Elderly Feel Pinch of State Budget

 

The Patrick administration has failed to follow through on key commitments to help older citizens avoid nursing homes and stay in their homes and communities, actions that could save the state significant money, advocates for the elderly and legislators said recently.

This year’s state budget includes $2.5 million to expand a pilot program that provides free counseling to frail seniors about alternatives to nursing home care, which the administration’s own analysis showed kept more than 300 people living at home in one year.

But the administration has not expanded the program, and Elder Affairs Secretary Ann Hartstein acknowledged in an interview with the Globe that the money was diverted to other community-based programs for the elderly that were facing budget cuts. Hartstein said the administration did not think it wise to expand the counseling program when it was unclear whether it would be funded beyond this year. She said the governor did not include money for an expansion in his budget proposal for the 2011 budget year .

The two legislators who chair the Joint Committee on Elder Affairs have filed bills demanding that the governor spend the money as directed and provide a written explanation of the status of the funds.

“I did ask the administration about the money,’’ said Representative Alice Wolf, a Cambridge Democrat who cochairs the committee. “I didn’t get an answer.’’

She and advocates pointed out that a 2006 state law gives the state’s elderly and disabled the choice of receiving state-funded care either at home or in a nursing home, and it stipulated they should receive counseling to let them know about alternative to nursing homes.

During budget cutting last fall, the Patrick administration asked lawmakers’ permission to not spend the allocated money for the expanded program, which has counseled more than 950 people in the Merrimack Valley, Metro West, and on the North Shore since 2008.

In a letter last November to lawmakers, Patrick said the expansion was not needed, stating that hospitals are already required under Medicare rules to provide patients information about nursing home alternatives during discharge. Lawmakers declined his request.

“If they can show us that the discharge planning from the hospitals is adequate, that would be a different story, but that’s not what we have heard,’’ said Senator Patricia Jehlen, elder affairs committee cochair.

Among the consumers helped by the program, is Mary Jane LaBrecque, 101, who briefly entered a nursing home in March 2009 because some of her children were worried she was too frail to continue living alone in her Methuen home, and they were unaware of state programs that help with home care.

Christine Lescatre — a counselor from Elder Services of the Merrimack Valley, one of the three sites in the pilot program — met with LaBrecque and her family and helped them piece together a home-care plan that includes payment for a home aide for a couple of hours a week to help with chores.

The plan also uses Medicaid money to pay LaBrecque’s daughter, Lois Scott , 74, about $12 an hour to care for her mother much of the time.

“She helped my mother get out of the nursing home,’’ Scott said. “I help bathe her, dress her, and Mom says her rosary, while I clean, make the bed, do dishes. Then we bowl on the Wii [video game]. Mom’s high score is 287.’’

Elder advocates say the Patrick administration has also sidelined a program that bought and retrofitted four small houses in Peabody, using a model similar to group homes for the mentally ill that helped thousands move out of institutions. The plan was to open dozens more such small group homes in Greater Boston, the South Shore, and in the Fitchburg area. But in early 2008, federal administrators warned the state that it needed to write new rules for regulating these homes before spending more federal funds for running them. The state has yet to submit those regulations, and in the meantime, federal money has dried up for expanding beyond the four Peabody homes, advocates said.

“It’s a bureaucratic quagmire,’’ said Paul Lanzikos, executive director of North Shore Elder Services, which coordinates services for the four Peabody homes. “We have sort of been stuck in place the last 2 1/2 years.’’ Elder Affairs Secretary Hartstein said the administration is still working on the proposed regulations, and she could not give a timetable for when they might be completed. “I understand the frustration,’’ she said. “But we need to do our due diligence, to make sure we have the protections for people and the right settings.’’

The total cost per day for a senior in one of these homes is slightly less than the average state payment for nursing home care. “We would have had 20 to 25 of these homes by now, statewide, easily by now,’’ said Al Norman, executive director of Mass Home Care, an association of nonprofit agencies that launched the home-care initiative.

-From “Elderly feel pinch of state budget” by Kay Lazar , The Boston Globe, April 8, 2010, http://www.boston.com/news/local/massachusetts/articles/2010/04/08/elderly_feel_pinch_of_state_budget/ retrieved 4/8/10.

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