Home Care Becomes Option for Elderly, disabled in La.

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Home Care Becomes Option for Elderly, disabled in La.

by Jan Moller, New Orleans Times-Picayune

January 22, 2004

BATON ROUGE - As an alternative to nursing homes and other institutional care, elderly and disabled Louisiana residents are now eligible to get home-care services under a new program that began taking applications this week.

The launch of the program, which is expected to cost $19 million in the fiscal year that ends June 30, was delayed by opposition from the Legislature and the state's influential nursing-home industry.

But a judge's ruling last summer, followed by federal approval in late December, opened the way for the program, which will finance services to help the elderly and disabled with daily tasks such as grooming, laundry and light housekeeping.

"We're excited about this," said lawyer Nell Hahn of the Advocacy Center , a New Orleans group that pushed for the program. "I think this is going to be very beneficial to people with disabilities in Louisiana . It gives them a choice of where they get their services."

State health officials said they plan to send letters next week to about 200,000 Medicaid recipients telling them about the program and how to apply for it. Department of Health and Hospitals Secretary David Hood said he's not sure how many people will sign up for services.

The program grew out of a 1999 ruling by the U.S. Supreme Court that the Americans with Disabilities Act requires states to provide people a choice between institutional and community care. That decision led to a follow-up suit by the Advocacy Center demanding greater access to community-based care in Louisiana , which the state settled in 2001 by agreeing to set up the home-care program as an entitlement.

About 90 percent of Medicaid spending on long-term care in Louisiana now goes to nursing homes, putting the state far behind a national trend that has seen resources diverted to home and community-based care.

For more than a decade, the Department of Health and Hospitals has provided home-care services through several waiver programs, which let the state control costs by limiting the number of people eligible for services.

Nursing-home care, by contrast, is covered for anyone who qualifies under Medicaid.

Hood said he expects the state will save money in the long-run now that home-care services have been added to the entitlement mix. "When you do the math on this, you can see that everybody doesn't need 24-hour institutional care," Hood said. "Some people can get by with just a few hours of care in-home. For that reason, I think it's going to be significantly less expensive."

To qualify for the program, a person must be a Medicaid patient at least 65 years old or must qualify for Social Security disability benefits, and have a monthly income of less than $552.

The income restrictions are stricter than those for nursing homes or home-based waiver services, which are available to people earning up to $1,656 a month.

Anyone who wants to apply for services can begin by calling (866) 229-5222 for an evaluation.