2. Home and Community Based Services Policy Forum March 15, 2016 Peter Notarstefano, Director of Home and Community Based Services

3. Outline Federal Budget/president’s budget Older Americans Act Adult Day Services Legislation Home Health Legislation Initiatives that will increase access to HCBS

4. What’s next in an Election Year? FY 2017 House Budget Resolution and where to cut $30 billion Stand-alone bill to cut mandatory spending/ budget resolution containing higher caps Possible Medicare reform bill

5. President’s budget Co-Payment for Home-Health Improving Access to Home and Community Based Services Under Medicaid Continue to Support and Improve Expired or Expiring HCBS Rebalancing Provisions

6. Older Americans Act Reauthorization Act of 2015 (S. 192) was unanimously approved by the U.S. Senate on July 16, 2015 Barriers- “hold harmless”/ formula House Needs to Act!

7. Eligible Medicare beneficiaries – coverage of adult day Community Based Independence for Seniors Act (S704/HR2704) Senate Finance Committee unanimously passed Community Based Independence fore Seniors Act (S. 704) Community Based Independence for Seniors Act (H.R. 4212) Community Based Independence Special Needs Plan (CBI-SNP) demonstration program

8. Adult Day Services Veterans Admin. Proposed Rule Allows Veterans Administration Provider Agreements- not finalized H.R.3236 - Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 SEC 4002 passed Veterans Access to Extended Care Act (S739/HR1369) Veterans Care Act S 2179 Veterans Access to LTC and Health Services Act (S2000)/ H.R.4591 Department of Veterans Affairs Purchased Health Care Streamlining and Modernization Act- Marked up in Committee

9. Home Health Home Health Planning Improvement Act HR 1342 and S 578 Bipartisan support

10. Bill that we oppose H.R. 3298, Medicare Post-Acute Care Value- Based Purchasing Act – Would supersede the Value based Purchasing programs already going into effect, with a bigger payment withhold – 2 cosponsors, no Senate bill

11. 116 PACE programs in 32 states serving 35,000 beneficiaries. Vet. Admin. demo PACE Innovation Act of 2015 (HR 3243/ S1362) passed the Senate and House- signed by President Flexibility in PACE to lead to expansion: Possible changes- Population served; Settings, IDT, approval, enrollment, non-Medicaid rates Programs of All Inclusive Care for the Elderly

12. Advocacy Your Senators and Representatives need to know you and you need to know them! Use LeadingAge Action alert http://www.leadingage.org/advocacy/action.aspx Marsha Padilla-Goad Director of Grassroots and Member Engagement MPadilla-Goad@LeadingAge.org MPadilla-Goad@LeadingAge.org 202-508-9442

13. Contact Information Peter Notarstefano, Director of HCBS LeadingAge 202 508-9406 pnotarstefano@leadingage.org