Claim about in-home care cuts Mostly False

After Eric Greitens vetoed a bill in late June that would have created a possible mechanism for funding in-home care for Medicaid eligible seniors, veterans and people with disabilities, Rep. Crystal Quade, D-Springfield, and Rep. Peter Merideth, D-St. Louis City, wrote an open letter condemning the governor.

In the letter published on Aug. 9, 2017, and picked up by several other newspapers, Quade and Merideth tried to rally support for a veto-override.

The letter said, "The governor’s cuts would kick over 8,000 people out of their homes."

But is the governor solely responsible for this outcome? And 8,000 people losing funding seems plausible, but physically kicked out of house and home? After talking to the chief of the public information office at the Missouri Department of Health and Senior Services, we found the representatives’ claim is not actually the case. (PolitiFact's database only allows us to check one speaker at a time, so we will check Quade here. The rating would also apply to the co-author, Merideth.)

To start, Quade and Merideth put responsibility for the loss of funding squarely on the shoulders of the governor. In a literal sense, that’s true: Greitens’ veto means there will be no funding in place once the budget cuts go into effect.

In early February, Greitens presented the annual budget proposal, which included cuts to Medicaid coverage for in-home care and nursing home services.

Legislators scrambled to come up with a way to keep funding for vulnerable seniors in the budget. In the last minutes of the 2017 session, a bill was passed that authorized the government to divert funds from other boards and commissions to senior services.

But Greitens called it a "budget gimmick." Because the bill failed to specify which funds were to be diverted, there was no guarantee there would be enough money to make up the difference.

Greitens proposed the original cuts. Legislators tried to make up the difference, and they got a bill over the finish line. Greitens vetoed that bill. While legislators could have considered other methods of funding, the cuts to the budget ultimately fall on the shoulders of the governor, and a significant number of people will lose funding for in-home care as a result of them.

We talked to Carol Hudspeth, director of the Missouri Alliance for In-Home Care, to get a better understanding of who these 8,000 people are that would supposedly be kicked out of their homes.

State funding allows senior citizens, veterans and people with disabilities to receive care in their own homes instead of being moved to a nursing home facility. Hudspeth said eligibility for in-home care is assessed on a points system. The number of points given to a Medicaid-eligible senior is based on things like the number of medications taken, a state-issued health assessment and other needs.

Currently, those assessed at and above 21 points are eligible for state funding for care. But budget cuts mean that now only those assessed at and above 24 points are eligible.

When we reached out to Quade and Merideth about where they found the 8,000 figure, they directed us to several different sources, but those sources ultimately pointed us back to the Department of Health and Senior Services.

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Sara O’Connor, chief public information officer at the Department of Health and Senior Services, said people are rated on a scale with intervals of three, which means no one can be assessed at 22 or 23 points.

The exact number of people currently assessed at 21 points, and effectively the amount of people currently eligible for funding that won’t be once these changes go into effect, is 7,913, according to the department.

That’s pretty close to 8,000, but that’s 8,000 people losing state funding, not 8,000 people losing their homes. 

When a senior is assessed by the state as being eligible for assistance with care, families can opt for a variety of ways to obtain it.

Hudspeth said some families move loved ones into assisted care facilities, but others hire in-home care providers who help, often on an hourly basis, with cooking, cleaning and bathing.

When cuts go into effect, certain seniors, veterans and people with disabilities will lose the funds to hire in-home care providers, and Hudspeth said that means they will also lose funding to receive care at nursing homes or assisted-care facilities. When these individuals are assessed as to whether they are eligible for state funding, that assessment applies to both in-home care and nursing home care. So when funding is cut, they may only get care at the hospital in emergent situations.

There are cases when these seniors, veterans and people with disabilities were initially assessed that they opted for their state-funded care providers to be family members. Though spouses are not eligible to receive state funding, children and other family members can be paid by the state to provide care. In fact, Hudspeth said that is a "very common" arrangement.

In cases like this, it is likely some families would be able to continue to care for the senior in their home without the funding. Other community organizations also make that kind of care possible.

The point is, without funding, vulnerable seniors, veterans and people with disabilities will certainly have to make adjustments that might put significant strain on families. Those adjustments don’t necessarily dictate loss of home.

Quade and Merideth said that the governor’s cuts would cause 8,000 people to lose their homes.

Greitens proposed the original budget cuts to in-home care and nursing home services for qualified seniors, veterans and people with disabilities. Legislators tried to come up with another way to fund these services, but Greitens vetoed that bill.

The numbers suggest that just about 8,000 people will lose their funding when the budget cuts go into effect, but that doesn’t mean these people will lose their homes.

These seniors, veterans and people with disabilities will lose the funding for both in-home care and nursing home services. But in some cases, they may employ other mechanisms to receive care, or depend more heavily on family-provided care that is not funded by the state.

We rate this claim Mostly False.

CORRECTION, Sept. 13, 2017: This article has been changed to reflect that when seniors, veterans and people with disabilities lose funding for in-home care, they also lose funding to go to a nursing home (or state-assisted living facilities) to receive care. An earlier version had said that the affected group would be forced to move into state-assisted living facilities.