From ADAPTer Randy Alexander of Memphis, Tennessee:
The Memphis Center for Independent Living has assisted three individuals, stuck in nursing homes to file OCR complaints, with three more coming by the end of this week.
Surprisingly, OCR in Atlanta has already contacted us, for more info on the first three complaints.
Folks, HHS OCR needs to hear from residents of nursing facilities as to whether they are being moved out into the community fast enough. If not, they should file a complaint ASAP.
Showing posts with label Tennessee. Show all posts
Showing posts with label Tennessee. Show all posts
Saturday, April 17, 2010
Monday, March 8, 2010
Tennesseans Sue State Over Budget Cuts
http://www.tennessean.com/article/20100305/NEWS0204/3050334/2+sue+over+health+cuts
2 sue over health cuts
They want state to pay for home treatment
By Clay Carey • THE TENNESSEAN • March 5, 2010
Two Tennessee men with severe disabilities have sued the state's TennCare program over cuts in home health care that could force them into nursing homes.
Justin Cochran, 27, and Glen Barnhill, 49, say in the federal lawsuit that the state violated the Americans with Disabilities act by cutting off their access to home-based nursing.
Both men are seeking a court order requiring the state to pay for them to get treatment at home, not in a nursing home.
This year, TennCare is launching a new program called CHOICES designed to give people the opportunity to get long-term care in their homes rather than in a nursing home. But to qualify, the cost of home care can't be more than the cost of a nursing home, TennCare spokeswoman Kelly Gunderson said.
Related
Advocacy group warns that TennCare cuts would lead to more hospitalizations
TennCare cuts won't be quite so deep after break from feds
According to their lawsuit, filed last week in U.S. District Court, the state contends it is less costly to provide Cochran and Barnhill daily, around-the-clock care in nursing homes, so TennCare would not cover the cost of their in-home care.
"For both of them, it would be an extraordinary loss of independence," said Katie Evans, an attorney representing Cochran and Barnhill. She said both men are able to live in their homes, with the help of caregivers.
"It would be extremely damaging to their mental health as well as their physical health if they were to be forced into a nursing home," Evans said.
Gunderson and a spokeswoman for the Tennessee Attorney General's office, which represents the state in court, declined to comment on the lawsuit Tuesday.
Cochran, who lives in a Knoxville apartment, has exhausted his administrative appeals, the lawsuit says. Five years ago he suffered a spinal injury that left him partially quadriplegic and dependant upon a ventilator.
Barnhill, who was left partially quadriplegic after a shooting in 1994, is awaiting an administrative hearing. He is getting treatment at Vanderbilt University Medical Center. Before his hospitalization, he lived independently, with help from caregivers paid by TennCare.
According to court documents, Barnhill told a clinical psychologist that he had a bad experience in a nursing home before, and he fears he would die if he were to be placed in a nursing home again.
Contact Clay Carey at 615-726-5933 or mcarey@tennessean.com.
2 sue over health cuts
They want state to pay for home treatment
By Clay Carey • THE TENNESSEAN • March 5, 2010
Two Tennessee men with severe disabilities have sued the state's TennCare program over cuts in home health care that could force them into nursing homes.
Justin Cochran, 27, and Glen Barnhill, 49, say in the federal lawsuit that the state violated the Americans with Disabilities act by cutting off their access to home-based nursing.
Both men are seeking a court order requiring the state to pay for them to get treatment at home, not in a nursing home.
This year, TennCare is launching a new program called CHOICES designed to give people the opportunity to get long-term care in their homes rather than in a nursing home. But to qualify, the cost of home care can't be more than the cost of a nursing home, TennCare spokeswoman Kelly Gunderson said.
Related
Advocacy group warns that TennCare cuts would lead to more hospitalizations
TennCare cuts won't be quite so deep after break from feds
According to their lawsuit, filed last week in U.S. District Court, the state contends it is less costly to provide Cochran and Barnhill daily, around-the-clock care in nursing homes, so TennCare would not cover the cost of their in-home care.
"For both of them, it would be an extraordinary loss of independence," said Katie Evans, an attorney representing Cochran and Barnhill. She said both men are able to live in their homes, with the help of caregivers.
"It would be extremely damaging to their mental health as well as their physical health if they were to be forced into a nursing home," Evans said.
Gunderson and a spokeswoman for the Tennessee Attorney General's office, which represents the state in court, declined to comment on the lawsuit Tuesday.
Cochran, who lives in a Knoxville apartment, has exhausted his administrative appeals, the lawsuit says. Five years ago he suffered a spinal injury that left him partially quadriplegic and dependant upon a ventilator.
Barnhill, who was left partially quadriplegic after a shooting in 1994, is awaiting an administrative hearing. He is getting treatment at Vanderbilt University Medical Center. Before his hospitalization, he lived independently, with help from caregivers paid by TennCare.
According to court documents, Barnhill told a clinical psychologist that he had a bad experience in a nursing home before, and he fears he would die if he were to be placed in a nursing home again.
Contact Clay Carey at 615-726-5933 or mcarey@tennessean.com.
Sunday, February 21, 2010
Medicaid State Budget Cuts in the New York Times
http://www.nytimes.com/2010/02/19/us/politics/19medicaid.html
February 19, 2010
States Consider Medicaid Cuts as Use Grows
By KEVIN SACK and ROBERT PEAR
WASHINGTON — Facing relentless fiscal pressure and exploding demand for government health care, virtually every state is making or considering substantial cuts in Medicaid, even as Democrats push to add 15 million people to the rolls.
Because they are temporarily barred from reducing eligibility, states have been left to cut “optional benefits,” like dental and vision care, and reduce payments to doctors and other health care providers.
In some states, governors are trying to avoid the deepest cuts by pushing for increases in tobacco taxes or new levies on hospitals and doctors, but many of those proposals are running into election-year trouble in conservative legislatures.
In Nevada, which faces an $881 million budget gap, Gov. Jim Gibbons, a Republican, proposed this month to end Medicaid coverage of adult day care, eyeglasses, hearing aids and dentures, and, for a savings of $829,304, to reduce the number of diapers provided monthly to incontinent adults (to 186 from 300).
“We are down to the ugly list of options,” the state’s director of health and human services, Mike Willden, told a legislative committee last week.
The Medicaid program already pays doctors and hospitals at levels well below those of Medicare and private insurance, and often below actual costs. Large numbers of doctors, therefore, do not accept Medicaid patients, and cuts may further discourage participation in the program, which primarily serves low-income children, disabled adults and nursing home residents.
In Kansas, a 10 percent cut in provider payments that took effect on Jan. 1 has prompted such an outcry that Gov. Mark Parkinson, who imposed it, now wants to restore the money by raising tobacco and sales taxes.
Even if Mr. Parkinson, a Democrat, overcomes resistance in his Republican-controlled Legislature, it will be too late for Dr. C. Joseph Beck, a Wichita ophthalmologist who informed his Medicaid patients last month that he could no longer afford to treat them.
Dr. Beck said that over eight months last year, his practice wrote off $36,000 in losses from treating 17 Medicaid patients. The state-imposed payment cut, he said, was “the final straw.”
“I’m out, I’m done,” Dr. Beck said in a telephone interview. “I didn’t want to. I want to take care of people. But I also have three children and many employees to take care of.”
Concerns about health care costs are likely to dominate the winter meeting of the National Governors Association, which begins Saturday in Washington.
In advance of the gathering, administration officials have urged governors to endorse President Obama’s health care proposals, or at least to avoid criticizing them. The Democratic plan, which is stalled in Congress, would vastly expand eligibility for Medicaid as one means of reducing the number of uninsured.
But many governors said they were more concerned about the growth of existing health programs. The recession and high unemployment have driven up enrollment in Medicaid while depleting state revenues that help pay for it.
A survey released Thursday by the Kaiser Family Foundation found a record one-year increase in Medicaid enrollment of 3.3 million from June 2008 to June 2009, a period when the unemployment rate rose by 4 percentage points. Total enrollment jumped 7.5 percent, to 46.9 million, and 13 states had double-digit increases.
Because Medicaid enrollment often lags behind unemployment, this year’s increase could prove even greater.
The National Association of State Medicaid Directors estimates that state budget shortfalls in the coming fiscal year, which begins in July in most states, will total $140 billion. Because Medicaid is one of the largest expenditures in every state budget, and one of the fastest-growing, it makes an unavoidable target.
“For most states, the fiscal situation is still dire, and the Medicaid cuts are significant,” said Scott D. Pattison, executive director of the National Association of State Budget Officers.
Governors and legislators have managed to defer the deepest cuts because the federal stimulus package provided $87 billion to states in Medicaid relief. The cost of Medicaid is shared by the federal and state governments, with states setting eligibility, benefit and reimbursement levels within broad federal guidelines, and Washington covering the majority of the expense.
But the stimulus assistance is due to expire at the end of December, in the middle of many states’ fiscal years, leaving budget officials to peer over a precipice. Congress and the White House are considering extending the enhanced payments for six more months, at a cost of about $25 billion.
The House has passed such a measure and Mr. Obama included it in his budget this month, but the Senate has not acted.
The extension would not come close to filling the Medicaid gap in many states. In Georgia, for instance, Gov. Sonny Perdue assumed in his budget proposal that the additional federal money would be provided, but that the state would still face a Medicaid imbalance of $608 million, said Dr. Rhonda M. Medows, the commissioner of community health.
Mr. Perdue, a Republican, decided it would be unwise to cut optional benefits because that might drive Medicaid patients into expensive emergency rooms. He proposed instead to levy a 1.6 percent tax on hospital and managed care revenues and to cut payments to many providers by nearly 2 percent.
Without the tax increases, which face opposition in the General Assembly, the state will have to cut provider payments by 16.5 percent, Dr. Medows said.
“I won’t have any primary care doctors left, much less specialists,” she said. “Certainly down here nobody likes to talk about taxes, but sometimes you have to bite the bullet and do what’s right for a whole lot of people.”
In the Kaiser survey, almost every state reported that Medicaid enrollment for the current fiscal year was exceeding expectations, making midyear budget cuts necessary.
The options are limited by several realities. To qualify for Medicaid dollars provided in the stimulus package, states agreed not to tighten eligibility for low-income people. And any time a state cuts spending on Medicaid, it loses at least that much in federal matching money.
Despite the ban on restricting eligibility, hard-hit states like California and Arizona are considering proposals by their governors that would remove hundreds of thousands from the rolls once the federal financing ends. Gov. Jan Brewer of Arizona, a Republican, has called for eliminating Medicaid coverage for 310,000 childless adults and ending the Children’s Health Insurance Program to help close a two-year budget gap of about $4.5 billion.
Gov. Phil Bredesen of Tennessee, a Democrat, is proposing the largest cuts in the history of TennCare, his state’s Medicaid program. To trim 9 percent of the TennCare budget, he would establish a $10,000 cap on inpatient hospital services for nonpregnant adults and would limit coverage of X-rays, laboratory services and doctor’s office visits.
“I have no choice,” Mr. Bredesen said.
February 19, 2010
States Consider Medicaid Cuts as Use Grows
By KEVIN SACK and ROBERT PEAR
WASHINGTON — Facing relentless fiscal pressure and exploding demand for government health care, virtually every state is making or considering substantial cuts in Medicaid, even as Democrats push to add 15 million people to the rolls.
Because they are temporarily barred from reducing eligibility, states have been left to cut “optional benefits,” like dental and vision care, and reduce payments to doctors and other health care providers.
In some states, governors are trying to avoid the deepest cuts by pushing for increases in tobacco taxes or new levies on hospitals and doctors, but many of those proposals are running into election-year trouble in conservative legislatures.
In Nevada, which faces an $881 million budget gap, Gov. Jim Gibbons, a Republican, proposed this month to end Medicaid coverage of adult day care, eyeglasses, hearing aids and dentures, and, for a savings of $829,304, to reduce the number of diapers provided monthly to incontinent adults (to 186 from 300).
“We are down to the ugly list of options,” the state’s director of health and human services, Mike Willden, told a legislative committee last week.
The Medicaid program already pays doctors and hospitals at levels well below those of Medicare and private insurance, and often below actual costs. Large numbers of doctors, therefore, do not accept Medicaid patients, and cuts may further discourage participation in the program, which primarily serves low-income children, disabled adults and nursing home residents.
In Kansas, a 10 percent cut in provider payments that took effect on Jan. 1 has prompted such an outcry that Gov. Mark Parkinson, who imposed it, now wants to restore the money by raising tobacco and sales taxes.
Even if Mr. Parkinson, a Democrat, overcomes resistance in his Republican-controlled Legislature, it will be too late for Dr. C. Joseph Beck, a Wichita ophthalmologist who informed his Medicaid patients last month that he could no longer afford to treat them.
Dr. Beck said that over eight months last year, his practice wrote off $36,000 in losses from treating 17 Medicaid patients. The state-imposed payment cut, he said, was “the final straw.”
“I’m out, I’m done,” Dr. Beck said in a telephone interview. “I didn’t want to. I want to take care of people. But I also have three children and many employees to take care of.”
Concerns about health care costs are likely to dominate the winter meeting of the National Governors Association, which begins Saturday in Washington.
In advance of the gathering, administration officials have urged governors to endorse President Obama’s health care proposals, or at least to avoid criticizing them. The Democratic plan, which is stalled in Congress, would vastly expand eligibility for Medicaid as one means of reducing the number of uninsured.
But many governors said they were more concerned about the growth of existing health programs. The recession and high unemployment have driven up enrollment in Medicaid while depleting state revenues that help pay for it.
A survey released Thursday by the Kaiser Family Foundation found a record one-year increase in Medicaid enrollment of 3.3 million from June 2008 to June 2009, a period when the unemployment rate rose by 4 percentage points. Total enrollment jumped 7.5 percent, to 46.9 million, and 13 states had double-digit increases.
Because Medicaid enrollment often lags behind unemployment, this year’s increase could prove even greater.
The National Association of State Medicaid Directors estimates that state budget shortfalls in the coming fiscal year, which begins in July in most states, will total $140 billion. Because Medicaid is one of the largest expenditures in every state budget, and one of the fastest-growing, it makes an unavoidable target.
“For most states, the fiscal situation is still dire, and the Medicaid cuts are significant,” said Scott D. Pattison, executive director of the National Association of State Budget Officers.
Governors and legislators have managed to defer the deepest cuts because the federal stimulus package provided $87 billion to states in Medicaid relief. The cost of Medicaid is shared by the federal and state governments, with states setting eligibility, benefit and reimbursement levels within broad federal guidelines, and Washington covering the majority of the expense.
But the stimulus assistance is due to expire at the end of December, in the middle of many states’ fiscal years, leaving budget officials to peer over a precipice. Congress and the White House are considering extending the enhanced payments for six more months, at a cost of about $25 billion.
The House has passed such a measure and Mr. Obama included it in his budget this month, but the Senate has not acted.
The extension would not come close to filling the Medicaid gap in many states. In Georgia, for instance, Gov. Sonny Perdue assumed in his budget proposal that the additional federal money would be provided, but that the state would still face a Medicaid imbalance of $608 million, said Dr. Rhonda M. Medows, the commissioner of community health.
Mr. Perdue, a Republican, decided it would be unwise to cut optional benefits because that might drive Medicaid patients into expensive emergency rooms. He proposed instead to levy a 1.6 percent tax on hospital and managed care revenues and to cut payments to many providers by nearly 2 percent.
Without the tax increases, which face opposition in the General Assembly, the state will have to cut provider payments by 16.5 percent, Dr. Medows said.
“I won’t have any primary care doctors left, much less specialists,” she said. “Certainly down here nobody likes to talk about taxes, but sometimes you have to bite the bullet and do what’s right for a whole lot of people.”
In the Kaiser survey, almost every state reported that Medicaid enrollment for the current fiscal year was exceeding expectations, making midyear budget cuts necessary.
The options are limited by several realities. To qualify for Medicaid dollars provided in the stimulus package, states agreed not to tighten eligibility for low-income people. And any time a state cuts spending on Medicaid, it loses at least that much in federal matching money.
Despite the ban on restricting eligibility, hard-hit states like California and Arizona are considering proposals by their governors that would remove hundreds of thousands from the rolls once the federal financing ends. Gov. Jan Brewer of Arizona, a Republican, has called for eliminating Medicaid coverage for 310,000 childless adults and ending the Children’s Health Insurance Program to help close a two-year budget gap of about $4.5 billion.
Gov. Phil Bredesen of Tennessee, a Democrat, is proposing the largest cuts in the history of TennCare, his state’s Medicaid program. To trim 9 percent of the TennCare budget, he would establish a $10,000 cap on inpatient hospital services for nonpregnant adults and would limit coverage of X-rays, laboratory services and doctor’s office visits.
“I have no choice,” Mr. Bredesen said.
Sunday, February 14, 2010
Tennessee Debates Bredesen's Approach
http://www.tennessean.com/article/20100214/OPINION01/2140338/1008
Editorial from the Tennessean:
There are times when evenhandedness can backfire. The proposed cuts to Tennessee's mental health services are a case in point.
By calling for cuts in virtually every segment of state government, Gov. Phil Bredesen appears to have fended off major opposition to his austere budget plan for 2010-11. But while most of the proposed cuts are tough, prudent, even admirable in the face of the state's continuing revenue shortfall, mental health is one area that should have been protected.
The state Department of Mental Health and Developmental Disabilities had to eliminate 672 positions, or a fourth of its staff, in 2008 and 2009. It also had to get rid of more than 247 beds at its state hospital. The budget for 2010-11 proposes $9.4 million in cuts, and it raises the question: What will happen to the many Tennesseans who rely on state help with mental health problems?
To its credit, the Bredesen administration has so far managed to keep the $21.5 million for the Behavioral Health Safety Net. That program helps the most severely ill mental-health patients who do not qualify for TennCare and do not have private insurance. But this does nothing for lower-income Tennesseans who get help with their mental illness through TennCare.
Editorial from the Tennessean:
There are times when evenhandedness can backfire. The proposed cuts to Tennessee's mental health services are a case in point.
By calling for cuts in virtually every segment of state government, Gov. Phil Bredesen appears to have fended off major opposition to his austere budget plan for 2010-11. But while most of the proposed cuts are tough, prudent, even admirable in the face of the state's continuing revenue shortfall, mental health is one area that should have been protected.
The state Department of Mental Health and Developmental Disabilities had to eliminate 672 positions, or a fourth of its staff, in 2008 and 2009. It also had to get rid of more than 247 beds at its state hospital. The budget for 2010-11 proposes $9.4 million in cuts, and it raises the question: What will happen to the many Tennesseans who rely on state help with mental health problems?
To its credit, the Bredesen administration has so far managed to keep the $21.5 million for the Behavioral Health Safety Net. That program helps the most severely ill mental-health patients who do not qualify for TennCare and do not have private insurance. But this does nothing for lower-income Tennesseans who get help with their mental illness through TennCare.
Friday, February 12, 2010
Letter from Tennessee
Sent to the DOF Blog this week:
Dear Friend,
My husband and I have been moving from town to town every year to be employed. We will buy a home after a period of time, and then learn the permanent job we were told about, is not longer available. We just left our home in Seminole, Alabama and we are renting a home in Memphis Tennessee. Paying two mortgages is costly. We like living in a home in the community, and not in assisted living. Keeping our independence is crucial to us.
Please ask congress to enforce the Olmstead Act, and keep long term support services in place. (CFC).
Just because a person has a disability, should not make any difference where one wants to live. Freedom is the number one deciding factor in the decision, and it is a matter of dignity.
Truly,
Deb and Jim
Dear Friend,
My husband and I have been moving from town to town every year to be employed. We will buy a home after a period of time, and then learn the permanent job we were told about, is not longer available. We just left our home in Seminole, Alabama and we are renting a home in Memphis Tennessee. Paying two mortgages is costly. We like living in a home in the community, and not in assisted living. Keeping our independence is crucial to us.
Please ask congress to enforce the Olmstead Act, and keep long term support services in place. (CFC).
Just because a person has a disability, should not make any difference where one wants to live. Freedom is the number one deciding factor in the decision, and it is a matter of dignity.
Truly,
Deb and Jim
Tuesday, February 9, 2010
Roundup of state fights from Kaiser Health News
We were made aware of Kaiser Health News' daily roundup by Bob Williams. To view updates on funding cuts that affect people with disabilities in Virginia, Tennessee, New Hampshire, Wisconsin and Alaska, go to http://www.kaiserhealthnews.org/Daily-Reports/2010/February/08/State-budget-and-Medicaid-issues.aspx. You can sign up for this daily alert at the bottom of the story.
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