There are a handful of Tennesseans about to face cuts to the services that support their decision to live in their home instead of an institutional setting. Some of these services include private duty nursing and extended personal assistance hours. These are people with disabilities with support needs that may range from several hours a day to having someone around 24 hours a day.
TennCare and the state contracted MCO’s are cutting these support services to those with the greatest needs, in what amounts to as a death sentence for people with disabilities. For the state, it appears they have decided to take a social Darwinistic policy approach. Where it is cheaper to cut services, and expedite your death, then to provide appropriate support services rather than the long term.
So why is this a death sentence? Many of these individuals will have to cut corners so severally they may have to risk their very lives on a daily basis to remain free from institutionalization. Some people will go to great lengths to state out of an institution including going without the very service that keeps them alive. One example is a person on a vent needs someone around 24 hours a day in case the machine stops working, the tubes get kinked, etc., but to stay out of a nursing home they may go without having someone around all the time. Other folks may have to rely on family, even family members that have neglected them in the past.
What about those that don’t have a family, a family that they can trust, a family that is safe or a family that can afford to quit their jobs to support them? These individuals will be forced by the state into nursing homes, which is surely a death sentence. Nursing homes do NOT provide the level of supports these individuals need and in so many cases are not available when needed. I know of several individuals in nursing homes that have died due to the lack of supports.
There are many ways to provide the services people need, and save the state money. Many of these services are currently only provided by nurses. Most of these support services could be provided by non-nurses, most other states already do this. TennCare could allow consumers to hire who they want. Consumer directed services was just passed into law but is not implemented yet.
If this was about saving some dollars there are ways to make that happen, but this is not about saving money it’s about making the Managed Care Organizations more money and eliminating services and supports to fellow Tennesseans. You see the Managed Care Organizations are about to come under capitation. Currently MCO’s are reimbursed for each service plus administrative fees. In November they all go under a capitation were they a paid a set fee per person and the more services they cut the more profit they make. So, if they can eliminate those with the greatest amount of support needs prior to November 1st, the more money they stand to make.
If you believe that we should provide the supports people need in a way that also allows the freedoms we all have, write us at MCIL. Tell us why you support providing these services, write condemning these cuts, just put it in your words and send it to: