News

April 1, 2011 - Advocates Seek More Funding for Long Term In-Home Care

by: Katrina Goggins | from: AARP Bulletin

Tom Clark can still remember the day he received the phone call from his mother.
Jersey Clark, of Columbia, was in a nursing home recovering from a fall when she demanded to return to her home. No one was selling her house and putting her in a nursing home, she insisted.Eventually, she got her way. But she couldn't live at home without assistance. The family was able to use savings and some federal aid to pay for the home-based care she required, including around-the-clock assistance, meal preparation, light cleaning and companionship. When Clark's mother died in May 2009 at age 93, he felt it was on her terms. "She was like, 'Hell, no. You couldn't blast me out of my house with dynamite,' " Clark said. "Those were her wishes and, by God, I was going to honor her wishes."

Like Clark's mother, most South Carolinians prefer to age in their own homes, an AARP survey has found. But the expense of the needed in-home services are out of reach for many, advocates for increased funding for home- and community-based services say."I've never met a person who said they preferred a semiprivate institutional room," said Johnny Belissary, president of the South Carolina Association of Personal Care Providers. "Budgets are tight, funds are being cut. And many states have looked at home- and community-based care as a way to stretch Medicaid dollars."

It costs the Medicaid program about $32 a day for home-based care compared with $127 a day for nursing homes. The state spends nearly $500 million annually for nursing home care, but about $142 million for home and community care. "And, for that, we serve more people," said Teresa Arnold, AARP South Carolina associate state director. Nearly 11,800 are in Community Choices, while around 11,500 are in nursing homes. Nursing homes provide around-the-clock skilled nursing care. Providing more money for home- and community-based care would duplicate services, nursing home advocates say.

"There is a need for a continuum of care, and those who believe otherwise are shortsighted and ill informed," said Randy Lee, president of the South Carolina Health Care Association, which represents the state's nursing homes. "Each aspect of the long-term continuum of care has its place. Each is cost-efficient at providing services at that level." Spending for institutionalized care is federally mandated, while it's optional for home- and community-based care. In tight budgetary times, state funds for those services are often cut.That's exactly what's happening in the Palmetto state, said Jeff Stensland, spokesman for the state Department of Health and Human Services.

Post Written By: Katrina Goggins

Post Source: AARP

February 24, 2011 - OPINION: Home-based care trumps nursing homes for efficiency


By John Belissary | Contributed
Published: January 23, 2011

Editor's note: The author serves as legal counsel and assistant administrator for New Generations Home Care and New Generations Adult Day Center.  He is currently president of the South Carolina Association of Personal Care Providers. 

In recent weeks, the South Carolina Department of Health and Human Services has been working with interested parties to explore ways to more efficiently manage our state's Medicaid program. The agency and work groups are specifically debating how to address the needs of a growing population of elderly and disabled with a dwindling revenue stream.

The agency and stakeholders agree the goals of all services should be to:

There is consistently one area of services that meets all these criteria – home and community-based services. Home and community-based services focus on programs to help individuals who want to live at home, need assistance with their care, and are financially eligible for Medicaid.  Under this option individuals can remain at home and avoid unnecessary or premature nursing home placement.  Services are available for persons age 18 years or older who are unable to perform activities of daily living such as bathing, dressing, and toileting due to illness or disability. In order to meet the qualifications to enroll into this waiver program, the individual must meet the same level of care that is needed to enter a nursing facility.

Services offered include assistance with general household activities, help with activities such as bathing, dressing, preparing meals, housekeeping, and observing health signs, companion services that provide short-term relief for caregivers and needed supervision of clients, home delivered meals, adult day health care (medically supervised care and services provided at a licensed day care center), transportation to and from the home for medical appointments, and temporary relief for the client's caregiver.

These options are cost efficient and provide services that have a higher return on investment.   Currently nursing homes account for slightly more than 43 percent of the state's long-term care expenditures which include home and community-based services, residential care and other waiver programs.  Communitychoices services cost on average of $32 per day while nursing homes cost $127 per day.  Nursing home patients are decreasing while costs are increasing. There are currently about 12,000 served by home and community-based services while there are about 10,500 served by nursing homes.

Home and community-based programs contribute in so many other ways to the stability of the family. Without these services, families would lose income because a family member would have to give up a job to take care of a loved one.  This can be a drain on family finances and take its toll on middle income families.  In most cases, it is the woman who gives up her career to take care of a love one; when the caregiver returns to work the earning potential is usually lower.  If we are going to continue to meet the needs of our elderly and disabled population, we need to use our state's monies in the most economical manner and the manner in which this population receives the best quality of life.  That is most definitely through home and community based services.

John Belissary
Florence

June 6, 2010 - New Generations Home Care Services

You may question if you or a loved one needs home care services.  New Generations Home Care, Inc. recognizes that this can be a difficult, and sometimes painful and frightening, decision.  Inherent in this decision is the fear of loss of autonomy, or independence.  However, home care more often than not proves to be a strong factor in improving, or at least maintaining, one's level of independence. 

Nevertheless, while recognizing that “someday” help may be needed for you to remain in your home,  determining when that someday actually comes may be a difficult decision.  But here are some indications that may help you with your decision.  You may be a candidate for home care services if:

  1. You realize that you are less able to care for yourself as you grow older
  2. You have a disability or a chronic illness
  3. You're recovering from an illness, surgery or a hospital stay
  4. You have a terminal illness.

Before you can make a decision about using home care, obviously you need to know how home care services can help you.  What levels of service are provided?  For those of you who need skilled medical monitoring, direct care and intervention so your medical needs may be met at home instead of having to be institutionalized, we can offer skilled nursing.  If you simply need a little help with normal daily activities and basic monitoring of your medical condition, a personal care aide (PCII) will meet your needs.  For those of you who need help in preserving a safe and clean environment, providing a break for caregivers and helping with personal care duties, a homemaker (PCI) is the best choice.  Companion or respite services provide short term or long term companionship for an exhausted caregiver either in a home or a hospital setting.  Often New Generations Home Care finds that a combination of these services is the most appropriate approach.  Our skilled office staff can determine the most cost-effective combination of services to meet your needs. 

 

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