7/27/13, No. 75
The other day I read this distressing news: “Federal officials are suing the state, alleging that hundreds of children with disabilities are being unnecessarily segregated in nursing homes in violation of the Americans with Disabilities Act. The U.S. Department of Justice filed suit . . . accusing the state of relegating nearly 200 children with significant disabilities to nursing homes who could be served at home or in other community-based settings.” Read more: Feds Sue Florida Over Kids In Nursing Homes
Why is this news disturbing? Federal officials are not addressing what provides the most cost-effective solution for the state’s taxpayers. These officials do not recognize that, from the taxpayers’ perspective, the worst thing that can happen to a child with severe and multiple impairments is to be left at home with the parents. These are children who are quadriplegics or paraplegics, blind, deaf, drooling, without speech, wearing diapers, needing feeding tubes and/or oxygen, and so forth. Their parents are likely to develop a morbid attachment to them, whereupon they will do everything in their power to keep them alive. These children should just get it over with and die. But if the parents are at all educated and/or intelligent, they learn how to apply for and receive state support—the medicaid waiver—that helps them keep their children alive. To say ‘receiving the medicaid waiver’ assumes of course that they have gotten their children off the state’s many-years-long waiting list.
In the short term, it is far cheaper to keep such children in their own homes rather than in nursing homes. Per annum, the state pays five-to-ten times more per child living in a facility than it does for one living with its parents.
However, keeping such children at home long-term is not at all a good deal for the taxpayers. Why? While it is true that the nursing-home-industry bills the state’s medicaid program top-dollar prices, it only does so for a relatively short time. After just a few years, the child usually dies prematurely from bedsores and/or a mistake made by the inattentive, overworked, and unmotivated minimum-wage staff. No public scandal attaches to these deaths because it is understood that the children were ‘medically fragile.’ In other words, everyone assumed they were going to die anyway.
Compare this efficiency with the the wastefulness entailed when the child is kept at home. The parents’ solicitous care may keep the child alive for ten, fifteen, twenty, or even more years. These costs add up over time, and by the tenth or fifteen year, the state finds that it has paid out more overall than it would have had the child at the start been transferred to a nursing home, where it would have died relatively quickly. In other words, the state at the beginning may pay out a lot on nursing-home bills for several years, but one doesn’t need to be a rocket scientist or use a calculator to understand what is at stake here.
Removing disabled kids from their parents’ care and placing them in nursing homes can be thought of as an investment: a large initial outlay must be made, but tremendous cost savings accrue over time.
There is nothing here that could possibly offend any right-thinking person or that could be construed as being out of line with the constitution of The Vince Foster Society, about which you can read more here: The Vince Foster Society