Post at least three times to this discussion forum, following the guidelines below. Your posts should include responses to any questions asked, as well as replies to classmates.
Read Kaye’s article on Shifting to Home & Community-Based Services (linked to within this lesson).
1. In your first discussion post, identify Medicaid’s three main programs. And your recommendations for managing the allocation of funds for long-term care. Where would you spend most of your funding to improve the health outcomes of the Medicaid population. (This includes low income elderly and disabled)?
2. Respond to at least two of your classmates’ initial posts providing feedback on their allocation of funds. For long-term care and what you believe would be successful or unsuccessful and why.
Medicaids three main programs consist of waivers, personal care, and home health.
Waivers also called 19159(c) waives offers assistance for many medical and nonmedical services. Care is distributed based on state, age, and the nature of the disability and include help with normal daily activities. Eligibility is different from state to state so a person must meet their states requirements to utilize services.
Personal care services provide care and assistance in daily activities to a larger population than that of the waivers. To be eligible a person must meet the states requirements. Even though personal care services can reach a broader population. The care is usually limited to a small quantity of hours or help per week.
Home Health is available is all states and is geared towards medical assistance with daily activities. And can also provide medical supplies and equipment. Staffing includes nurses, home health aides. And other providers in the home. Home health is provided to a large population of people in need of these services.
To ensure that long-term care is provided in the future we need to find a find a way to reduce the biggest uninsured risk we face presently. Managing the distribution of funds should come from us and come directly out of our paycheck. To qualify for this care, you would have to currently be working to pay into it. It could be a set rate of around 25 dollars a paycheck over the course of 10-15 years (or much longer).
This would give families and individuals security knowing the care they need will be available and can cover costs that Medicare/Medicaid do not cover. If individuals pay into their long-term care it provides more funding to improve the Medicaid population. Funds could be used to get people help sooner instead of waiting and it would also be a source of money they have that does not need to be depleted before Medicaid kicks in.
The three main home and community-based services program are Waivers, Personal Care, and Home Health. First, let’s take a look at what these three programs are and what they entail:
1). Waivers also known as 1915(c) Waivers. Provide an array of medical and nonmedical services, including personal assistance with daily activities, to selected population identified by each state, generally based on age and type of disability.
2). Personal Care. For those eligible, this home and community-based services program provides small number of hours of help per week, it is an optional Medicaid benefit offered by a majority of states, provide personal assistance with daily activities to people meeting the state’s functional criteria for such need. Many are served under this program compared with 1915(c) Waivers.
3). Home Health. This benefit is available across the country, i.e. all US states offers medically based services provided by nurses, home health aides, and other providers in the home, as well as certain medical supplies and equipment.
proponent of rebalancing home and community-based services
As a proponent of rebalancing home and community-based services, my recommend that Medicaid shift more funding to the Home and Community-based Service for both the elderly and the disabled. Home and Community-based service is cheaper, safer, and keeps the dignity of the client intact while receiving long-term care service in comfort of their own homes or a relatives’ homes. Being institutionalized resident of a nursing home, rehabilitation center, or long-term facility is depressing which contributes to rapid decline of health of the residents. Whereas, home and community-based care for many seniors contribute to the healing process of the elderly while reducing the workload on the aide.
Additionally, it is cost-effective. According to Kaye (2012), one study found that during a decade of expanding non-institutional long-term services in many states, those states with a high proportion of spending on home and community-based services spent no more on long-term services and supports than other states. Furthermore, states with well-established home and community- based services programs saved money on long- term services and supports over time compared to states spending a low proportion on home and services.