Health and Human Services Secretary Mike Leavitt unveiled a grant program Wednesday that seeks to help elderly and disabled to use Medicaid long-term care money in order to live at home instead of in institutions such as nursing homes.
"With this program, people who need long-term care and prefer to live in their own homes and communities can do so," said Leavitt, the former governor of Utah, in announcing the program.
HHS called for states to compete for a share of a newly approved $1.75 billion in grant money over five years in the new "Money Follows the Person" program. The states are asked to competitively propose new programs and methods "to help shift Medicaid from its historical emphasis on institutional long-term care services."
Utah has no immediate plans to apply for a grant but will continue to evaluate the initiative to determine if it would be a good fit for the state's current programs, said Tonya Keller, director of long-term care for the Utah Department of Health's Medicaid division.
The federal funding is available for a one-year period only. After that, states will be required to supplement the new programs with state dollars under the current federal match rate for Medicaid, Keller said.
"I do think we're sensitive to the fact that it would revert to the standard federal match that we now have," she said. "We don't want to commit ourselves to something and then have it be an issue for state appropriations."
Like many states, Utah continues to struggle with funding Medicaid services, particularly in the face of continued federal cuts to the government insurance program for low-income and disabled Americans.
HHS is offering to give higher-than-normal federal matches to state money not only for alternatives to institutional-care services like home care, but for programs to modify homes to allow the elderly or disabled to remain there; for respite services for home-care providers; for personal-care services; and for assistive devices.
Leavitt said the federal government temporarily may pay 75 percent to 90 percent of such costs to help transition individuals out of nursing homes and into community settings.
"States will also get more for their money by giving the elderly and people with disabilities more control over how and where they get the Medicaid-funded long-term care services they need," Leavitt said.
HHS said Medicaid traditionally pays for care for the elderly and disabled who need help with activities of daily living only if they live in institutions, because institutional care was the norm when Medicaid was formed 40 years ago. It said it is now seeking to "rebalance" that because of changes in how care is often offered.
"We've worked with advocates and states for years to end the institutional bias in Medicaid, and now we've got the best opportunity ever to do it," said Mark B. McClellan, administrator of the HHS Center for Medicare & Medicaid Services.
"We need to move as quickly as possible to make that shift across Medicaid. With new federal funding, there is no longer any excuse for the status quo," he said.
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