Those other Larrys
Why must Virginia's elderly be in nursing homes to get Medicaid support?
Date published: 4/3/2008
LARRY HAUBNER is a poster boy of sorts. The 105-year-old resident of Greenfield at Fredericksburg, an assisted-living facility, became the subject of news stories in The Free Lance-Star last year that were picked up by national and foreign media. Mr. Haubner, healthy and happy at Greenfield, was outliving his savings. It looked as if he might be unable to stay in his beloved home. His story highlights a gaping hole in Virginia's care for elderly residents: the failure of the state to ask for Medicaid waivers for people in assisted-living settings.
Piecing together the quilt of care the aged need is a daunting task for novices. Let's start with the basics. Just what is a Medicaid waiver? And why would a healthy centenarian be forced into a nursing home because he didn't have one?
Medicaid is the joint federal-state program created in 1965 to help low-income people get necessary medical help. Each state manages its own Medicaid program and establishes its own criteria for eligibility--along with the level of funding it wants to provide. When Medicaid began, assisted-living facilities did not exist, so the program covers only nursing-home care for elderly recipients.
But a rising number of older people need just a little help--the kind offered by assisted-living centers--to get by. To include such people in the Medicaid program, states must ask Washington to waive the requirement that a nursing home provide the person's care. Forty-one states have indeed sought that waiver--but not Virginia.
Thus, as Mr. Haubner's savings ebbed, it looked as if he would need to be moved to a nursing home so he could qualify for Medicaid. Instead, his plight came to the notice of the public, which contributed some $60,000 to supplement his income--enough to keep him at Greenfield a couple of more years.
The issue, of course, is funding. Asking the feds for Medicaid waivers for residents in assisted-living facilities would oblige the state to pay for another new category of people. What's been the relevant history so far?
In 1985, Virginia spent 7.7 percent of the state budget on Medicaid. By 2006, that figure had skyrocketed to 19 percent. The commonwealth ranks 22nd among the states in Medicaid spending, though it is 12th in population. The chance of extra Medicaid funding in these tight times? No chance.
Mr. Haubner's story had a happy ending, thanks to the generosity of the community and a few caring individuals. More people like him can be helped if Virginia seeks Medicaid waivers. (The governor's task force on health reform agrees.) For now, we await a sunny day, a window of opportunity, and a renewed will to help the frail elderly.
Date published: 4/3/2008
Most recent reader comments:
Not just Medicaid...
(posted by
Duncil
, Apr. 3, 2008 7:42 pm)
I read the story as questioning why we are forced into more expensive in-patient care when out-patient care is all that would be needed. The answer is the Medicorp political lobby. They and their cabal own health care in Virginia. We should be free to select our own health care options, not bow down to Medicorp.
Sorry to hear about your Father's situation Patrick.
(posted by
freedomfirst
, Apr. 3, 2008 6:59 pm)
I know that organizations like AARP sell medicare supplement insurance. That pays for certain out of pocket expenses. like deductibles and I believe extra days. You might look into that in the event you Father needs treatment for other issues.
The story above is about medicaid, which unfortunbately is used as primary insurance by some folks who have no insurance. It was set up to help the indigent and isn't funded to pay for the expanded clientele.
Why? Simple.
(posted by
Duncil
, Apr. 3, 2008 6:35 pm)
This has happend to my dad
(posted by
patrick4hp
, Apr. 3, 2008 9:32 am)
in a different way. For some reason, Medicare would only pay for his hyperbaric treatment, to treat Peripheral Artery Disease only if he was an impatient in the hospital. He couldn't do it on an outpaitent basis, and if you know anything about the treatment, you have to answer why? He only got 11 days of treatment, though the doctor wanted to do 30. In the end, his leg got amputated on Tuesday, and I can't help but wonder if the result would be different if he had the treatments. Really sucks.
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