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Federal officials slam Florida for warehousing disabled kids; and what is the ‘Contract With America’?


MIAMI – Florida health and disability administrators have been systematically dumping sick and disabled children — some of them babies — in nursing homes designed to care for elders, in violation of the youngsters’ civil rights, the U.S. Justice Department says.

Where The Action Really Is: Medicaid And The Disabled

Abstract

Discussions of Medicaid tend to focus on low-income children and their mothers and the institutionalized elderly as the principal beneficiaries, but Medicaid spends more on the nonelderly disabled than on any other group. In the past two decades Medicaid has helped finance the deinstitutionalization of the mentally retarded and a growing proportion of the mentally ill, but implementation of theOlmstead decision has deflected advocates’ attention from the more important issue of how managed care plans treat disabled Medicaid beneficiaries.
While the number of elderly Medicaid beneficiaries has remained static for a quarter-century, disabled beneficiaries have doubled.
One other dimension of the politics of the Medicaid disabled merits special note. While low-income children and their parents constitute one of the least influential groups in this society, and while elderly Medicaid beneficiaries tend to be disproportionately among the frailest and those with the fewest family supports, disabled beneficiaries are often much better connected to mobilized, or mobilizable, middle-class constituencies. The effectiveness of many organizations of parents of retarded children has been widely recognized, for instance.
This phenomenon has not been invisible, either, to advocates for the Medicaid program. Medicaid serves as the principal safety net for middle-class families suffering catastrophic events—whether the birth of an impaired child or traumatic injury to an adolescent or the onset of mental illness in a young adult. Of course, the quality of this safety net varies enormously from state to state, and even within states, and is often accompanied by all of the stigmatization and bureaucratic harassment that state and local officials can contrive. But in a society in which well-founded anxiety about continued access to health insurance and health care is an increasingly widespread phenomenon, it sure beats the alternative.
Thus, in 1995 and 1996, when Medicaid’s open-ended entitlements were under attack in the “Contract with America” Congress, defenders of Medicaid devoted considerable effort to redefining the general perception of the program from one that primarily benefited poor people to one that protected families that were or had been middle income. It is hard to accuse exponents of that strategy of dishonesty. And, as far as anyone can tell, the strategy seems to have worked, at least in the short term.
Hundreds of Florida children are spending their formative years in hospital-like institutions, sometimes growing up in the equivalent of hospital rooms with virtually no education or socialization, the Justice Department’s Civil Rights Division wrote in a 22-page letter to Attorney General Pam Bondi.
People with disabilities or medical conditions must be housed and treated in community settings whenever possible, not in large isolated institutions as most states did in previous decades. Since the law was passed in 1990, advocates for disabled people and children have used it to shut down often squalid institutions and to move disabled and mentally ill people into their own homes or into group homes that are part of larger communities.
In recent years, however, Florida health administrators have relied upon nursing homes to house hundreds of children who could safely live at home with their parents — often at less expense to the state, advocates claim. In his letter, Mr. Perez said the state has cut millions from programs that support the parents of disabled youngsters, refused $40 million in federal dollars that would have enabled some children to stay or return home, encouraged nursing homes to house children by increasing their per diem rate — and even repealed state rules that limited the number of kids who could be housed in nursing homes with adults. MORE AT SOURCE
The Times reports this morning on states’ efforts to rein in Medicaid costs with managed care programs and how these may affect the elderly in nursing homes.

Some health policy analysts doubt that managed care will save money, and advocates for the aging and disabled worry that the sickest and most vulnerable people may be hurt in the process.
“Managed care isn’t going to help — it’s just more money going off the top,” said Toby Edelman, senior policy attorney in the Washington office of the Center for Medicare Advocacy, who has written on the importance of Medicaid to Medicare beneficiaries and their middle class relatives. “The managed care company has to take its cut.”

Remember, If this is happening in Florida, how many other states across America is this kind of wasteful spending taking place?  shera~



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EDIT 09/11/2012 4:43am

Thousands Sterilized, a State Weighs Restitution. Remember It was only 40% Non-Whites

If you look back through history the US Government and Health Dept ,  sterilized  mostly white in NC;and through out the USA;   those they ‘deemed’ disabled or ‘non-productive’ so they wouldn’t become a ‘burden on society’  that's a fact.

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