Press Release: For Immediate Use - Mass Home Care



Press Release: For Immediate Use

Contact Al Norman, Mass Home Care: 978-502-3794 or

Carolyn Villers, Mass Senior Action, at 617-435-1926

Seniors Give Governor A Cell Phone:

“Can You Hear Us Now?”

Groups Visit Gov’s Office:End Home Care Wait Lists

STATEHOUSE---Senior Advocates want to talk with Governor Deval Patrick about chronic waiting lists in the home care program. Frustrated by silence from the Governor’s office, the seniors are now coming to the Governor’s office hoping for better reception.

A group of more than 50 elder advocates will assemble outside the Governor’s state house office at 11 AM this Thursday, January 17th, for a little impromptu performance to get the Executive Branch’s attention.

The group has a red cell phone to give the Governor, so he can hear their needs more clearly.

Four months ago, a coalition of elderly groups wrote to the Governor asking him to meet and talk about how to end the wait list for the state-funded home care programs, which have jammed the system in 2010, 2011, 2012, and 2013.

The advocates’ letter was never answered. Hence the visit to the state house Thursday.

“The Governor can text us, tweet us, or just pick up a phone---we need to talk about why seniors in a ‘community first’ state are waiting for care at home,” explained Al Norman, Executive Director of Mass Home Care.”

Carolyn Villers, Executive Director of the Mass Senior Action Council, said senior prefer to be cared for at home, yet two-thirds of the state’s long term care Medicaid dollars are going to institutional care. “If we can keep a senior at home, it saves the taxpayers money and gives seniors what they want---so the waiting lists must end.”

Norman said that because of community care alternatives, nursing home patient days paid for by Medicaid have plummeted -32% since the year 2000. “If we had to pay today for the level of nursing home care we sustained in 2000, it would cost taxpayers another $703 million this year,” Norman said. “We must invest some of that savings back into the home care program.”

Visuals: 50 or more senior advocates with cell phones raised high will be doing some call-and-response chanting outside the Governor’s office around 11 AM.

“NO REPLY” LETTER ATTACHED

Mass Home Care, Mass Senior Action Council,

Mass Council for Home Care Aide Services,

Mass Association of Councils on Aging,

Mass Association of Older Americans

September 25, 2012

Hon. Deval Patrick

Governor, Commonwealth of Massachusetts

State House

Boston, MA 02133

Dear Governor Patrick,

There are roughly 2,200 elders today waiting to get increased home care services, or any home care supports at all. We do not want this waiting list situation ever to become business as usual in this state. We want you to help us to end these waiting lists.

The additional investment that we are seeking for FY 2014 is far less than the “home care dividend” that is created when we keep disabled individuals out of nursing homes, which we estimate is in the $600 million per year range. This “dividend” far exceeds the $15 million in community services that we are requesting today.

The budget that you submit becomes the benchmark for the House and Senate budgets that follow, so it is important that we make a better first impression when your document comes out in late January.

Here are the numbers behind the elderly state of the state since you assumed office::

• The elder services line items have lost $36.4 million in buying power. According to the Mass Budget & Policy Center, the elder affairs accounts plummeted from $259.219 million in FY 2008 (in dollars adjusted by the index of goods and services purchased by the government), to $222.5 million in FY 2013 GAA funding.

• In unadjusted dollars, the elder affairs accounts fell from $232.95 million in FY 2008, to $222.806 in FY 2013—a loss of $10 million

• Focusing on the unadjusted home care and the enhanced home care line items, your budget submissions to the legislature since FY 2009 have fallen from $195.107 million in FY 2009, to $179.982 million in FY 2013—a cut of $15.12 million:

|Budget Account |Governor FY 2009 |Governor FY 2013 |

|Home care purchased services |$106.715 |$ 97.783 |

|Home care case management |$ 40.368 |$ 35.738 |

|Enhanced community options |$ 48.024 |$ 46.461 |

|Total |$195.107 |$179.982 |

From year to year, we have been able to move your recommendations up a small amount, but your January budget release sets the tone and expectation for the next six months of budget debate. As advocates for the elderly, we feel that we have clearly done a poor job of eliciting your financial support for these programs. Your Administration has embraced the policy of “community first” for elderly and disabled services---but we need to match the rhetoric with revenue.

Here are the 3 budget accounts we are focusing on for FY 2014:

• Home care purchased services (9110-1630) is one of the basic preventive programs that helps consumers avoid premature institutionalization. Since 2000, the number of patient days in nursing homes paid for by MassHealth has fallen a staggering 29%. The various home-based services are a significant factor in bending the curve on institutional use. The home care programs had significant waiting lists in FY 2010, 2011, and 2012. We began FY 2013 with a waiting list for home care services that could last all year long. The General Court appropriated $103.251 million for FY 2011 for home care purchased services. But on June 30, 2010, you vetoed $7.941 million, lowering the account to $95.311 million, which was an astonishing 89.3% of the FY 2009 appropriation. Roughly three months later, on September 27, 2010, the General Court restored $3.970 million—or 50% of the lost FMAP funding. This brought the account up to $99.281 million.The General Court added another $2.4 million to bring the account up to $101.68 million---which was still lower than the FY 2009 appropriation. In 2012, the legislature lowered the home care services account by $3.9 million below FY 2011 levels. In FY 2013, this account was level-funded:

Home care purchased services, in million)

|FY 2009 |FY 2009 9c cut |FY 2010 |FY 2011 |

|9110-1630 Services |$78.124 |$97.781 |+25 % |

|9110-1633 Care management|$32.978 |$35.738 |+8.4% |

The care management account today has only $2.76 million more than it had 15 years ago in FY 1998. In 1998, the care management account was 29.68% of the overall two home care line items. Today care management has fallen to 26.7% of the overall accounts.

• The Enhanced Community Options Program (ECOP), which combined two separate accounts in 2003, is targeted exclusively to seniors who are 1) not on MassHealth but 2) are eligible to be in a nursing home. This is a program that many home care basic program clients will transfer into as their functional capacity declines. As a result, this program is the only alternative to a nursing facility for people who are not yet on MassHealth but who are only a few months from spending down their income and assets to become MassHealth members. The ECOP program is 100% targeted to disabled seniors.

According to the Mass Budget and Policy Center, this program increased in nominal dollars by 18% since 2003, when the appropriation stood at $37.488 million. But in inflation adjusted dollars, this account has fallen -11%. In 2009, the ECOP appropriation stood at $48.024 million. Three years later, in FY 2012, the account had fallen -5% (- $2.23 million) because of 9c impoundments that were never restored. In FY 2010, FY 2011, and FY 2012, the ECOP account was frozen.

What do we want?

1) We would like you to include an appropriation for the Enhanced Community Options Program of $6.74 million in a supplemental appropriations bill for FY 2013. That’s the sum needed to end the ECOP waiting list effective October 1, 2012.

2) We would like you to propose FY 2014 funding that would restore the home care and ECOP items listed above to their FY 2009 funding level of $195.1 million, an increase of $15.1 million.

We have been making these “community first” arguments for years with your Administration, but we feel that our voices are not being heard. So we will need to raise our voices louder in the months ahead, to ensure that your FY 2014 budget does not look like the last 5 years of budgets released by your office.

We agree with your statement made in response to a Mass Home Care candidate’s survey in June of 2006:

“Currently the long-term care system in Massachusetts favors institutional care over care in the community and at home. This neither respects the wishes of most older adults, nor follows the law of requiring care in the least restrictive environment, nor spends public dollars prudently… A large portion of older and disabled adults see community care as the best choice. Massachusetts has made efforts and significant progress toward the rebalancing of the long term care system through support of community-based services…However, there is far more that needs to be done to fundamentally rebalance the system.

Care in the least restrictive setting is a civil right. We hope you will lift your FY 2014 numbers higher to help us keep the elderly living independently at home, where they so passionately want to be.

We would like the opportunity to discuss our budget needs with you directly. Please let us know if you can arrange for a time when we can meet.

Yours,

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Ann A. Stewart Christine Alessandro

President, Mass Senior Action Council Mass Home Care

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David P. Stevens Chet Jakubiak

Mass Association of Councils on Aging Mass Association of Older Americans

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Lisa Gurgone

Mass Council for Home Care Aide Services

cc: Secretary Jay Gonzalez, Secretary JudyAnn Bigby, Secretary Ann Hartstein

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