State slow to move to money-saving home health care

Indiana taxpayers are paying about $300 million a year in nursing home costs despite a state law that would allow the state to save millions while keeping many elderly and disabled Hoosiers in their homes or with family members.

The law passed eight years ago called for the state to pump money into home health-care services each year. The expectation was that more people would use the services to stay at home and that the number of residents in nursing homes would decline.

But the state has not committed to making the transition even though the two major home-care programs both have nearly 6,000-person waiting lists and 18 percent of the state's nursing home beds sit empty, The Indianapolis Star reported.

"We pat ourselves on the back that we managed to save this much money by not spending it on home health care, but what we have to remember is you're expending dollars to keep someone out of a nursing home, (and) that's what really busts the budget," said Sen. John Broden, D-South Bend, who worked on the 2003 law.

"Our constituents want it; it's what they prefer. And then when you couple that with the fact that it is cheaper, it is a constant struggle for me to ascertain why we don't embrace it," he said.

The Star found that Indiana pays nursing home costs for more than 28,000 elderly and disabled Hoosiers. If 10 percent of those patients had been shifted to home health care, the newspaper reported, the state would be saving from $4.8 million to $13.6 million this year.

Critics blame the nursing home industry's powerful lobbying and say the state needs to do better.

"There's not much of an excuse," said Ellen Miller, director of the University of Indianapolis Center for Aging & Community.

Currently, about 75 percent of Indiana's long-term care budget is devoted to nursing home care.

Wisconsin has reduced its nursing home rate to 41 percent and Washington state, which began shifting funds to home and community-based care 16 years ago, has lowered its rate to 33 percent.

Washington state saved $109 million in the first two years, said Kathy Leitch, who served as assistant secretary of the state's Aging and Disability Services Administration from 2000 to 2010.

Indiana officials say they've increased the number of people in home health care by about 6,000 from 2004 to 2010 even though they haven't used the 2003 law. That's been accomplished in part with federal stimulus money, The Star reported.

"We have really grown home- and community-based services," said Marcus Barlow, a spokesman for the Family and Social Services Administration.

But Indiana has not increased the amount of money it puts into the two key home-care programs since 2003, and the stimulus money is running out.

One of those programs, the state-run Community and Home Options to Institutional Care for the Elderly and Disabled program, or CHOICE, received $28.6 million this year, a $7 million cut from the year before. That could fall further under the budget lawmakers are considering.

One family says such cuts and wait times have forced them to look at traditional nursing homes.

Susie Dennis said she and her 14-year-old daughter, Marisol, have spent a year providing around-the-clock care to Susie's husband, Dennis, who suffers from Huntington's disease. They've been on a waiting list for 40 hours of care a week but still haven't heard back, and now they're looking at nursing homes.

"It just takes a lot out of you," Susie Dennis said. "Had we had the care over the last year . . . who knows how long he could have stayed at home."