Medicaid Program Expands Funding for Home Care, But Its Future Is Uncertain

Recently, the Biden administration announcedA total of $25 million has been granted to expand the Medicaid program. more than 90,000Seniors and those with disabilities can be moved out of nursing homes and back into their community.

Money Follows the PersonThis demonstration program is designed to assist states in expanding their home-care services. Demonstration programsThey are used to test innovative policies in the state.

August 22nd, nearly $25 million was announced to support early planning of MFP in Illinois and Kansas, New Hampshire and American Samoa.

Nursing home care is currently a Medicaid entitlement. This means that states must provide it to seniors or people with disabilities who require a high level assistance in their daily lives. The same requirement is not applicable to home care.

“People with disabilities and older adults should have a choice about where they live,” said Bethany Lilly, senior director of public policy for The Arc, one of the largest disability advocacy organizations in the United States, as well as a service provider.

Women are disproportionately responsible for long-term care of seniors and people with disabilities. Women make up over 80 percentthe majority of the long-term care workforce professionals. family caregiversAre women.

Joe Caldwell is the director of Brandeis University’s Community Living Policy Center and a nationally recognized expert for long-term health care. Money Follows the Person is one of the longest-running Medicaid demonstration programmes.

“When people move back into the community, their quality of life increases, across all populations — older people, people with developmental disabilities,” Caldwell said.

This was also true for Tyree Brown. She didn’t expect to live in a nursing home at age 20. After a car accident in 2015, Brown became quadreplegic — she experiences paralysis in all four limbs and uses a wheelchair to get around. Her parents’ house wasn’t wheelchair accessible and she needed a place to live, so the state placed her in a nursing home.

Brown was the oldest person to live in the nursing home. She had no privacy. She had to ask permission for permission to leave the facility. Even with that permission, there were difficulties. It wasn’t possible for Brown to attend church on Wednesdays and Fridays as she usually did before the accident because worship was at 8 p.m., after the nursing home’s curfew. Brown could theoretically have been able to attend church on Sundays. However, staff frequently failed her to get ready in time. Brown needs help with washing and dressing. She recollects lying naked in bed, waiting and hoping.

“I was at the end of my life before it even began,” Brown told The 19th.

Brown was able to return home to Capitol Heights, Maryland with Money Follows the Person. The program funded a ramp, widened doors, and stairlifts. Brown is assisted by her mother, who is certified in home health aides, with dressing and bathing. She no longer worries about whether she’ll be able to go to church.

“I don’t need to depend on a nurse who has 15 other patients. My mom goes [to church] too,” Brown said.

Despite the success of Money Follows the Person, the program’s future remains uncertain. Its funding will not be permanent and states will be less likely to take part. In fact, the three states in the Biden administration’s funding announcement previously had Money Follows the Person programs that stopped because of uncertainty around funding.

“Most states have adopted [Money Follows the Person], but at the end of 2020, states started to withdraw because they couldn’t count on the money showing up. Congress let the funding lapse,” said Lilly, who praised the program but expressed concern over Congress’s lack of commitment to funding it.

“If the program was permanent, states would have a set amount of money every year they could spend on the program. Instead, Congress has been funding the program randomly. Sometimes they’ll extend the money for a couple of years. Sometimes they’ll do it for six months. States can’t plan with that,” Lilly said.

President Biden’s Build Back Better legislation would have made Money Follows the Person funding permanent, but the deal collapsed in December 2021.

“[Money Follows the Person] shouldn’t be a demonstration program anymore. It’s proven. If a demonstration works, it should be permanent,” Caldwell said.