NEVADA FOCUS: Long-promised help for badly disabled finally delivered

CARSON CITY, Nev. - State officials say extra help for a small group of severely disabled Nevadans finally has materialized after 3 years - but advocates for the disabled aren't so sure.

Since the 1997 Legislature authorized $500,000 for the program, numerous delays help up federal approval needed to spend the Medicaid funds so that disabled Nevadans could continue to live in homes and avoid being institutionalized.

State inaction, a change in administration and staff turnover all were blamed for the holdup.

The money approved by the 1997 Legislature for the program was never spent. The 1999 Legislature doubled the sum to $1 million and urged the Guinn administration to try again.

GOP Gov. Kenny Guinn had inherited the delayed program from former Democratic Gov. Bob Miller. In addition to a new governor, staffing changes also occurred in the state division and federal agency involved in administering the project.

Complaints about the delays escalated last summer into threats of court action from advocates for the disabled, who have pressed to deliver the benefits to 60 more disabled people by mid- or late-2001.

Mary Wherry, deputy administrator in the state Medicaid Office, now says that goal should be met - although the delays kept the state from meeting its timetable of helping many of the disabled earlier.

The expansion of benefits required a waiver from the federal Health Care Financing Administration.

A waiver amendment request was filed by the state nearly a year ago, but was returned last April for ''clarification.'' That was followed by a series of phone calls and letters from the state to federal officials. The waiver from the Health Care Financing Administration finally came through in August.

Wherry said her agency began immediately to add new people to the program, which now helps about 130 Nevadans. She added that a waiting list has been reduced from more than 300 to fewer than 200 people.

But Bev Klinghesse of the Northern Nevada Center for Independent Living said that the people added since August ''may only be a handful. I don't see more people being helped.''

Klinghesse also said the reduced waiting list occurred ''in large part by changing the screening process. If someone doesn't reply in a timely manner to one of the state's inquiries, then that person is dropped immediately.''

The waiver lets severely disabled people who are able to work to earn from $500 to $1,500 a month without losing Medicaid benefits. The waiver allows them to avoid being placed in institutions or other highly restrictive living arrangements.

Klinghesse says it's ''unconscionable'' to keep people in nursing homes when they could be more independent with the personal care assistance the new program provides.

Her group has been a longtime critic of the delays, along with the Nevada Disability Advocacy and Law Center which had warned a lawsuit could be filed if the delays continued.

The physically disabled waiver program is a small part of a $500 million Medicaid program run by the state. In addition to helping people, advocates said it saves money by getting more people out of costly institutions.