FW: Help Your State Save Medicaid Funds and Comply with the ADA

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Help Your State Save Medicaid Funds and Comply with the ADA.

stevegoldada@...

Help Your State Save Medicaid Funds and Comply with the ADA.

Information Bulletin # 326 (12/2010)

Twenty-four states in FY 2009 spent less than 25% of their Medicaid Long

Term Care expenditures for home and community-based services. Yes, these

twenty-four states in FY 2009 spent more than 75% of their Medicaid Long

Term Care expenditures on nursing homes! [The list is below.]

Looked at another way, ten years after the Supreme Court in Olmstead

declared unnecessary institutionalization in nursing homes as

discrimination under the ADA, these twenty four states' Medicaid

expenditures are still significantly biased toward nursing homes.

In the last Information Bulletin, " Are you ready for a real fight? " we

discussed all the publicity and outcries about Medicaid expenditures. We

reminded advocates for elderly and disabled people that it was

significantly cost effective to provide services in the community, instead

of paying nursing homes.

We know the reason for the continued institutional bias bthe nursing

home industry contributes a lot of money to your Governors and state

legislators. These political contributions are not acts of charity, but

are the quid pro quo to keep the nursing home industry supplied with

Medicaid cash cows - elderly and disabled people.

Isn't it time to point out to the press, friendly legislators and other

advocates your state's hypocrisy -- complaining about Medicaid costs while

at the same time refusing to reduce nursing home Medicaid expenditures by

providing services in the community?

When Congress enacted the Affordable Care Act of 2010 (at section 10202),

it offered these 24 states the opportunity to receive an increased Federal

Medical Assistance Percentage (FMAP) of five percentage points if your

state rebalances its LTC to be less institutionally biased. [There were

another twenty-one states that spent between 25 % and less than 50% of

their Medicad LTC on community-based services. If these states rebalance,

they will receive an additional two percentage FMAP points.]

That's five additional percentage points on what your State spends on its

HSBC programs and services. We're talking a lot of additional money from

those five points!

Does your Governor want to increase the community-based expenditures by

five percentage points for basically complying with the ADA? It'll cost

no additional money - just rebalancing the budget.

Under Section 10202 of the ACA of 2010, if your Governor is really serious

about saving Medicaid funds, he/she must submit a plan to the U.S.

Department of Health and Human Services, and describe how the state will

rebalance its program to increase its community-based expenditures and to

decrease its nursing home expenditures. Let's hope HHS really holds the

States to a high standard.

This increased FMAP does require a state to have: (1) a single entry

point so that before a person goes into a nursing home, the person is

really offered the choice of community-based services; (2) an assessment

instrument used state-wide to determine what services a person needs to

live in the community; and (3) case management services that are conflict

free. One might think that these three would already exist in every

state, but obviously they do not.

Okay. That's what your Governor has to do to increase federal Medicaid

funds. Now the issue is whether or not your Governor will submit a plan.

Write letters to the newspaper posing the question. Telephone supportive

legislators. Find out if your state will submit a plan.

Here are the 24 States that in FY 2009 expended less than 25% of their

Medicaid LTC on community-based services and, therefore, conversely spent

more than 75% on nursing homes:

Alabama

Arizona*

Connecticut

Delaware

Florida

Hawaii*

Illinois

Indiana

Kentucky

Maine

land

Michigan

Mississippi

Nebraska

New Hampshire

New Jersey

North Dakota

Ohio

Pennsylvania

Rhode Island

South Dakota

Tennessee*

Utah

Wyoming

* Data for these states does not include certain LTC expenditures within

managed care programs.

Steve Gold, The Disability Odyssey continues

Back issues of other Information Bulletins are available online at

http://www.stevegoldada.com

<http://www.stevegoldada.com/> with a searchable Archive at this site

divided into different subjects.

As of August, 2010, Information Bulletins will also be posted on my blog

located at http://stevegoldada.blogspot.com/

<http://stevegoldada.blogspot.com/> To contact Steve Gold directly, write to

stevegoldada@... or call

215-627-7100.

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