Massachusetts Releases ‘Blueprint’ To Increase Funding, Options for Senior Home Care Services

Developing a system of long term care that allows seniors with medical disabilities to live at home rather than in nursing homes would be cost effective for the state and "honor" the preference of many seniors to remain in their communities, according to the findings of a study released on Aug. 22, the Worcester Telegram & Gazette reports. Noting that 83% of the state's $1.5 billion long term care expenditures last year went to nursing homes, the study, conducted by the Massachusetts executive offices of Elder Affairs, Health and Human Resources, and the Office of Consumer Affairs and Business Regulations, found that "unifying" health care services for seniors would be a more cost effective way of providing care. For example, a yearlong stay in a nursing home costs, on average, $34,100, compared to $6,329 for a senior to remain at home or in an assisted living arrangement (Luttrell, Worcester Telegram & Gazette, 8/23). In addition, the report found that seniors would prefer to remain in their homes if possible, as 30% of surveyed seniors who were receiving treatment for a serious illness said that they would "rather die than live permanently in a nursing home" (Powell, Boston Herald, 8/23).

Recommendations
Based on these findings, the report suggests that any system of long term care should incorporate the following goals:

Respecting seniors' wishes to remain in the community;
"Balancing" state appropriations between community-based and institutional care;
Increasing the availability and options of community-based care; and
Preventing "unnecessary" hospitalizations.

To achieve these goals, the report recommends that the state increase spending on community-based programs each year through 2006 and launch a variety of pilot programs over the next five years to develop a model for community-based care, including housing options and respite services. According to the recommendations, such a system should work in conjunction with hospitals and providers, employers and insurers to ensure that those seniors with private and employer-based coverage would have community-based care options. The report also suggests that the state standardize and subsidize training and career development for long term care workers to ensure quality of care (Report on Long Term Care, August 2001).

Reaction
The Herald reports that the findings were "hailed" by the home health care industry, which "hopes" the recommendations will lead to additional funding (Boston Herald, 8/23). As part of her FY 2002 budget, Gov. Jane Swift (R) included $6.1 million to fund recommendations from the report along with instructions for the elder affairs office to "enhance" adult day care programs and create teams to provide home care services 24 hours per day. Regarding the $6.1 million already appropriated, Lillian Glickman, secretary of the Executive Office of Elder Affairs, said, "It is certainly sufficient to implement the pilot programs in the report. It's a blueprint for the current state of affairs, and where we go from here." However, she added that the funding amount needed to implement all of the report's recommendations is unknown (Worcester Telegram & Gazette, 8/23). The report is available by calling 617-222-7460. For further information on state health policy in Massachusetts, visit State Health Facts Online.

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Massachusetts Releases ‘Blueprint’ To Increase Funding, Options for Senior Home Care Services

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