By Al Norman
The Conference Committee working out differences between the House and Senate budget for 2012 released its final version on the evening of June 30. The entire budget process from January to June was a reminder that elderly services are not a top priority on Beacon Hill.
It’s not that lawmakers don’t support services for the elderly. But there is always a long list of items that attract more attention and time than elderly issues. It might be local aid. It might be health care reform. It’s always something. How else do you explain the fact that in 2011 we are still spending two-thirds of our Medicaid long-term care dollars on nursing facilities, and only one-third on home care?
If the budget is supposed to be a reflection of what the taxpayers want, then two-thirds of our Medicaid dollars should be going to home care — because that’s where 99.99 percent of the elderly want to be cared for. If we were to split 50/50 our Medicaid long-term care dollars, home care would see a $600 million increase in funding.
As things stand now, there will be waiting lists again for home care over the next 12 months. We spend all spring fighting to get back money that was cut from elder abuse services and home care. When we got the money restored, all we had done was to dig ourselves out of a hole, and back up to level ground. We’ve been down so long it looks like up — when in fact funding for home care today is lower than it was in years past.
In the final days of budget discussions, the Conference Committee added $1.7 million back into the home care budget. But even with this restoration, the funding for 2012 for home care services is still almost $4 million below the FY 2011 funding level, and support for the care management account is $4.3 million below FY 2009 levels. Faced with increased demand for services, the home care program will fall farther and farther behind the level of rising demand.
The protective services program was funded at $16.25 million for 2012 — which is $1 million more than the governor recommended, but still $500,000 below the 2011 appropriation level of $16.7 million.
Today in Massachusetts there are almost 900,000 people over the age of 65, or roughly 13.6 percent of the population. By the year 2025, that percentage will be closing in on 19 percent of the population. We don’t have a lot of time left to get our priorities straight. Medicaid use of nursing homes beds has fallen by nearly 30 percent since 2001. We are saving $600 million this year because of the shift to care at home. We need to “rebalance” how we spent our tax dollars by honoring the desire of elders to live independently at home.
The 2012 budget was a holding pattern at best. For the 2013 budget, it’s time to tell our lawmakers: “Don’t come home without home care.”