"States Cut Services For Elderly, Disabled," and Our Response?
"States Cut Services For Elderly, Disabled," and Our Response?
by Steve Gold
The Wall Street Journal's article "States Cut Services for Elderly, Disabled " (11/20/08 at D1) should be read by advocates for people with disabilities and for the elderly.
Advocates should be aware that if your state reduces its Medicaid home-care services, whether personal attendant care hours and eligibility, home health, number of prescriptions, other services, there may be ADA legal challenges available to stop these reductions.
Be on the look out in your state for:
1. Medicaid reductions that discriminate based on severity of disability so that reduced benefits will provide adequate services for persons with less severe impairments but not be adequate for persons with more severe disabilities.
2. Community-based Medicaid reductions without any significant reductions in the institutional expenditures. Think about how much Medicaid funds could be "saved" in your state by reducing the nursing home Medicaid per diem reimbursements by $3.00 a day. With 53.3% of the 1,153,601 nursing home residents paid by Medicaid, a $3.00 per day reduction could go a long way to resolving other budgetary reductions.
3. Medicaid reductions that force people, in order to survive, to have to go into an institution to receive the same services that they had been receiving in the community. People with disabilities of any age should not have to go into a nursing home in order to receive services!
4. Medicaid reductions that are not individually determined and therefore do not provide for flexibly applying "reasonable accommodations" to assess what services may be necessary to stay out of an institution.
5. Medicaid waiver reductions that are based on "individual" cost neutrality rather than "aggregate" cost neutrality.
6. Reductions and payments for services that do not recognize and take different levels of "need" into account, but instead lump all disabled persons into one need-category.
Have no doubt that, if your state officials think the disability and elderly advocates will take reductions in community-based services lying down, they will use the current economic climate as an excuse.
Share your Stories
Let your fellow activists know what is happening in your state and how you are fighting by commenting below.
by Steve Gold
The Wall Street Journal's article "States Cut Services for Elderly, Disabled " (11/20/08 at D1) should be read by advocates for people with disabilities and for the elderly.
Advocates should be aware that if your state reduces its Medicaid home-care services, whether personal attendant care hours and eligibility, home health, number of prescriptions, other services, there may be ADA legal challenges available to stop these reductions.
Be on the look out in your state for:
1. Medicaid reductions that discriminate based on severity of disability so that reduced benefits will provide adequate services for persons with less severe impairments but not be adequate for persons with more severe disabilities.
2. Community-based Medicaid reductions without any significant reductions in the institutional expenditures. Think about how much Medicaid funds could be "saved" in your state by reducing the nursing home Medicaid per diem reimbursements by $3.00 a day. With 53.3% of the 1,153,601 nursing home residents paid by Medicaid, a $3.00 per day reduction could go a long way to resolving other budgetary reductions.
3. Medicaid reductions that force people, in order to survive, to have to go into an institution to receive the same services that they had been receiving in the community. People with disabilities of any age should not have to go into a nursing home in order to receive services!
4. Medicaid reductions that are not individually determined and therefore do not provide for flexibly applying "reasonable accommodations" to assess what services may be necessary to stay out of an institution.
5. Medicaid waiver reductions that are based on "individual" cost neutrality rather than "aggregate" cost neutrality.
6. Reductions and payments for services that do not recognize and take different levels of "need" into account, but instead lump all disabled persons into one need-category.
Have no doubt that, if your state officials think the disability and elderly advocates will take reductions in community-based services lying down, they will use the current economic climate as an excuse.
Share your Stories
Let your fellow activists know what is happening in your state and how you are fighting by commenting below.
We are facing proposals to lower the eligibility for Medicaid in Virginia to 74% of the Federal Poverty Level, down from the already too low 80% of FPL which already exludes almost everyone who has SSDI benifits and not SSI benifits. We are also facing proposals to freeze the Medicaid roles and to lower Medicaid payments to doctors and other providers. We are also facing cuts in community services so more folks will end up in psychiatric and other institutions except we also had a cut in funding for community psychiatric units so folks may end up with no care or in state hospital beds opened up which is the most expensive way to "treat" someone.
Posted by: Alison Hymes | December 01, 2008 at 11:24 PM
After trying for months to get some computer training and maybe some better equipment so I could work from home. I got a letter saying I was being re-veiwed for benefits. The Voc-Rehab guy then put me into a Computer search for jobs program-3 hours a day-fifteen, usually more like 10 hours a week at minimum wage. I have trouble sitting straight through for 3 hours, but I'm afraid they will kick me off SSD if I dont do what they say. They constantly threated to fire us.
Voc-Rehab paid this subcontractor in the neighborhood of 5 grand and maybe more to put me in this hell-hole position. I can only hope it leads to something worthwhile.
Posted by: AL | December 02, 2008 at 10:24 PM