Medicaid Managed Care - U.S. Senate Special Committee on Aging

10
obstetric and gynecological services from a specialist knowledgeable about
disability. As she ages, she will require an orthopedic or physical medicine
specialist to assist her in determining which mobility aides she should use to
balance the competing needs for mobility and exercise.
Summary Needs: Although it is difficult to draw general conclusions from only four profiles
of individuals with disabilities, there are several overarching themes that
can be identified from these people.
* The first and most important theme is their need for access to a variety of specialists,
especially those knowledgeable about disability. These specialists may or may not be most
effective playing the role of primary care physician, depending upon the unique needs of
each individual.
* The second theme is the need for home and community-based long-term services and
assistive technology. These essential supports enable individuals with disabilities to -
access health care, to work, to attend school, and to recreate. They are critical for the
prevention of secondary disabilities; as they enable people with disabilities to avoid
behaviors that trigger secondary conditions. The classic example is spinal cord injured
persons who restrict drinking fluids because they have no assistance in using the
bathroom, which leads to a urinary tract infection.
* Prescription medications assist people in managing the myriad conditions that often
accompany disability. They too can prevent or delay the onset of secondary disabilities
and debilitating conditions that can transmute into expensive acute care episodes..
* Service coordination is needed to afford continuity among the many specialists and
related service personnel (long-term, assistive technology, and social services).
Appropriate application of coordination, as opposed to case management, of health and
related services can both raise the quality of services delivered and reduce the cost of these
services.
* One often overlooked theme is that most individuals with disabilities are quite healthy.
Routine health screenings to maintain this good health are vital for the prevention of
secondary disabilities as well as the prevention of other common ailments affecting the
general population.
I have attached a list of important principles for your consideration when designing managed care
programs intended to serve individuals with disabilities. Thank you for the opportunity to share
this information with you. I would be happy to answer any questions you might have.
United Cerebral Palsy Associations Page 3 of 9