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March 19, 2007 The Honorable John Spratt Dear Chairman Spratt: The undersigned members of the Consortium for Citizens with Disabilities (CCD) are writing to strongly support the inclusion – in the FY 2008 Budget Resolution -- of a “sense of Congress” resolution opposing the issuance of a regulation cutting the Medicaid rehabilitative services option by $2.3 billion over the next five years. CCD is the largest coalition of national organizations representing people with disabilities, their families, caregivers, and advocates. Over 40 states use the rehabilitative services option to finance an array of critical community-based services for persons with disabilities, including individuals with developmental disabilities, intellectual disabilities, and serious mental illnesses. These services are essential to reducing physical and mental disabilities as well as to maintain the health and daily functioning of people with disabilities in the community. Despite a lengthy public record indicating the Administration’s support for community-based services and choices for persons with disabilities rather than institution-based care, (i.e., The New Freedom Initiative and Executive Order 13217 related to community-based alternatives for individuals with disabilities), the Centers for Medicare and Medicaid Services (CMS) had repeatedly sought to narrow the definition of rehabilitative services under Medicaid. Paradoxically, this policy will have the effect of increasing the use of institutional facilities, emergency rooms, inpatient hospitals and nursing homes and enhancing the already strong institutional bias of the program. The overall CMS approach to this matter adds another worrisome component. After the Congress rejected Administration proposals to narrow the rehabilitative services option during deliberations surrounding the Deficit Reduction Act (DRA), CCD was troubled to learn that the agency is now taking the unprecedented action of seeking the exact same programmatic changes through regulations alone. Mr. Chairman, CCD believes that the proposed concurrent resolution is the first step toward Congress ensuring access to these important Medicaid services. If the rehabilitative services option needs to be re-examined, the committees of jurisdiction should take appropriate action after consultation with the nation’s governors, state legislators and county governments. Thank you for your attention to this important matter. Sincerely, ACCESS/DSPA Alliance |
