Massachusetts home care lobby disappointed with House budget

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BOSTON >> Months ago, one of the nurses who had cared for Susan McCarthy's 13-year-old daughter for a decade in their home left her position in search of one with higher wages, so she could manage the college tuition payments of her own children.

McCarthy said the nurse was part of a team providing 24-hour intensive care to her daughter, Caitlin, in their Walpole home, and had been holding out for years in hopes that a raise would eventually come.

"She is still part of our family, always will be part of our family, but she had to make that difficult decision to leave us to go to a higher paying job," McCarthy said during a Home Care Alliance of Massachusetts lobby day Thursday. "I want that to be something that everyone thinks about when you think about the budget. We need to keep these kids at home. Caitlin has no other place."

After days of deliberation, the House on Wednesday passed its $39.5 billion budget for the 2017 fiscal year. Of the more than 1,300 amendments filed by lawmakers, those that were rejected included the creation of a commission to study oversight for home health and private-pay home care, a study of MassHealth home health rates, and funding to give raises to both home health aides and homemakers, according to the Home Care Alliance.

"For us, it's disappointing," said James Fuccione, the alliance's director of legislative and public affairs. "We know that it's tough to get funding for any one item. We thought that an oversight commission ... was an easier kind of sell, so we're disappointed in that. We're encouraged by support in the Senate, and we were talking and it just didn't kind of make it through, so that's kind of where we were in the House, but the House has traditionally been kind of tough for us."

The House tacked on to its budget $3.1 million in additional spending for health, human services and elder affairs through a consolidated amendment comprised of various individual proposals made by lawmakers.

"We were asking for 18 [million] on our own," Fuccione told the News Service. "None of that went to us."

An $18.9 million amendment that would have increased the MassHealth senior care appropriation for home health agencies, filed by Rep. Chris Walsh, was not included in the consolidated amendment. According to the alliance, home health aide rates paid by MassHealth have remained at the same level since 2007.

Elder groups had sought nearly $70 million in new funding through the House amendment process, according to Mass Home Care executive director Al Norman.

The funds would have supported programs including home health agencies, homemakers and adult foster care, Norman said. The money the House did approve — $642,000 for "naturally occurring retirement communities" and $750,000 for home-delivered meals — restores those accounts to the same level as appropriated this year.

"You're left essentially with a zero-sum game. You didn't really accomplish any new ground," Norman told the News Service. "There was a lot of money on the cutting room floor. Everybody in the elderly services field knows that filing an amendment these days is a long shot."

There are 1.3 million people over the age of 60 in Massachusetts, an age group that is projected to account for 24 percent of the population in 2020. UMass Gerontology Institute figures peg that by December 31 of this year, the state will have more residents over the age of 60 than under the age of 18.

Rep. Denise Garlick, the House chair of the Joint Committee on Elder Affairs, cited those statistics in a floor speech during budget deliberations and said that while seniors have different needs depending on their age and health, they all "seem to want to live as independently as possible for their own situation, directing their own lives to their fullest extent possible."

Norman said that although the elder population is "rapidly climbing," the general perception seems to be that "elders are doing OK," and issues important to the older population aren't getting the attention of issues like local aid and education.

"Older people have dropped off the public policy radar," he said. "I don't know why. I've been in this business for a long time, and it's surprising even to me, and I've seen a lot of bizarre things in that building. When I look at what's being talked about, what's being written about, it's not older people."


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