Medicaid for Seniors

Theological/Ethical Perspective

• Society can be measured by how it cares for vulnerable people, such as the frail elderly
• Government should support families, not divide and impoverish them

Problem with Budget Proposals

The following budget proposals will have a devastating effect on poor frail elderly.

• Changes in look-back period for transferring finances to family members

                -       increasing from 36 to 60 months for institutionalized individuals

                -       adding the same for non-institutionalized spouse

                -       care could be denied for inadequate record keeping.

• Change in penalty rule computation from date of asset transfer to date of Medicaid application

                -       prevented by law from discharging patients without suitable arrangements can be made. health care providers will have to give
                        uncompensated care

                -       severely disabled seniors will be left with unsafe and inadequate care if community services are also cut.

                -       households will have less income for medical needs if a family member must leave a job to provide care.

• Restricting/Eliminating Spousal Refusal

                -       federal law enacted in 1988 prevents the impoverishment of spouses whose mates need nursing home care.  New York law also
                        authorizes.

                -       spousal refusal allows the healthy spouse to maintain assets to generate income for their own living expenses and future long
                         term care needs.          

                -       this proposal would restrict spousal refusal in nursing home care to limited exceptions  and eliminate it for home care cases
                        except where one spouse is absent.        

                -       vast majority filing for Medicaid under spousal refusal have provided extensive care at home and assistance is sought as last
                         resort.

• Adding a Penalty Rule for home care

                -       presently no asset transfer penalty period for community based home care

                -       home care recipients could have services abruptly terminated if they made transfers in last five years

                -       violates Americans with Disabilities Act.by restricting access to home care services or forcing institutionalization

                -       burdens caregiver spouse/may lead to health problems so they also need care.cause

                -       punishes elders who  help their family and then experience unforeseeable medical event

 What will help

• not change current eligibility provisions until there is a comprehensive long term care program for seniors
• not seek waivers except to expand or improve services
• include input from consumers and their representatives in developing plans.

    3/2004