Updated 20:56 Monday, April 4, 2016
Graph shows the evolution of Medicare spending for the services of home and community care; 2c x 3 inches; 96.3 mm x 76 mm;
Graph shows the evolution of Medicare spending for the services of home and community care; 2c x 3 inches; 96.3 mm x 76 mm;
Photo: K.vineys, APCHICAGO (AP) - The federal government states urging elderly in nursing low-income to keep at home and instead put them into housing schemes and community.
The change occurs when the demand for long-term care increases. In 2050 it is expected that the number of people triple to more than 18 million on 85th These elderly people are to have the highest rate of disability and the increased need for long-term care generally.
The tug of war between the growing demand and cost control have lawyers to disturb the elderly in the quality of care.
Medicaid is one of the biggest issues for the States, and is a program that saving money is looking when budgets are limited. Medicaid spending for long-term care was in the 2013 fiscal year $ 146 billion, including nearly $ 89 million just for seniors.
Supporters say that the programs for the elderly often find themselves on the chopping block.
For example, Illinois is considering changes to the program at home and Community funding of around $ 200 million to reduce.
"I think many people are afraid of change, regardless of what the change," said Andrea Maresca, director of federal policy and strategy of the National Association of Medicaid Directors. There is room for improving programs, Maresca said, states also try to ensure that older people do not lose access to services.
Loren Colman, the Department of Human Services of Minnesota, said the state some 25 years took to move from institutional care housing schemes and community. The goal is now to older people stay at home, help, expensive nursing home to delay care and support for caregivers.
To control costs, some states the remuneration for services care change payment systems are managed, a fee per person usually pays for providers who manage the health of the elderly and social services.
Gwen Orlowski, lawyer of Central Jersey Legal Services, said the New Jersey Managed Care program is an improvement over the previous system, but not without problems. I had some older people call service to help cuts.
"I fear that the provision of services is responsible, the money managed care companies to receive money (State) and want to do it," said Orlowski, whose office provides legal assistance free of low-income seniors.
To address environmental concerns, they have to strengthen new federal regulations proposed protection of the elderly in care management, including support for calls. A final rule is expected this spring.
Now working States on the implementation of the above rules in 2014 aiming to improve the quality of care in all programs. In return for the federal funds, states must ensure that older people have a say in where they want to live, and treated with dignity and respect.
Robyn Grant, director of public policy and the defense of national voice of consumers on the quality of long-term care, said that the rules are "a step in the right direction", but there must be a correct application. "Unfortunately, this is very nebulous is," Grant said.
The cornerstone of housing programs and community is the personal care, such as providing support to cook or clean to help. These services cost only a fraction of a nursing home.
The average cost per person for the program Community Care in Illinois is $ 860 per month, less than a third the cost of a nursing home. Over the past decade, however, enrollment has doubled to more than 83,000 people, will cost the state nearly $ 1 billion for the year, 2015.
One of the elders is Yuen Wong Chu, 71, of Chicago, of there until his retirement in a chocolate factory working nearly a decade. Wong has the support of home care applied there about seven years ago, when his health began to deteriorate.
Help, Wan Ling He, washcloths Wong and her husband, the apartment clean and traditional Chinese soup prepared. Both women have developed a friendship, often speak in their native Cantonese cuisine fairs and cooking. Wong called his help "an old friend."
Illinois now suggests about half of the elderly in their program on a new initiative to spend, he says, is the flexibility to increase and reduce costs. For example, you can go Uber doctors appointments instead pay a driver to send to nursing homes.
Lori B. Hendren, deputy director of public support and awareness of AARP Illinois, said the new proposal raises questions about the state's commitment to people independently and with dignity in aging house.
"If the money come from?" hendren said. "The devil is in the details."
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EDITOR'S NOTE - connected Alejandra Cancino long-term study of health issues and care as part of a 10-month scholarship AP-NORC Center for Public Affairs Research, the independent research and journalism AP NORC. The scholarship is funded by the SCAN Foundation.
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