TCDD Position Statement: Access to Health Care
Position Statements
The Texas Council for Developmental Disabilities believes that all people, regardless of their disability, age, or ability to pay, should have access to affordable, comprehensive health care. TCDD supports efforts to increase the access and affordability of health insurance for employer groups and its employees and for those not eligible for employer coverage. The Council believes that full access to health care must be based on the following critical principles:
Comprehensiveness
All people, regardless of their disability, age of onset, or age, must have access to a comprehensive, integrated array of health, behavioral health, rehabilitation, personal, and support services across all service categories and sites of service delivery. To be comprehensive, these services should be provided in the context of a medical home, where the clinician works in partnership with the individual and/or family to ensure that all of the medical and nonmedical needs of the patient are met. A medical home is defined as primary care that is comprehensive, accessible, continuous, consumer-centered, coordinated, compassionate, and culturally effective. Through this partnership, the clinician helps the individual and/or family coordinate and access specialty care, educational services, out-of-home care, family supports, and other public and private community services that are important to the overall health of the individual and/or family. In addition to the traditional acute care hospital and physician services, comprehensive health-related services include, but are not limited to the following:
- wellness and preventive services, including services to prevent secondary conditions or a loss of functional ability;
- health promotion/education services;
- diagnostic services;
- long and short term home and community-based services;
- prescription drugs, biologicals and medical foods;
- mental health and counseling services;
- rehabilitation services and specialty care, including audiology, occupational, physical and respiratory therapy, speech-language pathology services, cognitive therapy, vision and hearing care, behavioral therapies, and therapeutic recreation;
- personal assistance services and independent living services; and
- durable medical equipment and other assistive technology devices, equipment and related services.
Choice
All people, regardless of their disability or age, must be assured that comprehensive health, rehabilitation, personal and support services are provided on the basis of individual need, preference and choice which:
- ensure a level of consumer choice in relation to services and providers;
- ensure a range of service settings through an integrated delivery system;
- ensure an appropriate amount, scope and duration of services; and
- ensure the availability of trained personnel.
Equity
All people, regardless of their disability or age, must be ensured equitable participation in all available health care systems and not be burdened with disproportionate costs. An equitable system:
- limits out-of-pocket expenses and cost sharing requirements;
- provides access to services based on health care need, not income level or employment status;
- ensures adequate reimbursement for service; and
- ensures equity in coverage between mental health and physical health benefits.
Efficiency
All people, regardless of their disability or age, must have access to a comprehensive health care system - including wellness, prevention and treatment services - that provides appropriate, effective, quality services and which minimizes administrative waste. An efficient system:
- reduces administrative complexity and minimizes administrative costs;
- allocates resources in a more balanced way between preventive services, acute care, rehabilitation and chronic care management; and
- maintains effective cost controls so that all people can get the health care services which they need.
Non-Discrimination
All people, regardless of their disability or age, must be able to fully participate in all health care systems and have access to health care services:
- provided in locations and facilities that fully comply with the Americans with Disabilities Act and other applicable accessibility requirements;
- that embrace research that recognizes and includes people with disabilities as a disparity population; and
- that are affiliated with health care training programs which include developmental and mental health disease and best practices.
Transition and Coordination
All people, regardless of their disability or age, must have access to and receive services needed to enable and facilitate sensitive and planned transition and coordination from one health service provider or setting to another, including at least the following situations:
- among primary care and specialty care providers;
- upon discharge from one setting to another, such as from acute inpatient care to less intensive care settings, including to care provided in the home;
- when moving from a pediatric to an adult-serving medical home; and
- when considering and upon entering palliative or hospice care settings.
Reviewed August 6, 2010
