From the New York Times:

A growing number of states are teaming up with Medicaid to help elderly people and those with disabilities move out of nursing homes and back into their communities.

Walter Brown, 72, says the transition to his own home has dramatically improved his life. Brown, who had a stroke two years ago, said living in a nursing home was “like being in jail.” Now he says he is “more confident in my future.”

The new programs in 29 states are a sharp departure from past practices, in which Medicaid practically steered people into nursing homes. Each participating state has designed its own program, called Money Follows the Person. The federal government provides extra funding for the first year.

“Medicaid has had an institutional bias in favor of nursing homes,” even for people who do not need them, said Gene Coffey, a staff lawyer at the nonprofit National Senior Citizens Law Center. “Federal law requires states to provide nursing home services. They don’t have to provide home or community-based services.”

(Photo from the New York Times)

From the New York Times:

People with speech disabilities question why Medicare and private insurers are declining to cover mainstream devices like iPhones and netbook PCs that can help them communicate.

Insurers say coverage is restricted to medical devices, not gadgets that can also be used for nonmedical purposes like playing video games or browsing the Internet. Consequently, they are limiting coverage  to dedicated, proprietary devices that cost 10 to 20 times more and can do far less.

Kara Lynn uses a $300 Apple iPhone 3G running $150 text-to-speech software, which serves her better than the $8,000 Medicare-approved computer that she used previously.

For Ms. Lynn, the iPhone, with the special software, is cheaper, more effective and essential. “Technology has become as important to me as air, food, water,” she wrote.

By Barbara Shelly in the Kansas City Star:

Hundreds of people with developmental disabilities in Kansas are waiting years after completing high school to get a job or placement in a sheltered workshop.

The problem is so pervasive that advocates have a term for it – graduating to the living room. The state invests millions of dollars in public school special education programs, and then leaves the graduates to languish at home.

Emily Thomas, who has multiple physical and intellectual disabilities, has been idling at home for four years without a place to go or a purpose to her days. Her mother worries that the state’s neglect has left Emily isolated, and deprived her of the opportunity to have friends outside her family.

Helping Kansans like Emily lead a productive life is a state responsibility – one that lawmakers and governors have largely shirked for a decade.

From the Austin [TX] American-Statesman:

Four years after lawmakers approved a program designed to help thousands of Texans with disabilities, the program serves only 69 people across the state, according to state officials.

The program allows adults with disabilities to work and still be eligible for Medicaid, the federal-state health insurance program.

Officials say a major obstacle is the public perception that people with disabilities will lose their benefits if they go to work.

The Lexington [KY] Herald-Leader reports that the U.S. Department of Health and Human Services has launched a civil rights investigation into Kentucky’s Medicaid program after a family complained about a reduction in home care services for a man with multiple disabilities.

Creasa Reed, who is herself disabled, filed the complaint after Medicaid cut her son’s budget for in-home care by 40 hours each week. The cuts left Reed and her husband responsible for providing 88 hours of care each week to their 31-year-old son, James, who is described as autistic, bipolar and mentally handicapped.

The Reeds say their son is in danger of being sent to an institution if home care services are not restored.

According to a June 12 letter that the U.S. Department of Health and Human Services Office for Civil Rights sent the Reeds, the office will be investigating whether state Medicaid officials acted appropriately when they cut James Reed’s services without considering that Creasa Reed has a disability and might not be able to provide 88 hours of care.

See also: Report from WKYT-TV

From the Seattle Times:

The families of three children with Down syndrome have filed a suit in federal court to stop the state of Washington from cutting back on their Medicaid-funded in-home care. The families say budget problems cannot be used to justify cutting back on services the children are legally entitled to receive.

According to [the Department of Social and Health Services], the cuts would affect approximately 3,100 disabled children and save the state about $3 million over two years.

According to the lawsuit, … the plaintiffs have disabilities so severe they would be eligible for placement in state institutions if they were not cared for at home. The suit says the children’s parents and guardians already save the state money by assuming responsibility for their care.

… Each child currently receives between 72 and 141 hours of in-home assistance each month.

State actions show a ‘deficit of decency’

Columnist Adrian Walker writes in the Boston Globe that Massachusetts budget cuts promise “a bloodbath for the disabled,” even though disability advocates played a key role in the lobbying effort that is bringing the state an extra $90 million in federal Medicaid funding.

Walker says only a fraction of that money is headed for healthcare, and almost none will go to the agencies that helped fight for it. Instead, Walker says, the money will go into the state’s general fund “to be spent on whatever.”

The impact on the developmentally disabled will be direct and immediate. Roughly 4,500 families will lose state aid that helps them care for the disabled at home. Employment and job training programs have been cut.

All this for a community that was underserved even before the cuts.

… It’s easy – far too easy – to paint lawmakers as villains when they are dealing with the worst fiscal crisis in well over a decade. But legislators routinely drone on about their commitment to the most vulnerable among us in public, while failing to follow through in private. This is just a particularly blatant example.