Secretary of Health Speaks on Needs of Maryland's Older Adults
By: Source: AARP.org Date Posted: 2004-02-02 10:31:10
AARP Maryland spoke with Secretary Nelson Sabatini of the Department of Health and Mental Hygiene to discuss the challenges of meeting the needs of older citizens. Secretary Sabatini shared his thoughts on "deinstitutionalization" of seniors in nursing homes, allowing them to stay home with their loved ones while still receiving the care they need.
"There are significant numbers of seniors in nursing homes who could have their needs met in the community with the quality of life being better and the costs being lower,'' Sabatini said.
But the plan must work with existing Medicaid programs to make sure no seniors are left with unmet needs. The Medicaid Waiver for Older Adults allows nursing home-eligible participants to receive services in home- and community-based settings. But Maryland has stringent guidelines for Medicaid participants seeking nursing home admission, which affects eligibility for some home- and community-based services. AARP has advocated easing this standard to allow more options for seniors.
"The issue is, to the extent that you relax that standard, you have to pay for it. We're facing a billion-dollar [state-wide] deficit. How can you add more costs?" posed Sabatini, referring to the 2005 fiscal year. "Believe me, I'm not trying to minimize the needs. I don't know how we can find the money unless we figure out a way to move people into a lower-cost setting.''
Sabatini sees cost-saving potential for community services, but points out that the transition must be done properly. He cited the mixed success of past deinstitutionalization efforts.
"When we deinstitutionalized the developmentally disabled population, we did it right," he said. "We had a bit of a different experience with the mentally ill population - we didn't have the community infrastructure. With the right kind of support, we can do that."
AARP Advocacy Representative Donna DeLeno noted, "It is a worthwhile endeavor to deinstitutionalize nursing home residents who want to be back in their communities, but there are different challenges for the developmentally disabled and the older adult population."
"What's more important for older adults is to prevent them from being institutionalized in the first place by providing more home- and community-based services," she added.
DeLeno pointed to studies showing significant cost savings by offering home- and community-based services.
"Keeping people in a community setting is a win-win situation," Sabatini said. "It enables them to stay in a more familiar environment while keeping costs down."
AARP will work with Sabatini this legislative session to support his goals to create effective home- and community-based care.
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