The 1999 Olmstead v. L.C. decision says unnecessarily segregating people in mental hospitals, nursing homes and other institutions amounts to discrimination. Advocates for the mentally ill, older people and the disabled cite the ruling in arguing for home and community-based care.
Florida's ranked behind 46 other states and the District of Columbia in its allotment of Medicaid money to non-institutional care. It earmarked about 35 percent of Medicaid long-term care funding to home and community services in 2012, up from about 26 percent a decade ago, but well below the national average.
Florida officials are starting to look for ways to steer more people into home and community based care. The move is a central part of the push to controlling Medicaid costs for low-income people. According to Department of Elder Affairs administrator Cheryl Young, thousands of people have received assistance over the last fiscal year.
“We’ve released over 19,000 people to receive services since July 1 of this last fiscal year, so the state, because of the increase in funding, has been able to release individuals from the waiting list more frequently,” she says.
The state has put more money into the program, but the number of people eligible for services has also increased. About 36,000 Floridians are on a waiting list for home and community-based care. The Agency for Healthcare Administration is looking into ways to improve the way it screens applicants for the program, which is largely composed of physically disabled adults over 18 years old. There is a separate waiting list for services for developmentally disabled people which is also funded by Medicaid.