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Senate Finance Committee Health Care Bill Reflects APA Priorities

The bill includes provisions related to integrated care, prevention and wellness, workforce development and other top APA priorities.

Democratic congressional leaders continue to aim for a year-end 2009 deadline to complete an overhaul of the nation’s health care system. With committee-level work now complete, attention turns to the coming floor debate, amendment process, and likely conferencing of the House and Senate bills. Provisions within the Senate Finance bill related to PI-GRO’s HCR priorities include:

Integrated Care: Creates a new State plan option that provides enrollees with at least one serious and persistent mental health condition to qualify for services that include comprehensive care management, care coordination and health promotion, and comprehensive transitional care.

Prevention and Wellness:  

  • Establishes annual wellness visits for Medicare beneficiaries;
  • Removes co-payments and deductibles for certain, recommended, wellness screenings under Medicare;
  • Encourages States to cover and increase access to recommended prevention services and immunizations under Medicaid;
  • Directs the Secretary of Health and Human Services (HHS) to develop healthy lifestyle programs under Medicaid that use relevant, evidence-based resources and address the unique needs of the Medicaid population;
  • Includes language from the APA-supported Elder Justice Act, S.795/H.R. 2006, to establish mechanisms to address elder abuse, neglect, and exploitation;
  • Includes language from the APA-supported Melanie Blocker Stokes MOTHERS Act S. 324/ H.R. 20, to authorize support services, education, research related to postpartum depression and psychosis; and
  • Prohibits cost-sharing for all American Indians and Alaskan Natives with incomes up to 300 percent of the federal poverty level for all insurance exchange plans and public programs.

Workforce: Authorizes the development of a national strategy to address workforce shortages and to encourage training in key focus areas that support delivery system reform goals, with mental and behavioral health identified as high-priority topics.

 Health Disparities:

  • Establishes uniform categories to collect data on race, ethnicity, gender, and primary language and requires the Center for Medicare and Medicaid Services to collect data on individuals with disabilities;
  • Requires federally funded health surveys to collect sufficient data on racial and ethnic subgroups to yield reliable results in studies that compare health disparities populations;
  • Mandates that HHS share health disparities data, measures, and analyses with other relevant agencies;
  • Requires the Secretary of HHS to ensure appropriate privacy and safeguards, with respect to health disparities data and its collection, analysis, and dissemination;
  • Establishes a National Strategy to Improve Health Care Quality, to reduce health care disparities across populations and geographic areas;
  • Directs the President to convene an Interagency Working Group on Health Care Quality, to collaborate and consult on the National Strategy; and
  • Requires hospital facilities to conduct community health needs assessments, at minimum of once every three years.

Consumers, Families, and Caregivers

  • Provides continued funding at a level of $10 million per year for five years to Aging and Disability Resource Centers;
  • Creates the Community First Choice Option, to establish a Medicaid State plan option for eligible individuals with disabilities to receive community-based attendant supports and services; and
  • Incentivizes State structural reforms that increase nursing home diversion and access to home- and community-based services in their Medicaid programs. ]