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Published: 2/6/2007

Study: In-home care for elderly saves state cash

BY JIM PROVANCE
BLADE COLUMBUS BUREAU

COLUMBUS - A study released yesterday suggests Ohio taxpayers could save hundreds of millions of dollars by caring for more of its elderly and disabled at home rather than in nursing homes.

The study, commissioned by the home-health-care industry, renews the tug-of-war over $5 billion in annual Medicaid spending on long-term care that occurs before passage of each two-year state budget.

"We see it as a win-win situation. We are able to provide assistance for the care that [patients] want in a manner in which they would like to receive it, and also save the state millions of dollars," said Kathleen Anderson, executive director of the Ohio Council for Home Care. The trade association represents about 350 home-care agencies.

According to the study, it costs $11,800 a year to care for a person at home compared to $56,000 in a nursing home.

Roughly 3,000 Ohioans are on waiting lists for home care.

The study estimates that if 70 percent of the 45,510 new people expected to need Medicaid-funded, long-term care between now and 2030 were to receive care at home or in community settings instead of nursing homes, the state could save as much as $898 million a year.

Ohio ranked 49th in the nation in 2005, ahead of only Mississippi, in terms of the percentage of its Medicaid long-term care budget spent on in-home care, according to the study conducted by the Columbus research firm of Levin, Driscoll & Fleeter. Ohio spent 23.6 percent of its long-term care budget on home care. The national average was 39.1 percent.

"This is not an attack on nursing homes," said Howard Fleeter, the study's co-author. "What we're saying is we don't think that Ohio can afford to keep doing what we're doing right now." Another of the study's co-authors, Richard Levin, recently became Gov. Ted Strickland's tax commissioner.

The Ohio Department of Job and Family Services said roughly 64,000 Ohioans are in either nursing homes or intermediate care facilities while 62,000 have taken advantage of community-based or home-care programs.

Ohio has been slowly increasing the number of people it cares for at home via its Passport program and a pilot assisted-living program. But despite the slow growth, Ohio fell from 48th to 49th because Michigan increased the home-care slice of its long-term-care pie from 20.5 percent to 32.1 percent in 2005, leaping from 49th to 37th.

Peter Van Runkle, executive director of the nursing homes' Ohio Health Care Association, said there's room for both.

"There's going to be nothing but growth in the ranks of the elderly and disabled," he said. "But if they are suggesting that we cut rates for nursing homes, we have to remember that people in nursing homes need care too. We can't move them all out."

Home-care providers also want increases in their rates in order to recruit and keep nurses.

"We have not seen an increase in reimbursements since 1997," said Felicia Evans, director of Deaconess HomeCare in Perrysburg, which provides in-home medical care for 40 youths ranging from 6 months to 22 years old.

"I have nurses that we hired on in 1999 at $15 to $16 [an hour]," she said. "Now it's 2007, and they have not had an increase in their rate of pay."

Contact Jim Provance at:

jprovance@theblade.com

or 614-221-0496.



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