A settlement between the state and federal agencies over housing the mentally ill in nursing homes is forcing change in the health care industry in Louisiana.
And while it is welcome that some are likely to be better served, the long-term costs of the settlement are far from clear yet.
The current tab: $13 million.
That is the first installment of a plan to resolve concerns that the mentally ill are too often housed in nursing homes; the alternatives are health care programs that allow residents to remain in their communities and receive appropriate levels of help.
Overseen by a U.S. district judge, the deal with the U.S. Justice Department requires the state to expand home- and community-based services for people with mental illness. The agency must screen those in nursing homes to determine if they can be diverted to less-restrictive settings.
A two-year federal investigation determined Louisiana violated the Americans with Disabilities Act because of over-reliance on nursing homes for those who are mentally ill.
On Feb. 9, Rebecca Ellis received a letter in the mail that she'd waited more than 10 years to see. Her 13-year-old son Jackson, who has devel…
This is probably not a surprise, as Louisiana typically relies more on nursing homes for elderly care. The U.S. DOJ filings said Louisiana also has one of the highest percentages of adults with serious mental illnesses living in nursing homes.
If, though, as the court documents asserted, at least 3,800 people, or 14.5 percent of all nursing home residents in 2016, were mentally ill, alternatives will cost money.
"Individuals with serious mental illness in nursing facilities in Louisiana who express a desire to leave the facility and return to their own communities routinely receive little or no assistance to do so," the Justice Department wrote.
This means that Louisiana may well have to invest more in the home- and community-based programs that would help those willing — and able — to move from nursing homes.
That can be problematic for the budget, subject to months of tiresome dispute in the State Capitol this year. Home- and community-based services are in an annual tussle in the Legislature with traditional nursing homes for limited dollars.
This can also be problematic for individuals who are without family support. Obviously, in an aging society, nursing care is necessary for the elderly in physical need. The possibility that many who want to leave a home may not be medically able to do so, even if given more community-based services, requires a discernment that — according to settlement documents — has been somewhat lacking in Louisiana.
The settlement requires an initial step, assessments of the desires and abilities of those wishing to live independently. That's probably overdue in Louisiana.