Post-acute care providers and others share comments with DOJ on home-based services

The Civil Rights Division of the U.S. Department of Justice and the U.S. Attorney’s Office for the District of South Dakota recently held listening sessions in Chamberlain and Sioux Falls as a part of their investigation into whether South Dakota provides sufficient home care to older adults and people with disabilities.

The DOJ has determined that South Dakota has one of the highest nursing facility utilization rates in the nation. The department has further alleged that the state has not taken advantage of federal funding opportunities to create additional cost savings for home- and community-based services.

Alexandra L. Shandell, trial attorney for the DOJ Civil Rights Division, said that South Dakota improperly relies on nursing facilities to provide services rather than providing services at home. Shandell added that the Medicaid system is at fault in contributing to the issue. Nearly 30 people attended the Sioux Falls session, including representatives from SDAHO, the state Department of Social Services, the state Department of Health and several independent and system-affiliated post-acute care providers.

Some in attendance commented that the DOJ should take into consideration the state’s unemployment rate and the average age of those who were interviewed. Others expressed concerns with adding burden onto working family members in order to provide care at home.

Other comments included:

  • Increase reimbursements to family members caring for loved one
  • Provide education for case managers as to which home based services are available
  • Provide reimbursement for training on complex care needs for a loved one
  • Increase funding for rural community-based services and adequately reimburse providers for in-home services
  • Consider funding for traumatic brain injury for post-acute services
  • Provide services specifically for patients who fall between the “gap” and that don’t qualify for services
  • Assist the state in becoming aware of alternative funding/grant options available to help populations
  • Consider supporting the development of a shared living models for the state

The DOJ is currently in the settlement phase with the state, and efforts to implement changes will likely encompass several years.