In a settlement approved by a U.S. District Court, Louisiana agrees to expand Medicaid recipients' access to home and community-based alternatives to nursing home care.
A class of Medicaid recipients sued the Louisiana Department of Health and Hospitals (DHH) alleging that the state violated the Americans with Disabilities Act in failing to offer long-term care services 'in the most integrated setting' and violated the Medicaid Act by failing to provide recipients a choice between institutional and community services or to provide services with reasonable promptness.
Alternatives to institutionalization are available through several waivers granted to DHH by the U.S. Department of Health and Human Services: the Personal Care Attendant waiver, the Elderly and Disabled Adult waiver, and the Adult Day Health Care waiver. Under federal Medicaid law, waiver services may be made available to those persons who would, absent a waiver, qualify for institutional care. Currently, such waiver programs have years-long waiting lists for very few spaces. The class members included all Medicaid recipients who are unnecessarily segregated in a Medicaid-funded nursing facility, as well as all individuals who are eligible for the state's home and community-based services (HCBS) program, but are at risk of institutionalization because of the state's failure to provide appropriate services. The plaintiffs pointed out that approximately 90 percent of Louisiana's expenditures for long-term care go to institutional services, half of which are nursing homes services.
In a settlement agreement approved by the U.S. District Court on September 19, 2001, DHH agrees to take all reasonable steps to expand its capacity to provide waiver services and to endeavor to eliminate waiting times for those seeking waiver services who are in a nursing home or at imminent risk of being placed in one. The agreement also calls for individual long-term care assessments that will eventually include a single point of entry system.
Commenting on the settlement, DHH Secretary David Hood said, '[W]ith this agreement, Louisiana will soon join with the most progressive states in better meeting the needs of aging baby boomers.'
Subscribe to the Knowledge Bank.
