Health Plan for the disabled

Plan Would Hire at-Home Health Aides for DisabledSource:

Cincinnati Post

Publication date: 2005-05-31

Arrival time: 2005-06-01





COLUMBUS -- Up to 200 disabled people would leave nursing homes and use the state and federal money that would have gone to the institutions to hire home health aides in an experimental project the Senate proposed in the state budget.

Several states have pilot projects in which Medicaid money goes directly to the person to spend on health care instead of nursing homes.



States must ask federal permission to start such programs, and President Bush favors the concept, said Mary Kahn, spokeswoman for the federal Centers for Medicare and Medicaid Services.



Ohio's application would be made only if the proposal stays in the budget through a full Senate vote this week and then a joint committee to work out differences with the House version of the $51 billion, two-year spending plan. Gov. Bob Taft must sign a balanced budget by July 1.



Kahn said she couldn't comment on Ohio's chances, but added, "We are predisposed to be positive about such waivers."



The program is one of several changes in Medicaid, a state- federal program that provides health coverage for the poor and disabled, the Senate Finance Committee made to the budget passed by the House. Most were aimed at restoring Taft's proposals after the House made changes considered more favorable to nursing homes.



For example, the House wanted just 1,000 openings for a new program that would help people go to assisted living centers instead of nursing homes, but the Senate restores it to the 1,800 Taft wanted. Also, the Senate version removes House language that would have restricted the benefit to assisted-living wings within nursing homes.



Sen. Lynn Wachtmann, R-Napoleon, proposed the program for letting people hire help directly. It would be limited to 200 people who would get up to 75 percent of the cost of nursing home care. The state's area aging agencies would oversee the cases.



"We're going to have to take money from the nursing home industry and put it toward these other providers," he said.



Sen. Eric Fingerhut, D-Cleveland, who proposed the assisted living program, said that Wachtmann's idea will help.



"The goal is to provide alternatives that are less costly and less restrictive than putting someone in a nursing home," he said.



It can be difficult to leave a nursing home after going on Medicaid, because the person often has to find new housing and then try to find replacement health services, said Steve Proctor, spokesman for the Department of Aging.



"It sounds like this program would demonstrate another option is possible," he said.



Other states have found high consumer satisfaction with hiring help directly with Medicaid dollars, said Richard Browdie, president of the Benjamin Rose Institute in Cleveland, which provides adult day care and other services. He was a member of the Ohio Commission to Reform Medicaid, which recommended that the state set up its own voucher program.



There was little criticism of the proposal from nursing home and advocacy groups except for slightly confusing language in the bill, like whether it requires that participants be in a nursing home before they apply. Wachtmann said that's what he intends.