Saturday 15 October 2011

Savings at home

As if any more evidence were needed, a recent survey offers more reasons why Indiana should direct more long-term care dollars to home-based services instead of costly institutional care.
Genworth Financial’s 2011 Cost of Care Survey finds that Indiana is one of only two states where the cost of receiving care in the home has decreased – by 0.5 percent a year over the past six years. Meanwhile, the cost of a private nursing home room has increased by 5 percent annually over the same period.
Another new study, by AARP and the SCAN Foundation, illustrates the long way Indiana has to go in making home- and community-based care more available for Hoosiers. The state ranks 47th for long-term services and support for older adults, people with physical disabilities and family caregivers, according to the study. It ranks 49th for access and affordability of long-term care services.
If Indiana followed the model set by Minnesota, the best-performing state, it could provide more than 7,600 additional Medicaid waivers, which are required if an individual qualifies for nursing home-level care but prefers home services. That would eliminate the waiting list for waivers, which was 5,351 as of Sept. 15.
More important, it would provide the community-based services that Hoosiers prefer.
“Over 90 percent of our clients make the statement” that they would prefer to stay at home, said Connie Benton Wolf, president and CEO of Aging and In-Home Services of Northeast Indiana. “It’s a method of getting people the support they need that builds around their strengths.”
Orion Bell IV, who oversees the counterpart agency in central Indiana, noted the indirect cost to the state when family caregivers have to provide services at home. Often, a spouse or child has to quit work or reduce hours to care for a loved one at home.
Indiana has made progress in rebalancing a system that for too long favored more costly nursing-home care. Under an aging reform agenda adopted in 2006, the goals were to rebalance long-term care spending, increase service capacity and improve public awareness. The number of certified assisted living providers has increased, as well as the number of adult day service providers and adult foster care homes.
The two-year budget approved this spring initially included a 15 percent reduction in funding for home-based care, but lawmakers restored the money – a strong indication that they are listening to their constituents when it comes to providing for low-income Hoosiers in need of services.
Kristen LaEace, CEO of the Indiana Association of Area Agencies on Aging, notes there is more that could be done.
“Ohio has been able to aggressively rebalance its long-term care system by essentially combining its nursing home and Medicaid waiver budgets, and making waiver services a state entitlement, compared to the federal entitlement of the nursing homes,” she said in an email. “In Indiana, the waiver and nursing home budget are administered separately, and there is no waiver entitlement.”
LaEace also said the federal Affordable Care Act has two programs the state could use, the Balancing Incentives Payments program and the Community First Choice program.

“They provide enhanced federal match for Medicaid waivers to aid in state rebalancing efforts,” she said. “We are hopeful the state is considering making applications for these programs.”
Indiana’s progress so far is worth noting, but the AARP study illustrates how far it has to go, while the survey on annual care costs offers more evidence that, fiscally, it’s clearly the right direction to go.
Source www.journalgazette.net/
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