Amid Protests, Alabama Medicaid Still Refuses Federal Grant

Amid Protests, Alabama Medicaid Still Refuses Federal Grant

Officials Won’t Budge On Anything Affecting Nursing Home Industry

As I reported in my recent editorial on the subject, our government is circling the wagons to protect their nursing home boondoggle while those who want to receive care at home are left out in the cold. This is a justice issue, and everyone should be paying attention as freedom of choice is denied and our most vunerable citizens are deprived of full lives in the community. Here’s the latest update from the Birmingham News:

Medicaid funding decision jeered
State agency declines to seek federal funds to send elderly home

Friday, September 22, 2006
News staff writer

About 100 activists held a rally at the Capitol on Thursday to protest the state’s decision not to apply for a federal grant that would help the elderly and disabled leave nursing homes and get care in their homes. The federal Centers for Medicare & Medicaid Services this summer announced a Nov. 1 deadline for state Medicaid agencies to apply for their share of $1.75 billion over five years. To qualify for the “Money Follows the Person” program, states must allow Medicaid recipients more access to home and community-based services for long-term care.

But Alabama’s Medicaid commissioner said the program requires too dramatic an overhaul of the state’s long-term care system to be accomplished by the January 2007 start date. The state agency would first have to make sure the
infrastructure is in place to provide enough housing, trained personnel and support systems to care for patients leaving nursing homes, said Commissioner Carol Herrmann-Steckel.

“Taking someone out of the nursing home and putting the person in the community is not easy,” she said.

The new federal initiative also requires state matching money, when the state agency has no money to spare, Herrmann-Steckel said.

Groups such as AARP, Alabama Arise and the Center for Independent Living on Thursday decried the state’s decision not to jump at a chance to get more federal money to give people choices besides a nursing home. The new program offers 85 percent federal money to the state’s 15 percent the first year a person is able to leave a nursing home. That compares to the usual formula of almost 70 percent federal money to fund the health program for the poor.

“We believe it’s a civil right that everyone should have the choice where they want to live if they have the support in the community,” said Scott Renner, executive director of the nonprofit group Montgomery Center for Independent Living.

Differing opinions:

The groups said moving people out of nursing homes will save the state money in the long run.

Herrmann-Steckel said that’s not necessarily true. First, the enhanced
federal match for the new program is only for one year. Secondly, if you move someone out of the nursing home and start paying for that patient to be at home, another person could move into the vacated nursing home bed, adding yet another person to Medicaid’s rolls.

Renner didn’t buy that argument.

“There is no waiting list to get into nursing homes,” he said.

The Medicaid commissioner said the state does have a number of home-care and community-based programs already, although funding for them is capped while state law does not allow the agency to cap the number of nursing home beds
for which it will pay. Herrmann-Steckel also said the state’s Department of Senior Services applied for a pilot program in the Black Belt under the “Money Follows the Person” initiative, but was recently turned down for funding.

“We’re not just sitting back saying `No,'” Herrmann-Steckel said. “We would very much like to see a system where people are allowed to make their own health care choices.”

The advocacy groups plan to push a bill in the Legislature again next year that would require the state to pay for more long-term care options for Medicaid patients. A similar bill died this year. In the meantime, they hope to change state officials minds on applying for the federal grant.

“We’re not giving up,” Renner said

© 2006 The Birmingham News
© 2006 All Rights Reserved.

Filed Under:
Health care and Disability Rights