Medicaid in-home care services are proving an easy place for lawmakers to cut as states face increasingly tight budgets, but the changes are putting some residents with disabilities in a tough spot.
In-home care generally costs less to provide than institutions, nursing homes or group home settings for individuals with disabilities, but the flexibility of the services also mean they are easier and quicker to put on the chopping block. Plus, in-home care is one area that states have some wiggle room as opposed to other Medicaid services like hospital visits and nursing home care that are mandated by federal law.
Already this year, South Carolina, Vermont and California are among the states making drastic cuts to in-home care as Medicaid becomes a bigger part of nearly every state’s budget. And the situation is likely to get worse next year when extra Medicaid funding provided by the federal government through the stimulus program is set to expire.
The results can be devastating for individuals who rely on assistants to use the bathroom and for other critical needs. Recipients of in-home care across the country are learning that the number of hours each day their personal attendants will be paid are being slashed. In some cases, family members are able to pick up the slack. But long-term, cuts could end up costing states more, experts say, as family members age and are no longer able to take over where in-home supports left off, reports The Wall Street Journal. To read more click here.
On behalf of my adult son with a disability and myself as his state contracted care provider, I am part of a 5 family lawsuit against the state of Washington. In 2009 my state made a 3 1/2 % reduction in services for our family members. My state did this to balance their budget. Each of our family members with various disabilities are on what our state of Washington calls “Waivers”. People on “waivers” are supposed to be protected from state cuts to services. Our state told us that the person with the disability was supposed to tell us which of their services they no longer needed. My son, doesn’t even know what services he needs, let alone what he no longer needs. These cuts have put my son’s life and the life of many in danger. His health, safety and life depends on him receiving all of the care he is entitled to. The “waiver” program is a Federal program and our state (in our opinion) has violated Federal mandates. We will not allow our state to make cut after cut to the services of our family members. They did it last year (but obviously not without a fight from me and the other 4 families) and without opposition, they will do it again. My call the everyone in every state, is to get a good lawyer and fight these decisions made against people with disabilities. Their lives depend on it.
Waivers are not an entitlement. Medicaid state plan services are an entitlement. The waivers waive the entitlement and allow states to develope waiting lists or other service limits, i.e., age, disability type, etc. ICF-MR institution is NOT an entitlement. ICF-MR is an “optional” state plan service and has been since its creation. SNF is an entitlement (skilled nursing facility). So, if you are MR/DD and need skilled nursing care, you will be eligible for SNF. I have written my federal representatives begging for this to be changed due to the new entitlements ObamaCare will add to all state plan services (133% of poverty, no age or disability required). It is important to know the difference between your state plan services and any waiver service. By the way, CA is the only state where ICF-MR and other MR/DD services are an entitlement because decades ago they passed the Lanternman Act and that is currently under assault.