Good news! There is hope that caregivers in the Adult Foster Care program may eventually be recognized as the asset they are. Several sections of the Massachusetts Medicaid Policy Institute's report indicate that MassHealth and the State legislature may be at last "getting it" even if not for the more honorable reason.
Rebalance Long-Term Care
Improvements in long-term care can forestall institutionalization, increase patient satisfaction and provide lower cost options for many.
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Historically, the most significant component of the cost of long-term care has been institutional long term care. In State FY 2006, Medicaid spent 24 percent of its funds on nursing homes and other long-term care institutions versus 12 percent for all community based long term care services combined. (* footnote * …. "Community-based long-term care" includes MassHealth spending for: …., Adult Foster Care, ….)
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The challenge for Massachusetts is to create a system that provides needed long-term supports in appropriate settings, with an emphasis on preventing or delaying admissions to institutions, while living within the resource constraints of the state budget.
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MassHealth members using long-term supports do not have homogeneous needs.
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Placing greater emphasis on HCBS will also require addressing workforce shortage issues, including possibly increasing reliance on family caregivers. The state will need to work out the extent to which it is willing to pay for what may now be unpaid family labor.
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It is likely that the state will also have to address wage and benefit issues for community long term care workers in order to attract and retain an adequate workforce.
Although "lower costs" is usually not the most emphasized benefit, be assured that the "constraints of the state budget" sadly take precedence over the health and welfare of those insured.
So what's the problem? It shouldn't take an Einstein to realize that investing in programs such as AFC will undoubtedly save the State thousands if not millions of dollars. So why has MassHealth treated AFC caregivers so abysmally? Not many people can make the decision to accept the impoverishment that being an AFC caregiver now entails.
Hopefully this blog's subsequent AFC posts will chronicle true progress, and prove that MassHealth will finally treat caregivers with respect and appreciation, and be willing to work with them rather than exploit their good-nature.
A link to the informative "The Outlook for Medicaid in Massachusetts, March 2007" can be found at A Healthy Blog – New Report on MassHealth
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