PHLP Comments on Community HealthChoices; Highlights Threat Facing 18- to 21-Year-Olds

Community HealthChoices is the name of Pennsylvania’s plan to require dual eligibles (those on Medicare and Medicaid), as well as all adults on Waivers administered by the Office of Long Term Living, to be enrolled in managed care plans for their Medicaid and any long term care services they receive. In December and January, PHLP submitted detailed comments and recommendations. This included writing on behalf of more than 35 organizations and individuals to request that the Department of Human Services (DHS) reconsider its decision to raise the minimum age of eligibility for Community HealthChoices from 18 to 21 for young adults with significant physical disabilities—e.g., muscular dystrophy, cerebral palsy, spina bifida, and spinal cord injury; disabilities that significantly limit mobility. 
PHLP’s statement details the services that keep these young adults in their homes and communities and out of institutional care—e.g., respite, home modifications and residential habilitation. Denying 18-, 19-, and 20-year-olds these essential supports will place them at serious risk of institutionalization. 
It also contradicts basic principles of adolescent development. As youth move into adulthood around the age of eighteen (often on completion of high school), their choices and challenges shift to decisions about post-secondary education or vocational training, entry into and transitions within the labor market, moving out of the family home, and sometimes marriage. These are positive milestones, but the Department’s current approach will delay, at a critical time, this transition to adulthood. Unaltered, Community HealthChoices will isolate young adults with disabilities, unnecessarily blocking their path to becoming independent and productive.