy at the Center for Health Care Strategies, discussed the most practical policy changes necessary in the near-term to increase access to, and the quality and accountability of, home and community-based services.  Finally, Judy Feder, a Senior Fellow at the Center for American Progress Action Fund, offered testimony on some of the most promising systemic long-term care reform proposals, as well as the feasibility of incorporating these or other ideas into discussions of ongoing health care reform and legislation addressing Medicare and Medicaid.
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