Home Care Bill Signed

BOSTON - Thousands of Massachusetts senior citizens now have the option of home care instead of nursing home care under landmark ''equal choice'' legislation signed into law yesterday by Gov. Mitt Romney.

''This will provide opportunities for adults who overwhelmingly want to age gracefully in settings in which they are comfortable,'' Romney said. ''Until now, they have had far too few options.''

Al Norman, the executive director of Mass Home Care, called it ''an important civil rights milestone for the elderly and individuals with disabilities throughout Massachusetts.'' Mass Home Care is a senior citizen advocacy group that lobbied hard for the bill.

''This law says that people with disabilities are capable and worthy of participating in the full measure of community life,'' Norman said at the Statehouse bill signing.

The transition to home care would be gradual, but ultimately profound, Norman said. About 41,000 people receive home care now in Massachusetts, he said.

MassHealth, the state's Medicaid program for people living on low incomes, now spends $1.6 billion a year to care for 32,000 people in nursing homes. That represents about 70 percent of state's total nursing home residents.

Part of a trend

Even before Romney signed the bill yesterday, the trend toward home care already had begun, said David Ball, spokesman for a professional organization representing the nursing home industry.

Massachusetts nursing homes today house 5,000 fewer Medicaid-dependent residents than five years ago, Ball said. About 45,000 people live in the commonwealth's nursing homes.

The new law would allow greater flexibility to shift part of that Medicaid money to home care for personal care attendants, private duty nurses, adult day care, and medical transportation. Some states that have passed equal-choice laws now spend 50 percent of their long-term care budgets on home care, while Massachusetts currently spends 25 percent, Norman said.

The lawmakers who fought for the measure said it would save the state $134 million over the next five years because home care is less costly than nursing home care. It costs the state $52,000 per person for nursing home care, while home care can be half that amount, legislators said.

Community Choices

Elder Services of the Cape and Islands provides some level of at-home care to almost 1,600 Cape elders.

The basic home-care package is $244 a month, said Paul Wild of Elder Services. But 30 individuals receive $1,900 worth of services per month under a new state pilot program called Community Choices.

''It's nothing compared to $5,000 to $6,000 a month for nursing homes,'' Wild said. ''It's a significant savings for taxpayers.''

The new law also sets up a counseling process before people enter nursing homes, for both Medicaid recipients and private payers, to see whether home care would be more suitable.

The Romney administration is seeking a federal waiver that would expand Medicaid financial eligibility for long-term care, making another 4,000 people in the state immediately eligible for home care, Norman said.

The state wants to raise income eligibility limits from $816 per month to $1,715 per month, and asset limits from $2,000 to $10,000 to qualify for Medicaid.

Janet Sheehan of Centerville wishes Romney's legislation would help people in a broader range of income categories.

Sheehan's mother, Mercedes, moved into her home 12 years ago and relies on home health aides for care when Sheehan is at work during the day.

Her mother pays for most of her care out of her savings, Sheehan said. ''I think it would be helpful to have some sort of assistance for people in the middle income bracket.

''It's important for people to be home, be around their families,'' she said. ''We've modified the home in a way that's a good setup for us.''

Widespread support

The home care law had wide support in the state Legislature, though it was years in the making.

''Long-term care is one of the most serious issues senior citizens and their families face,'' Sen. Robert O'Leary, D-Barnstable, who represents the Cape and Islands District, said in a statement. ''This bill allows them to choose their setting of long-term care, including the option of staying at home.''

But some people need the type of round-the-clock care provided by nursing homes, Ball said.

It's important that they continue to be funded, he said. ''Nursing homes play a vital role.''