Logo reading "Freedom Clearinghouse"

Sign Up


Stuff to KNOW

Stuff to DO

Who's behind

What is our


Home page




Photo Credits


Image of woman writing

The letter of the law you'll WANT  to read, over and over!

To: The Whole Wide World
From: Candace Hawkins
Re: A major victory for disability rights

June 28, 2000, Missouri Governor Mel Carnahan signed into law a Medicaid Appropriations Bill, printed below, which will give approximately 53,000 people the freedom to choose where they live when they receive long-term care services.

Despite a last-ditch veto push by the home care industry (you read that right, not the nursing home industry but the home care industry), Carnahan stayed the course. As of July 1, Missouri is the first state to revise its law and policies in line with the Olmstead ruling.

There's a piece of it up front, about increases in n.h. funding that must go to direct care staff. Glide on by that to the real thing. And note that ALL individuals eligible for Medicaid long-term care are eligible for the Personal Care Option, therefore all diagnoses are included, and all ages. (I know it doesn't look that way, but that's what it is.)

Some of the state's departments report that they will actually be ready to roll this out on July 1, the day that the money is freed up.

Up front of the bill are a couple of paragraphs from Candace on how the work got done.

We approached legislators about doing a bill. However, Rep Quincy Troupe, said "You are talking about freeing money to follow the person, right? Well, you don't need a separate bill. We direct spending through appropriation bills, so I'll put it in right now." He's chairman of the Dept of Social Services appropriations committee, so it was amazingly easy for him to do. He just told his committee this was required by the Olmstead Supreme Court decision and no one balked. Those committees are so used to folks asking for more money, so just freeing up what was already there was a piece of cake.

Keep up the good fight and let me know if there is anything I can do to help.








3992L.04T 2000



To appropriate money for the expenses, grants, and distributions of the Department of Social Services and the several divisions and programs thereof to be expended only as provided in Article IV, Section 28 of the Constitution of Missouri, for the period beginning July 1, 2000 and ending June 30, 2001.

Be it enacted by the General Assembly of the state of Missouri, as follows:

There is appropriated out of the State Treasury, to be expended only as provided in Article IV, Section 28 of the Constitution of Missouri, for the purpose of funding each Department, Division, agency, and program enumerated in each section for the item or items stated, and for no other purpose whatsoever chargeable to the fund designated for the period beginning July 1, 2000 and ending June 30, 2001, as follows:

Section 11.005. To the Department of Social Services

... .......

Section 11.445. To the Department of Social Services

For the Division of Medical Services

For funding long-term care services

For the purpose of funding home health, respite care, homemaker chore, personal care, advanced personal care, adult day care, AIDS, and children's waiver services, Program for All-Inclusive Care for the Elderly, and other related services under the Medicaid fee-for-service and managed care programs.

The department shall gather information from the industry, demonstrating the extent that the industry has complied with legislative intent that rate increases funded herein shall be used to increase direct service worker salaries and benefits.

In accepting the increased rates, the individual members of the industry agree to provide such information. Provided that an individual eligible for or receiving nursing home care must be given the opportunity to have those Medicaid dollars follow them to the community and choose the personal care option in the community that best meets the individuals' needs. This includes the Consumer Directed Medicaid State Plan Amendment that is administered by the Department of Vocational Rehabilitation and the Department of Education.

And further provided that individuals eligible for the Medicaid Personal Care Option must be allowed to choose, from among all the options, that option which best meets their need; and also be allowed to have their Medicaid funds follow them to whichever option they choose.

>From General Revenue Fund $73,167,298

>From Federal Funds 113,977,534

For the purpose of funding home-delivered meals distributed according to formula to the Area Agencies on Aging

>From Federal Funds 4,191,968

For the purpose of funding care in nursing facilities, Program for All-Inclusive Care for the Elderly, or other long-term care services under the Medicaid fee-for-service and managed care programs.

>From General Revenue Fund 140,888,000

>From Federal Funds 278,402,068

>From Uncompensated Care Fund 35,600,000

Total (0 F.T.E.) $646,226,868


Freedom Clearinghouse is a project of
Free Hand Press, publisher of Mouth magazine.
Website developed by
Cliffwood Organic Works.
Website hosted by
| E-mail | Home |