Published On: Tue, Mar 17th, 2015

Will California’s Long-Term Rehab Facilities Lose their Funding–Again?

MediCal was developed in 1965 as a California state companion to the federal Medicaid program created that same year. Such programs were intended to provide medical access to the disabled, the elderly, and to children (and low-income parents). However, this funding, while a significant step forward, was not all inclusive.

Going unfunded

In an effort to protect the mentally ill from the warehouse conditions that asylum facilities of earlier decades are infamous for, Medicaid and MediCal denied program funding to what they defined as “residential care facilities.”

MediCal was still permitted to provide support for women who attended residential facilities in order to cope with substance abuse or mental illness, provided those women were perinatal. (This covers the time period directly before, during, and after birth, at which point the funding stops.)

Facilities with 16 or fewer beds were also granted funding, but because 16 beds aren’t enough to cover costs (think one table in a fine dining restaurant) most long-term residential rehabs in California have sought funding from outside third parties. The result is, of course, a disconcerting absence of supervision and regulation, creating long-term rehabs that look and act more like an extended meeting of Alcoholics Anonymous than a medical facility. With the most senior sober member taking the lead and the bearing the responsibility.

photo TaxRebate.org.uk

photo TaxRebate.org.uk

Federal money spread thin

The Substance Abuse and Mental Health Services Administration is a federal agency that provides funding via state issued block grants, which are divvied up across counties, which then spread money thinly across the various rehabilitation centers. $100 per patient daily, and no limit on stay, but representatives said California still (and always had) lacked adequate funding for their substance abuse programs. An estimated 9 out of 10 people in California were routinely left without the services they required, leave ERs, jails, and homeless shelters to deal with the overflow.  

A slippery slope of social burden

This load of this burden was greatly reduced by the 2014 Affordable Care Act, because the state’s most needy (not just the disabled, and elderly) became eligible for MediCal. 11.3 million Californians use the newly available program, according to state Department of Health Care Services spokesperson Carol Sloan. That’s a lot of people.

But now, state health care officials are hoping to reform the MediCal system again, entirely eliminating funding aimed at long-term rehabilitative services in an effort to cut spending. If their proposal passes, even the once available federal block spending with be reallocated.

The state’s proposal is currently under review by the US Centers for Medicaid and Medicare Services, and if approved it will amount to a massive overhaul of MediCal, much of which will be marked by expansion and growth. Unfortunately, for those who require long-term, live-in rehabilitation services it may mark the end of the treatment they need to survive.

Guest Author: Lolita Di

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