Medicaid/Medicare

Title XIX of the Social Security Act is the largest payor of health and long-term supports and services for low-income individuals with significant disabilities and is the single largest federal and state source of funding to providers like Mosaic. In fact, this joint federal and state program provides the only source of any health and long-term support coverage available to individuals with disabilities who rely on Supplemental Security Income (SSI).

Together, Title XIX and Title XX (State Children's Health Insurance Program - SCHIP), provide payment for critical coverage to Mosaic constituents ... children and adults with disabilities and the elderly. As the lifeline for people with disabilities and the primary funding source for providers supporting people with disabilities, it is critical that Mosaic maintain its national role in addressing federal legislative, administrative and financing policies affecting Medicaid and evolving state responses.

Mosaic increasingly provides supports to individuals covered by Medicare and by the combination of Medicare and Medicaid.  These two programs provide the overwhelming majority of financing for health and long-term supports to individuals with disabilities of all ages.  We must continue to address Medicare policies and their intersection with Medicaid.

Direct Support Professional Workforce Crisis

Enhancing the lives of people with disabilities by obtaining the resources to recruit, train and retain a sustainable direct support workforce is a top Mosaic priority. Providers are experiencing a national crisis in the availability of qualified direct support professionals. Mosaic must continue its national role in raising awareness of this crisis, working with the American Network of Community Options and Resources (ANCOR) to develop federal policy responses and inform constituents of state and national initiatives regarding recruitment and retention of quality direct support professionals.

Mosaic is supporting the Direct Support Professionals Fairness and Security Act, H.R. 1279, introduced by Representatives Lois Capps (D-CA) and Lee Terry (R-NE). This legislation addresses the need for higher wages for direct support professionals.

We are also supporting Senate Resolution 613 introduced by Senator Ben Nelson (D-NE), with ten original co-sponsors: Senators Max Baucus (D-MT), Jeff Bingaman (D-NM), Sherrod Brown (D-OH), Jim Bunning (R-KY), Susan Collins (R-ME), Christopher Dodd (D-CT), Orrin Hatch (R-UT), John Kerry (D-MA), Pat Roberts (R-KS) and Gordon Smith (R-OR).

This Senate Resolution designates the week of September 8, 2008, as National Direct Support Professionals Recognition Week.

• National Advocacy Campaign

Revenue Enhancements/Protection

As states experience economic issues, alternative and/or replacement resources need to be sought, including additional short-term federal funds.

Housing - Supporting Choices for People with Disabilties

A cornerstone to life in the community for people with disabilities and the providers who support them is the availability of decent, safe, affordable, accessible housing. The lack of such housing is the second greatest barrier to community integration and full implementation of the Supreme Court's Olmstead decision. Increased federal housing assistance is imperative.

Self-Direction - Supporting Choices of Individuals with Disabilities

People with disabilities, providers, as well as federal and state governments are actively engaged in evolving support delivery systems based upon participants directing their choice and financing of health care and long-term supports. ANCOR has a national role in developing federal policies and financing mechanisms that assure successful self-directed services and supports.

Human Rights

National and international groups and alliances are taking steps to encourage enforcement of human rights for people with disabilities around the world.

Mosaic is a member of the international alliance, IMPACT.

• IMPACT Alliance

Transportation

National issues impact access to communities through public and private transportation.

Employment/Training for People with Disabilities

Employment is an essential component to people with disabilities living full, inclusive lives in the community. While people with disabilities want to work, most remain underemployed or unemployed -- with only 19 percent of working-age individuals with disabilities employed. Mosaic provides vocational and employment services and supports that have an important role in local, state and federal programs that support these goals. Mosaic, working with ANCOR, will maintain a focus on vocational and employment-related services and federal policies to enhance opportunities.

Health Care

More than 47 million individuals nationally -- including people with disabilities and those who support them -- are uninsured.  The rising costs of health care and long-term supports affect the availability and affordability of coverage for all Americans, place increased pressure on Medicaid, and affect Mosaic's capacity to attract a competitive workforce.  ANCOR must play a national role in the growing health care debate, its affect on state reforms, and the capacity of providers like Mosaic to meet their mission.