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Expand Community-Based Care and Improve Outcomes for Seniors and People with Disabilities

The Community First Choice option expands access to home- and community-based care in your state, leading to better health outcomes for older adults and individuals with disabilities. We are taught in Pirkei Avot to not separate ourselves from the community, but too often people with disabilities are forced to do just that. Urge your governor and state legislators to implement this option, allowing increased matching funds for more services to more people. 



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  • Health Care
  • Background

    Currently, states receiving federal Medicaid funding are only required to provide nursing home services, while home- and community-based care services are optional. Despite the fact that the vast majority of seniors and people with disabilities strongly prefer to live in the own homes, and that institutional care costs on average over three times more than home-based care, only 35 states currently provide personal care services through their Medicaid plans. Implementing the Community First Choice option would provide states with a six-percentage-point increase in their federal matching payments, allowing them to open eligibility to people with higher incomes and to offer additional services.

    The Community First Choice option would provide greater opportunities for seniors and people with disabilities to live independently in their homes and communities. It would help eliminate Medicaid’s institutional bias, a form of segregation that often forces seniors and people with disabilities unnecessarily into nursing homes. 

    Jewish tradition teaches that providing appropriate health care is not just an obligation for the medical system, but for society as a whole. Maimonides, a medieval Jewish scholar and physician, lists health care among the ten most important communal services that a community must offer its residents (Mishneh Torah, Sefer HaMada IV:23). Judaism also stresses the obligation to ensure equal access for all people and to help facilitate the full participation of individuals with disabilities in religious and public life. We are taught, “Do not separate yourself from the community” (Pirkei Avot 2:5); accordingly, we must prevent anyone from being separated against their will.

    The Community First Choice option expands access to home- and community-based care in your state, leading to better health outcomes for older adults and individuals with disabilities. Urge your governor and state legislators to implement this option, allowing increased matching funds for more services to more people.
    For more information, please contact Eisendrath Legislative Assistant Deborah Goldberg at 202.387.2800.

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