Money Follows the Person in USA Today

Nursing-home residents get aid to move out

By Phil Galewitz, Kaiser Health News

PEACHTREE CITY, Ga. — Richard Hasselbach and Deborah Kadlec met in a nursing home and dreamed of a life together outside its walls.

Their health conditions made living on their own a challenge: Hasselbach, 63, is disabled from a stroke and lost a leg to a blocked artery. Kadlec, 52, has multiple sclerosis. They both use wheelchairs and need help with basic chores such as bathing, cooking and remembering to take their medicines. Most of their relatives live in other states.

Despite those obstacles, Hasselbach and Kadlec got their own apartment and a personal care aide last summer through the help of a federally funded program run by the state. The program, known as Money Follows the Person, is the nation's most ambitious effort to move people out of nursing homes and other long-term-care facilities. It aims to help them live on their own and also save tens of millions of dollars for Medicaid, the state-federal health insurance program for the poor and disabled that pays for two-thirds of nursing home bills in the U.S.

Nationally, nursing home care averages about $75,190 per patient each year. Care in the home, through such services as meals-on-wheels and daily visits by a health aide, averages $18,000 a year, according to the AARP Public Policy Institute.

The program gives nursing home residents personal and financial help to live on their own or in small group settings, as well as payments for costs such as apartment security deposits, household furniture and alterations to make homes or cars accessible to the handicapped.

Georgia is one of 29 states and the District of Columbia participating in Money Follows the Person. Its experience shows both early successes and an illustration of the program's slow start nationwide. Georgia had hoped to move 1,312 people from nursing homes and other long-term-care facilities by 2013. Through the end of last year, though, it had moved only 221.

Combined goal: Moving 37,000 out

Congress established Money Follows the Person in 2005, and states set a combined goal of moving out more than 37,000 residents from nursing homes and other facilities by 2013. Most states, including Georgia, started their programs in 2008. Two years later, just 5,774 residents have moved nationally.

Most states are moving slowly for various reasons: problems finding affordable housing, resistance from nursing homes and stringent federal rules that limit who is eligible and what types of community settings they can move into, according to a study by Mathematica, a Princeton, N.J.-based think tank that is evaluating the program for the federal government.

For more, see http://www.usatoday.com/news/health/2010-04-21-nursing-homes_N.htm.