As reported by the Associated Press, January 12, 2008.

UConn Reports on Care for Aged

In-Home Services Seen As Crucial

By Stephanie Reitz

Many Connecticut residents hope to stay in their homes as they age rather than move to nursing facilities, but they underestimate the cost of services and overestimate how much insurance and government programs will cover, according to a new report.

Compiled by the Center on Aging at the University of Connecticut Health Center, the report is the state's first overview of long-term care issues in more than 20 years. The findings are part of a broader assessment being presented Wednesday to legislators.

Some lawmakers and advocates for the elderly say Connecticut must prepare by putting more dollars toward in-home and community long-term care services, shifting away from its heavy emphasis on institutional-style facilities that currently get the lion's share of Medicaid funding.

The General Assembly commissioned the report to help lawmakers and state budget officials anticipate demand in the coming decades and decide how to allocate government funds to give people more say in where they live as they age.

Long-term care is defined as services for people of all ages with chronic illnesses or disabilities. They range from help with basic activities such as shopping and cleaning house to around-the-clock, intensive medical care.

About 188,000 state residents currently need long-term care, but that is expected to reach at least 240,000 by 2030 as baby boomers become elderly and need more services, the report concludes.

Julie Evans Starr, executive director of the Connecticut Commission on Aging, said Medicaid covers some in-home and community services, but only for people whose disabilities or special circumstances qualify them for limited, specific programs.

The majority of people seeking in-home services so they can avoid nursing homes do not qualify for those programs or, in many cases, do not know they exist, she said.

"What we're pushing for is a system that respects people's wishes and choices, and one in which a person's location and services aren't dictated by arbitrary restrictions or the funding stream," she said.

About 32 percent of Connecticut's Medicaid spending goes to home and community-based services, placing it 26th among the states and close to the U.S. average.

Advocates for the elderly say that percentage is too low, and that some people who could stay at home with appropriate services may end up in more expensive nursing facilities simply because that is what Medicaid will pay for.

"The reality is that most people see a nursing home as a last resort and don't want to go there if there's any way to stay in their homes," said state Sen. Paul Doyle, D-Wethersfield, co-chairman of the legislature's Select Committee on Aging.

"It's a win-win for the state if we can keep people out of nursing homes for as long as possible," he said. "That care is more expensive, and that's not usually the option that people want for themselves."

Some Connecticut officials want the state to emulate Oregon, which spends about 70 percent of its Medicaid dollars on home and community-based programs.