Governor's action on budget deal saves Yukon woman from possible nursing home move
Oklahoma City — For Dana Dixon, the Legislature's budget deal last week was a reprieve she hoped would let her stay in her home, at least a little longer.
Gov. Mary Fallin's actions late Friday was an answer to Dixon's prayers. While Fallin vetoed much of the bill, she left funding in place for some agencies and emergency funding for the Department of Health. As a result, the state's Advantage waiver program, which pays much of the cost of Dixon's care, was preserved.
Dixon, who survived three traumatic brain injuries and also has epilepsy, stays at Heritage Living Center in Yukon through the Advantage waiver program. The program provides in-home supports for people who qualify for nursing home care because of a disability or age-related conditions, but who don't want to live in one. Some people, like Dixon, receive the services in an assisted living home or retirement community instead of in an individual home.
Dixon, 49, lived in a nursing home for two years because she couldn't safely stay alone — for fear of falling and worsening her old injuries. She said she prefers assisted living, where she has more space to herself and can go out if she wants, so she was disturbed when she got a letter saying it wouldn't be paid for starting in December. The apartment she has at the center would be out of her financial reach if Advantage ended and she had to rely on her Social Security disability checks.
“I was confused, and I was hurt, and I was upset, and I kept praying, ‘Please let something come through. Please don't let me lose my home,'” she said through tears Thursday during an interview.
It appeared Dixon and the other 21,146 people who use the Advantage program may not have to move now. The Senate voted Friday morning to send a patch for the state's $215 million budget hole to Gov. Mary Fallin and immediately adjourned. The House passed the same bill by a narrow margin Wednesday before adjourning.
Then late Friday, Fallin gave a lifeline to some programs and called for another special session so lawmakers could again attempt a budget deal she would sign.
The Oklahoma Department of Human Services, which oversees Advantage, lost about $69 million when the Oklahoma Supreme Court struck down the $1.50-per-pack cigarette tax this summer. Advantage was on the department's list to cut, as were child care subsidies and programs for adults with developmental disabilities.
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The bill narrowed the department's loss to $4 million, which spokeswoman Sheree Powell said it could absorb without further cuts. The department is expecting to spend about that much less on child welfare because fewer children have come into the foster care system, she said.
The department estimated about half of the people receiving Advantage services could have ended up moving into nursing homes if they lost home-based care. In that scenario, the state would have had to pay $124 million more through the Oklahoma Health Care Authority for nursing home services, and it isn't clear if there would have been enough beds available, Powell said.
Nursing home care is considered a right under Medicaid for people with serious disabilities. The original Medicaid law, written in the 1960s, didn't consider home-based services to be a right, so recipients who need extensive care but don't want to live in a nursing home have to get them through a “waiver” program like Advantage.
Advantage members would have had only a few options if the program ended, Powell said. They could have tried to get by with unpaid help from family and friends, or they could go into a nursing home. Some have said they would go without care rather than enter a nursing home, she said.
“We've heard from so many of the people we serve that say they'd rather die,” she said.
The program's future still isn't certain. The state faces a large budget gap next year, which again could force agencies to take reductions.
Dixon said she had on eye on the budget situation, but was trying to rely on her faith instead of worrying.
“I do wonder about next year, but I believe the Lord is the god of the eleventh hour,” she said. “Even if it's down to Dec. 30 or Dec. 31, those funds are going to come through.”
Friday evening, her prayers were answered.