Why Little Rock?

National ADAPT focuses on Arkansas to demand all US states choose the Community First Choice Option

By Tim Wheat

National ADAPT felt it was important to make the point in Arkansas that people with disabilities demand for the Community First Choice Option is a bipartisan benefit to US states. Although it is part of the Affordable Care Act, it may be optioned independently and adds a six percent incentive to state Medicaid programs.

Failing to choose the Community First Choice Option not only keeps state residents isolated in expensive undesirable institutions, but it fails to take advantage of the cost-savings of home and community services in addition to the Medicaid enhanced rate. State funding for long term services and supports for seniors and people with physical disabilities is institutionally biased in Arkansas with 69.7% of Medicaid funding going to nursing facilities.

“That is pathetic,” said Mike Oxford, and organizer from Kansas. "Seniors and people with disabilities don't want to be forced into nursing facilities, but that's what the state is doing. This is not about spending more money, it is about reprioritizing so that funds that are currently spent on nursing facilities to fund services and supports that allow individuals to move out of these institutions or to avoid institutionalization altogether," Oxford said.

ADAPT supports Medicaid reform to make the system more efficient and effective and prevent US states, who administer the federal Medicaid program, from forcing people into institutions to balance the state budget. ADAPT holds that implementing real Medicaid reform, which restrains spending while promoting the independence and freedom of people with disabilities, is the most cost-effective use of state public money.

ADAPT proposes expanding community-based services, expanding consumer-directed services, de-medicalizing services, eliminating wasteful bureaucracy and taking advantage of "re-balancing" funding. Advocates point out that estimates show the state of Arkansas would save money by making this change and implementing the Community First Choice Option. CFCO is a federal Medicaid program that gives seniors and people with disabilities a real alternative to institutional placement and provides extra federal funding to do it.

Home And Community - Based Services (HCBS) allow people with disabilities to remain in their own homes. HCBS programs often suffer because states cannot make cuts to institutional care, but they can cut the optional Medicaid services. This institutional bias in the federal Medicaid law keeps public funds flowing into expensive institutions although most people would prefer to remain at home.