The lobby that fought back













A "strong and well-organized senior lobby" pushed in Oregon for a law in 1981 that made the state serve seniors in the "least restrictive setting" -- 2 decades before the Olmstead ruling, write University of Minnesota researchers Robert L. Kane, Richard C Ladd, Rosalie A. Kane and Wendy J. Nielsen.

"The nursing home industry maintained a low profile and did not publicly oppose the creation of the 1981 law that created a new division to serve seniors and, not incidentally, also directed that the state would. . . use the money saved from what would have been spent on nursing home institutionalization for home and community alternatives. . . .

"Opposing the legislation would have placed the nursing home industry in an awkward position, given the high level of interest among seniors, and the industry did not want to be seen as 'anti' senior programs." The lobby bided its time.

When the Senior and Disabled Services Division created under the law "proposed a major reduction in nursing home usage along with major increases" in using less expensive in-home services, seniors started choosing home-based options -- "and that made nursing home profits start to fall."

Now the industry took action, filing a complaint with federal Medicaid, charging that Oregon had violated the "terms of the federal home and community-based care waiver [the first waiver ever granted by Medicaid] by forcing people out of nursing homes." It pressured state legislators, and brought the new Division under fire. Investigations followed, but concluded there'd been no violations of any federal programs.

The brouhaha ended with advocates "picketing the annual convention of the Oregon Health Care Association."


Source: "Long Term Care Profiles"


Nursing home lobby money and state legislators

What Medicaid spends -- comparisons

States can offer in-home services under Medicaid now -- if they choose to

Countering the 'Woodwork Effect'


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