Recently, much has been made about what LTC services should be provided to elderly prison inmates, and where those services should be provided. The politics of the issue has focused on persons convicted of sexual offences and violent crimes, though, of course, any ex-inmate committing any criminal offense in any LTC setting will grist for that mill (as compared with someone never convicted of a crime who commits the same crime in an LTC setting).
The financial issue is that LTC services provided in prison must be paid for out of only state tax revenues or "General Funds" (GF). Ex-inmates could be eligible for Medicaid, and that means that our Federal tax dollars, in the form of Medicaid, could be used to provide LTC services. The services would likely be less expensive, too, given the increasing costs of security.
But old inmates are only the beginning of the issue. There will be many more inmates coming out of our prisons (one way or another, all of them), and some of them will require LTC supports at one or more times in their life. There is a very real possibility that the political problem of security will allow a back door method for recreating large institutions.
We need to be thinking through the general issue of personal security in community based LTC. Two principles should be that individuals can live on their own with supports, and that people should never be forced to accept any room mate. Another should be that individuals receiving community-based LTC should be able to choose assistive technology that supports their personal security.
At a higher level, organizations that manage LTC and organizations that provide supports need to include these principles in their work, and everyone who gets LTC needs to consider personal security as part of their LTC planning.
Or we may see real LTC reform corrupted by all too common fears.
Norman DeLisle, MDRC
"With Liberty and Access for All!"
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/