WASHINGTON – The number of beds in assisted-living facilities in Maryland will double in the next 10 to 15 years as the state’s population ages, Maryland officials told the Senate Subcommittee on Aging Wednesday.
But Maryland’s growing senior population could live longer on its own, the witnesses said, if more money for home-based care services was made available under the Older Americans Act.
“If I had my druthers, I would like to see Congress pour half a billion dollars into local, home-based services,” said William Bechill, chairman of Maryland’s Commission on Aging.
He said new money would help area agencies on aging across the nation serve seniors struggling to stay independent. Home-based care typically includes help with daily basics such as bathing, meal preparation and monitoring medication.
But the Maryland Department of Aging said that 1,445 seniors were on waiting lists for such state-funded, home-based care services at the end of 1998.
In Baltimore City alone, 420 seniors are currently waiting an average of 12 to 18 months for help at home, said Neetu Dhawan-Gray, the executive director of the city’s Commission on Aging and Retirement Education.
“My fear is that people now go to work, lock the door … and say, ‘Is Mom going to be OK until I get home?'” Dhawan-Gray said after the hearing.
Bechill said after the hearing that investing in home-care can save Medicaid and Medicare money in the long run by reducing the number of seniors who go into nursing homes prematurely and by preventing injuries and illnesses that keep seniors returning to hospitals.
The average monthly cost for Maryland seniors receiving home-based care through the state’s Senior Care program is $215, while a nursing home runs $3,000 to $4,000 a month and assisted-living facilities cost between $1,000 and $5,000 a month, according to Maryland’s Department on Aging.
Despite a public preference for home-based care, the National Association of Area Agencies on Aging said government policies are still biased toward institutionalization.
“Nursing home care is seen as a Medicaid entitlement, but funding for home-based care is an exception,” said Janice Jackson, executive director of the association.
“We need to reverse the institutional trend now, and reverse it fast,” Bechill said.
But the Health Facilities Association of Maryland said that it has not seen seniors going into nursing homes prematurely. In fact, Maryland nursing homes currently have a 10 percent vacancy rate, said Ann Rasenberger, the association’s vice president for regulatory affairs.
One reason for that, she said, is that seniors must be medically eligible for nursing home care before they can receive Medicaid funding.
Dianne Dorlester, executive director of the Maryland Assisted Living Association, said the state does not provide much funding until seniors are so sick that they need nursing home care and qualify for Medicaid.
“We want to see Maryland catch up in terms of funding for in-home and assisted-living, community based services,” Dorlester said.
She noted that 40 states currently allow Medicaid waivers that let the elderly choose between at-home, assisted-living and nursing home care. Maryland has a limited waiver program, serving fewer than 80 seniors, but lawmakers in Annapolis have proposed expanding the program.
Rasenberger said her association sees nursing homes as part of a continuum of care and supports funding for other options of elder care as well, including at-home or assisted-living services. While she also supports the Medicaid waiver bill, she said it is important that people will be willing — and able — to leave their homes or assisted- living facilities when they become sick enough to need nursing home care. -30-