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The following editorial from LeadingAge PA President Ron Barth appeared in the Sept. 14 edition of the Patriot-News.The environment of Pennsylvania’s senior care has changed dramatically during the past few decades. What was once a landscape of strictly nursing home care has now branched out into a wide variety of more community-based settings that include continuing care retirement communities, senior housing facilities, assisted living residences, personal care homes and a broad range of services and care that can be delivered at home.
Today, more families are turning to home and community-based services to ensure their loved ones remain independent for as long as possible, allowing them to stay in their home or apartment or a homelike setting and around their families.However, our government fails to provide proper support for low-income persons who need these crucial senior services. That’s unfortunate because home and community-based services provides a wide variety of opportunities to protect the quality of life seniors expect to enjoy.Home and community-based services providers offer a broad range of services, from routine check-ins, vital sign monitoring and assistance with medications to assistance with activities of daily living such as help in dressing or toileting.Some services, such as home care, home health and housekeeping, are provided directly in the home while others, such as adult day services, are available at settings within the community.There are many not-for-profit organizations that provide home and community-based services. Not-for-profits place their focus on delivering high quality, innovative and compassionate care rather than emphasizing financial gain.A popular aspect of home and community-based services is the wide variety of choices presented to seniors to match their established lifestyles. We can and should provide the choice of home and community-based services to our seniors whose needs can be safely met in these settings when it costs less than caring for them in higher level care settings.This is not to say that 24-hour care in nursing facilities are never the right option. Individuals whose care needs require the constant presence of nurses, therapists and other highly trained health care professionals will still need these types of services, and these services also need funding for those with limited income.The problem is that choice doesn’t exist for all Pennsylvania seniors. In most areas, our senior care provider community has a multitude of options for families to consider if they are paying privately. However, low-income seniors relying on state funded services face a different reality.Unfortunately, costs continue to rise and state government support continues to stagnate. Since 2000-01, total spending in the Pennsylvania state budget has grown by almost 60%.In the same time frame, state funding for senior care and services — home and community-based services and nursing facility spending combined — has grown by only 6%, an average increase of 0.50% each year. This at a time when the population of Pennsylvanians over the age of 85 is growing 10 times faster than the rest of the population.Meanwhile, the costs of caring for our seniors continues to skyrocket, and private pay consumers and direct care staff foot the bill in the form of higher costs for services and lower wages, respectively.While LeadingAge PA recognizes the budget limitations government is facing not only this year but also in future years, it believes a long overdue systemic change is needed in the way Pennsylvania pays for senior services for those with limited means.LeadingAge PA would reduce the number of high-cost Medicaid nursing home stays by working to take a number of nursing facility beds off-line and replace them with lower-cost care in personal care homes, assisted living residences and, when possible, home and community-based services.By paying adequate rates for fewer nursing facility beds and expanding options for 24/7 care, this strategy could save taxpayers as much as $90 million a year. This savings would then be available to use for additional expansion of home and community-based services, something Pennsylvania’s low-income seniors need and deserve.Pennsylvania can, and should, do better for older Pennsylvanians. Programs to keep our loved ones out of high-cost care settings are available, but how much longer they’re available will depend on our lawmakers in Harrisburg and Gov. Tom Corbett. The same approach of cutting rates and crossing our fingers must end.