(DENVER Dec. 12, 2011) Leon Rodriguez began as the Director of the federal Health and Human Services Office of Civil Rights in early September and today visited the Denver regional office as part of a nationwide “listening” tour. What he heard was that there is still a strong institutional bias in Colorado and that Olmstead implementation is still far off.
Dawn Russell an organizer of Atlantis ADAPT, the Denver chapter of the largest grassroots direct-action organization for people with disabilities, challenged the Director to show progress and meet benchmarks that would demonstrate Olmstead compliance.
Mr. Rodriguez noted that his organization was complaint-driven but that he plans to institute “self-initiated compliance reviews.” The director said that he is compiling information from around the nation on “how you do Olmstead” and he said he plans to look at that data to develop benchmarks.
“Some of the discrimination is not just individual instances of inequality,” said Dawn Russell. “When you are in the institution you get a high level of expensive custodial services regardless of your need. The day you move out; however, your service levels are minimal and based on need.”
On the most basic level the payment methods make it simple for a Medicaid eligible individual to move into an institution, while it is difficult to move into the community and receive the same Medicaid services. This discrimination is obvious when you consider that in the institution a person with a disability the payment is about three times the Medicaid reimbursement of the same individual in the community. The nursing home payment is in advance and consistent, while home-health services are provided first and reimbursed dependent on an individual’s need.
The economic incentive tends to concentrate people with low needs in the institutions where they are most profitable to the facility and drives people with high needs into the community where home health can get a skilled rate over the very low custodial care rate or homemaker services. Likewise, someone with very little medical or skilled needs may find it difficult to get a home health that will provide custodial care without the higher Medicaid rate.
“We see agencies cherry-pick Medicaid consumers,” said Anita Cameron of ADAPT. “They know the formula and won’t pick-up someone because they just are not profitable enough.”
Velveta Howell, the Denver Regional Manager of the HHS Office for Civil Rights introduced Leon Rodriguez to the crowd of about 40 who came to the listening session this morning. Ms Howell invited people to stay updated with the OCR by using their listserv at: http://www.hhs.gov/ocr
Mr. Rodriguez also stated that the HHS OCR enforces Health Information Privacy and has new authority that adds gender discrimination under Section 1557 of the Affordable Care Act. He said that his office will soon inform people nationwide of their right to view and correct their medical record.