The manner in which a state treats its most vulnerable citizens is a profound commentary on how that government decides its priorities and where it sets its moral compass. We have a humanitarian obligation to care for those who have often spent their lives sustaining our economy, educating our children, building our roads, and serving our country. Our seniors deserve our compassion, understanding, and respect. But our Governor has decided that his political ambitions are worth more than those who need his help the most. Those with chronic disability, which includes both the elderly as well as children, have consistently been turned away from the services that they need most because our Governor outright refuses to provided them with the reliable and excellent care that they need and deserve. The Governor’s four million dollars in budget cuts for home care for people with disabilities was a startling example of how he is choosing to set his fiscal priorities.
As part of the Affordable Care Act, President Obama enacted a new Community First Choice Program, which was created to extend long-term healthcare services to people in their homes. When community-based health services are not widely available and affordable, people with chronic disabilities are often forced to seek long-term care in the hospital, in an intermediate care facility, or in a nursing home1. By enacting the Community First Choice Program, participating states would receive an increase in financial assistance from the government in order to provide community-based services to more people. This was a win-win proposal. It should be in the interests of any state government to ensure that each of its citizens are well-cared for in a manner that they are capable of choosing, rather than forced into.
Under the Community First Choice Program, states are required to provide2:
• Assistance with activities and instrumental activities of daily living (ADLs and IADLs) and health-related tasks, including hands-on assistance, cuing, and supervision.
• Acquisition, maintenance, and enhancement of skills to complete those tasks.
• Back-up systems, such as beepers, that will ensure continuity of training and support.
• Training on hiring and dismissing attendants, if desired by the individual.
States also have the option of providing3:
• Transition costs, such as the first moth’s rent, rent or utility deposits; and kitchen supplies, bedding, and other necessities for an individual to move from a nursing facility to the community.
• Coverage for additional items noted in an individual’s care plan that will increase independence or substitute for personal assistance.
Why is this important?
Many states already provide personal care services through Medicaid, including Louisiana. This plan would expand the number of people eligible for those services while increasing the matching funds that the federal government provides those states to provide those services.
The Community First Choice Program helps keep seniors in their homes, which maintains their independence and allows them time and space to prepare for the end of their lives. This program also helps keep other medically fragile people4, including children, at home with their families instead of moving them to an unfamiliar living facility, which is an admittedly traumatic and disruptive experience for anyone.
Despite all the tremendous good that this program offers, Governor Jindal has withdrawn Louisiana’s application to participate because of concern regarding the cost of having to expand these services to those who need them the most. Fiscal considerations are obviously a significant part of the Governor’s responsibilities, but it is difficult to swallow that he is comfortable with handing over millions and millions of dollars in tax credits to the movie industry, while rejecting opportunities to provide vital services to his own people.
1. White House. (2013). Community first choice for people with disabilities. Putting Americans in Control of Their Health Care. Retrieved from http://www.whitehouse.gov/health-care-meeting/proposal/titleii/community-first
2. FamiliesUSA. (2013). Long-term services health reform provisions: Community First Choice option. Retrieved from http://www.familiesusa.org/issues/long-term-services/health-reform/community-first-choice-option.html