Ellington

In a silent but massive social shift, the Mississippi House voted unanimously to allow Medicaid to pay for home care for eligible Medicaid beneficiaries.

"This bill is the closest thing to the Lord's work as we're going to get this year," said Steve Holland, D-Plantersville. "It's well known that caring for people at home is cheaper than keeping them in a home. I don't know why this hasn't been done earlier."

The bill specifically allows the executive director of Medicaid to transfer a portion of nursing facilities money to pay for home- and community-based services for residents who choose them.

The House has enjoyed a recent sense of unity following the devastation of Hurricane Katrina, such that lawmakers who were formerly rabid opponents now cling to each with a victim mentality—as if desperate to show strength through unity in the face of widespread natural disaster. In this spirit, the House has chewed through the bill roster this legislative year with a volley of "yes" votes.

In this atmosphere, lawmakers passed the controversial Wellspring project, and a tobacco tax and seatbelt law—both dropped in previous years—along with HB 1379. Though the bill sailed through without fanfare, Mississippians in their 30s and 40s who are coming to terms with aging parents racked by debilitating diseases will immediately feel its repercussions.

"I worry that I'll have to put my mother in a home eventually," said Jean Bateman, a North Jackson resident whose mother Olivia Hessell is in her early 70s and showing early signs of dementia. "We arranged for her to live in a house just down the street from us, and we've done everything to make her life easier and keep her independent, but I know she'll eventually need help, and I couldn't stand the idea of putting her in a home."

People in Bateman's position will be able to use money formerly earmarked for nursing-home care for home-care services, such as Professional Private Duty Nursing or Prime Care Nursing, in Jackson.

Representatives for the disabled point out that the law will apply to more than just the elderly.

"The Department of Medicaid said in a House hearing that it costs an average of $52,000 a year for a person to stay in a nursing home and between $15,000 to $22,000 for someone to stay in the community," said Mary Troupe, executive director of the Coalition for Citizens with Disabilities, which helped author the bill. "We're estimating that 500 people could move out of the nursing home this year, and that would save around $10 million."

The bill, should it survive the Senate and the governor, will come into effect no later than Sept. 1, 2006. In fact, two months before the implementation of the "money follows the person" process, the executive director of Medicaid will send a letter to all Medicaid-eligible nursing-home residents, informing them of the option to go with home care. Holland says the process is predicted to cut nursing home occupancy.

Ramona Khanifar, whose mother, Dean Tindall, is also an Alzheimer's victim and lives under Khanifar's daily supervision, said she appreciated the intent of the bill, but regretted that it would not help her mother much.

"It's good that they're trying to help Medicaid patients, but my mother doesn't qualify for Medicaid. She only gets Medicare. What does the bill do for people like her?" Khanifar said. "If we can get this from state senators, why can't we get this from the federal government?"

Attorney John Maxey, a lobbyist for the nursing-home industry, said people who use the law to opt their loved ones out of nursing home care should be honest with themselves about the patient's needs, saying some patients' health could deteriorate under the conditions of home care nursing.

"Nursing homes consider a resident who's severely injured and in need of temporary care ... a success story," Maxey said. "But what could happen is somebody leaves a nursing facility, who has a medically recognized need for long term skill care. They go into a situation where they have a substantially reduced level of care and their acuity level drops. They later go back in the nursing facility and the nursing home is forced to deal with somebody who was in fair condition when they left but when they come back they're in worse condition."

Holland said lawmakers with a clean heart should back the bill.

"I can't think of anybody who would not stand behind this bill," Holland said. "People want to be home. They want their independence."

That vote now moves on to the Senate.

Previous Comments

ID

65222

Comment

Mr. Maxey it seems is not aware of the waivers that are now available for individuals to live in the community and the desire of the Central Medicare and Medicaid Services in Washington that states move to the Home and Community based type of care. There are so many individuals who want these waviers, but the waiting list is up to 2 years. It is also a federal Supreme Court decision, Olmstead that states that individuals should have the right to live in the most integrated setting possible. Also he must not be aware that the bill includes a pre-screening and evaluation process. Mississippi does not have a prescreening process for Nursing Facilities. This will be put in place and individuals will be evaluated for the care they need and given an option of NF care or Home and community based services. He also needs to define "medically recognized need for long term skill care". Would that be the lady who just left the NF after she was placed there for the 100 days Medicare covers to get PT after a stroke and just left after 5 years. There are many individuals who are in NF who were given no options and who do not need NF care. Many individuals with disabilities cannot receive the care they really need in a NF. The care they need and want can and is provided in the community and they have there independence to make their own decision, what to eat, when to sleep or get up and even when and what to watch on the TV and be with their loved ones. There wil always be a place for Nursing Facilities, but it can not be the only option for those that cannot afford other services.

Author

troupe

Date

2006-02-18T20:07:54-06:00