Care Managers already working with 100 or more Elders
SOUTHWEST BOSTON, MA (July 24, 2009) — Elder rights groups this week are turning up the volume on their requests to state lawmakers for an unexpected override by Governor Patrick of $1.5 million in home care funding. They have roughly one week left to make their case.
The Governor vetoed $1.5 million from the account that pays for home care managers. These workers are responsible for meeting with elders in their homes, assessing what care they need, developing a care plan, buying the services from vendors, doing a reassessment visit—and handling any request or change that comes up on any given day. “Care managers are the service that unlocks every other service,” explained Ethos Executive Director Dale Mitchell. “Their role and support is critical to the lives of more than 50,000 seniors in Massachusetts.”
Mitchell said that care managers today are juggling caseloads that run from 90 to 120 elders per worker. They are responsible for sorting through a complex list of service options designed to keep each elder living at home. When they succeed—the taxpayers win too.
Mitchell said elder rights groups were dismayed that one of the items on Governor Patrick’s veto list was $1.5 million in cuts to care managers. This account stood at more than $40 million at the start of FY 2009, and the Governor’s action has reduced it to $36 M. This is the only account used to pay for care management—but it also has to cover all the support costs of the Aging Services Access Points (ASAPs).
In FY 2001, the 1633 account stood at $35.6 million. If the Governor’s veto stands, the $36 million appropriation for care management return the system back to the level of funding it had in FY 2001—nine fiscal years ago.
A cut in this account translates into even higher caseloads for workers at a time when the elders being served are increasingly disabled. Fewer workers are dealing with more disabled clients. Today, in the home care programs alone, more than 10,000 people are at home—-who otherwise would be in a nursing home. If we had to care for these same elders in nursing homes, the bill to the state would be more than $420 million a year.
This cut to care managers was unexpected. It was not in the Governor’s original budget for FY 2010 or in his most recent revised budget—so there was no indication he wanted to cut it at all.
The home care program is delaying or preventing institutionalization. Many home care clients die at home while in the home care program, never spending a single day on MassHealth in a nursing home. This is part of the reason why nursing home patient days have fallen nearly 20% since 2000.
“It is disheartening to know that many important needs are not being met because of revenue shortfalls,” Mitchell added. “But in the case of home care, we can serve two people at home for the cost of one person in a nursing facility—so the economics of cuts to home care don’t add up. This is a program that is saving taxpayers hundreds of millions of dollars every year.”
“Already many of our care managers are trying to work with as many as 100 elders at once,” Mitchell concluded. “It’s just not possible to ask them to take on more clients. If you had a family with 100 relatives, it would be impossible even to remember all their names. Home care workers have been pushed to the limit.”