John Laidler
October 1, 2009
Local agencies that serve seniors are warning that state budget cuts will leave many area elders unable to obtain needed home care services.
The state's 27 elder home care agencies, at the direction of the state Executive Office of Elder Affairs, on Sept. 8 initiated waiting lists for the state's basic home service, according to Al Norman, executive director of Mass Home Care, an association of senior care agencies.
Jim Cunningham, executive director of Chelsea Revere Winthrop Elder Services, said his agency's waiting list for home care already has reached 18 to 20.
"It's a tough situation,'' he said. "I understand the state and federal governments are in tough straits, but we've got to take care of the most vulnerable people in the society: the aged. If we don't honor that, we're going backwards.''
Through the home care program, agencies arrange for people 60 and over with impaired mobility to get help with such tasks as bathing and dressing. The state pays most or all of the costs depending on the person's income level.
Norman said that there are approximately 250 people on the waiting lists statewide and that he expects the number to grow signficantly by the end of this month. He also predicted that the waiting lists could grow to up to 6,000 by the end of this fiscal year next summer.
There have been waiting lists occasionally in the past because of state revenue shortfalls, including in the fiscal year that ended June 30, according to Norman. But "this waiting list could be the worst one we've had in the 35-year history of the program,'' he said.
"I'm quite concerned,'' said Paul Lanzikos, executive director of North Shore Elder Services, which provides home care in Danvers, Marblehead, Middleton, Peabody, and Salem.
Lanzikos, who is president of Mass Home Care, said he worries not only that agencies will be unable to immediately provide services to those requesting it, but that many seniors "aren't even going to make themselves known to us'' because of an assumption that no help is available. He noted that there are exemptions to the waiting list, such as for seniors who have been discharged from hospitals or nursing homes who require home care. Even when seniors are wait-listed, agencies may be able to locate other services for them, he said.
At a meeting with health service providers on Monday, state officials warned even more funding cuts should be expected soon, according to Norman.
"We understand as providers that the state has a serious revenue issue,'' Lanzikos said. But he said the state "should not short-circuit'' funding for home care. "We can keep a lot of frail folks in the community and avoid institutional care, which ends up being much more expensive and is not where people want to be.''
Kristina Barry, spokeswoman for the Executive Office of Health and Human Services, said in a prepared statement, "During these challenging economic times, the Executive Office of Elder Affairs, like others across state government, needs to operate within current budget realities. As a result, the Home Care Program has put a wait list in place for many consumers. The program is currently enrolling applicants who have the most critical needs, and elders will be enrolled based on needs as capacity becomes available.''
According to Norman, funding for basic home care is down $6.4 million, or 6 percent, for this fiscal year. A separate account that funds the program's case managers is down $4 million (10 percent). Funding also fell $2.4 million (5 percent) for a program that provides a more intensive level of home care.
To achieve a $10 million cost savings in a program that provides home care to Medicaid patients at risk of being placed in nursing homes, Norman said, the state moved 2,000 of those seniors into the basic home care program. Absorbing those seniors is increasing the waiting list for basic care, he said.
Rosanne DiStefano, executive director of Elder Services of the Merrimack Valley, said her agency's waiting list already has reached about 50 names.
DiStefano said she worries about those who need care but now have to wait, pointing to a 92-year-old woman on her agency's waiting list as an example.
"She has diabetes and hypertension, and is unsteady on her feet,'' she said of the woman, who lives alone. "She is managing her own personal care so far, but with difficulty.''
When elders go without help, they will sometimes undertake tasks that require more physical ability than they possess, such as carrying grocery bags up the stairs, DiStefano said. "Often, that results in a fall, and a fall for someone at an advanced age can often lead to hospitalization, which in turn can very quickly lead to a long-term nursing home placement.''