Will the legislature end home care waiting lists?


By Al Norman

In September of 2012, a coalition of five elder advocacy groups sent a letter to Gov. Deval Patrick urging him to help end the home care waiting lists. Their letter was never answered. More than 100 activists went to the State House and presented the governor with a cell phone, hoping for “better reception” for their proposals.

As of Jan. 15 there were 1,224 people on a home care waiting list — and the numbers are rising. For a state that calls its eldercare policy “Community First,” the idea of people waiting to get community care is an oxymoron. Ironically, we have a 12 percent vacancy rate for nursing homes beds.

alnorman_headshotWe have proven that home care creates a major cost-savings for taxpayers. Over the past 12 years, nursing home days paid for by MassHealth have fallen by roughly 32 percent. That’s more than 4.5 million fewer nursing home days in 2012 compared to 2000. This has produced a savings to taxpayers of more than $703 million a year in avoided institutional costs. We call this “the home care dividend.”

In 2010, the state’s Bureau of Health Care Safety and Quality projected that by 2015 we would have 10,772 surplus nursing home beds in Massachusetts. The private marketplace has been ‘rebalancing,’ but we still spend two-thirds of our MassHealth long-term care dollars on institutions.

Since the governor took office six years ago the elder services line items have lost $36.4 million in buying power. In June of 2006, then candidate Deval Patrick said the following: “The long-term care system in Massachusetts favors institutional care over care in the community and at home. This neither respects the wishes of most older adults, nor follows the law of requiring care in the least restrictive environment, nor spends public dollars prudently … A large portion of older and disabled adults see community care as the best choice. Massachusetts has made efforts and significant progress toward the rebalancing of the long term care system through support of community-based services … However, there is far more that needs to be done to fundamentally rebalance the system.”

Yet the governor’s budget mostly flat-lined home care programs. We have turned to the General Court to add nearly $13 million to the governor’s budget to help us keep the elderly living independently at home, where they so passionately want to be. That $13 million is a small price to pay as a down payment on the home care dividend.

It’s about time that the governor and the General Court recognize that home care programs have helped conquer one of the greatest ‘budget busters” facing this state: the cost of nursing home care. Expenditures on nursing homes in 2012 were $290 million less than in 2005. That’s a remarkable turnaround.

“Can you hear us now, governor?” the elder activists chanted in the State House. The governor clearly did not hear the message. His budget was flat. Now the $13 million question is: “Can the legislature hear us now?”

Al Norman is the executive director of Mass Home Care. He can be reached at info@masshomecare.org, or at 978-502-3794.