Keeping them home

October 23, 2005

When elderly parents become so ill and infirm that they can't care for themselves, what son or daughter doesn't hope for an affordable vacancy in the best nursing home around? But until that day, as family members slow down, become disabled or suffer from chronic illness, they should be able to remain at home with help. How many have heard the plea from a hospitalized relative, "I just want to go home"? The state wants to allow more disabled citizens and sick elderly to get care at home by convincing the federal government that its Medicaid dollars would be better spent in the community. It's the right way to go, and the Ehrlich administration deserves credit for pursuing it.

The state is seeking a waiver of Medicaid program rules to expand a successful project that serves about 400 disabled people and 2,800 elderly and keeps them at home longer. Maryland pays about $60,000 a year for nursing home care for a Medicaid patient. It can cost several thousand dollars less to keep that same patient at home by providing a personal aide, a stipend for a family caregiver and specialized equipment.

To ensure that at-home patients receive the medical assistance they need, newly created HMO-like firms would be paid a fee to oversee their care under the state's proposed CommunityChoice program. The savings in dollars can be significant. But the real bonus is the well-being of those able to maintain some semblance of independence at home.

Maryland's nursing home costs under Medicaid have doubled in the past decade. And with health care costs increasing and baby boomers aging into senior citizens, Medicaid expenses most certainly will rise. CommunityChoice seeks to deal efficiently and humanely with those future costs.

Officials caution that any savings probably won't be realized until after five years, but that shouldn't deter federal officials from granting the state's waiver of Medicaid rules so it can move ahead.

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