A number of folks responded to the "Money Follows the Person "Rebalancing Benchmarks'" Information Bulletin that was issued a few days ago. I suggested that "A true rebalancing benchmark would reduce those ratios [of Medicaid expenditures for the Aged/Disabled] so that each year, as one example, the percentages for institutional care would be reduced by 5% and the community- based services expenditures would be increased by 5%. By the end of the five year grant, we would see a true 'rebalancing.' The same principle applies for MR/DD services."

People were quite upset with only a 5% rebalancing per year. I was reminded that at least five states (Oregon, Alaska, New Mexico, Washington, and California) were already at the 50% -50% institutional versus community Medicaid expenditures for "Aged/Disabled" long -term care services.

So we were challenged. Why not 50% - 50% in "Aged/Disabled" MA expenditures by 2010 for every state?

Outrageous? The Human Services Transition Team for Massachusetts new Governor has proposed a 50/50 balance by 2010. In FY 2005 (the last year for which we have data), Massachusetts spent 77% on institutional Aged/Disabled and 23% for community-based services. Massachusetts' 2010 goal reflects a meaningful rebalancing.

Here are the States, starting with the most Unbalanced (again FY 2005). We provide the % going to institutional for Aged/Disabled. (This data is from the CMS 64, Office of State Agency Financial Management, as collected and published by Medstat on July 7, 2006.)

These States have a VERY LONG WAY TO GO! It's not too late.

Institutional for Aged/Disabled; % of total long term care expenditures:

What are the Aged/Disabled advocates doing in these States to achieve a 50/50 balance?