article by Elsa Gillis; reporting for KTBS3 News | May 10, 2015
LOUISIANA (KTBS) -54,000 Louisiana residents are waiting for waiver services, and Louisianans wait longer than the rest of the country. According to the audit by the LA Legislative Auditor's Office, Louisiana is in the planning stages to utilize more waiver services for Medicaid recipients, this includes the elderly, and people with physical and developmental disabilities.
The audit found that because the demand for waivers exceeds the number of allocated slots. There were 54,677 applicants waiting for waiver services as of October 2014. About 66% are on the list for a "Community Choices Waiver," with an average wait time of 4.35 years.
Mary Alice Rountree at the Caddo Council on Aging says this is not only hurting our aging population - but costing the state more. “We were very, very disappointed because we think so many people can live at home. We know there's a lot of seniors living in nursing homes that didn't need that 24/7. But remember that assisted living is not paid for by Medicaid and so people at home that were needing just that little bit of care had to jump over that assisted living area of just a little bit of help, but still living independently into full time nursing homes."
Nursing facility costs range from $139-187 per day, whereas the Home and Community based programs range from about $21-135/day. Rountree says if there were more waiver slots available, Louisiana could stretch the Medicaid dollar more.
About 24% of those waiting for waivers are for the "New Opportunities Waiver" program, with an average wait time of 10.41 years. This waiver program is for those age 3 and older who would otherwise require the level of care provided at a facility for the developmentally disabled to stay in their communities.
KTBS recently brought you a story about the Arc of Acadiana Northwest, which has decided to move in that direction - and slowly close its large facility - and use waiver services to get residents into community based care.
“Facilities like this are just a thing of the past. They're considered a lot more restrictive, and you want people to have the option of living in a house. And choosing who they live with. It's just the direction a lot of these places are going in," says April Lee of the Arc. She told us this gives their residents more choice, and it's also quite expensive to run a large facility. In fact, according to the audit, intermediate care facilities for the developmentally disabled rates average $160/day - again compare that to a range of $21-135/day for waiver services.
But if there's a wait list for these “New Opportunities Waiver” programs, and the large facilities are closing - how are people getting the care they need?
Here's what Lee told KTBS: “There is “priority waiver” access for individuals residing in public ICF/DD facilities and for individuals who were residing in a CEA Facility (which is what our facility is) at the time of privatization; therefore, these individuals will be able to transition from the facility to Home and Community Based waiver opportunities, without having to be on the Request for Services Registry. Most of our residents will not be impacted. Anyone who is currently a resident of a public ICF/DD or currently a resident of a former public ICF/DD that privatized has an “automatic slot”. Anyone who has not lived in a public facility or one that has gone through the CEA process would be impacted. This would be people who are currently on the waiting list and people who need services but are not currently receiving any.”
But as legislators and other stakeholders move forward - the auditor says this report should act as a guide to make decisions about Medicaid funding and long term care services.