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Medicaid in Fiscal Year 2000- Information Bulletin 5/23/01Medicaid is the primary payment source of health care for disabled and low-income persons. It is also the primary payment sources of what we call Personal Attendant Services. Where the Medicaid dollars go shows whether persons with disabilities receive services in "the most integrated setting" as the Supreme Court required in the Olmstead decision, or whether persons with disabilities receive their health care services in segregated settings. Medicaid's "long term care expenditures" (mostly PAS) can be broken down into (1) community-based services (which includes the Personal Care Option, Home and Community-Based Services Waiver, and Home Health Care) versus (2) institutional-based services (which includes Nursing Homes and Intermediate Care Facilities for persons with Mental Retardation). ICF-MRs. Range from 200 bed institutions down to 6 bed group homes. In federal fiscal year 2000, the long term care expenditures were: 6% for the personal care option, 18% for waivers, 3% for home health care, 58% for nursing homes and 15% for ICF-MR. Therefore, 73% of Medicaid's long term care money went to keep persons with disabilities institutionalized and 27% went to provide services in the community. Let's compare fiscal year 2000 with some earlier years.
While these percentages present a national picture, there is a great variation among States. Obviously, many States spend far more than 27% of their long term Medicaid dollars on community services, and other states spend far less than 27%. Where is YOUR State? How much progress has YOUR State made since 1992? Go to www.hcfa.gov for Your State's Medicaid statistics. In actual dollars, as opposed to the percentages, Medicaid's national total long term care expenditures went from $39 billion in 1992 to $67.7 billion in 2000. In dollar terms, there was an increase in expenditures for community-based services from $5.6 billion in 1992 to $18.1 billion in 2000. Unfortunately, there was also an increase in institutional expenditures from $33.1 billion in 1992 to $49.6 billion in 2000. Obviously, the most growth in community-based services from 1992 to 2000 was with waivers which went from 5% to 18% of the overall long term care expenditures. However, there has NOT been any substantial growth in the two other Medicaid categories of community-based services - the personal care option (See the Information Bulletin - 4/11/01 for more on the "PC Option") and the home health care. In our efforts to expand community-based services, advocates should:
You are moving the system! Keep up the pressure! FREE OUR PEOPLE ! The 2001 Disability Odyssey - Steve Gold [The above analyses were derived from data based on the information gathered by the MEDSTAT Group, Inc. using the HCFA 64 reports.] |
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