Guest essay: NY Medicaid changes mean higher costs, fewer freedoms

By Michelle Fridley
Messenger Post
Posted Apr 10, 2011 @ 12:38 PM

Canandaigua, N.Y. — Medicaid needs to be fixed; however, Gov. Andrew Cuomo’s proposal to put the Consumer Directed Personal Care Program (CDPAP) into Managed Long Term Care (MLTC) makes things worse. It denies people like myself our independence, and denies Medicaid the savings that the CDPAP was designed to create.

Two years ago in Seneca County, the only care I could receive was managed care. I was allowed two to three hours per day of home health aides that were very limited to what they could do. I had a letter written by my doctor saying that without more hours of care, I would have to go into a nursing home; and another from the home health nurse that said that I dd need more hours of care, but their agency didn’t have the home health aides available. They even contracted with other agencies and still had a hard time covering just the two-three hours per day. I was very close to going into a nursing home.

To avoid a nursing home, I moved to Ontario County, where I could receive the CDPAP. My life has absolutely flourished since then, as I have gained my independence. I’m raising my daughter on my own; I’ve returned to school, become Ms. Wheelchair New York 2010 and, now, am proudly a productive member of society.

Yet here I am, again facing a nursing home as the governor plans to put me back into Managed Long Term Care. The CDPAP saves Medicaid money, while allowing people to live in the most integrated community setting. I hire, train, schedule, supervise and fire my attendants for free. MLTC will have to pay someone else to do this.

I have many “nursing” needs that I’ve trained my attendants to do, and have been without more expensive skilled nursing since being on CDPAP. What will happen to me and others that have a higher need of care, under MLTC, is placement into more expensive nursing homes. We need more hours of care than can be provided due to the shortage of home health aids can. All of the things that make CDPAP special and cost-effective currently would be eliminated in this new format.

In reality, the governor’s proposal for MLTC without the CDPAP as an option is not going to save Medicaid money. It will increase spending, while taking away the freedoms of our seniors and disabled.

Michelle Fridley of Canandaigua, Ms. Wheelchair New York 2010, is the Center for Disability Rights Board Director.