Job Creation, Save Substantial Medicaid Funds, and Do What Disabled and Elderly Want

Steve Gold's Information Bulletin #267 (11/08) With the economy belly-up and a buzz for a job creation program, this is an opportunity for the disability and elderly communities to jointly suggest a "three fer:" jobs, saving Medicaid Funds and integration in the community! Nationally, in FY 2007, out of the $311.8 billion dollar total Medicaid expenditures, $46.9 billion (15.6%) was spent to institutionalize disabled and elderly people in nursing homes and $12 billion (3.9%) to institutionalize people with MR/DD in ICF-MRs. That's right - nearly 20%of Medicaid funds institutionalize people with disabilities and the elderly. (This data has been relatively consistent for a number of years.) Here's a short list of points to consider. We know:

• 1. Most of the people in these institutions could reside in the community with appropriate services and supports.
• 2. Many of these people want to reside in the community but either are unaware of community services or are afraid.
• 3. Most of these institutionalized people receive primarily custodial care in the institutions (not medical care or treatment), or they do not require medical care or treatment that is not already available and provided in the community.
• 4. There are long waiting lists for people who want to live in the community and who need primarily non-medical assistance with basic activities of daily living.
• 5. We have provided for years appropriate and integrated community services and supports for every mirror-image person institutionalized!

So the President-elect and Congress want a jobs program? How about a"Personal Attendant Care/Community Service" program? Let's hire and train people to provide attendant care services for people who want to leave nursing homes and ICF-MRs now. This is not inventing a new program, but expanding the successful programs, albeit too few and too small, that exist throughout the country.

This is a program for which existing Medicaid funds which presently go to the institutions could go to persons with disabilities and elderly who are nursing home or ICF-MR certified and who want to have funds to hire,supervise, etc their attendants.

It's really not rocket science! It's not even a novel idea [see the Community Choice Act that has been reintroduced in Congress for years]. It takes courage to take on the institutional industries that keep people unnecessarily institutionalized and that have contributed to our elected political officials who are apparently beholden to the industries.

Can it be changed? Yes it can! But, power concedes nothing without a struggle.

Steve Gold, The Disability Odyssey continues