No more cuts
Dear Governor Baker,
We are writing to urge you not to impose further 9c cuts to elderly home care.
On October 19, 2014, Governor Deval Patrick made a total of $2.37 million in 9c cuts to Elder Affairs line items, including $1.52 million to home care services. Protective services, congregate housing and meals programs were also cut.
In October of 2008, Governor Patrick chose to make a total of $15.511 million in 9c cuts to the Executive Office of Elder Affairs (ELD) line items (9110 accounts). The accounts lost 5.3% in overall funding. The impact of these cuts are still felt today in the ELD accounts, seven budget years later.
Among the programs hardest hit were the home care purchased services item, and home care case management, which lost $6.77 million. As the chart below demonstrates, the home care line items never recovered from the 9C cuts of FY 2009. Funding in FY 2015 is roughly where it stood—or lower–than eight budgets ago in FY 2007:
Home care purchased services (top), care management and agency costs (bottom)
Previous 9c cuts have not only affected the 28,200 elders in this program, it has resulted in lower CHIA rates for this program, since Chapter 257 rates are based largely on restrained historic levels of funding. It has also pushed up caseloads to over 100 per worker at some agencies, and depressed salary levels.
At the same time, the home care accounts have had a significant positive financial impact on the state’s bottom line by reducing spending in nursing facility appropriations. Home and community based services have dramatically changed nursing facility use by MassHealth:
Between FY 2000 and FY 2014, the number of nursing home patient days paid for by MassHealth fell by 4,500,000 days (-34.4%). In FY 15, the median cost of a MassHealth SNF patient day is $189.64. The costs avoided from 4.5 million fewer patient days is $853.38 million. This “home care dividend” is a smart investment, which provides the state with an immediate ROI: when we keep an elder out of a MassHealth nursing facility bed today, that same day we provide them with care in the community for less than half the cost. Home care spending also attracts more federal FFP bonuses from CMS.
For all the above reasons, we ask you not to impose further 9c cuts to the home care accounts. Our elderly clients have already paid a significant price for 9c cuts over the past seven years.
Mass Home Care
Michael E. Festa
Mass Councils on Aging
Mass Senior Action Council
Of Older Americans
Home Care Aide Council