Berkshire Senior Online

  Last week, Massachusetts took an important step forward as lawmakers and state health officials agreed that more state dollars should be directed toward at-home and community care.  The Massachusetts Committee on Human Service and Elder Affairs advanced a bill to allow senior citizens to choose the type of long-term care to be purchased through Medicaid. 

  The intent of this bill is to provide our seniors and disabled individuals with the necessary care but in the physical and emotional comfort and surroundings of one’s home or community.  It is believed that this shift will also save the Commonwealth money. 

 Currently, more than 90% of Massachusetts’ Medicaid long-term care dollars are spent on nursing home care.  Many will argue, myself included, that these state and federal dollars can be better spent while still tending to patient care.  Most elders would prefer the choice to remain at home rather than be forced into a nursing home in order to receive adequate long-term care.  There are situations within which at-home and/or community settings would be adequate with the proper personal care or group assistance, and the cost would be a portion of the Medicaid dollars paid out toward nursing home coverage.   

  Under Title II of the federal Americans with Disabilities Act, disabled individuals have a right to receive “services…in the most integrated setting appropriate to the needs of the qualified individuals with disabilities.”  This was reaffirmed by the 1999 U.S. Supreme Court ruling, known as the Olmstead decision, which protects disabled people from “unjustified segregation” in an institution.  The decision further states, “…institutional placement of (disabled) persons who can handle and benefit from community perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life.” 
A number of states, our neighboring Connecticut being one, have adopted plans based on the Olmstead decision, specifying that if an individual is eligible for a Medicaid-funded nursing home bed, Medicaid funding will be available for community services should that individual so choose.  In other words, the “money follows the person.”

  It is important that Massachusetts move toward serving our seniors and disabled citizens with more at-home and community services.  The proposed bill to make this a reality still has a ways to go in advancing though the House and Senate, but, here is hoping we can continue to provide better services and more desirable long-term care solutions for our seniors.  As a results, these people will be better served, and it will save the Commonwealth money in the end.