Long-term care shifts to in-home setting
Providers of in-home health care across the state are rallying around the governor”™s call to treat the elderly in their own homes and communities to free up space at hospitals and nursing homes.
In his budget proposal for the 2014 and 2015 fiscal years, Gov. Dannel Malloy proposed a $13 million investment, in addition to $72.8 million in available federal funding, to rebalance long-term care services and support. Home health care providers say they”™re happy to see the aggressive stance.
“We know people, by and large, want to age in their homes and their communities,” said Julia Evans Starr, executive director of the state Commission on Aging. “People have a right to do so and from the state government perspective it costs a lot less money.”
Keeping a person in stable health at their home costs less than $300 a day, while a hospital stay can cost thousands of dollars a day, according to some estimates.
Medicaid is among the largest budget items, representing about 25 percent of the expenditures included in Malloy”™s budget proposal.
While only 7 percent of residents eligible for Medicaid used long-term care services and supports in 2012, those services ate up 47 percent of the state”™s Medicaid expenditures, totaling nearly $2.8 billion.
Advocates say the state”™s Money Follows the Person program will be a key driver in rebalancing the long-term care system, which has already transitioned about 1,400 people out of nursing homes and into the community in the last three years.
The program directs the savings toward finding resources to help individuals live at home with the necessary supports. By 2015, the goal is to get 5,000 people back into the community.
To reflect its commitment to the growing role of home health care, the Connecticut Association for Home Care and Hospice unveiled Feb. 28 its name change to the Connecticut Association for Healthcare at Home (CCHH).
“Home health care providers are really excited about the opportunity to have care delivered at home,” said Deborah Hoyt, CCHH CEO. “There are options for care and there”™s no better place than home.”
Hoyt said the association has been an active participant in the home health care industry, which has evolved from nurses checking in on home-based patients to reflect the now-growing capabilities technology improvements have allowed. Equipment, sensors and monitors can measure vitals, if a patient is out of bed and report back the information to primary care doctors.
“It”™s not your mother”™s home health care,” Hoyt said. “It”™s all about wellness and prevention and keeping people cued into what could go wrong. We”™re changing the way we educate and work by collaborating with patients through the use of technology and working closer with primary care doctors.”
But both Hoyt and Starr said the rebalancing initiative isn”™t without its challenges.
Hoyt said providers and doctors aren”™t being reimbursed at high enough rates to cover their expenses. Last year, four home health care agencies, including one in Stamford, closed.
Plus, they said there”™s the issue of finding enough qualified and trained employees to staff home health care agencies. Over the next four years the state will need an additional 9,000 direct care workers to support the community, according to the Commission on Aging.
“I think we”™re being very aggressive right now,” Hoyt said. “The focus on health is finally coming to home.”