NCD advises CMS to caution states against blanket waiver usage that could increase institutionalization

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April 15, 2020

WASHINGTON—The National Council on Disability has sent a letter to the Centers for Medicare & Medicaid Services regarding potential institutionalization of people with disabilities due to COVID-19.

The letter, addressed to CMS Administrator Seema Verma, requested her to caution states’ usage of CMS blanket waivers pertaining to long-term care facilities, skilled nursing facilities (SNFs) or nursing facilities (NFs).

NCD understands the COVID-19 pandemic is of the like that our country has never seen and understand that drastic measures need to be taken in preparation to combat the pandemic,” wrote NCD Chairman Neil Romano. “However, freeing up hospital beds for COVID-19 patients should not be achieved at the detriment of persons with disabilities.”

The specific blanket waivers that lead to the institutionalization of people with disabilities are waiver of the three-day hospitalization stay prior to admission to an SNF, Minimum Data Set (MDS) assessments, staffing data, and Preadmission Screening and  Resident Review (PASRR).

 “Persons with disabilities incur long-term repercussions when transferred to an institutional setting. Even if the intent is short-term,” wrote Chairman Neil Romano.

Last May, NCD published the report Preserving Freedom: Ending Institutionalization of People With Disabilities During and After Disasters. The report highlighted the institutional rate of persons with disabilities during and after Hurricane Katrina, Harvey, Irma and Maria.

“Clearing hospital beds should not be achieved by placing people with disabilities in a restrictive setting in which they risk the loss of autonomy, home, employment, community supports and in the wake of COVID-19, their life.”

The letter is available at NCD.gov.