Medical Assistance and Living in the Community
February, 2005

Steve Gold writes:

Newspaper stories regarding Medicaid changes seem to appear daily. For persons with disabilities who have been fighting for years to require federal Medicaid funds be used "in the most integrated setting," as the Supreme Court in Olmstead ruled the ADA requires, one potential change is in the right direction.

Specifically, the new Secretary of Health and Human Services, Mike Leavitt, stated on 2/1/05 in a speech entitled "Medicaid: A Time to Act," that HHS was looking for ways "to improve Medicaid coverage." Here's what he said that disability advocates should use with their States.

"We can ensure that seniors and people with disabilities get long-term care where they want it. The President's New Freedom Initiative points us in the right direction. Home and community care can allow many Americans with disabilities to continue to live at home, where they can enjoy family, neighbors, and the comfort of familiar surroundings. MEDICAID SHOULD NOT FORCE THESE PEOPLE TO LIVE IN INSTITUTIONS. Just as importantly, WE CAN SERVE MORE PEOPLE."

"Look at Vermont and New Hampshire. Vermont has a highly developed home and community based health care system. New Hampshire continues to relay on institutional care. In Vermont, 85% of Medicaid population over 65 still live at home. In New Hampshire, only half can live at home. And Vermont spends less than half as much per elderly person on Medicaid as New Hampshire, freeing up money that can serve more people."

"Let me repeat that. PROVIDING THE CARE THAT LETS PEOPLE LIVE AT HOME IF THEY WANT IS LESS EXPENSIVE THAN PROVIDING NURSING HOME CARE. It frees up resources than can help other people. AND OBVIOUSLY, MANY PEOPLE ARE HAPPIER LIVING AT HOME."

Advocates. Tell your State immediately do two things:

1. A "Money Follows the Person" program. Have your State offer this program to every person in a nursing home who answered the 12/30/04 MDS Q1a question "Yes" to wanting to live in the community.
2. A "Close the Front Door" program. Before anyone enters a nursing home in the future, make sure someone who believes in community living, offers the person community-based services.

Remember, the National Governors' Assn. between 2/26 and 3/2 will be meeting in DC to consider Gov. Rendall's Resolution that would, if passed, endorse both "the Money Follows the Person" and "close the front door."

Steve Gold, The Disability Odyssey continues.

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