Indiana advocates worry about cuts to in-home health care

From The AP:

Advocates for Indiana's seniors warned Jan. 26 that Gov. Mitch Daniels' proposed spending cuts for a state program that provides in-home health care for the elderly and disabled would hurt people on the program's long waiting list.

State officials contend that wouldn't be the case if the General Assembly approves the cuts because a Medicaid waiver offers many of the same home health services as the state-funded CHOICE program. Under Daniels' proposed budget, state appropriations for CHOICE would be reduced $4 million in each of the next two budget years, down from the $48.7 million appropriated for the current fiscal year that ends June 30.

John Cardwell, chairman of the Indiana Home Care Task Force, said during a Statehouse news conference Monday that if lawmakers approve the proposed CHOICE cuts for state fiscal years 2010 and 2011, many elderly or disabled Hoosiers won't get home health services they're qualified for.

He and other advocates for seniors also said they are upset that the Indiana Family and Social Services Administration recently asked the state's area agencies on aging to temporarily stop enrolling people in the CHOICE program.

"We are extremely concerned about this," Cardwell said.

As of Nov. 30, 3,810 Hoosiers were enrolled in the CHOICE program, which is a first come, first served program. Another 3,128 were on a waiting list to get into CHOICE, according to FSSA. June Lyle, state director of AARP, said the longer people remain on the CHOICE waiting list, the more their health will deteriorate.

"They're likely to become increasingly ill and increasingly frail until the point where they need to go into an institution, a nursing home," Lyle said.

FSSA spokeswoman Elizabeth Surgener said Cardwell and other advocates for seniors are wrong to suggest that the proposed CHOICE cuts and the agency's hold
on additional enrollments will lead to more Hoosiers ending up in nursing homes.

She also said that no person currently in the CHOICE program will see any reduction in services, nor will any individuals be removed from the program.

Although state funding for CHOICE will be reduced by $4 million in 2010 and 2011 - to $44.7 million each year - she said FSSA is advising the state's 16 area agencies on aging how they can use about $1.4 million in federal money that went unspent last year but is now available to help people already enrolled in CHOICE.

Sen. Vaneta Becker, R-Evansville, said it's early in the legislative session and therefore unclear whether the General Assembly will endorse Daniels' suggested funding level for CHOICE or opt instead to allocate a larger amount of money.

But Becker said she is also concerned that cutting CHOICE funding could result in elderly and disabled Hoosiers ending up in nursing homes sooner than they would have if they had gotten into the CHOICE program sooner and benefited from its services.

"What we want to do is make sure that seniors have the option to stay in their own homes and not be prematurely forced into nursing homes, which will cost the state more money," she said.

Surgener said many elderly and disabled Hoosiers can receive the same type of in-home nursing services available through CHOICE through a Medicaid Aging and Disabled waiver. However, the eligibility requirements for that waiver are more restrictive, geared toward people with lower income levels and in poorer health.

Cardwell said people who don't qualify for the Medicaid waiver and have not yet been enrolled in CHOICE are left in a "no man's land" where their health can worsen.