ARKANSAS
Arkansas state officials took a number of steps in 2002 to improve quality of long-term care services and to increase access to home and community-based care services (HCBS). One effort involved a task force report that recommended increased funding for HCBS for people with developmental disabilities and "money follow the person" policies for nursing home transitions. Another task force proposed ways to increase housing options for people with disabilities.
Planning and Reports
A 23-member Governor's Integrated Services Taskforce (GIST) released a comprehensive draft plan for long-term care reforms in October 2002. Governor Mike Huckabee had authorized the Department of Human Services to appoint the task force in June 2001 after a year of work by an Olmstead Working Group. The task force, consisting of consumers, advocates, providers, and agency officials, met from July 2001 through May 2002, and then began writing a plan. Highlights of the plan include the following.
- Assessing all individuals who seek to enter a nursing home to determine eligibility and to inform them of their community options.
- Allowing money that is spent on a nursing home resident to follow the resident after a move to his or her own home or another community setting.
- Providing quicker access to home and community-based services, including a request for an additional $6.4 million for the Medicaid developmental disabilities waiver program.
- Instituting major changes to the state's mental health care system, including funding for adult inpatient acute care, shifting funds to children's outpatient services, and working on commitment laws and insurance parity issues (people with mental illness having the same access to treatment that people with other physical illness have).
Housing for People with Disabilities
The Governor's Task Force on Supported Housing submitted its report on June 6, 2002. The report recommends both using existing housing and creating new housing stock for people with disabilities. The housing task force proposed the creation of a pilot program in cooperation with the GIST to operate in an urban and a rural community. The pilot group would receive assistance to obtain bridge rental subsidies through the state HOME program and permanent subsidies through the local public housing authorities, and would receive assistance to link with service providers.
In September 2002, Governor Huckabee ordered the Department of Human Services to increase staffing requirements in the state's nursing homes, a move facilitated in part by revenue generated from a quality assurance fee (or "bed tax") approved by the legislature in 2001. The fee produced almost $150 million, which was reimbursed to Arkansas nursing homes to improve care.
Consumer Direction
In another long-term care development, the U.S. Department of Health and Human Services approved the state's request to allow all beneficiaries in a Medicaid personal care services demonstration program to direct their own services and expenses. Since 1998, Arkansas has operated its Independent Choices Program, which provides cash allowances to 800 participants to hire their own workers, choose the services or supplies they wish, and schedule their services. Another 800 participants have been serving as a control group, using traditional agency services. Now, all 1,600 participants will be allowed consumer choice.
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