NPR Shines its Spotlight on Home and Community Based Services

From NPR (12.2.10):

Home Or Nursing Home: America's Empty Promise To Give Elderly, Disabled A Choice

About this series:

There's been a quiet revolution in the way the elderly and young people with disabilities get long-term health care. A new legal right has emerged for people in the Medicaid program to get that care at home, not in a nursing home.

States, slowly, have started spending more on this "home- and community-based care." But there are barriers to change: Federal policies are contradictory, and states face record budget deficits. As a result, for many in nursing homes — or trying to avoid entering one — this means the promise to live at home remains an empty promise.

Read or Listen to the first story from All Things Considered

Care At Home: A New Civil Right

by Joseph Shapiro

>>> For the story

>>> For the transcript

A second story on federal enforcement since the Olmstead decision runs on All Things Considered Friday. The transcript will also be available at www.npr.org.

Home Care Might Be Cheaper, But States Still Fear It

by Joseph Shapiro

For states, it's the big unanswered question about expanding opportunities for elderly and disabled people to get their long-term care at home: How much is all this going to cost?

In 1999, the U.S. Supreme Court ruling in Olmstead v. L.C. said that the unnecessary institutionalization of people with disabilities is a form of discrimination. State Medicaid programs are required to provide alternatives so that the elderly and disabled can choose to get their care at home, instead of in state institutions or nursing homes…

>>> For the whole story

>>>For an Interactive Map of Community-Based Medicaid Spending by State

Olivia Welter, Other Severely Disabled Adults Win Round In Court Battle

by Joseph Shapiro

A U.S. District Court judge in Illinois has certified a class action lawsuit on behalf of eight people with severe disabilities who have either aged-out of a medical program for children or who are in danger of soon reaching the age cut off.

Among those included in the suit is Olivia Welter, an Illinois woman who turned 21 on Nov. 9 and as a result faces losing the level of state-funded care that her parents say has kept her healthy and alive...

>>> For More on Olivia and Home Care for the Children of Illinois

Next week, two more stories will run. The first will run on Morning Edition, December 9th. It looks at the surprising group that is a growing percentage of the nursing home population: 31 to 64 year olds. This is built around the story of Michelle Fridley, at an ADAPT action in Washington in the spring.

That night on All Things Considered, NPR will run a story on the Children's Freedom Initiative, an attempt to find alternatives to nursing homes for young people with disabilities.

These stories and more will be available through www.NPR.org so stay tuned.

Comments

[J. Ito-Carver]

People who are unable to care for themselves should be given a variety of options and not feel forced to live where insurance dictates. Providing a superior quality of life for individuals who are unable to care for themselves should take priority over the cost of care. The quality of life in nursing home facilities can be quite disheartening for some because the staff is overwhelmed with the large number of residents that they need to care for. Although there is a direct correlation between adequate staffing and quality of care, at the facility that I’m familiar with, the ratio on any given night is two aides to 50 residents. I have also observed poor housekeeping practices and poor nursing care which leads to deteriorating health for many of these individuals.
Home based care, on the other hand, has many advantages. Many seniors prefer to stay in their own home for as long as possible and home based care can be more economical. It’s a higher level of care at a lower cost and most seniors are healthier, happier, and able to maintain a better quality of life.
The only thing worse than change, is change that you have no control over and we need to ensure that seniors and individuals with disabilities feel that they still have some control over their life and are able to maintain the highest level of independence, as well as their dignity, for as long as possible.

[Shannessy M. Mitchell]

Seniors and individuals who have disabilities should be given the choice as to where they would like to reside, granted that family members are wiling to care for the elderly or person with disabilities. Quality of life is something that we all strive for. A person who is unable to care for themselves should be a part of the decision making process that ultimately affects their life. It is inhuman to make decisions for a person who is cognitively aware to make decision for themselves. On that same note insurance companies should not have control over where a person resides and cost issues should not take precedents over a person quality of life. Speaking from experiences nursing homes are not always up to par. The nursing home where my loved one resided gave inadequate care, paid little attention to the needs of the individual, and it appeared that the nurses there were burnt out. Ultimately my loved one received poor care and it seemed as though she had no will to live after being in a nursing home for two weeks. It is crucial to provide options for elderly persons so they can live out the rest of their days with the highest level of happiness possible.

[jward52]

There is 'NO CHOICE' for the DISABLED Citizens! - Just ask the so-called State BVR's,-- These agencies for so-called Voc-Rehab talk "CHOICE", but actually mean - do as we the Counselors say or else- You incompetent Disabled's. - Like Ohio RSC BVR,- they also talk- "CHOICE',- but the Disabled Client gets little or NO Personal CHOICE in developing an IPE- Individual Plan for Employment! - Their' Policy is "Don't-Rock-the-Boat" - because You Disabled Clients DO-NOT know what is best for You!!??