Bill Championed by Tucker, L’Italien
By Edward Mason and Zach Church
Staff writers for Eagle Tribune
Yoram and Barbara Shahar of North Andover are more than a decade away from making the hard choices that come with retirement. One choice they do not want to make is having to go into a nursing home.That is why they approve of a bill championed by two local lawmakers and signed into law by Gov. Mitt Romney yesterday, which allows Massachusetts elderly and people with disabilities to obtain state help to live at home rather than a nursing home when they can no longer care for themselves.
The bill allows the state Medicaid program to pay for that home-based care. Previously, the Medicaid program, called MassHealth, paid mainly for nursing home care.
Andover Democrats Sen. Susan Tucker and Rep. Barbara L’Italien helped write the law and guide it through the Legislature.
At yesterday’s bill signing, they talked about how it gives seniors and people with disabilities control over their lives and the ability to live with dignity.
“The No. 1 issue in the mind of seniors is what will happen to me if I can no longer care for myself,” said Tucker, co-chairman of the Legislature’s Committee on Elder Affairs. “The No. 1 answer is they fear going off to a home.”
“The law signed today backs up the assertion that every person has the right to determine where they’d like to live,” L’Italien said.
Barbara Shahar, 51, agrees with L’Italien.
“I think it’s appropriate we do more for senior citizens,” she said. “Compared to a lot of other countries, we don’t do enough for our elderly.”
To the Shahars, the new law is about “options.”
“As we all know, when you get to that age, you are often on a fixed income,” she said. Her husband, Yoram, 52, observed that many people may not need the comprehensive care that comes with nursing homes.
“People are working out. They’re eating healthier,” he said.
Elliot Aronson, 70, of Andover shudders at the thought of having to go into a nursing home.
“I would never want to leave my house,” said Aronson, who has forgone retirement to continue work as an attorney in Methuen.
Aronson said he is doing all he can to keep fit so he can always live at home regardless of the new law. But he said the new choice is a good one for others.
Under the law, seniors and people with disabilities who qualify for MassHealth long-term care coverage would be told they have a choice of home or nursing home care. They would then have their physical and mental health assessed to determine whether they can live at home.
If they don’t need intensive nursing home care, MassHealth would pay for them to live at home and have access to the same services provided by nursing homes. Those include personal care attendants, homemaker assistants, private duty nurses, day habilitation, adult foster care and medical transportation.
The law is expected to reverse an imbalance toward nursing home care.
“We have learned that a community-based approach to care delivery is cost-effective and that it honors the preferences of elders and people with disabilities to remain members of the communities that they helped to build for as long as possible,” said state Elder Affairs Secretary Jennifer Davis Carey.
MassHealth spends about $1.6 billion per year to care for about 32,000 individuals, or 70 percent of all nursing home residents. Choice proponents believe that could shift to a 50/50 split over the next decade.
It also is expected to bring Massachusetts in line with other states, like Oregon and Vermont, which are giving elders and people with disabilities more say in their long-term care.
Moreover, it should save the state money. MassHealth spends $52,000 a year to care for each nursing home resident. That is expected to be cut in half.
As part of the new law, people choosing in-home care also would be allowed to keep more of their own money.
The state wants to raise the MassHealth eligibility threshold for home care from $2,000 a month to $10,000 a month. The $2,000 current limit for nursing home care would remain the same.
Supporters of the bill described its passage as a matter of civil rights, insistent the state ought to offer equal opportunity for residents hoping to stay in their homes.
Some states spend half their long-term care budget on community-based care, double Massachusetts’ 25 percent – a figure Al Norman, executive director of Mass. Home Care, said would change incrementally.
“What we are doing today is helping to eliminate a form of discrimination in our land,” Norman said.
During his visits to senior centers, Norman said, he frequently asks for a show of hands from those hoping to enter nursing homes. “No hands ever go up. There’s a lot of nervous giggling.”
Although the law was signed yesterday, it is not yet clear when people will be able to benefit from its changes.
State Health and Human Services Secretary Timothy Murphy said the state first needs to get a Medicaid waiver from Washington to make the changes in the law. That waiver is due Oct. 1, 2006.
Material from the State House News Service was used in this report.
