Relates to a nursing facility transition and diversion Medicaid waiting list

Showing the cosponsors who are on Agora, A to Z. The official record may list more.

• Democratic5

Shown in neutral colors by design; Agora is non-partisan.

◆ The sponsor's argument

Why Gustavo Rivera says this is needed

The Nursing Home Transition and Diversion (NHTD) Medicaid Program exists to allow eligible individuals, 65 years and older or those with physical disabilities, to receive services in a community-based setting. NHTD provides a variety of home based care services, intended to prolong the amount of time before a patient goes into a nursing home, or allowing some individuals to leave a nursing home and return to their communities while supporting their independence. The current system is managed as a statewide program with a maximum set number of participants and once that threshold is reached, enrollment is either paused or the waiver is amended to increase said threshold if it is larger than what is approved by the federal Centers for Medicare and Medicaid Services. This statewide system paired with the enrollment pause creates a barrier for individuals looking to apply for the waiver after the threshold is reached. Once an individual applies for the NHTD waiver after the threshold is reached, a letter will disclose that their referral to the NHTD waiver program will no longer be considered. This bill will make the Department of Health (DOH) establish specified waiver regions and form region-based waitlists for the NHTD program once the federally approved capacity has been reached. Having a waitlist divvyed up by region makes this system more seamless and effective for eligible users; and individuals who apply for the NHTD waiver will have increased transparency on the status and location of their application. The bill would also allow DOH to draw from the waitlist out of order to identify and provide services to eligible individuals and populations who are the most in need of care. An additional issue is that the current state of open applications may have been lost prior to the waiver being capped. Extending the NHTD to January 1, 2032 will make enough time for these individuals to have their needs assessed, increasing their accessibility to care and ensur- ing fairness in the application waiver process.

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.