Remember ME - You Me and Dementia

June 26, 2006

USA: Low-Income Elderly Deserve Choice of Care

BOSTON (The Boston Globe), June 26, 2006: Low-income elderly and disabled consumers deserve a choice about where they want to get care -- in a nursing home or in their communities, says a front page editorial in The Boston Globe. Right now, the choice is limited by the funding: More than two-thirds of the state's long-term-care Medicaid money is spent in nursing homes. And there are restrictions on spending in community settings. Legislation in the State House, the Equal Choice Bill, would make it easier to spend more Medicaid dollars in community settings, so that people could go home and still get the care they need. The money would follow the person to the most appropriate, least restrictive care setting. Having more choice about where to get care would give people more dignity and more ways to stay connected to their family and friends, improving their quality of life. The Senate has passed the bill. And 137 representatives want it put to a vote. But House Speaker Salvatore DiMasi is waiting. A spokeswoman says DiMasi supports the idea, but he wants to make sure it is cost effective. It's an understandable concern, especially since the Romney administration at one time estimated that the bill could cost an extra $83 million. But a more recent, more rigorous analysis shows that the state could combine the bill with a federal waiver to craft a program that would save money. There would be an initial investment of $12 million. But there would be an overall net savings of $134 million from 2007 to 2011, according to Jennifer Carey, the state's Elder Affairs secretary. It's a win-win scenario: Consumers would get more choice, and the state would save money. The key savings factor: At an average cost of $28,000, a year of community care is a lot cheaper than a year of nursing home care, which costs some $51,500. One worry is that Equal Choice willdraw people out of the woodwork, creating new demand and driving up costs. But the state can use the federal waiver to control this by setting caps on eligibility and cost, focusing resources on the most vulnerable people. Vermont and Oregon have already successfully used this strategy to lower their long-term-care costs, according to Carey. The bulging population of aging baby boomers makes it almost certain that Massachusetts will eventually pass the bill, because it promises to limit costs. But the House should act now. DiMasi's spokeswoman says work is being done to tweak the bill to ensure costs savings. That's reasonable as long as it doesn't diminish the bill's intent and as long as the bill can get to Romney's desk during this legislative session. Opting for more choice and less cost would be a compassionate, economically smart move for Massachusetts. © Copyright 2006 Globe Newspaper Company.

No comments: