March 21, 2008
CALLING ON CONGRESS
ETHA demonstration project moves forward
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Housing Works staff Susan Miles and Beverly Sutton explain the importance of ADHCs as Clinton staffer Ann Gavaghan takes notes |
Five Housing Works clients and staff went to Washington, D.C., this week to prod New York's Congressional delegation to sign a letter urging the Centers for Medicare and Medicaid Services (CMS) to match New York State's $1.4 million rate increase for AIDS Adult Day Health Care (ADHC) programs with $1.4 million in federal dollars.
The staff at each one of the 14 offices visited said they supported the increase and many agreed to sign on to the letter—though all were hesitant to take the lead.
The lobbyists-for-two-days visited the offices of New York City Congressional Reps. Carolyn Maloney, Charles Rangel, Vito Fossella, Nydia Velazquez, Edolphus Towns, Joseph Crowley, Gregory Meeks, Yvette Clarke, Jerrold Nadler, Jose Serrano, Anthony Weiner, and Eliot Engel and Sens. Hillary Clinton and Charles Schumer. While all Congressional staffers voiced their support for a CMS rate increase and most said they would sign onto a letter, only Schumer's office has already written one.
AIDS Day Health Care (ADHC) programs are a critical point of access to cost-effective services for more than 1,700 people living with HIV/AIDS in New York State. ADHCs provide a "one-stop-shop" array of programs, including medication management, health care monitoring, case management, mental health and substance abuse services, nutritional services, and health education.
CMS' refusal to match New York state comes despite its approval of the increase under the state Medicaid plan in 1996. CMS is now asking New York to apply for a federal waiver—which could mean two more years before funds are approved. ADHCs might not have that long: Eight of the nine ADHC programs lost money last year, an average of $19 a day, for total losses of $510,000 of program revenues on average. In January, the Long Island at Catholic charities ADHC closed, and others could succumb to the same fate. On the state level, all one-house budgets allow for the release of $1.4 million to cover the state's share.
"Being an ADHC client taught me about taking my medication and what I need to do to stay healthy. That allowed me to go into the Housing Works Job Training Program. Soon I'll be working and paying taxes," said Housing Works ADHC client Nelson Alston, who told his story to Congressional staffers.
Meanwhile in D.C...
A modified Sen. Gordon Smith/Sen. Hillary Clinton Early Treatment for HIV Act (ETHA) demonstration project amendment was accepted by the U.S. Senate March 13 as part of the Senate Budget Resolution. The $500 million set-aside for the project was removed, but the removal conforms with many of the other reserve funds included in the bill. The AIDS Institute's Director of Federal Affairs Carl Schmid said the change isn't a reason to be nervous. However, it's not a reason to get excited either, since advocates seem resigned that the ETHA demonstration project isn't in the cards for this Congress. "If we can't pass SCHIP (the State Children's Health Insurance Program), how are we going to pass the demonstration project?" Schmid said. "It's more just to keep ETHA on the radar."
The project is the first step on the road to ETHA itself, which would allow states to extend Medicaid coverage to low-income people with HIV before they became disabled by AIDS, something that current Medicaid eligibility requires.