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Miller trusts bridge Medicaid gap in Georgia.

Nursing homes and ombudsmen in Georgia scrambled all summer to help nearly 1,700 residents whose Medicaid nursing home coverage ended in October due to cuts in state spending.

Bringing a financial tool called "Miller trusts" to Georgia for the first time, attorneys, the state's ombudsman office, and the nursing home industry helped many of those affected channel their money into the qualified income trusts.

The Miller trusts, allowed under federal law only in states with no medically needy programs, enabled residents to remain Medicaid eligible.

Atlanta attorney David Pollan, who specializes in elder law, worked to begin Miller trusts in Georgia. "Under federal law, a person whose income is more than the Medicaid cap--$1,692--may be able to divert the overage into the Miller trust where it will not be counted as income for purposes of Medicaid eligibility," Pollan explained. "Georgia attorneys had never worked with these trusts before and had to learn how to do them. There was a mad rush to get people trained and started in setting up trusts before the deadline."

The cuts, which eliminated Georgia's medically needy program, were originally to go into effect on July 1, but a public outcry influenced lawmakers to grant a three-month extension. According to Becky Kurtz, Georgia's tong term care ombudsman, approximately 200 residents were still unable to make alternative arrangements as of late September. A lawsuit asking for more time has been filed in federal court on behalf of some of these residents, and a settlement is expected.

Georgia's medically needy program helped nursing home residents whose monthly income topped the Medicaid cap but did not have enough money to pay the approximately $3,000 to $3,500 per month required to live in a Georgia nursing home. It bridged the gap.

State officials said they were forced to eliminate this program and make other tough cuts--such as $50 million in nursing home reimbursements--to balance the state budget. Derrick Dickey, a spokesman for Georgia Gov. Sonny Purdue, said, "Due to the growth in Medicaid enrollment, its skyrocketing costs and the state's downed economy, the governor asked for 5 percent cuts across-the-board from all state agencies. The Department of Community Health (DCH), which runs the state's Medicaid system, recommended removing $10 million from the adult medical needy program--a recommendation that passed both the House and Senate."

Fred Watson, president of the Georgia Nursing Home Association, said he had been encouraged by the three-month extension, but he would have liked more time and assurance that Medicaid would not be cut again next year. "It's a sad day for our elderly when these programs are cut," he said.
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Title Annotation:Front Page
Author:Shuxteau, Jan
Publication:Contemporary Long Term Care
Geographic Code:1USA
Date:Nov 1, 2004
Words:439
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