The state hopes to move about 415 Medicaid clients out of hospitals and nursing homes and into community-based facilities over the next four years with help from a $10.3 million federal grant.

Those targeted will be those who do not necessarily need institutional care but have nowhere else to go.

Moving them back into the community where they can be more independent and productive will free up acute-care hospital and nursing home beds and save the state about $70,000 a patient, said state Director of Human Services Lillian Koller at a news conference yesterday.

This new "Going Home Plus" program will build on an existing Department of Human Services program that helps elderly and disabled individuals transition out of hospitals and other institutional settings into residential settings.

"With the first wave of baby boomers nearing retirement age, the demand for these services will jump dramatically in just a few years. The need is especially great in Hawai'i, given the high percentage of kupuna in our population," Koller said.

DHS is currently in the process of hiring someone to oversee the program.

"This new federal money will help us tackle more complicated cases with disabled and elderly who need specialized assistance and even offer them the opportunity to move out of hospitals and nursing homes, if they wish, into community-based settings, into their own home, into foster homes," Koller said.

Over the past four years, the original "Going Home" program has moved 765 clients into foster family homes.

Thomas Laury's family put him in a hospital when he started losing strength a year and a half ago. After six months with little else to do but lie in bed and look out the window, Laury, 77, said he was starting to lose his mind.

The opportunity to move into an adult foster care home saved his sanity and gave him new friends and family. He refers to his caregiver, Nonita Acorda, as an angel.

"I don't regret it at all," he said.

With the federal grant, the state will be able to work with harder-to-place Medicaid clients, said Koller.

Hawai'i is one of 29 states and the District of Columbia to receive this kind of funding.

"These demonstration grants are a clear sign of our continued commitment to expand choice to all Medicaid beneficiaries, as well as allowing them the independence to live at home and contribute to their communities," Leslie Norwalk, acting administrator of the U.S. Centers for Medicare and Medicaid Services, said in a release. "The concept of money following the person to the most appropriate setting improves beneficiary satisfaction while reducing Medicaid costs."

Reach Treena Shapiro at tshapiro@honoluluadvertiser.com.