April 29-- Apr. 29--In addition to supporting good health outcomes, a goal of government-funded health insurance is to do it in a cost-efficient way.
A program funded by the state and federal governments called Open Doors is accomplishing both, letting many New York residents move out of nursing homes or other long-term care facilities and into standard housing. It also is producing significant savings for taxpayers by reducing the number of people staying in facilities for which Medicaid picks up the tab.
Gerilyn Capps, the Open Doors program coordinator at Western New York Independent Living, told The News that more than 200 people in the region have been able to leave nursing homes in the last three years thanks to the program.
Medicaid, funded jointly by federal, state and county governments, spends billions of dollars for nursing home care each year, funding the stays of most residents who have used up other forms of insurance and their savings.
A story in The News on Wednesday described how Janine Ziomek-Witek stayed for five years in a Buffalo nursing home that she had entered for rehabilitation after having a leg amputated in 2014. Her stay at Emerald South had cost taxpayers hundreds of thousands of dollars. She thinks she could have left sooner.
With the help of Open Doors and a regional nurse for Grand Healthcare, she relocated to an apartment in Amherst that's part of a Medicaid-supported long-term care program. The state reimbursement rate when she left Emerald South was $212 per day. Her rent in her new apartment is about $20 a day.
The Open Doors website states its goal is to "promote rebalancing efforts toward which states increase the use of home and community-based services and reduce the use of institutionally based services."
Ziomek-Witek's relocation was both a personal victory for her and one for taxpayers. And it took some convincing for her to be allowed to leave Emerald South after questions were raised about whether she was able to live on her own.
Ziomek-Witek's husband, Michael Witek, became homeless for a short time after his federal Supplemental Security Income checks ran out during his wife's second year at Emerald South.
It's likely that a family with more financial means could have lobbied more forcefully for Ziomek-Witek to be released.
"I joined the resident council and became president and was trying to work through the council to get out, but that went nowhere," she said.
Western New York has many pockets of poverty, with thousands of people drawing Medicaid benefits. Beyond financial support, people in that position also need advocates to help them negotiate health care bureaucracies that leave them feeling marginalized. And for that matter, so do people who are well versed in the intricacies of government health care. A second set of eyes is always useful and, sometimes, it's crucial.
Western New York Independent Living, which helped Ziomek-Witek get free of Emerald South, is one such resource available to advocate for those who need help. The agency has branches in Erie and Niagara counties and the Genesee Region.
The Center for Elder Law and Justice, a source of legal assistance, told The News that nursing home residents who need help having their request for a discharge acted upon should start by contacting a social worker at the home. They can help break through red tape when it becomes an institutional shackle.
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