PLATTSBURGH — Health-care reform is complicated for most everyone, but it can be overwhelming to those who rely on consistent and capable health care as they grow older.
The Affordable Care Act, passed by Congress in 2010 and still facing an uncertain future as the nation heads toward the 2012 general election, was designed to provide health-care coverage to all U.S. citizens and to make health-care costs affordable for all.
Still, the law is filled with a plethora of sidebars, some that have already been enacted and some that are scheduled to start up by 2014, a fact that adds to the confusion for many.
"The act goes into effect in stages," said Robert Poulin, systems advocate for the North Country Center for Independence. "A lot of parts in the act have gone into effect that people are not aware of. New York state has received significant monies to enact those parts."
For instance, New York state received $34.6 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. Money from this fund goes toward programs designed to prevent illness and promote health, including $26.3 million invested in primary-care training to expand and support the state's health workforce.
ALTERNATIVE OPTIONS
"There are a lot of things happening already," said Crystal Carter, executive director for the Clinton County Office for the Aging. "Many of our agencies and disability resource centers started well ahead of the act. We've put services into play to help people navigate the system."
Long-term care is one of those areas that have been highlighted by advocates for seniors and the disabled, she added.
"Someone will make a call and say that they want to put mom in a nursing home," she said. "But we want people to know that there are a lot of things we can do first, programs like home-delivered meals and personal response systems. There is information available to help people through these kinds of decisions."
One section of the Affordable Care Act targets that incentive to provide people with alternatives to nursing-home care. The Community First Choice Option is a community-based Medicaid state plan that includes hands-on assistance and safety monitoring as well as targeting a person's needs based on his or her functional needs, not on diagnosis or age.
The plan, which was endorsed by Gov. Andrew Cuomo in his State of the State address, has the potential to save the state $90 million a year in Medicaid savings.
Services through the Community First option must be provided in a home and community-based setting and cannot be provided in a nursing facility, institution for mental disease or intermediate-care facilities for the mentally disabled.
Health advocates
Another new Affordable Care Act development through the state's Community Service Society is the Community Health Advocates program. This program offers educational support for such programs as the new Medicare Part D requirements and problems such as disputes with insurance companies and learning how health insurance works.
"They are there to help figure out and find available insurance, whatever the situation may be," Poulin said. "Helping people with prescription drugs is a part of it."
"That's a complicated issue for everybody, but more so for older people," Carter added. "Some people may be on 30 or more prescription drugs. There are a lot of different plans available, and they will help you look at prescription formulas for the best plan for you."
New York state is also actively looking at changing its overall Medicaid program through the Medicaid Redesign Team organized by Cuomo. As that project moves forward, it will add to the complexities created by the Affordable Care Act.
But advocates stress the positive support that is already available through the act, not on what may happen as the nation's political climate changes or remains steady.
"We need to focus on what is here now," Carter said. "We don't know what will happen with changes, and we are not waiting to find out before we implement those parts of the law that are already in place."
"The states will have a huge role in describing how health care looks at the state level," Poulin added. "New York has a lot of work ahead, but there are already millions of dollars available to help us move in a future direction."
Email Jeff Meyers at: jmeyers@pressrepublican.com
