Skip to main content

5 things to know on the anniversary of Olmstead

By WTOP Staff

MATT SEDENSKY
Associated Press

Advocates cheered when the Supreme Court ruled in Olmstead v. L.C. that people with disabilities should be given options to live outside institutions. Fifteen years later, progress has been made, with every state allocating more funds to home and community care, but results vary widely depending on where patients live.

Here are five things to know about the state of long-term care in the U.S. on the anniversary of the Olmstead decision:

CHECKERED PROGRESS: Nationally, the share of Medicaid long-term care spending going to home and community care has surged, from 28 percent in 1999 to 50 percent in 2012, according to federal statistics. Each state made progress, but the amounts are widely different. “It shouldn’t be that different if you’re in a state in the Northeast or the Southeast or the Northwest,” said Dr. Bruce Chernof, chairman of the federal Commission on Long-Term Care and president of the nonprofit SCAN Foundation. “At the end of the day, you should expect to have reasonable access to home and community care.”

NO GUARANTEE: The ruling offers few specifics. Though Medicaid beneficiaries in need of long-term care are guaranteed services in a nursing home or other facility, a waiver must be obtained for home or community care, leading to what advocates call the “institutional bias.” Sen. Tom Harkin, D-Iowa, plans to introduce legislation he says will set “clear requirements for states” and eliminate such bias.

TYPICALLY CHEAPER: Home and community care is generally cheaper than institutional care. Medicaid paid an average of $225.04 per person per day in 2012 for those receiving institutional care. For those with waivers for home and community care, the average cost was $125.24 daily. GenWorth, the leading provider of long-term care insurance in the U.S., found in its survey of care costs that a shared nursing home room had a median annual cost of $77,380 this year, compared with $45,188 for a home health aide.

CRACKING DOWN: Enforcement of the ruling has been ramped up under the Obama administration. Forty-four cases representing 46,000 people in 24 states have been pursued since 2009, according to Jocelyn Samuels, the acting assistant U.S. attorney general who oversees the Justice Department’s civil rights division. Statewide settlements related to Olmstead were reached in eight states: Georgia, Delaware, Virginia, North Carolina, New Hampshire, Rhode Island, Texas and New York.

FEELING FREEDOM: For those released from institutional settings, the same word arises again and again: Freedom. Willy Gray, 82, a retired truck driver from Atlanta, spent eight years in a nursing home after a stroke in 2002, even as his wife was home in their three-bedroom apartment. Now that he has obtained a waiver for in-home care, he gets by with two-hour visits from an aide twice a week. At home, he can enjoy the company of family and sleep through the night without a nurse entering. “I feel like I’m free,” he said.

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

By WTOP Staff
Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
Read Next Story

Related News

Frustration grows in Venezuela as earthquake death toll reaches 1,430

Israel and Lebanon sign framework agreement with US in ‘first step’ toward peace, Rubio says

Trump-endorsed populist poised to become Colombia’s next president as rival challenges vote