|
Nursing homes rule long term care
From Steve Gold
Information Bulletin # 35
 |
|
Steve Gold |
The 2001 Medicaid data is now available (www.medstat.org or
www.hcbs.org). Progress is slowly being made to reverse in the institutional bias in Medicaid expenditures. However, we have a long way to go to end the discrimination that results in warehousing people with disabilities.
This Information Bulletin presents one aspect of the institutional bias" Medicaid funds expended per state to keep people institutionalized in nursing homes COMPARED TO Medicaid funds expended to keep persons in the community and in their own homes.
In order fairly to compare nursing home expenditures with the community, we have added the Medicaid's Personal Care option (see Information Bulletin # 8,
www.stevegoldada.com), Medicaid's Home Health (see Information Bulletin #10) , and the Medicaid's Waivers for Aged, Aged/Disabled, and Physically Disabled which are intended to offer persons a community option instead of nursing homes.
Under the Medicaid statute, before persons go into a nursing home, they MUST be offered the "choice" of living in their own homes WITH APPROPRIATE SERVICES (e.g., services provided in the Personal Care option, or one of the Waivers, and any necessary home health care). If your state has been complying with the law, people with disabilities should be told about the community based services and given the option to stay in their own homes before entering into a nursing home.
WHAT ADVOCATES COULD DO:
1. Organize to require your State's Medicaid nursing homes funds to "follow the person." If the nursing home funds were available to the person, then each person could exercise a meaningful choice between the nursing home and the community.
2. Ask your state to put a moratorium on nursing homes until your state achieved a real parity with community services.
3. Share the disparity with the press. They really do not know what a big for-profit business the nursing home industry is.
Here are the numbers for 2001: the amount of Medicaid funds for nursing homes COMPARED TO the total amount spent on both Medicaid's Personal Care option, Home Health and the three Waivers that are supposed to avoid unnecessary segregation in nursing homes.
| STATE |
FUNDS
TO NURSING HOMES |
FUNDS
IN COMMUNITIES |
% |
| Alabama |
673,000,000.00 |
87,000,000.00 |
89% |
| Alaska |
71,000,000.00 |
32,000,000.00 |
69% |
| Arizona |
12,000,000.00 |
2,500,000.00 |
83% |
| Arkansas |
369,000,000.00 |
134,000,000.00 |
73% |
| California |
2,598,000,000.00 |
1,612,000,000.00 |
62% |
| Colorado |
359,000,000.00 |
148,000,000.00 |
71% |
| Connecticut |
1,024,000,000.00 |
224,000,000.00 |
82% |
| Delaware |
110,000,000.00 |
15,000,000.00 |
88% |
| D.
C. |
158,000,000.00 |
16,000,000.00 |
91% |
| Florida |
1,702,000,000.00 |
209,000,000.00 |
89% |
| Georgia |
760,000,000.00 |
138,000,000.00 |
85% |
| Hawaii |
148,000,000.00 |
25,000,000.00 |
86% |
| Idaho |
118,000,000.00 |
50,000,000.00 |
70% |
| Illinois |
1,499,000,000.00 |
175,000,000.00 |
90% |
| Indiana |
817,000,000.00 |
70,000,000.00 |
92% |
| Iowa |
373,000,000.00 |
64,000,000.00 |
85% |
| Kansas |
479,000,000.00 |
145,000,000.00 |
77% |
| Kentucky |
565,000,000.00 |
189,000,000.00 |
75% |
| Louisiana |
1,158,000,000.00 |
33,000,000.00 |
97% |
| Maine |
201,000,000.00 |
35,000,000.00 |
85% |
| Maryland |
696,000,000.00 |
99,000,000.00 |
88% |
| Massachus |
1,423,000,000.00 |
98,000,000.00 |
94% |
| Michigan |
1,743,000,000.00 |
197,000,000.00 |
90% |
| Minnesota |
901,000,000.00 |
267,000,000.00 |
77% |
| Mississippi |
415,000,000.00 |
36,000,000.00 |
92% |
| Missouri |
1,040,000,000.00 |
231,000,000.00 |
82% |
| Montana |
111,000,000.00 |
46,000,000.00 |
71% |
| Nebraska |
369,000,000.00 |
56,000,000.00 |
87% |
| Nevada |
92,000,000.00 |
24,000,000.00 |
79% |
| New
Hampshire |
209,000,000.00 |
20,000,000.00 |
91% |
| New
Jersey |
2,193,000,000.00 |
322,000,000.00 |
87% |
| New
Mexico |
165,000,000.00 |
88,000,000.00 |
65% |
| New
York |
6,392,000,000.00 |
2,863,000,000.00 |
69% |
| North
Carolina |
876,000,000.00 |
508,000,000.00 |
63% |
| North
Dakota |
151,000,000.00 |
8,000,000.00 |
95% |
| Ohio |
2,313,000,000.00 |
208,000,000.00 |
92% |
| Oklahoma |
426,000,000.00 |
76,000,000.00 |
85% |
| Oregon |
542,000,000.00 |
256,000,000.00 |
68% |
| Pennsylvania |
3,684,000,000.00 |
1,558,000,000.00 |
70% |
| Rhode
Island |
244,000,000.00 |
23,000,000.00 |
91% |
| South
Carolina |
373,000,000.00 |
114,000,000.00 |
77% |
| South
Dakota |
155,000,000.00 |
7,000,000.00 |
96% |
| Tennessee |
784,000,000.00 |
4,000,000.00 |
99% |
| Texas |
1,604,000,000.00 |
670,000,000.00 |
71% |
| Utah |
92,000,000.00 |
8,000,000.00 |
92% |
| Vermont |
84,000,000.00 |
27,000,000.00 |
76% |
| Virginia |
528,000,000.00 |
92,000,000.00 |
85% |
| Washington |
614,000,000.00 |
454,000,000.00 |
57% |
| West
Virginia |
293,000,000.00 |
86,000,000.00 |
77% |
| Wisconsin |
960,000,000.00 |
338,000,000.00 |
74% |
| Wyoming |
39,000,000.00 |
5,000,000.00 |
89% |
| Total |
42,705,000,000.00 |
12,192,500,000.00 |
78% |
Steve Gold, The Disability Odyssey continues
Back issues of other Information Bulletins are available online at http://www.stevegoldada.com with a searchable Archive at this site.
Data supplied by The MEDSTAT Group from HCFA 64, Office of State Agency Financial Management.
Nursing Homes and HUD
Steve Gold
Information Bulletin # 34
HUD is at it again! HUD admits that people with disabilities have "worst case" housing needs and cannot find adequate affordable, accessible integrated housing. Nevertheless, when it comes to real action and real financial assistance (follow the money), HUD responds to institutional providers - the nursing home industry.
HUD insures mortgages for nursing homes and Assisted Living facilities under a program called Section 232. The nursing home industry has used this program to warehouse people with disabilities in nursing homes. This for-profit $70 billion a year industry is now seeking relief for its mortgage loans on which it is defaulting. In 2001, there were $174 million in HUD-insured nursing home mortgages in default and another $58 million in default in 2000.
How much money will HUD waste on the nursing home industry in 2002? .
Rather than provide an adequate supply of affordable and accessible housing in the most integrated setting “Our Homes, Not Nursing "Homes" HUD has wasted at least $234 million of public money and is perpetuating segregation by propping up an industry that is corrupt and by any estimation failing. This is a prime example of federal support for "corporate welfare" that segregates and unnecessarily institutionalizes persons with disabilities.
Where is HUD's commitment to the President's New Freedom Initiative? HUD has established a committee of representatives "Section 232 stakeholders," including the American Health Care Association which recently reported on these defaults [AHCA is the multi-million dollar lobby for the nursing home industry]. Guess what they'll recommend? Once again, the fox will be guarding the hen house.
What advocates can do?
1. Tell HUD to foreclose on the defaulting mortgages and then acquire the nursing home properties for sale. Tell HUD to sell the acquired properties and use the money for affordable, accessible integrated housing that will keep or get folks out of nursing homes.
2. Ask your local HUD officials which nursing homes were bailed out under the 232 program. Then ask them why they were not sold?
3. Tell HUD to stop financing nursing home mortgages and stop segregating persons with disabilities.
Don't mourn ... Organize.
Steve Gold, The Disability Odyssey continues
Back issues of other Information Bulletins are available online at http://www.stevegoldada.com with a searchable Archive at this site.
|
