State gives elderly a look at options
Posted on Sunday, February 17, 2008
Most senior citizens don’t dream of living out their golden years in a nursing home.
But locating information about alternatives to nursinghome care hasn’t always been easy. That’s why a state agency has set up a hot line to serve as a one-stop source for information about long-term care options.
The Choices in Living program was established by Act 516 of 2007, which was sponsored by Rep. Sandra Prater, D-Jacksonville.
“I have heard this many, many times from some of my seniors saying, ‘I’m not sure what’s out there to help me, ’” Prater said.
Prater said she wanted to help people continue living in their homes as long as possible. She also hopes the program will lead to Medicaid savings if senior citizens opt for less expensive in-home care over a nursing home. The state could then use the savings to assist more senior citizens, she said.
The legislation was not “antinursing home,” Prater said, adding that nursing homes provide needed services.
The hot line, which can be reached at (866 ) 801-3435, opened in January.
Herb Sanderson, director of the Department of Human Services’ Aging and Adult Services Division, said that often people enter the long-term care system during a health crisis. Family members typically aren’t aware of options other than nursinghome care, Sanderson said.
“Before we started this program, there wasn’t a single number you could call to get information,” he said.
Sanderson said a variety of home-based care programs for the elderly and disabled are funded by Medicaid, the state-federal health insurance program.
A personal care program involves a caregiver going to a person’s home several times a week to help with bathing, meal preparation and light house cleaning. Another program is designed to help disabled adults live in their own homes with the assistance of an attendant who helps eight hours a day.
Eligibility for each Medicaidfunded program varies, but usually involves asset and income restrictions. Generally the programs are for low- to moderate-income individuals, he said.
People working the hot line help determine if a caller is eligible for the various programs and then connects the caller with a caseworker to help him apply for services.
The home-based care programs not only give the elderly and disabled alternatives to nursing-home care, but also help families who are caring for their loved ones at home, Sanderson said.
“Families provide the vast majority — over 80 percent — of all care for people with long-term care needs,... so what these programs do is supplement the service and make it possible for the families to continue without total exhaustion,” he said.
The nursing-home alternatives also make sense from a public policy perspective, Sanderson said.
“It seems logical that you would want to reserve nursinghome beds for those people who truly needed 24-hour — that high level of care,” he said. “For people who don’t really need that, it makes sense to provide a lower level of care.”
In 2005, Arkansas had a highports and Services, said the state is already seeing indications that its nursing-home spending is decreasing as a result.
Specific savings amounts were not available because administrators have not yet published an analysis of the Michigan program, Head said.
The legislation also requires nursing homes to inform all potential residents or their representatives of the Choices in Living options counseling program when they apply. Nursing home residents who apply for Medicaid assistance must also be notified of the program, Sanderson said.
AARP Arkansas supported and helped draft the legislation.
“We felt like we needed to do all we could to help people stay in their own homes and get the health care that they need there,” said James Smalley, lead volunteer for AARP Arkansas’ advocacy team.
The organization plans to hold er percentage of nursing-home residents requiring only low care — meaning they could live in a community setting with the proper supports — compared with the national average, according to a recent report published in the health policy journal Health Affairs.
The Choices in Living hot line program, which includes about 20 staff members, is expected to cost the state about $ 1 million a year. But if 120 people chose home care over nursing-home care, the state will save about $ 2. 9 million a year, Sanderson said.
The state’s Medicaid program receives about 10, 000 applications for nursing-home care a year, he said. In 2005, there were 17, 689 Arkansans who lived in nursing homes for at least 90 days.
Michigan started a similar long-term care options counseling program in early 2007. Michael Head, director of that state’s Office of Long Term Care Suptraining sessions for hospital discharge administrators and social workers to make them aware of alternatives to nursing-home care so they can inform patients and their families, Smalley said.
The Arkansas Health Care Association, which represents the state’s nursing homes, also supported the legislation. But Executive Vice President Randy Wyatt said he’s not convinced that it will result in savings for the state.
Nearly all of the people who investigate nursing home care do so out of necessity for their loved one and for the family’s peace of mind, he said.
“We believe that people need to be able to stay in their homes as long as they can, but it also puts an untold burden on other family members,” Wyatt said.
The hot line gets about five to eight calls a day, said Kris Baldwin, assistant chief program administrator for the Aging and Adult Services Division.
“We’re not interested, I guess, in volume so much as we are in really being able helping people,” she said.
Many callers aren’t aware of the state’s home- and community-based services and get excited when they hear about those options, Baldwin said.
The program will also help division administrators identify gaps in available services and plan ways to address those gaps, she said.
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