Long-Term Care: You Decide Where
By: Source: AARP.org Date Posted: 2006-10-23 12:32:18.545689-04:00
In early 2006, AARP Pennsylvania joined with other advocacy groups to encourage Pennsylvania to make home and community based services a more important part of the long-term care system in Pennsylvania. This Update provides information on developments that took place as a result of that effort, and describes the further need for advocacy on this important issue.
Background
Pennsylvania's state spending on long-term care is heavily weighted toward nursing homes—only a few states use as high a percentage of their funding for long-term care on skilled nursing facilities. Although Medicaid waiver programs for home and community based care do exist, a more innovative source of assistance for home and community based services is included in Pennsylvania's OPTIONS program, funded by the Pennsylvania lottery. This program assists individuals at income levels up to 300% above poverty with a portion of the costs of home and community based care on a sliding cost-share basis. Equally as important, there is a not a requirement for individuals to be nursing home-eligible in order to participate in the program.
The OPTIONS program competes for funding with other lottery-funded services, including free and reduced cost transportation, property tax/rent rebate assistance, and the largest expense, Pennsylvania's pharmaceutical assistance programs, PACE and PACENET. A source of savings to the lottery fund was realized this year, however, when legislation coordinating PACE and PACENET with the federal Medicare Part D program was enacted. State officials estimate that the annual savings to the lottery fund as a result of this action will approach $170 million annually.
2006-07 Budget Negotiations
AARP and other advocacy groups made a strong case to the Governor and General Assembly that these savings to the lottery program should be invested in other programs funded by the lottery. The OPTIONS program, with its potential to increase the number of Pennsylvanians receiving home and community based services, was AARP's first choice to receive additional funding. But the Governor chose not to take this approach, and submitted a budget to the General Assembly which placed the entire amount of the savings into the Medicaid budget, with the savings dedicated to long-term care. Despite the efforts of AARP and the other advocacy groups, which included thousands of telephone calls to legislative offices, the General Assembly went along with the Governor's suggestion. In essence, lottery funds replaced $170 million of General funds in the Medicaid budget. That money was spent elsewhere in the budget.
Next Steps
Although the effort to direct these savings to home and community based services in the 2006-07 budget was unsuccessful, there is the possibility that this decision could be reversed in future budgets, as Pennsylvania will continue to save approximately $170 million each year because of the coordination of PACE and PACENET with Medicare. AARP has already written to the Governor and members of the General Assembly to express our disappointment at the outcome of this year's budget and restate our desire that the savings should go toward lottery-funded programs instead of the Medicaid budget. AARP feels Pennsylvania's long-term care system must undergo dramatic changes, and increasing funding for the innovative home and community based care program that is part of the OPTIONS program is one place to start.
Pennsylvanians want affordable choices in long-term care services. They do not want to go to a nursing home until failing health may necessitate such a drastic step. Pennsylvania taxpayers deserve a cost-effective, efficient long-term care system. Also, Pennsylvania lottery players should know that lottery proceeds are going where they are intended—for programs that help older Pennsylvanians. We must insist our elected officials follow these guidelines as they address the long-term care issue.
If you agree, here are a few steps you can take:
- Call the Governor on his hotline at 1-800-932-0784.
- Call your members of the General Assembly on AARP ' s legislative hotline at 1-800-515-8134.
- Ask candidates for Governor and the General Assembly about this issue at community events.
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