------------------------------------------------------------------------------ NewsBank, inc. - The Commercial Appeal - 1998 - Article with Citation ------------------------------------------------------------------------------ Headline: PLAN WOULD GIVE DISABLED CHOICE TO GET CARE AT HOME Date: November 20, 1998 Section: Metro Page: B1 Edition: Final Dateline: NASHVILLE Length: 916 words Author: Paula Wade The Commercial Appeal\ Nashville Bureau Text: In what state officials and some advocates for the disabled called a "good first step," Health Commissioner Nancy Menke Thursday outlined a limited new state-federal program to provide long-term care services for eligible people who want to stay out of nursing homes. But, even as Menke unveiled the draft proposal in Capitol Hill's Cordell Hull Building, wheelchair-using members of the American Disabled for Attendant Programs Today (ADAPT) staged a protest in Menke's office three floors above and were removed from the building by state troopers. The group supports allowing all eligible elderly and disabled to choose between nursing homes or state-supported long-term care at home, using the state's existing $750 million nursing home budget to pay for it. Menke's proposal would only cover as many people as could be afforded with new funding, separate from the state's current nursing home budget. Gov. Don Sundquist is expected to recommend $10 million in state dollars, which would be matched on a two-to-one basis by the federal government to provide a $30 million program for Medicaid-eligible Tennesseans. Menke said she believes the package of services described in the proposal would cost an average of $12,000 per person per year to deliver. With a $30 million budget, she said, the waiver program could serve 2,500 people a year. The draft proposal, unveiled before the state's Long Term Care Planning Council and Long Term Care Advisory Council, will provide the basis for a comprehensive long-term care program in future years, Menke said, noting that needed community-based long-term care services aren't even available in many regions of the state yet, and must be developed at some level before the program expands. Right now, almost all of the state's long-term care funds are spent on nursing home services, leaving poor and disabled Tennesseans with few alternatives to nursing home care. The proposal will be submitted to the federal Health Care Financing Administration in the form of a request for a waiver of Medicaid rules. Menke said state officials are still working with the language of that application to give the state the best possible flexibility to administer the program. The ADAPT protest was led by Dawn Russell, a member of the Long Term Care Advisory Council who declined to meet with the rest of the group Thursday because of her objections to Menke's approach. "By continuing to give 99 percent of the money to nursing homes, they've shown where their commitment is, to the nursing homes and not to people with disabilities," Russell said. "All we want is for people to have a choice as to where they want to live and receive services." Sundquist, who was told of the protest during the Republican Governors Convention in New Orleans Thursday, said ADAPT members have "been described as militants. They're not interested in getting anything done. I don't think they're after solutions; they're after media attention." Menke said she regrets that the group opted not to be a part of Thursday's discussions. "I don't think that was the best venue to take when we're all trying to come up with a plan that will help as many people as we can, given the state's re-sources." To be eligible for services under the proposed program, people must be Medicaid-eligible and must meet the medical criteria for nursing home admission. Their care needs at home must cost less than it would cost for them to be in a nursing home. Officials also must be convinced the person has enough of a support system that they are safe staying at home. Carol Westlake, executive director of the Tennessee Disabilities Coalition, said the proposal "is a decent start, but we have a ways to go before we have a comprehensive system of long-term care. It's a good start, because it will help the state build an infrastructure that can be enhanced in the future." Under the program, a nurse or social worker would design a plan of care for each recipient, detailing the types and amounts of services the person needs in order to live at home. The covered services, according to the draft proposal, include: case management, homemaker services (chores, meals, errands), personal care services (personal hygiene, movement), adult day health programs away from the home, minor home modifications, specialized medical equipment, assisted care living, home-delivered meals, nursing services and transportation. The advisory council, created by the legislature to come up with a comprehensive long-term care plan for the state, comprises members of the home care and nursing home industries, advocacy groups and others. The panel has met for four months with state officials to craft a long-term care program, trying to identify what types of services are needed by the elderly and disabled, how to best manage and coordinate services, and how to see that services are available statewide. The waiver program, if approved by HCFA and funded by the legislature, has a target startup date of July 1. To reach reporter Paula Wade, call (615) 242-2018, or E-mail wade@gomemphis.com Copyright 1998 The Commercial Appeal, Memphis, TN Accession Number: 9811200113 ------------------------------------------------------------------------------