JACKSON —  

The Mississippi AARP’s foot soldiers have accomplished a notable feat in a tough budget year: they persuaded lawmakers to approve $5 million for programs to benefit the disabled and elderly.

The legislation also requires the Division of Medicaid to develop a plan that meets the national standards for the Program for All-Inclusive Care for the Elderly, known as PACE.

The plan must be submitted to the Center for Medicare and Medicaid this year. The program pays for a person 55 or older who qualifies for nursing home care to receive treatment in their own home instead.

The AARP has been pushing for the changes for several years. This time, the organization refined its strategy, said Sherri Davis-Garner, senior state director. She said the AARP Mississippi’s nearly 300,000-membership was educated about the issues last fall and then encouraged to contact their lawmakers, which they did.

“We knew we had to do something different because we up against the nursing home association, which is pretty powerful,” Davis-Garner said. “We were rolling in and out of the Capitol pretty much the whole time during the session.”

According to AARP, keeping more Medicaid patients in their homes instead of nursing facilities saves Mississippi millions in health care dollars in the long-run. Citing a 2009 Metropolitan Life market survey, Davis-Garner said it costs $68,000 to keep a person in a nursing home each year, compared to $18,000 to provide home- or community-based care.

The AARP said $3 million will go toward assisted living and elderly and disabled program waivers. Waivers for home-delivered meals and independent living programs will get $1 million each.

The funding is expected to make a dent in the waiting list of 6,745 people for the elderly and disabled waivers. Medicaid spokesman Francis Rullan said the agency is studying the waiver programs to determine the best way to implement the expansion.

Rullan also said in an e-mail that Medicaid had considered the PACE program in past fiscal years.

“It is very expensive to implement initially and in some states has not resulted in substantial savings or substantial improvements in the quality of health care services for beneficiaries,” Rullan said.

During the session, the Mississippi Health Care Association and the Independent Nursing Association contended one advantage of institutional care was that patients get 24-hour care in nursing homes, which they say isn’t the case with home-based or community-based services.

House Public Health Committee Chairman Steve Holland, who authored the bill, believes nursing homes have their place, but an expansion of the waivers was needed.

Holland, D-Plantersville, said it was time to begin changing Mississippi’s “health care culture” when it comes to some institutional care.

“Anytime you can de-institutionalize a human being it’s more economical and more dignified. If you get sick and you’re elderly, you don’t get presented many options in this state,” Holland said.

Holland has personal experience with the issue. He said his father fell down at home about two years ago. He was hospitalized for about a month and then underwent rehabilitation therapy for another month. Holland said a doctor advised the family to place his father in a nursing home. When his father’s money ran out, Holland said the family turned to Medicaid.

“When I presented his case to Medicaid, I said ‘What is wrong with community-based services?’ They said it’s a waiting list. I put him on the waiting list,” Holland said.

Holland’s father, who is 80, now lives at home.

“Nurses come in and neighbors look after him. There’s a whole community who have enveloped his care at home,” Holland said. “It’s not like the whole idea is to empty nursing homes because they have a necessary place in the health care matrix.”