Right now, over 2,000 persons with disabilities are living state institutions and over 5,700 persons with disabilities are living in nursing homes. On June 22, 1999, the United States Supreme Court held in Olmstead v. L.C. that the unnecessary segregation of individuals with disabilities in institutions constitutes discrimination based on disability. However, Georgia still spends only 39% of its Medicaid long-term care dollars on Medicaid home and community based waiver services.
States will get additional help from the federal government to support elderly and disabled Medicaid recipients who wish to live in the community rather than institutions, HHS Secretary Mike Leavitt announced on July 26th.
Georgia's "institutional bias" has created real financial disincentives to offer these persons in institutions real choices where they can live.
You can help by adding your organization to the letter written to the Governor below that urges Georgia to adopt a policy that will allow money to follow persons from nursing homes and institutions into the community. You can add your organization to this letter with just one click.
July 26, 2006
Honorable Sonny Perdue
Office of the Governor
State Capitol
Atlanta, GA 30334
Dear Governor Perdue:
On June 22, 1999, the United States Supreme Court held in Olmstead v. L.C. that the unnecessary segregation of individuals with disabilities in institutions constitutes discrimination based on disability. The court ruled that the Americans with Disabilities Act requires states to provide community-based services rather than institutional placement for individuals with disabilities. This historic decision makes attainable a goal long-sought by the disability rights movement, a community first approach to long term care (LTC).
In the July/August issue of the Journal Health Affairs, H. Stephen Kaye’s, professor at the Institute for Health and Aging at the University of California - San Francisco noted that in recent years, there’s been a large and steady increase in the number of home and community based (HCBS) workers — from 264,000 in 1989 to 894,000 in 2004. The aging baby boomer generation will continue to increase demand.
After years of mounting evidence that the long term care system is failing people with disabilities, health policy experts agree, it's time to reduce our dependency on nursing homes and other institutions and implement a community first approach. Both the Olmstead decision and DRA present an opportunity to rebalance Georgia's long term care system. One of the biggest problems with Medicaid-financed long-term care has been its "institutional bias." Medicaid paid mostly for nursing home care and much less for home care over the years. That imbalance has been changing for a decade or more but still exists. In fact, according to CMS, as part of clinical assessments of all residents in Medicare or Medicaid certified nursing homes, 5,774 Georgians expressed a preference to return to the community. During the same year, Georgia spent $1,065,938,986 of its Medicaid long-term care dollars on nursing facility services (nursing homes, ICF/MR institutions, swing beds) (61%). In contrast, Georgia spent $419,092,665 (39%) of its Medicaid long-term care dollars on Medicaid home and community based waiver services (Community Care Services Program, Mental Retardation Waiver, Community Habilitation and Support Services Waiver, Model Waiver, Source Program, Dedicated Case management, and Independent Care Waiver Program).
The undersigned groups want to know which incentives in DRA you plan to utilize to meet Georgia’s commitment to people with disabilities. In particular we're interested in Money Follows the Person (MFP), a policy that Texas successfully implemented. CMS released the Request for Proposal (RFP) for MFP on July 26th and it is our expectation that Georgia will respond to this RFP and begin the long overdue journey to re-balancing the LTC system.
We'd appreciate a response by August 15. To sit on the sidelines would be a disservice to all Georgians. We look forward to working with you to prepare a sound proposal.
Sincerely,
The Undersigned
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