At Flawed Medicaid Forum, AIDS Advocates Push for Affordable Housing

Leroy Rose, an HIV+ Medicaid user, addresses the reform team.

AIDS advocates stood among the hundreds of people who crowded an auditorium in New York City on Friday to tell New York State's Medicaid redesign team what it should -- and shouldn't -- change when the state overhauls the program.

"New York is at a critical fork in the road," said Housing Works' organizer for New York issues Derrick Chandler, addressing the team of 27 policymakers that will craft the program's reform process. "It can either decimate its fragile health care safety-net for poor New Yorkers living with HIV/AIDS or strengthen a comprehensive community-based model of care."

The most frequent suggestion made by AIDS advocates for saving on Medicaid dollars: Protect and expand access to affordable housing for low-income people living with AIDS to help keep them healthy. Nearly half of the 125,000 HIV-positive people the state rely on Medicaid for critical care. AIDS advocates have spent years arguing that housing is the best way to keep them healthy -- and prevent the spread of the virus. A growing body of data backs that argument.

Also a high priority for AIDS advocates: The protection of funds for Adult Day Health Care Centers, the licensed community centers that provide health, therapy and social services to those at risk of being placed in a nursing home or other institution. Housing Works runs several, as does Harlem United. "By helping medically frail clients avoid costly nursing home care, Harlem United's Adult Day Health Centers saved Medicaid more than $5 million last year," said Harlem United Chief Operating Officer Stephane Howze.

An Open Process?

In January, Gov. Andrew Cuomo promised that the overhaul of the $53 billion-plus Medicaid program would be a transparent, collaborative process. Indeed, Friday's meeting at Baruch College was one in a series of public forums in which Medicaid users and providers could make suggestions to those who will decide where to make cuts.

But more than 100 individuals spent the first part of the meeting in a holding room, as the state did not find a space large enough to accommodate the audience (those in the holding room were permitted to attend the forum once others trickled out). The state did not allow exchange between the public and the redesign team members, meaning policymakers could not ask questions about the suggestions. There was just one Spanish interpreter for the more than 400 people who attended, despite the state's multilingual population.

Several community members came to the mic to point out that there is just one individual on the redesign team -- Lara Kassel of Medicaid Matters New York -- to represent the 4.7 million people who use the program.

"Listen to the patient," said Susan Dooha, executive director at Center for Independence of the Disabled New York, standing before the redesign team and urging its members to craft their decisions based on Friday's input. "[The patient] is trying to tell you the diagnosis. . . . and would also like to tell you the remedy."

Attend the Next Medicaid Meeting

The redesign team will meet Wednesday to discuss its findings so far. This is not a public comment forum, but community members can come to listen. The redesign team will deliver an initial cost-savings plan on March 1.

February 9, 10:30 AM - 2:30 PM
Hunter College School of Social Work
129 East 79th Street (between Lexington and Park Ave)
New York, NY 10065
10th Floor Room 1010