Mary Gustafson, McKnight's Staff Writer
Mary Gustafson, McKnight’s Staff Writer

It’s hard not to be struck by the number of transitions that are occurring all over the place this time of the year. My refrigerator is plastered with birth announcements, wedding invitations, high school and graduation party invites, baby shower registries, new jobs, guest lists and vendor lists.

Less visible, but no less significant, are more somber transitions: the first Memorial Day for friends and family members of soldiers killed in Afghanistan; parents coming to grips with having an empty nest for the first time, come September; mass layoffs; a new unwelcome diagnosis. Sorry to get a bit dark here, but there’s a reason that the church I go to has a whole ministry devoted to helping parishioners deal with life’s biggest transitions.

Maybe it’s because I’ve been listening to so many commencement speeches lately, but the optimist in me believes that the most gratifying moments in life tend to follow some of the darkest and challenging transitions. I suspect that anyone who works in long-term care knows this, too.

That much was clear in an article last week from Kaiser Health News about the federal Money Follows the Person program and the resistance some states are finding as they struggle to implement it. The program was started as a way to help elderly and/or disabled Medicaid recipients out of nursing homes and back into their former homes or communities.

Unfortunately, MFP has encountered multiple roadblocks to getting off the ground. Florida never used the $35.7 million it was awarded for the program because of the state’s challenge to the Affordable Care Act, which authorized the funds. Other states, such as California, suffer from a fragmented system. Joel Weeden, who runs California’s MFP program, told Kaiser that logistical nightmares keep his state from being able to integrate the services.

Kate Ricks, who leads Maryland-based Voices for Quality Care, told Kaiser “It’s very frustrating to us. At the rate they’re getting people out, everyone who is eligible will be dead.”

MFP’s shortcomings have resulted in many former nursing home residents needing to return to nursing homes within a year of being discharged back into their communities.

A day or two following the Kaiser article, the Department of Health and Human Service announced the creation of Aging and Disability Resource Centers that are intended to be “one stop shops” for elderly and disabled individuals, as well as veterans, who want to remain in their communities but need services.

By the time the news of this program broke, however, all hell had broken loose in the comments section of the website, as readers on both sides of the home-care-versus-nursing-home debate swarmed to share their respective horror stories.

It quickly became apparent there that neither nursing home nor home-and-community-based care is perfect, and nobody should pretend that it is. The truth is that both models of care need each other to survive.

The comments on our site were a good reminder that for every heartwarming tale of someone finding happiness outside of a medical  institution, there are equally touching tales of renewal and vitality inside their walls.