Berkshire Senior Online

by Robert P. Dean, Executive Director

  The Governor’s proposed budget for fiscal year 2005, which is currently before the legislature, seeks level funding for the Prescription Advantage Plan, the Councils on Aging, and for the types of home care and other services that Elder Services and the Aging Services Access Point network provide throughout the Commonwealth. The Governor’s budget also proposes that $140.8 million of Medicaid and Medicare funding be allocated for a new program called Senior Care Options.

  The new Senior Care Options program, which is not initially available in Berkshire County, is a managed health care program designed to avoid unnecessary nursing home and hospital admissions, and to eventually save the state money by emphasizing the preventive care necessary to keep elders out of hospitals and nursing homes. Massachusetts currently places elders in nursing homes at a rate significantly higher than the national average. Six percent of Massachusetts elders reside in nursing homes, in comparison to 4% nationally. The administration estimates that statewide, approximately 118,000 low income elders, who are eligible for Medicare and Medicaid, will be eligible to voluntarily enroll in the Senior Care Options program. According to the US census there were almost 1.1 million elders age 60 or over residing in Massachusetts in 2000. Eligible elders will be assigned a doctor, a nurse, and a geriatric care coordinator, who will develop individualized care packages. Three agencies have been selected to manage the Senior Care Options program in Massachusetts, two of which are "for profit", while the third is a non-profit organization. Many elders who are eligible for the Senior Care Options program rely on non-medical services and supports such as assistance with bathing, dressing, and toileting in order to remain independent and at home. Elders considering enrollment in the Senior Care Options program must be assured that they will continue to receive these essential non-medical services in addition to the primary and preventive health care services they will receive through the program.

  Currently, there is a piece of legislation before the House and Senate, which goes a long way towards giving elders the help they need to stay in their own homes for as long as possible. It is known as the Dollars Follow the Person Bill, and identical versions have been filed in both the House (H.1302) and the Senate (S.767). This bill, which appears to have the support of the entire Berkshire County delegation in the House and Senate, gives an eligible elder the choice of where to receive his or her care by guaranteeing that the money for the care will follow the elder wherever the elder is served, whether at home in the community or in a nursing home.

  In the Senate, twenty-six Senators including Senator Andrea Nuciforo have sent a letter to Senate President Travaglini in support of the Dollars Follow the Person Bill, stating that: "This bill is fundamentally about the civil rights of the elderly. It asserts that disabled elders who are eligible for Medicaid long term care services are entitled to receive care in the least restrictive setting possible if they so desire. Under the bill, an elderly disabled individual who might have been cared for only in a nursing home, would now be eligible for a richer package of home and community based services." The letter also states that: "This legislation builds on the successful ‘Community Choices’ program... but is broader in several respects... participation in the Community Choices program is limited to those at imminent danger of nursing home placement. Under S.767, the successful choices concept could be expanded. That means that more elders could have choices and more choices would be available." The letter concludes by asking that the bill be moved quickly to the Senate floor for a vote. As we go to press, the House version of the Dollars Follow the Person Bill is before the House Medicaid Committee. Stay tuned...