Published Thu, Dec 10, 2009 02:00 AM
Modified Thu, Dec 10, 2009 06:33 AM
RALEIGH Over 37,000 elderly and disabled citizens in North Carolina rely upon the assistance of trained home care aides to be able to remain in their own homes. They need assistance with such basic activities as bathing, dressing, eating, toileting and ambulation. This Medicaid program, called Personal Care Services, saves North Carolina many millions of dollars, because most of these elderly and disabled individuals would be in much more expensive nursing homes and rest homes without this basic assistance.
Unfortunately, this cost-effective, essential program is under siege with recent plans by the state Department of Health and Human Services (DHHS) to cut over 8,000 elderly and disabled people from the program and reduce the services for the remaining 29,000 to such an extent that most will no longer be able to remain at home.
DHHS recently signed a $24 million non-competitive, no-bid contract with a vendor that will take control over the determination of which elderly and disabled persons can receive in-home assistance and how many hours of care they will receive. The stated objective of this contract is to cut over 8,600 elderly and disabled people from the Personal Care Services program and cut hours of services by an average of 45 percent for the rest. These cuts are being planned even though doctors have ordered the services as being medically necessary for each individual in the program.
To illustrate the impact of the service cuts, an elderly person who needs assistance with bathing and eating will receive less than half the hours he or she was previously receiving - 20 hours or less a month. This is not even an hour a day.
Most of us believe it is necessary to be able to take a bath and eat every day. However, those individuals who rely on the help of aides to be able to perform these tasks will have to decide whether they want to eat on a Monday or a Wednesday, but certainly not every day.
A study conducted by the AARP Public Policy Institute shows that persons needing assistance with two activities of daily living (such as bathing and eating) require four times as much assistance as the department plans to provide with its changed policies.
The elderly and disabled who rely on this Medicaid program also will no longer have the assistance of an aide to do grocery shopping or pick up medicines. Perhaps DHHS has concluded that this is an inappropriate service that must be eliminated, but for the many thousands of elderly and disabled who have no other way of getting food and medicines, it is essential to have this assistance to remain at home.
Not only is DHHS' plan cruel and unfair to the elderly and disabled who need this program, it is shortsighted. Many of the 8,600 individuals who DHHS plans to eliminate from the program, and the many thousands more who will have their services drastically reduced, will have to be cared for in more expensive rest homes and nursing homes. This will be much more costly for the Medicaid program and taxpayers.
Many thousands of aides also will lose their jobs, at a time when North Carolina's unemployment rate is already above 10 percent. If these cuts are a matter of the Medicaid budget, then it makes no sense to take actions that will increase the budget by forcing people out of their homes and into more expensive institutions.
DHHS should stop its plans to cut this essential Medicaid home care program that allows so many elderly and disabled people to remain in their own homes and communities.
Timothy R. "Tim" Rogers is CEO of the Association for Home & Hospice Care of North Carolina.