State backs away from changing rules for disabled
ANCHORAGE - The Knowles administration has dropped plans to revamp the state's home and community-based care program for the disabled, leaving the thorny issue to the incoming administration of Frank Murkowski.
Dozens of people testified against changes in Medicaid rules at a Nov. 13 public hearing. Parents, foster parents and others said the proposal would hurt Alaska's efforts to keep severely disabled people out of institutions, where care costs more.
As a result, Health and Social Services Commissioner Jay Livey withdrew the proposed rule.
"This restores faith," said Steve Lesko, executive director of Hope Community Resources, Alaska's largest agency for the disabled.
About 2,700 Alaskans with mental retardation, developmental or physical disabilities get services through the program, which costs about $90 million a year, or more than $33,000 per person.
The program pays for such things as bringing an aide into a home to work with a mentally retarded child or a respite worker to give parents a break. A disabled adult could be taken on outings to practice basic skills such as ordering a meal. Payments to foster parents and assisted-living homes also are covered.
The state sought to limit some types of in-home help, bar the purchase of some special equipment, increase standards for workers who coordinate care, restrict money for home modifications such as wheelchair-accessible bathrooms, and put new restrictions on foster families.
"I think we concluded that the public clearly was having a very, very difficult time getting their hands around what was a very broad and complex set of regulations," said Elmer Lindstrom, deputy commissioner of health and social services.
The program "has experienced tremendous growth and growing pains," Livey wrote in withdrawing the rule.
The state contended some of the spending went beyond the program's intentions. For instance, some disabled people got specially equipped bicycles costing $1,200 that state officials said weren't essential to independent living.
Helping people live at home is still cheaper than nursing home care. The average cost of serving someone with a developmental disability through home-based services is $58,700 a year, compared to about $100,000 in a nursing home.
It's too soon to say if rules on home-based services will be changed by the Murkowski administration, said spokesman John Manly.