Lisa Trigg
The Tribune-Star
TERRE HAUTE —
Senior citizens and people with disabilities who rely on home health care could experience a 15 percent funding reduction in the publicly funded care they receive come July 1.
That could result in many more Hoosiers forced into nursing homes rather than remaining in their homes while receiving less-expensive home health care visits.
Civic leaders from the Indiana Home Care Task Force shared their concerns Wednesday in Terre Haute as they talked about the Indiana Family and Social Services Administration’s decision to reduce funding for the CHOICE home care program by 15 percent, and continue a freeze on enrolling new clients in the Medicaid aged and disabled waiver.
“This will drive people into nursing homes,” said John Cardwell of Hoosiers First, an organization representing senior and disabled citizens.
The CHOICE program is the Community and Home Options to Institutional Care for the Elderly and Disabled provided by the FSSA. It was enacted by the Indiana General Assembly in 1987 as a means to help keep low-income seniors living in their own homes and receiving appropriate care rather than forcing them into more-expensive nursing home facilities.
For example, through the reduction expected to start July 1, an employed, wheelchair-bound person age 60 or older who receives a daily CHOICE home health care visit in order to get out of bed, bathe, change clothes and head to work will see services cut from five days to three days. Cardwell said that means the person will be less-able to maintain employment, so to receive these services, the person will likely end up in a nursing home sooner and at higher cost to the public.
The state’s CHOICE home care program averages more than $5,000 per person per year in all costs, while Medicaid-funded nursing home care averages more than $55,000 per person per year, according to an FSSA annual report for fiscal year 2009. The average cost per month for a CHOICE client was $423 while the average cost per month for a nursing home client was $4,575.
It makes fiscal sense to keep elderly people and those with disabilities out of nursing homes, Cardwell said, especially if they can receive appropriate care at home via daily nursing visits.
Jim Wallihan, president of United Senior Action, said that Indiana has increased the number of people in nursing homes from 25,000 in 2005 to more than 28,000 in 2010.
By comparison, the state of Washington has reduced its nursing home census to 14,000 people by aggressively encouraging the home health care option rather than nursing homes. Washington has a comparable population demographic to Indiana, Wallihan said, and has seen a huge savings in its Medicaid spending.
Elmer Blankenship, president of the Indiana Alliance for Retired Americans, pointed out that most senior citizens would rather remain in their own homes than enter a nursing facility.
“Nobody wants to go into a nursing home, even those that know that’s the best place for them,” Blankenship said. He added that he knows people who say they have saved up pills to use to commit suicide rather than go into a nursing home.
The state’s plan to reduce funding for Medicaid services by 15 percent will affect the state’s most economically challenged senior citizens, Cardwell said. And it could be seen as an effort by the nursing home industry to feed more people and their Medicaid money into the system.
Cardwell offered analysis of the lobbying groups who support the 15 percent funding reduction, as opposed to the people who utilize the home health care service.
“The people who use this home care are generally poor,” he said. “These are people who do not make political contributions. People who do run nursing homes do make political contributions.”
Cardwell suggested that the public contact state legislators and the governor’s office asking for a change to the FSSA decision to reduce CHOICE funding by 15 percent.
Lisa Trigg can be reached at (812) 231-4254 or lisa.trigg@tribstar.com.
