South Coast Today
by: Brian Boyd
January 13, 2009
Squeezed by state budget cuts, elderly service agencies have been forced to place people on waiting lists for a home care program that helps seniors stay out of nursing homes.
The home care program's budget was cut by $6.7 million statewide in October as part of Gov. Deval Patrick's effort to balance the budget. While they are maintaining assistance for existing clients, local agencies are required to reduce their average monthly caseloads by June 30, the end of the current fiscal year, officials said.
Without the help of the home care program, families might decide elderly relatives can no longer remain on their own, said Charles Sisson, executive director of Coastline Elderly Services Inc., a New Bedford-based agency that serves eight communities.
"If the family is trying to maintain a person in the community and we're not able to support them, what happens a lot of time is it gets to the point where they feel the best alternative is nursing home placement," Mr. Sisson said.
Local agencies arrange contracted services to provide seniors with their needs at home, including homemaking and bathing.
Coastline has 69 potential clients on its list following the state cuts, and it has to reduce its caseload of 1,444 clients by another 69, he said.
New Bedford resident Lisa Ferreira said her 84-year-old mother, Clem, is one of the seniors on Coastline's waiting list.
Ms. Ferreira said she and her family do what they can to help her mother, who lives in Dartmouth, but they cannot be there for her all of the time. She said they are looking for someone to help with housekeeping and assisting their mother when she takes a shower, and it would put the family "at ease" if someone with medical training was providing the assistance.
"I don't mind assisting her in the shower," Ms. Ferreira said. "I get nervous if something would happen. I'm not in the medical field."
The directors of local agencies argued that helping people stay at home, rather than be moved to nursing homes, saves money.
The agencies are reimbursed by the state $9 per customer per day, while it typically costs $165 a day to take care of a person in a nursing home, Mr. Sisson said.
"Putting money in our services offsets the need for nursing facilities placement," said Nancy Munson, chief executive officer of Fall River-based Bristol Elder Services Inc. "That saves all taxpayers money."
"They want to be able to age at home," said Diana DiGiorgi, executive director of Old Colony Elder Services, which is based Brockton. "Hopefully, the majority can rely on other supports such as family, neighbors and maybe some volunteer services."
All regional agencies face the same problem.
Bristol Elder Services has 75 people waiting for a space in its home care program and must reduce its caseload of 1,480 clients by about 200, said Ms. Munson. The agency serves 15 communities, including Freetown and Westport.
"We haven't had a waiting list for years," Ms. Munson said. "We started a waiting list in December when we realized we had to deal with the cuts."
While it is not dropping current clients, the agency has to reduce the caseload through attrition and limit the number of new cases, with certain exceptions, such as elderly who suffered abuse or who are leaving nursing homes after temporary stays, she said.
Potential clients are still encouraged to apply, because they could fall under an exemption, prove to be eligible for another program or at least get in line for an opening in regular home care, Ms. Munson said.
Elder Services of Cape Cod and the Islands Inc. began its waiting list Jan. 5, and it had grown to 14 as of Friday. The agency has to cut its caseload of approximately 1,700 by about 100, said Leslie Scheer, the agency's executive director.
"When calls do come in for our basic home care program, every call is being triaged," Ms. Scheer said. "If someone is high risk or in need of services, we're able to take them on. For other people, there will be a delay in service."
Old Colony Elder Services, which serves 23 communities, including Wareham and Lakeville, has to reduce its monthly average caseload of nearly 1,700 people to 1,600 by the end of the fiscal year, Ms. DiGiorgi said.
The cutbacks resulted from emergency budget cuts made by Gov. Patrick, said Kristina Barry, spokeswoman for the state Executive Office of Health and Human services.
"Unfortunately, during the challenging economic times, the Executive Office of Elder Affairs had to make the difficult decision of reducing funding for the home care program," Ms. Barry said.
With the state likely facing an additional budget gap of $1 billion, local officials worry what would happen if home care receives another whack.
"If it hits the home care budget again, this could really hurt," Ms. Munson said.
"We're waiting for the second shoe to drop," Mr. Sisson said.
Ms. Barry said she does not know whether there will be additional cuts to the home care program.
Brian Boyd can be reached at bboyd@s-t.com.