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Budget Shift Lets More Residents Receive Long-term Care at Home

Home- and community-based care gets a boost

AARP legislative victory that establishes financial parity between nursing home and home- and community-based care in the state's Medicaid budget, woman at home getting care.

Photo by David Joel/Getty Images

Nearly 13,000 Ohioans will be able to receive care at home instead of in a nursing facility as a result of budget changes approved this year by the state legislature.

Ohio is pumping more money into home- and community-based care over the next two years, a move that pushes the state closer to equalized spending with nursing home care.

The biennial budget passed earlier this summer included $532 million above current spending on Medicaid home- and community-based services. Since July, that's meant more money for Medicaid programs that pay for services to help people stay in their homes longer.

See also: Resources for caregivers.

The state says the additional money will shift spending for home and community services from about 36 percent of the long-term care budget to just over 42 percent by the middle of 2013, with the balance going to institutional care. Nursing home care costs three to four times as much as in-home care.

Gov. John Kasich, R, championed the changes. He said they reflect what older Ohioans want: to stay in their homes as long as possible.

"Older Ohioans deserve respect and independence and comfort and health," Kasich told the AARP Bulletin. "If we can help provide that kind of care, it not only saves money for your children and grandchildren — who are taxpayers also — but you or your parents are going to be happier and more comfortable."

Nearly 13,000 more Ohioans — older people and those with disabilities — will be able to receive home care thanks to the additional money for services. People qualify if their income is low enough to be Medicaid-eligible and if they require the level of care provided in a nursing home.

People 60 and older will see the greatest impact through the state's PASSPORT program, which provides in-home help with services from bathing and dressing to transportation and some medical checks.

Agencies are gearing up to enroll an additional 4,800 people 60 and older in the program over the next two years, said Larke Recchie, executive director of the Ohio Association of Area Agencies on Aging.

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The state's commitment to open enrollment sends a message that the program is a reliable alternative, Recchie said, adding that's important for decision makers dealing with crisis situations.

"Many families are not aware that someone can have some level of disability and still do quite well at home with the right level of support," said Laurie Petrie, communications director for the Council on Aging of Southwestern Ohio.

All 12 of Ohio's Area Agencies on Aging offer free, in-home assessments and individualized care plans. To learn more, call your local agency or 1-866-243-5678, toll-free.

Nurses and social workers know what questions to ask and what signs to look for that indicate a person needs some in-home assistance, Petrie said.

The changes are welcome news for AARP, which has pushed for this kind of restructuring for more than 15 years, said Bill Sundermeyer, AARP Ohio advocacy director.

"Approving a budget with more money for home-based care shows a commitment from the governor and the legislature to provide access to those who want to live at home and don't want to be in a nursing home," he said.

The timing is right, he said. Between now and 2040, Ohio's population needing long-term care is projected to more than double.

As more people need long-term services, Sundermeyer said, the state can spread its money further by using less costly alternatives and an approach people say they want.

Nine out of 10 AARP members polled for a 2011 survey said it was extremely or very important to have services that will allow them to stay in their homes as long as possible.

"Having a system that's moving in a direction to reflect that desire is very, very important and very, very valuable," he said. More than 1.6 million Ohio residents provide unpaid care for aging relatives, according to a 2009 study by the AARP Public Policy Institute.

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Sarah Hollander is a writer living in Cleveland.