In-home, assisted living options in Ohio shrinking

From The Cincinnati Enquirer:

In-home and assisted-living care options for Ohio seniors and disabled adults are another casualty of the state's smaller 2010-11 budget.

These significantly less-expensive housing options than nursing homes for qualifying adults lost $15 million a year in state money for each of the next two years and created waiting lists for applicants and costs taxpayers money.

That's because the average stay in a nursing home costs $4,800 a month, compared to $1,100 for in-home care through programs such as Ohio's Passport initiative, which provides in-home help, such as dressing and eating, for people who otherwise can live independently.

Advocates, such as the Council on Aging of Southwestern Ohio, would like to see all of the state's Medicaid money put into a single pool and allow consumer demand and need to determine where the money is spent.

Worse, advocates say, if a person is in an assisted-living arrangement and runs out of money, that person might need to move into a nursing home and be placed on a waiting list before being able to return to an assisted-living situation.

The last time the state had a waiting list for assisted-living and in-home care - in 2007 - Ohio taxpayers spent an additional $190 million in Medicaid money on short-term nursing home care, according to the Scripps Gerontology Center at Miami University.

Legislation is being drafted in the Ohio General Assembly that could address current problems with the system. It could be introduced within the next few weeks.

"We want to eliminate these costs," said State Sen. John Carey, R-Wellston, who is working with Senate colleagues on the measure. "We're trying to address waiting lists for Passport."

Advocates for housing choices for seniors, backed by the Ohio Department of Aging, are pushing for a 50-50 balance of institutional and home-care options. Ohio still ranks 43rd nationally with 72 percent of its spending going to nursing homes and other institutions, versus 28 percent going to home-care spending, Miami's Scripps Center reports.

Ohio uses about $4.7 billion a year in Medicaid money for long-term care, which accounts for 42 percent of the state's total Medicaid spending. Medicaid is a national health insurance program established in 1965 for poor people. Under federal Medicaid guidelines, states must provide nursing-home care but home care, assisted living and other less-costly services are optional.

Statewide, spots in in-home and non-institutional programs for seniors have dropped from 900 to the current 680 a month.

Starting Dec. 1, the state will reduce those spots to 500 vacancies a month. The Council on Aging of Southwestern Ohio - which covers Butler, Clermont, Clinton, Hamilton and Warren counties - has dropped from 65 spots a month to 62. It used its allotment of slots Monday to clear a waiting list that had formed during October. No more slots are available until Dec. 1 at the earliest.

Still, the assisted-living and in-home service programs are accepting applications, and seniors are urged to apply.