So many older Bay Staters, and so little funding


By Al Norman

According to a new study from the U. Mass Donahue Institute, the population aged 65 plus in Massachusetts will increase by over half a million (548,699), expanding from 14 percent of the state’s total population in 2010 to 21 percent, by 2030.

Under state law, elders and individuals with disabilities who are on MassHealth have the right to care in “the least restrictive setting appropriate to their needs.” This is a civil rights law, not just a human services law.

alnorman_headshotDespite the fact that one of the few things growing in the Commonwealth today is the older population, there has not been a focused effort by the Patrick administration to make sure that we invest our dollars in community care. One look at the budget numbers since the governor submitted his first budget for fiscal year 2008 proves the point:

•State appropriations from 2008 to 2014 grew 27 percent;

•Human Services (EOHHS) grew 38 percent;

•Elder Affairs accounts fell  — 14 percent;

•Home Care Services fell — 8.3 percent; and

•Elder Care Management fell — 11.3 percent.

Gov. Patrick’s budget requests over the past seven years have added $4.9 billion to the Human Services accounts, versus a $13.18 million loss to the home care and care management accounts. Yet these home care programs are part of the reason why MassHealth patient days in skilled nursing facilities have fallen by 33 percent over the last 12 years.

According to an analysis by the Executive Office of Elder Affairs, consumers who were discharged from home care programs in FY13 averaged 34 months in the home care program — 10 months of which they were eligible for nursing facility care. The savings to the Commonwealth from these avoided nursing facility months is predicted to be $1.2 billion over the next six years. We call that “the home care dividend.”

When he was running for governor in 2006, Deval Patrick said: “Currently 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 … My administration will expand opportunities for older adults and the disabled to stay in and connected to their communities as their care needs increase.”

Yet in 2014, Gov. Patrick asked for $13.3 million less for home care than he did in 2008. With the baby boomer numbers beginning to hit Massachusetts, we need the governor to step up to the home care challenge, and “expand opportunities” for seniors to stay at home.

Home care is one of the few investments we make as taxpayers that returns an immediate dividend. Every day an elder avoids nursing facility care is a savings back to the Commonwealth. I urge readers to call the governor at 617-725-4005. Tell him he has very little time left in office to address the needs of older citizens in this state.

Al Norman is the executive director of Mass Home Care. He can be reached at