Legislators: Embrace home care for elderly
Advice for Arkansas legislators: Never get old.
If you ask an old person, What's the worst thing about being old?, the answer may surprise you. It's not the nagging pains of arthritis or neuralgia. It's not the need for incontinence products or the forfeited driver's license. It's not the Post-it reminders all over the house, the pill-dispensing boxes in the kitchen, or the 5X magnifier next to the telephone. Rather, it's the loss of choices — when to rise and shine, what to wear, what to eat and when to eat it, and — at the top of the list — where to live.
Whoever said that when you reach old age, you suddenly don't care whether you continue to live in your beloved home, surrounded by neighbors you know in a community as comfortable as an old shoe, or whether you share a tiny room in a hospital-like setting with a total stranger? AARP tells us you do care. We older folk overwhelmingly want to stay in our own homes, "aging in place." So why isn't anyone listening? Why did the state of Arkansas hire The Stephen Group, a nationally recognized health care consultant, to tell us to stop pouring long-term care dollars into nursing homes if we aren't going to take its advice?
In its first report to the legislature, The Stephen Group pointed out that almost 70 percent of the state's long-term care spending is on nursing homes. Arkansas Medicaid paid private nursing homes $605 million in 2014 to care for an average of 11,544 residents per month. During the same timeframe, Medicaid spent $344 million to provide home and community-based services to 18,963 individuals per month, including 775 residing in assisted living facilities.
Clearly it is more cost-effective to give old people and people with disabilities what they want — more care options within their own communities. The Stephen Group says that reform of Arkansas's long-term care system must be driven by an overall commitment to shift funds from institutional settings into "the least restrictive setting" that became the law of the land with the 1999 Supreme Court Olmstead Decision.
But, as John Brummett said in his "Stuff and Nonsense" column on April 15, 2015, "that would alarm the nursing homes, the smart ones of which ought to quit spending money to buy judges or lobby the Legislature to cap damages or build more old-people warehouses, and instead spend that money to open home-health and community-based programs as components of a modern full-service company. Everyone else is adapting these days. So should the nursing homes."
Speaking before the legislature on behalf of the Arkansas Health Care Association on Sept. 16, 2015, association president Jim Cooper implied that the financial bottom line of nursing home owners outweighs the wishes of consumers because, "We have skin in the game." The packed audience of consumers, self-advocates and families of elderly relatives and people with disabilities visibly cringed at the suggestion that the financial viability of a failed business model was more important than their own future and that of the people they love.
Legislators who care about their parents and grandparents — and understand that they also will one day be old — can act now to give their family members and themselves down the line the peace of mind that comes from having choices. Rebalancing the long-term care system to equally fund institutional and home and community-based long-term care services will save Arkansas Medicaid a bundle while easing the minds of those of us who value our independence and hope to keep it as long as possible.
North Little Rock
From the web
In response to the March 4 Arkansas Blog post, "Auditor Lea caught not telling the truth":
It's amazing, isn't it, that the first thing officeholders do upon taking office is to try to figure out a way to get around the Arkansas Freedom of Information Act? My advice is to forget about it. You can't do it. Arkansas's FOIA is just about the best in the country.
This situation is disappointing, since Lea was previously one of the more intelligent GOP legislators. But now she is in a legitimate scandal.
I'll guess that she got some bad advice. She can redeem herself be throwing her bad advisor under the bus.
"As I've learned through my years of public service, transparency should be the foundation of any public office, and that would be my foundation if Arkansans elect me to be their next State Auditor." — andrealea.com.
One consequence of the GOP's rigid orthodoxy is that saying the right things is more important than competence.
Who needs an actual "auditor" who is honest and knows anything about finance when the primary qualification for office in Arkansas is opposing Obama's liberal agenda?
An auditor who makes side deals with attorneys in secret so they can't be audited is simply demonstrating freedom, I suppose.
Paying Top Dollar for Legislators
I'm not certain exactly where it is, but I think there may be an amendment to the Arkansas constitution that specifically exempts elected Teapublibans from telling the truth or acting in an ethical manner. Couldn't some of those researchers you have on staff help find that for us?
Her offered excuse is that she could not access her state account from home (dubious, to start with). But if that were the issue, then why direct her employees to send from a personal account? Why not simply send to her normally with a copy to her personal email? (Yes, the questions are rhetorical.)
People make mistakes, but this was no mistake. This was a concerted effort to create a communications channel among a constitutional office entrusted to honestly and fairly oversee the state's business. It is clear now that Lea is more concerned about concealing what they're doing than being open and transparent in the conduct of the office. She's sorry now that she's been caught. The honorable thing would be to resign. Lea can never again be trusted.