My Life, My Choice Campaign Tells House Hearing Homecare is Preference of Seniors, Costs One-Third as Much as Nursing Homes

HARRISBURG — At a hearing chaired today by State Representative Todd Eachus, a spokesperson for the My Life, My Choice campaign said Pennsylvania needs to join states like Washington, Oregon, Massachusetts, Michigan, California and Wisconsin in creating a state solution for quality homecare and to “do it as quickly as possible.

“It just makes sense,” Kathy Lind, a retired Registered Nurse told the hearing. “Homecare costs about a third what nursing home care costs, and with a large and growing elderly population, Pennsylvania needs desperately to expand capacity to care for them.  By making this a priority, Pennsylvania will not only provide seniors a choice, it will help to increase and improve the homecare workforce, ensuring that seniors who wish to stay at home can find qualified caregivers.”

Lind explained that the My Life, My Choice campaign is a project of Pennsylvania AARP, the Center for Advocacy of the Rights and Interests of the Elderly – or CARIE – and SEIU Healthcare Pennsylvania, who together represent about 2 million Pennsylvanians with a shared interest in seeing that seniors have satisfying and dignified lives.

“Like everybody else, seniors want to live with dignity in our communities,” Lind said. “And we want control over essential and intimate aspects of our lives. For that reason, today’s seniors and their families have an overwhelming preference for receiving care in their homes, and we also want to control our care, by being able to choose our own caregivers, deciding when the caregiver does or doesn’t come to our homes, and tailoring services to meet our needs and preferences.”

Lind said that by setting up a state program similar to those in Oregon and across the country, Pennsylvania will connect seniors with qualified, well-trained caregivers, allowing seniors to choose workers who speak their language, who accommodate their schedule, or who they are most comfortable with in their home. The Commission will also establish and monitor standards of performance and care and act as a centralized information center and as a source of back-up workers. Through the My Life, My Choice campaign, seniors hope to persuade elected leaders to make home care -- and the benefits that come from a well-trained and sustainable homecare workforce -- a central part of our state’s long term care system. My Life, My Choice volunteers are criss-crossing the state, actively lobbying county councilors and commissioners, calling on newspaper editorial boards for support, visiting senior centers and asking seniors to sign cards indicating their support for a state solution for quality homecare.  Lind told the hearing:

“It is no secret that as baby boomers retire and age, the demand for long-term care services will surge. By 2020, almost 20 percent of Pennsylvanians will be over 65, representing an increase of nearly half a million seniors since the 2000 census. The over-85 population – the group most likely to need long-term care -- will have increased by 52 percent. Over the next thirty years, the number of older adults with disabilities will more than double, increasing from about 10 million to about 21 million.

“And if these numbers aren’t sufficiently sobering, experts tell us that each boomer will need, on average, more hours of paid care than seniors in the past. Increasing divorce rates, declining family size and more women in the workforce mean that aging boomers cannot rely on “eldest daughter caregiving” as frequently as could their predecessors. Demographers predict that by 2040 there will be only about 9 adults between the ages 25 to 64 to support each disabled older adult, down from about 15 younger adults currently, and fewer of these will be available to give family care. Thus paid hours of help per frail adult is projected to increase from today’s 163 hours per month to 221 hours in 2040. Multiply this by the number of boomers coming into the system and the total number of needed paid care hours will triple for this group of seniors.”

Lind said that the State’s reliance on nursing homes is expensive, costing nearly $60,000 per year per resident, and that homecare would cost about one-third that amount. She said seniors overwhelmingly would choose homecare if it were available. “ More than 80,000 older Pennsylvanians are residents of nursing homes, putting our state fourth in the nation for nursing home use. At the start of 2005, 54,602 of these residents had their care funded through Medicaid. But Medicaid paid for only 13,231 seniors to receive care in their communities.

“So right now we spend a lot of money giving seniors what they don’t want. Would we save money if we realigned our system with seniors’ preferences? Absolutely On average, the annual cost of supporting a senior at home through the PDA Waiver is a third that of supporting her in a nursing home. What experts call “rebalancing” – changing our long term living system form one centered on nursing homes to one centered on seniors’ homes is a no brainer. We just need more homecare.

“I am sold on these Commissions. I recently had the opportunity to join a delegation of Pennsylvania caregivers and advocates who visited Oregon to see a balanced long term living system in operation and to visit Oregon’s Home Care Commission. Oregon’s commission was created about 8 years ago and is now a developed and integral part of their long term care system. It is governed by a board whose majority is homecare clients. Now that they have mastered the basic functions of training, screening, and registering workers, they have moved on to do things that really make consumer-directed care simple and safe. For instance, Oregon’s registry and referral system available by internet 24/7. They have training for seniors to help them to better manage their employees and to understand their rights and responsibilities. They are just now rolling out a drug free workplace initiative to make drug screening part of the caregiver qualification, and to help home caregivers to become and stay drug free.”

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