‘Live at home on your dime or accept nursing care’
March 3rd, 2009
Young adult finds rigid Medicaid rules limit her options after a stroke; Institutional bias stymies people with disabilities and their families.
From the Wichita Eagle:
After Kansas resident Nicolette Perez (left) survived a stroke last year, her parents faced a difficult choice: place their 28-year-old daughter in a nursing home with government funding, or keep her at home with no government funding for home care. They decided to go it alone and care for their daughter at home.
Even though everyone involved agreed that paying for home health care would be cheaper for the government and better for Perez, federal Medicaid law considers community-based services optional while nursing-home care is an entitlement. In tough economic times, optional programs are increasingly losing funding.
By comparison, the state of Vermont recently rewrote its laws and renegotiated its contracts with the federal government to give people with disabilities a choice between institutional care and home care.
In doing that, Vermont substantially cut the number of high-cost nursing-home days it pays for, freeing an estimated $80 million a year to expand home- and community-based services.
“It takes away what is called the ‘institutional bias,’ ” said Joan Senecal, commissioner of the Vermont Department of Disability, Aging and Independent Living. “The goal was not to save money, but to serve more people with the same money. It’s worked out very well.”
(Wichita Eagle photo)
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