Steve Gold, The Disability Odyssey continues
Earlier this year, we provided a breakdown by Independent Living Centers
of the number of persons in 2005 that each center successfully relocated
from nursing homes. We also provided national data for 2004.
Some ILCs questioned the accuracy of the data and RSA's reporting process.
Some were upset that we published the name of their ILC with the low
numbers. Some thought that the ILC movement should not publicly provide
the data. Please be very assured that my purpose of providing such data
is to push a debate - not editorialize nor imply opinions - regarding the
role of ICLs, and to move beyond whether we should be getting people out
of nursing homes.
To recap, in 2004, there were 2,864 people ILCs reported to RSA, the
federal funding agency, who were "successfully relocated" from a nursing
facility to the community. In 2005, there were 2,867.
Pursuant to the Freedom of Information Act, we obtained RSA data for 2006.
Even though we have this information by state and by ILC, we decided to
summarize the data, instead of providing it by ILC.
These results are for only federally-funded ILCs as they reported the
information to RSA.
The national total for 2006 was 2,631 people whom federally-funded ILCs
relocated from nursing homes.
RSA had requested each ILC to set a goal of the number of people the ILC
hoped/planned/set as a goal to relocate from the nursing homes. It also
requested the actual number that the ILC relocated.
These 2,631 people represent 54% of the total number (i.e., 4,894) that
the 354 federally-funded ILCs had hoped to relocate and had set as their
goal. Here are the results.
17% of the ILCs had set a goal of relocating zero nursing home residents.
18% had set a goal of relocating one or two nursing home residents. 18%
had set a goal of three to five. 10% had set a goal of six to nine. 18%
had set a goal of ten to twenty. 19% had set a goal of twenty-one or more
relocations.
If these goals had been met, then the ILCs would have relocated 4,894
people from nursing homes.
The actual accomplishments show that:
- 21.5% of the ILCs each relocated zero nursing home residents
- 23.6% of the ILCs relocated one or two nursing home residents
- 15.7% relocated three to five nursing home residents
- 17.5% relocated six to nine residents
- 11.5% relocated ten to twenty residents
- 10% relocated more than 21 nursing home residents
The ILCs in 2006 relocated a total of 2,631 people from nursing facilities.
These percentages present a number of questions:
- Is there a correlation between the size of the ILCs and either the
goals or their actual accomplishments? A correlation between amount of
ILCs budgets and accomplishments?
- Are ILCs who relocate more people making this a budget priority
regardless of size of budget? Making this a primary service and providing
the "core" required service to this population?
- What is the relationship between a State's Medicaid "targeted case
management" funds and the ILCs? Do ILCs contract with the Medicaid office
who receive and use these funds relocate more people than ILCs that do not?
- Is "success" even related to the numbers? Is it fair to use data? Is
it fair or reasonable to presume that ILCs should be relocating persons
from nursing homes?
- What assistance would an ILC in your State need or want in order to
increase their outreach to nursing home residents? Assistance in working
with their Medicaid offices? Increasing affordable, accessible housing in
existing federally funded programs?
- Is it unfair to focus on this issue without also providing data for
ILCs regarding, e.g., assistance in finding employment or housing, or in
diverting people from going into the institutions and staying out?
- What would it take to increase the numbers substantially?
- What practices are the ILCs which relocated ten or more people doing
that they can share with other ILCs? What barriers have they faced? What
successes did they have? What is the forum for this dialogue to take place?
- Why isn't there a national focus on this? What has happened to the
Rehabilitation Act making this a "core" service?
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