ALFA Commends Senator Bill Nelson's Commitment To Co-Pay Equity For Home And Community Based Seniors

Main Category: Seniors / Aging
Also Included In: Caregivers / Homecare
Article Date: 06 Mar 2009 - 1:00 PDT

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The Assisted Living Federation of America (ALFA) today praised Senator Bill Nelson (D-FL) and his leading bipartisan co-sponsors Sen. Jeff Bingaman (D-NM) and Sen. Susan Collins (R-ME) for their introduction of the Home and Community Services Co-payment Equity Act of 2009. This legislation will provide nearly one million dually eligible individuals (those receiving Medicare and Medicaid services) across the nation living in home and community based settings, such as assisted living communities, with the same prescription drug benefits under the Medicare Part D Prescription Drug Program (Part D) as those living in institutional settings such as nursing homes.

"This bill will restore fairness to some of our most vulnerable individuals regardless of the setting in which they choose to receive their care," said U.S. Sen. Bill Nelson.

"Senator Nelson continues to demonstrate his dedicated leadership on the matter of making the Medicare Part D program work for all of America's seniors," said Richard Grimes, President and CEO of ALFA. "The need to correct this issue, which has plagued dually eligible individuals in assisted living and other home and community based settings since Part D's inception in 2006, has grown even greater given the current economic downturn."

Under Part D, low-income dually eligible beneficiaries in skilled nursing facilities are exempt from prescription drug co-payments. Regrettably, dually eligible residents in home and community based settings are not included in that exemption despite being exempted from co-payments for prescription drugs under prior Medicare and Medicaid prescription drug programs that were replaced by Part D.

Dually eligible residents in home and community based settings typically take an average 8-10 prescriptions per month, with copayments for these medications ranging from $1-$5 - all while living on personal needs allowances of as little as $30 per month.

Assisted living is one of the fastest growing long-term care options, and costs about one third to one half the amount of nursing homes. As Medicaid programs save between 50 to 66 percent for each resident cared for in an assisted living community, most states are currently undertaking "re-balancing" efforts, to ensure that those individuals who can receive care in less-restrictive home and community based settings, such as assisted living, are doing just that. By reducing the financial burden of prescription drug copayments on dually eligible individuals, this legislation fully supports those state efforts.

ALFA is pleased to co-advocate on behalf of this legislation with the National Center for Assisted Living, the assisted living arm of the American Health Care Association. In addition a coalition of consumer and provider organizations supported the identical legislation last year including the Alzheimer's Association, Center for Medicare Advocacy Inc, National Community Pharmacists Association, and the American Geriatric Society.

The Assisted Living Federation of America (ALFA) is the largest national trade association representing companies operating professionally managed assisted living communities for seniors. ALFA advocates choice for seniors, quality of care, and accessibility and portability of long term care for all Americans.

Assisted Living Federation of America