Steve Gold, The Disability Odyssey continues

In 1987 Congress enacted the Medicaid Nursing Home Reform Act. This Act placed specific requirements on States regarding persons who had a diagnosis of "Mental Retardation/Developmental Disability" and who were either in a nursing facility or were entering one. In 2007, there are still 33,000 persons in nursing facilities who have a MR/DD.

Since 1987, the "State mental retardation or developmental disability authority must review and determine" if persons with MR/DD meet two specific criteria:

1. whether or not the nursing home resident "because of [his/her] physical and mental condition, requires the level of services provided by a nursing facility;" and
2. whether or not the resident requires specialized services for mental retardation."

The State authority cannot delegate this responsibility to a nursing facility. The State office of MR/DD must be the entity to "review and determine" the need for "specialized services" for each person in the nursing home.

States "must ... provide for (or arrange for the provision of such specialized services) for the ... mental retardation." "Specialized services" for persons with MR/DD are above and beyond the typical nursing facility services and be directed to the MR/DD.

In most States, the Medicaid office, which reimburses nursing facilities, and the State Department of Health, which inspects and monitors the nursing facilities, are entirely separate from the "State mental retardation or developmental disability authority."

Are nursing facilities in your State providing "specialized services" to each person with MR/DD who requires such services? Has your State office of MR/DD reviewed each individual and determined what "specialized services" that person needs? How does your State office ensured that "specialized services" are actually being provided to persons who need them?

There are about 33,000 persons who have MR/DD in nursing facilities. Twenty years is a long time to implement this aspect of the Nursing Home Reform Act. Whether these 33,000 people were dumped in these nursing facilities, or somehow got passed through the PASSAR screening, it is quite difficult to believe that they are in fact receiving "specialized services," or that your State office for MR/DD reviews each person individually and holds the nursing facilities accountable for failure to provide "specialized services."

Advocates should not let State MR/DD officials off the hook.

What a great opportunity for the older American and disability advocates to work with the ARCs and Protection and Advocacy Agencies in your State and to offer them assistance in navigating the nursing facility maze.

Following is a list of States and the approximate number of persons in each States who has Mental Retardation/Developmental Disabilities.

Source: Steve Gold, The Disability Odyssey continues
Write to stevegoldada@cs.com, call 215-627-7100, or visit the website http://www.stevegoldada.com