Governor John Kasich talked about his vision for care for the elderly in his State of the State speech last month.
“If your mom and dad want to stay at home instead of going into a nursing home, we should help make that happen," Kasich said. "You get what I’m saying? Mom and dad can stay at home. Instead of going into a nursing home, go and talk to your mom and dad about going in a nursing home sometime. You know what will happen if they can stay at home and get help? They’re going to be happier and more comfortable and taxpayers will save a bundle of money. This has been discussed for decades. It is time to get this done.”
But researchers at a Cleveland-based progressive-leaning think tank say his actual budget won’t do that. Susan Ackerman with the Center for Community Solutions says the budget actually makes deep cuts to the PASSPORT program, which is the in-home care program the state operates for adults over 60.
“The funding for PASSPORT is reducing by about 2%, but during the next two years, the caseload is going to grow by 14%," Ackerman says. "So what’s really going to happen is that money that’s available is going to be spread more thinly among more people.”
Ackerman says she’s very concerned about how people will be affected by cuts in personal care assistance, such as getting dressed, eating and bathing.
“We just feel that these are not services that people can go without and remain safely in their own homes," she says. "And what the real concern is that these cuts are actually going to end up sending more and more folks to higher intensity nursing homes.”
But that’s not the way the Kasich administration sees it. Greg Moody directs the Governor’s Office of Health Transformation, and he says while the state would rather see people stay in their homes than go to more expensive nursing homes if possible, the governor demanded all areas of the budget contribute to cost containment – and that includes PASSPORT.
“The governor’s budget increases number of seniors in PASSPORT by 4,800 people while improving efficiency in the system and saving 18 million dollars," Moody says. "Now there is a question about how do you serve more people with less money, but that’s exactly the same challenge we’re posing to every provider group.”
Moody says hospitals and nursing homes will have the same situation – increasing numbers of people being served with less money. But Moody says PASSPORT providers are only taking a 3% hit, compared to a 7% for providers with nursing homes and 5% for hospitals. Moody says overall, the reduction for PASSPORT will be 10% in the first year and 6% in the second. And he thinks it’s a challenge that those working in the program will meet, without those who are served by the program suffering.
“I don’t believe when it comes down to it that PASSPORT providers are going to want to serve fewer people. I think the demand will be met. I think folks will continue to provide a high quality product, and I think we will be able to achieve the efficiencies we’re talking about in the buidget.”
But activists for seniors aren’t so sure, and neither is Susan Ackerman with the Center for Community Solutions.
“The governor’s goal clearly was to keep the door to the program open," she says. "The problem is that there’s not enough funding in this program in order to serve all the people who are going to need services.”
There are 32,000 Ohioans in the PASSPORT program now. The Center for Community Solutions says the state’s average monthly cost for each person in PASSPORT statewide is a little over $1,100, compared to more than $5,000 a month for each person in a nursing home.