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State health-care action urged
Progress sought for seniors, the disabled
by Julie Edgar, Detroit Free Press,
September 19, 2002
For more articles on disabilities and special ed visit
www.bridges4kids.org.
With a new budget year looming, advocates for seniors and
people with disabilities are frustrated that another year
could pass without much innovation in the way Michigan cares
for those populations.
The state, said a leader of ADAPT, a disability rights
organization, is dragging its feet in complying with the
Americans with Disabilities Act, which requires states to let
people with long-term care needs live in the least restrictive
setting possible.
"Rather than budget more by eradicating beds at particularly
bad nursing homes, they're taking a
we'll-wait-till-they-force-us kind of approach," said Scott
Heinzman, 40, of Livonia.
And there is skepticism about the future of a 2-year-old
document designed to guide plans for a comprehensive long-term
care system for elderly and disabled people.
"The scorecard is zero," said Sandra Reminga, head of the Area
Agency on Aging 1B, which serves six counties, including
Oakland and Macomb.
In 1999, Department of Community Health Director Jim Haveman,
other officials from his department and four legislators --
members of the Long Term Care Workgroup -- fashioned the
recommendations. They included four models for coordinating
care and goals that included closing loopholes to Medicaid
accessibility and keeping people in their homes while they get
services.
So far, the state has completed a public service campaign to
promote long-term care insurance and awarded $7 million in
grants to agencies for everything from respite care for
caregivers to professional development of geriatric nurses.
The Legislature is discussing a dozen bills that fit with the
overall goals in the report, including one that would provide
$4 million in nursing scholarships.
Michigan is also awaiting federal approval from the Centers
for Medicare and Medicaid Services to streamline the budget
for long-term care, so that money would follow individuals as
they proceeded from home-based assistance to nursing homes.
Haveman said approval could come any time.
"The workgroup report is a live document that is not sitting
on the shelf," Haveman said.
However, the state is stalling on at least one program that
fits the mission of the report, advocates say. They are
distressed at the continued enrollment freeze on the Home and
Community Based Waiver, which to them represents the best way
yet of keeping people integrated in the community.
The $126-million program enables some Medicaid recipients to
buy medical services in their homes or assisted living
facilities at a much lower rate than the cost of nursing home
care. Last year, the state closed the program to new
enrollees, and gradually the number of unused waiver spots
dropped from 15,000 four years ago to 10,000 this year.
The state doesn't have the money to lift the freeze, and the
program needs reforming, because there are people getting the
waiver who shouldn't, Haveman said.
Michigan could be forced to move on the waiver program. A
lawsuit filed by the Michigan Protection and Advocacy Service
earlier this year alleges the state hasn't complied with a
U.S. Supreme Court ruling known as Olmstead. The ruling
requires states to move away from a so-called institutional
bias by providing low-income people with disabilities the
least restrictive living setting possible.
Contact JULIE EDGAR at 248-586-2605 or
edgar@freepress.com
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