Home and community-based services save money
By Robert P. Dean
As we go to press, the state legislature is reviewing Governor Patrick’s proposed budget for state fiscal year 2011, which begins July 1, 2010. For the most part, the Governor’s budget maintains funding for home care and other elder line items at their current levels. (Many of these elder line items have already been significantly reduced in the last two budget cycles.) We appreciate the Governor’s efforts to maintain these line items at their current levels and not reduce them even further.
During tough economic times, the need for basic human services goes up - not down. More people need food and fuel assistance, and home care. Home care should be the first resort for seniors in need of assistance. It is far less costly than nursing facility placement and helps delay or avoid such placements. It will ultimately cost taxpayers more in the long run if seniors in need of assistance receive more costly institutional care instead of home care.
The House is expected to make its budget recommendations in April, at which point the proposed budget will go to the Senate, which will make its recommendations in May. Shortly thereafter, a conference committee comprised of House and Senate members will meet to reconcile any differences between the House and Senate recommendations. Once the House and Senate reach agreement, the revised budget will be returned to the Governor - probably in June - for his approval, or his veto of any of the recommendations that he so chooses.
As the House and Senate engage in their budget deliberations this April and May, it is important that the following budget priorities receive sufficient funding and not be cut further:
1. State Home Care and Care Management (line items 9110-1630 and 9110-1633). The State Home Care program provides an array of essential family-like services that are designed to promote independent living. Such services include in-home assistance with personal care needs such as dressing, bathing, and bathroom assistance, and with homemaking. Here in Berkshire County, we are serving more than 1,000 seniors each month in our Home Care programs. Since October 2008, statewide funding for the State Home Care and ECOP programs (see #2 below) has been reduced by more than $13 million a year. In March 2010, more than 2,000 seniors - 90 of whom are Berkshire County residents - were on the statewide State Home Care program waiting list.
2. Enhanced Community Options Program - ECOP (line item 9110-1500). This program provides in-home care to frail seniors who are clinically eligible for nursing facility placement. The ECOP program provides a higher or enhanced level of the in-home services provided by the State Home Care program (see #1 above) including assistance with personal care needs such as dressing, bathing, and bathroom assistance, and with homemaking. Sufficient funding must be available to meet the need for these services. ECOP costs the state approximately one-third of what a nursing facility placement would cost.
3. Elder Lunch – Meals on Wheels (line item 9110-1900). This past year, Elder Services prepared more than a quarter-million meals in our Lanesboro kitchen. Our Meals on Wheels drivers traveled more than 226,000 miles to deliver over 200,000 meals to homebound seniors. The remaining meals were served to seniors at 14 lunch sites located throughout the county. Meals on Wheels is a lifeline for Berkshire seniors. In addition to a hot, nutritious noontime meal, the program also provides a well-being check for the frail, homebound seniors who receive the meals. In many cases the Meals on Wheels driver may provide the only face-to-face contact a senior has that day. This past year, federal stimulus dollars through the American Recovery and Reinvestment Act (ARRA) provided essential statewide financial support to the Nutrition/Meals on Wheels programs. Unfortunately, these federal stimulus dollars are one time only in nature, and this financial assistance will not continue.
4. Councils on Aging - COAs (line item 9110-9002). Services provided by Berkshire County Councils on Aging include information and referral, transportation, outreach, food distribution programs, health education and screenings, as well as fitness, social, and recreational opportunities.
5. Protective Services (line item 9110-1636). Elder Services is one of 22 agencies statewide that provide a first line of defense for seniors by investigating and resolving reports of physical abuse, emotional abuse, sexual abuse, caretaker neglect, self-neglect, and financial exploitation. Vulnerable at-risk seniors must be protected.
As the Commonwealth continues to struggle with reduced revenues and limited state dollars, it is important to remember that home and community based services are a cost-effective and most efficient use of those limited dollars.
Robert P. Dean is Executive Director of Elder Services.
