Letter to Sarah Steenhausen At DHS Re: Money Follows the Person

October 2, 2006 

Sarah Steenhausen
California Health and Human Services Agency
1600 9th Street, Room 460
Sacramento, CA 95819

Hi Sarah,

I enjoyed participating at the Money Follows the Person (MFTP) discussion the other day and also believe, as Paula Acosta mentioned, the stars are beginning to align for Olmstead reform in California.

I am hopeful when you say MFTP will involve significant consumer stakeholder input.  This was not the case with ALWPP.  I think if you ask many senior advocates their opinion you'll find almost universal concern that ALWPP reflects an institutional bias, restricts provider participation and is poorly designed because it did not rely on adequate market research nor significant local stakeholder input.  AB 499’s author and its lead sponsors have also expressed similar concerns.  I do not believe your department fully understands the liabilities associated with ALWPP and I am quite concerned when you mention ALWPP will be related to future MFTP measures. 

In Los Angeles, out of approximately 2,000 RCFEs, there are currently five participating with ALWPP.  Most are non-profit, none are small providers and only one accepts patients who are wheelchair dependent or with Alzheimers.  ALWPP does not reflect sound public policy when it is convoluted, bureaucratic, wastes medi-cal dollars and is based on unfunded mandates that thwart provider participation and restrict consumer choice.

Olmstead encompasses many issues, all of its goals are laudable, but specifically in regards to RCFEs I believe public policy is being developed in a vacuum.  DHS does not license RCFEs and should not presume to be an expert for these settings.  At the few meetings I have attended (usually by phone conference) I notice there is usually little or no participation by Community Care Licensing, RCFEs or advocacy groups related to these settings.  Nowhere is this more evident than the complete lack of representation by these groups on the California Olmstead Advisory Panel.  

RCFEs will be a critical component for MFTP patients wanting to transfer to these settings.  In respect to the 2007 MFTP grant from CMS, I would suggest it prudent to solicit small provider opinion before developing any public policy that specifically involves these settings especially when ALWPP was never designed to accommodate small RCFEs. 

In a week, our Los Angeles based coalition will host a meeting specifically devoted to this topic. Our city should be considered as one of the MFTP pilot program sites since we are a major metropolitan area with more RCFEs and nursing homes patients than any other city in California. And, since many of our RCFEs are affordable, having MFTP in our city would be an ideal way to show how medi-cal cost savings can be used to offset nursing home diversion expenses.

If we can devise a RCFE component for MFTP that is elegant, cost efficient and attractive to RCFEs would your department be receptive to using our template instead of ALWPP? 

Call me anytime, if you would to discuss these issues further.

Kind regards,
 
Jason  Jason Bloome Owner, Connections Referral Service, Inc./ Founder
Olmstead Now Campaign
800-330-5993
http://www.carehomefinders.com/ carehomefinders@earthlink.net