KENTUCKY
Budget shortfalls led to limits being imposed on a number of the state's long-term care services, ranging from nursing home eligibility to personal care services provided in the home. The state moved forward, however, with planning that proposes increasing community options for persons with disabilities over a 10-year period.
The Budget
In January 2003, Governor Paul Patton announced $250 million in Medicaid cuts, about 6 percent of total Medicaid spending. Some nursing home residents were expected to lose Medicaid eligibility when the state began its annual review of resident eligibility beginning in April 2003. The state no longer would cover people with "low-intensity" needs, such as help with daily activities such as bathing and dressing. The changes would apply to nursing home residents or those receiving personal care services at home under the Medicaid program. The state also planned to tighten income limits for some Medicaid recipients in nursing homes or those who apply for coverage.
Planning and Reports
In May 2002, the secretary of the Cabinet for Health Services created the Kentucky Olmstead Consumer Advisory Council through an Administrative Order. The mission of the advisory council is to help implement a compliance and systems change plan to meet the broad mandate of the Olmstead decision. In December, the Cabinet for Health Services in collaboration with the Advisory Council, released an Olmstead Compliance Plan for FY 2002 through FY 2012.
The compliance plan outlines state programs that currently support community-based efforts, makes recommendations, sets goals and strategies for each initiative, and lists challenges with Olmstead compliance. The goals of the plan include ensuring that consumers and families have meaningful information about choices that they can understand, that an individual's eligibility and need for services are based on objective criteria, and that plans are developed to move appropriate individuals from institutions into the community. Other goals include making appropriate housing and transportation available and increasing the employment rate for people with disabilities.
In September 2002, a Statewide Transition Committee was formed to develop a uniform process for moving people with mental retardation from ICF/MR facilities to the community when the individual desired the move, the treatment team believed community placement was appropriate, and a slot in the Supports for Community Living (SCL) program was available. SCL is a Medicaid waiver program administered by the Kentucky Division of Mental Retardation.
2002 Legislation
The 2002 legislature required long-term care facilities that provide special care to Alzheimer's patients to offer specialized training to all staff, including training in etiology and treatment, disease stages, behavior management and resident rights. The legislature also authorized the state to develop a Medicaid waiver program to provide services for children with pervasive developmental disorders or autism.
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