Keep on Pushing for Community Care, says AoA Chief Greenlee

September 30, 2010

ATLANTA, GA – Advocates for senior citizens and people with physical and developmental disabilites should continue their crusade to help people stay at home and in their communities, Assistant Secretary for Aging Kathy Greenlee told the National Home and Community Based Services Conference on Monday.

“Every major accomplishment since 1965 has been moving us out of institutions and into communities,” Greenlee said.  By opportunities, The Americans with Disabilities Act “was one of the most important civil rights laws the nation has ever passed,” she said.  And then the Olmstead decision by the Supreme Court guaranteed disabled persons the right to community care. The 2005 deficit reduction law created “Money Follows the Person,” making it easier for individuals to purchase care in the home community. All these have a common thread, “community living,”   she said. 

The Affordable Care Act, she said, takes the next step by guaranteeing insurance coverage for all those with pre-existing medical conditions, a new approach that will have a significant impact in making it possible for some people with serious health problems to live at home rather than being forced to go into nursing homes.
Advocates have “come to this common place from different movements,” she said. All sought to increase the autonomy of the individual, whether “from the developmental disabilities world, the physical disabilities world, or the world of aging,” she said.

The Affordable Care Act offers new opportunities for the allies and advocates from different movements to expand further in helping people meet their needs in the community, according to Greenlee.  States and local agencies will receive $68 million in federal funds to help individuals increase their chances of getting care and remaining independent, the Department of Health and Human Services announced Monday. (SEE HHS Announcement)

The grant will include:

-funding for 20 state counseling programs to educate people about community resources in health and long-term care.

-funding for 50 states and 125 tribal groups to tell Medicare beneficiaries about benefits, including new preventive care.

-funding for 24 states to help people move from nursing homes back to the community, and to expand the Money Follows the Person program.

One especially promising area to keep people healthy and at home is the adoption of best practices in prevention for older people, according to Greenlee.  The best single prevention measure is reducing falls among the elderly. An accidental fall can lead to a broken hip, hospitalization, and transfer to a nursing home, all with potentially devastating consequences. Medication management also is vital, she noted. 

Greenlee, who runs the federal Administration on Aging, said her agency had simplified and accelerated the procedures for applying for grants under the Older Americans Act. She said federal officials were sensitive to the fiscal plight of state governments, which have seen revenues drop sharply during the current Great Recession, the biggest economic slump in 70 years.

States will be working to implement the provisions of the Affordable Care Act, which will add 16 million people to the Medicaid rolls by 2014 even as they struggle with the impact of the recession.

“We don’t have easy or quick answers for the states,” she said in an interview after her speech.   “We are aware of what happens in the states and the pressures they face and we are supportive as we can be,” she said.   But the long-range goal should continue to be focused on community living, she said. “This is what people like and it is less expensive.”

Greenlee was the keynote speakes at the plenary session at the meeting, which was the 26th National Home and Community Based Services Conference.