Elderly, disabled aid costs soaring
Print
Email
Save
Twitter
Social Media
Del.icio.us
Digg
Facebook
Reddit
About 5,428 people are getting the care that keeps them out of nursing homes and other institutions. At the beginning of the decade, 1,300 were getting state-funded services.
The developments are the result of what is known as the Barthelemy case, a federal civil rights action.
The lawsuit is named for its lead plaintiff Lee Barthelemy, who, on the part of himself and others, accused the state of violating the constitutional rights of the elderly and disabled by not allowing them to live in the least-restrictive environment possible.
Louisiana entered into a settlement agreement in 2001, which outlined steps the state would take in providing more community and home-based care options.
Today, the case is still active because goals in the settlement have not yet been reached.
In addition, problems — such as average cost of an individual’s care are too expensive and the waiting lists are too long — have developed
Lawyers for the state Department of Health and Hospitals and The Advocacy Center, which filed the class-action lawsuit, are back in court trying to win approval of a new agreement that would end the case by Dec. 31, 2009.
The proposed agreement would reduce the number of hours personal-care attendants and other aides can help people in their homes and limit services based on the needs of individuals. The hope is to bring costs in line with federal standards while reducing a 9,063-person waiting list for Elderly and Disabled Adult Program services.
“Like anything else you change, there are some winners and some losers in the new agreement,” said Hugh Eley, assistant secretary of DHH’s Office of Aging and Adult Services.
“It might result in quite a cut for some individuals,” said Advocacy Center lawyer Nell Hahn, who represented Barthelemy.
State officials would negotiate with people directly to minimize the impact.
To the extent there are savings because of individual service cutbacks, dollars would be plowed back into the program to provide services to more people on waiting lists, Hahn said.
Services include daily living activities, such as bathing and dressing, as well as “companion care” such as a health-care provider supervising someone with dementia. The program also provides for help in remodeling projects to make homes more accessible and safe for the handicapped and elderly.
To be eligible, people have to be age 21 or older with disabilities that would meet nursing home-resident criteria both medically and financially. Two-thirds of the individuals receiving services are over the age of 65.
Under federal rules, the combined Medicaid-funded cost of community services cannot exceed those of nursing home or other institutional care. The most recent statistics put the per-person cost on the nursing home side at $29,673 a year, while community services are running $33,708 a year.
The federal Centers for Medicare and Medicaid Services warned state officials about the trend of rising costs, Eley said.
“If they do a corrective action plan, it could be much worse than what we are proposing to do,” Eley said.
The amended settlement agreement seeks to fix the problem and serve more people in the process, Eley said.
Under the proposal, the maximum number of hours of community care a person may receive would be reduced from 54 to 42 hours of service a week. In addition, caps would be placed on services based on the “acuity level” or needs of the person receiving assistance.
The original agreement required the state to get the waiting list for services down to 90 days.
“The list of people wanting these services just kept growing,” Hahn said. “There continued to be thousands on the waiting list. They couldn’t get it down to 90 days.”
“It’s probably not realistic to think you are not going to have some kind of waiting list,” Eley said.
Eley and Hahn agree that at the rate the average cost is rising, the waiting list would not improve.
Hahn said the plaintiffs are willing to go along with the amended settlement agreement — being realistic about the need to stay within federal guidelines and hoping that more people will get services.
Another part of the settlement agreement requires the state to file reports tracking the number of people who end up going into nursing homes because they cannot get sufficient home services.
|
Elder spending
|
||
| The chart below illustrates what has happened since Louisiana agreed to a 2001 federal court settlement that requires it to provide more services to keep the elderly and disabled out of nursing homes and other institutions: | ||
|
Fiscal year
|
People served
|
Expenditures
|
|
2000
|
1,303
|
$9,263,607
|
|
2001
|
1,653
|
$10,030,961
|
|
2002
|
2,403
|
$16,300,931
|
|
2003
|
3,229
|
$37,676,768
|
|
2004
|
3,429
|
$79,613,310
|
|
2005
|
3,503
|
$110,952,662
|
|
2006
|
3,603
|
$165,327,689
|
|
2007
|
5,228
|
$251,862,911
|
|
2008
|
5,428
|
unknown yet
|
| Source: Louisiana Department of Health and Hospitals | ||
 | ||||
| Most Popular | Most Emailed | Hot Topics | ||
