This, too, should be part of health care reform - qe
The Wall Street Journal
Babes Among Elders: Nursing-Home Kids
Parents Want Cheaper Home Care, but Medicaid
Pays to Institutionalize; Ronnie's Journey
By CLARE ANSBERRY
June 28, 2007; Page A1
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Thousands of other children are growing up in nursing homes across the country, many for the same reason as Ronnie. Federal disability insurance guarantees nursing-home care for the disabled. But in many states, its coverage isn't enough to let those people, children included, live at home -- even when the cost to taxpayers, and the strain on families, is often much lower.
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About 4,000 children nationwide live in nursing homes, according to Medicaid -- a small, often hidden population that has wound up in these incongruous settings, often against their parents' wishes. While some of the homes cater to children, many are traditional facilities designed for the aged. Their staff may dote on young residents but are often more familiar with geriatrics and dementia. Visits to family may be limited: Nursing facilities often give away residents' beds if they spend more than 10 nights a year away from the home.
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But for these families, there is often no alternative. Parents may seek help after their disabled child suffers a life-threatening emergency, or a divorce leaves a single working parent without time or resources for child care. Depending on what institutions are located near the family, a child may be sent to a group home, a state or private school or, often in the case of the most severe disabilities, to a nursing home. A total of about 26,400 children are in out-of-home facilities across the country.
Home care isn't an option for many parents. Medicaid, the federal-state program that insures people with low income or disabilities, automatically pays for nursing homes. It's up to individual states to decide how much they will pay for in-home services. Few states fund the level of skilled care such patients require, leaving parents with a burden that can run tens of thousands of dollars annually. Nationwide, there also aren't enough home-care workers, nurses and therapists to serve these families. About 93,000 developmentally disabled Americans of all ages are on waiting lists for home and community-care services.
When home care is available, it typically costs taxpayers less. Georgia spends about $81,000 a year for each resident in institutional care, which includes nursing homes. Home and community care, by comparison, costs about $26,000 a year, according to the University of Minnesota's Research and Training Center on Community Living.
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