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Advocates decry cuts to Indiana home health program

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Advocates say a decision by Indiana's human services agency to cut a home health care program for aged and disabled people will cost the state about $4 for each $1 the belt-tightening saves.

The Indiana Family and Social Services told Area Agencies on Aging that a 15-percent cut in funding for the program known as CHOICE will take effect with the start of the new state fiscal year on July 1, saving about $7.3 million from the program's $48.8 million annual budget.

But representatives of the Indiana Home Care Task Force, United Senior Action of Indiana, the Indiana Alliance for Retired Americans and the Generations Project said the loss of CHOICE services such as physical therapy, medication setup and transportation will force people into nursing homes at a cost about 11 times higher than in-home services.

"Home health care is the least expensive option, by far," said Jim Wallihan, president of USA-Indiana.

CHOICE stands for the Community and Home Options to Institutional Care for the Elderly and Disabled. The state-funded program served 9,225 people last year. It serves a wide range of people, but a typical recipient is a woman age 85 or older living alone who has circulation, muscle or nerve problems, or a combination of them, according to an FSSA report.

FSSA spokesman Marcus Barlow said most state programs have been cut during the current economic turndown, allowing Indiana to avoid running up deficits or raising taxes. He also said not every person on CHOICE qualifies for nursing home care.

If Indiana cut its current nursing home population of about 28,000 people in half it would save $800 million in costs to Medicaid, the state-federal health care program for the needy and disabled for which FSSA bears about 37 percent of costs. Those people could instead be served by the less expensive in-home care, advocates claim.

Wallihan termed the potential savings "an opportunity right under our nose."

June Holt successfully sued the state to get it to pay for in-home care for her son, Joe, now 30, after he suffered a brain tumor. He had spent two years in nursing homes where he received limited services and gained little independence.

"They never came into his room to teach him how to get in and out of bed. They never tried to teach him how to use the toilet," said Holt, an outreach and education coordinator for the Generations Project.

With in-home services, Joe Holt now lives in an Indianapolis apartment, she said.

Scott Tittle, president of the Indiana Health Care Association, issued a statement saying the nursing home industry group supports home- and community-based care where appropriate.

Since CHOICE is not an entitlement program, it has a waiting list that has grown by about half to about 3,200 names in recent years, the advocates said.

The 2009 CHOICE annual report showed the average monthly cost for services was $424, compared to $4,576 per month for nursing homes. Since the state paid 37 percent of Medicaid, its share of that nursing home bill came to $1,693, or about four times what it would cost CHOICE.

For the full year, the average CHOICE recipient cost the state $5,086, compared to $54,911 for Medicaid-funded nursing home care. CHOICE saved the state $18,470 per person last year and the federal government $31,355, according to the report by FSSA's Division of Aging.

FSSA spokesman Barlow said the agency didn't cut CHOICE during this current state fiscal year but held back about $2 million in funding that will be released on July 1.

"We're seeing reductions in funding all over state government, so this really shouldn't come as a surprise to anyone," he said. "We're not in the red like almost every state."

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  • Save The Limo Drivers
    Limo Divers Protest Medicare Mediciad Reform Cuts, It's rumored this issue could become part of the Tea Party movement. AmeriChoice Health also rumored to take a position on this issue. Recirculate those tax dollars? Help keep limo drivers working, benefits flowing and overpaid tax dollars remain in abuse.

    Medicare.gov as well as other Federal agency's encourage you to report any fraudulent activities, yet, the same government agency's were notified the way this company does business yet did nothing. Three years ago they were reported to these Federal agency's and as of todays date not only were they allowed to continue doing business but were never charged once. Protected vendor status sure, politics sure, limited government budgets sure, Federal and State officals looking the other way sure, and rather then stop these activities a strong desire not to rock the boat previals. Even with the vast changes in the laws, budgets,a hands off policy remains, you tell me what's wrong with this picture?

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    Hey, it's your tax dollars don't complain now.. then don't complain later onâ?¦

    psâ?¦ I know times are tough for a lot us, but it would be great to have a free limo to go to the Doctors, Pharmacy, Movies, Grocery shopping, and given free tickets for the movies. Offered soda, pop corn and hotdogs, as well as have them receive free coupons for Grocery itemsâ?¦Kind of makes you wish qualified for Medicare and Mediciad right?

    For three years now, a woman has left her home in Poughkeepsie, New York, five days a week and taken a taxi to visit her child at St. Margaretâ??s Center, a nursing home for disabled children in Albany, New York. Each night, she rides home by taxi. That costs $300 a day. What dedication by taxpayers. That is right. Taxpayers have shelled out $196,000 over the past three years so that she can make this Poughkeepsie-Albany commute each day. Incredibly, state health officials defended this daily abuse of taxpayers. Could not the woman move to Albany? It would have been cheaper to buy her a Cadillac Escalade and have her drive herself. But under Medicaidâ??s incomprehensibly illogical rules, taxpayers had to give this woman a whopping $65,000 subsidy. We underpay doctors by 20% or more. But one â?? likely two â?? cab drivers have a gravy train going there. For New York state, the bill comes to $98,000 â?? with federal taxpayers shelling out another $98,000.

    Oh and this happens all over the place. Ambulances in Southern West Virginia became taxis as they shuttled people off to the drug store and the like â?? and then billed Medicaid. New York state Comptroller Thomas P. DiNapoli said the $196,000 taxi drive was part of at least $169 million in misspent funds. â??We found the state Medicaid system is leaking millions of dollars,â?? DiNapoli told the Albany Times-Union. â??Safeguards designed to protect the taxpayers by detecting waste, fraud and abuse keep failing.â?? Taxpayers finance $196,000 ride By CATHLEEN F. CROWLEY Staff Writer Published: 01:00 a.m., Wednesday, December 23, 2009
  • Ditch Daniels
    It is a shame the Mitch Daniels is withholding the $2M from this program just to make his book looks good. My husband is a quadriplegic and because he works, they are putting pressure on us to take us out from Choice. It seems better if he doesn't work because if he does, every penny that we earn goes to pay for attendant care. Even though, we just made enough to made ends meet and have completely no money for retirement, vacation and extra stuff. We just want to pay all our bills including medical bills and debts. So if Choice is taken away, we will be even more in debts and to help us be on Choice, my husband has to consider stop working. This is ridiculous!!
  • Choice?
    The two people killed in the car accident by a quadriplegic had no CHOICE.
  • SAVE CHOICE
    Hi, my name is Angie Monahan. I am a 38 year old wife and mother. I also happen to be a quadriplegic after suffering a severe stroke 14 years ago during childbirth. I always felt so fortunate blessed to live in a state that provided CHOICE, which provides in-home care so that I can live a normal life at home with my husband and my son.

    I have been on the CHOICE program since 1998 and I depend on this service to get me up and out of bed each morning. My caregivers shower me, dress me, help me go to the bathroom, prepare meals, help me take medications, and help me with light housekeeping. Their compassion, reliability, and dedication make me feel safe, give me quality of life, and fills me with hope everyday.

    I am only 38 years old; if I don't have this service I will have to go into a nursing home...please don't let that happen! It is hard for people to understand the desperation of this service until you (GOD FORBID)need it yourself. Please, please help me save this program...too many people rely on CHOICE. What can we do?
  • Gov's values
    It is a real shame, when the Governor would rather spend $700 Million of taxpayer dollars to build a useless highway (I-69) than provide care for those most in need. We have seen this with almost any support for the welfare and needs of the state, be it in health care, education, law enforcement, and the list goes on. The Governor took $700 million when he sold the toll road and set is aside to build a new terrain I-69 across the south west part of the state. Breaking many families and their farms apart, only to build something we already have plenty of, roads, but we can't maintain them.

    What a shame. When will our lawmakers step up and pull those dollars from the Governor and INDOT, and place the money where it is desparately needed?
  • Daniels rationing health care
    Cutting the CHOICE program means Mitch Daniels is rationing health case. The old and infirm will either stop receiving care they need or they will have to give up their homes so that Mitch can save a few bucks. When will people start to protest that Mitch's cuts affect real people and that the state has obligations that must be met even if it means going into debt or raising taxes. People will die and Mitch's primary concern is bragging about a balanced budget.

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