Mental Health, Disability, and Service Delivery Systems
Explore the intersections of mental health, disability, and service delivery systems, including the social determinants of health, challenges in accessing HCBS, and the role of programs like Medicaid in promoting equity. Learn about Medicare, Medicaid, and the payment for Long-Term Services and Supports (LTSS) in the context of healthcare coverage and access.
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Presentation Transcript
Medicare Mostly 65+ and people with disabilities Medicaid Many eligibility categories No income/asset eligibility limit Tax history relevant Income/asset limits Past taxes irrelevant Federal program Limited, short term LTSS Covers LTSS (HCBS Fed/state program optional)
but who pays for LTSS? Nope Private/Employer Marketplace? Medicare? short-term nursing facility stays & limited home care few have it or can afford it Private long-term care insurance? Yep! Medicaid!
Challenges Accessing HCBS Hard to maintain community housing Direct Care staffing shortages and difficulty filling hours Difficulty defining the direct care workforce and ensuring it includes all types of staff. Often pushes family and friends to provide unpaid care Cannot easily move from state to state
Medicaid and Equity Medicaid covers a higher share of Black, Indigenous, people of color, and people with disabilities. Health disparities between these populations can be stark. We have little data on people of color with disabilities, but evidence suggests that they face additional barriers to care. Efforts to improve health equity should start with Medicaid.
