For
the past year, Texas' "Money Follows the
Person" bill has been under scrutiny. Steve Gold
from The Disability Odyssey recently issued several
reports on the results of the program.
Texas passed it in late 2003, enabling people who
were placed in nursing homes to end their
institutionalization and have the Medicaid "money
follows the person" into the community. That is,
instead of Medicaid funds paying for nursing home care,
Medicaid funds were shifted to community care.
As of Dec. 31, nearly 3,200 people opted to use
Texas' Medicaid funds to move from nursing homes and
mental health institutions into living arrangements of
their choice. Within this group, six people living in
the community were more than 100 years old when they
moved out of the nursing homes. Another 245 - 8 percent
- were between 90 and 100 years old. A total of 65
percent were more than 65 years old, and 35 percent were
under 65 years old. 66 percent were females.
Nearly all of them chose to receive Medicaid waiver
services to pay for personal care assistants and other
in-home support. Forty-three percent chose to live with
their families; 32 percent decided to live in
"alternative living/residential care"; and 106
resided with other people who were in a Medicaid waiver
program, usually in group homes.
Surprisingly, only 20 percent opted to live alone. I
thought the number would be higher, but finding reliable
in-home care is difficult because of the low wages and
lack of health benefits offered by home health agencies.
Nationally there are 1.4 million people living in
nursing homes. Of those, 19.5 percent, or 273,859,
disabled people have stated they want to live in the
community. Years of research have shown that
nursing-home costs are much higher than any other living
arrangements. But few states have adopted or fully
implemented the "Money Follows the Person"
act, which could save them thousands, if not millions,
of precious Medicaid dollars that are shrinking with
every fiscal budget.
"Allowing persons with disabilities to engage in
`self-direction' is a high priority for the Bush
administration," said Mark McClellan, administrator
of the Centers for Medicare and Medicaid Services, the
agency that oversees federal health insurance programs.
"Self-direction is a proven approach to higher
beneficiary satisfaction for the same or lower
costs."
Human Health Services in Texas reports high consumer
satisfaction with the program, with nursing-home
occupancy rates slowly falling.
If every state adopted and fully implemented a
"Money Follows the Person" act, nursing home
occupancy rates would fall by 20 percent. This would
create jobs in the home health and medical
equipment/supply industries. It would allow Medicaid
monies saved to be moved into existing and new programs.
It would give back the right to pursue happiness to
those who have been long denied.
It's something that doesn't come by often: a win-win
situation.
