How the Government Really Works: A Train Wreck IV

The Rest Home lobby must have one of the most powerful – or lucky – lobbies in North Carolina.
 
A few years ago, Congress passed a bill to give states the flexibility to care for elderly Medicaid patients in their homes instead of in Rest Homes and almost every state jumped at the opportunity – except North Carolina.  Under Secretary Lanier Cansler, North Carolina is the only state that prefers putting patients in Rest Homes.
 
Why Cansler prefers Rest home may be illogical. But how he did it was straightforward:  He just said to get care in his home a patient had to have three physical handicaps, but the same patient could get care in a Rest Home if he only had one handicap.
 
Cansler also told legislators requiring a patient to have three handicaps to receive home care would allow him to drop 22,000 patients from the Medicaid Home Care program – which he said would save $50 million.  But what he didn’t tell legislators was it also created 22,000 new patients who could only get care in Rest Homes – which would cost $150 million.
 
Disability Rights, the non-profit, described Cansler’s plan this way:  “Congress enacted…the Affordable Care Act…to give states more flexibility to provide home and community-based services and decrease institutionalization.  Instead, NC is using the authority to encourage institutionalization.”  Disability Rights went on to explain that by making it three times harder to get in-home care as opposed to Rest Home care Cansler’s Department was steering patients straight to Rest Homes and concluded, “Typically, it costs three times as much to support an individual in an Adult Care Home (Rest Home) than it does to support him in his own home…DHHS myopic goal of cutting PCS…will ultimately cost the state and federal government money.”
 
To be continued…
 
 
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How the Government Really Works: A Train Wreck IV

The Rest Home lobby must have one of the most powerful – or lucky – lobbies in North Carolina.
 
A few years ago, Congress passed a bill to give states the flexibility to care for elderly Medicaid patients in their homes instead of in Rest Homes and almost every state jumped at the opportunity – except North Carolina.  Under Secretary Lanier Cansler, North Carolina is the only state that prefers putting patients in Rest Homes.
 
Why Cansler prefers Rest home may be illogical. But how he did it was straightforward:  He just said to get care in his home a patient had to have three physical handicaps, but the same patient could get care in a Rest Home if he only had one handicap.
 
Cansler also told legislators requiring a patient to have three handicaps to receive home care would allow him to drop 22,000 patients from the Medicaid Home Care program – which he said would save $50 million.  But what he didn’t tell legislators was it also created 22,000 new patients who could only get care in Rest Homes – which would cost $150 million.
 
Disability Rights, the non-profit, described Cansler’s plan this way:  “Congress enacted…the Affordable Care Act…to give states more flexibility to provide home and community-based services and decrease institutionalization.  Instead, NC is using the authority to encourage institutionalization.”  Disability Rights went on to explain that by making it three times harder to get in-home care as opposed to Rest Home care Cansler’s Department was steering patients straight to Rest Homes and concluded, “Typically, it costs three times as much to support an individual in an Adult Care Home (Rest Home) than it does to support him in his own home…DHHS myopic goal of cutting PCS…will ultimately cost the state and federal government money.”
 
To be continued…
 
 
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