Budget cuts up-close and personal

Cuts to in-home services for the elderly produce quick consequences for some

0 | Legislature, Health Care Delivery, Medicaid-CHIP

Wilma Young, 76, moved to a nursing home in Oskaloosa after cuts to the Medicaid-funded services that helped her live in a small apartment in McLouth. "I don't like it here," Young said of the more expensive nursing home. "I wish I had my own place back."

Wilma Young, 76, moved to a nursing home in Oskaloosa after cuts to the Medicaid-funded services that helped her live in a small apartment in McLouth. "I don't like it here," Young said of the more expensive nursing home. "I wish I had my own place back."

— State officials haven’t yet fully gauged the consequences of reducing in-home services for the elderly.

But Sharon Hansen’s perspective is up-close and personal. She says the budget cuts killed her 92-year-old mother.

“She’d fallen and hit her head,” Hansen said. “She’d been approved for what they call 24-hour care and she was doing all right in her little apartment.”

Then two or three days before Christmas, her mother’s case worker called to say that due to state spending cutbacks her mother would be getting only four hours of care a day.

“My sister and I pooled our savings and tried to keep the services going but there was no way we could afford it,” said Hansen, a long-time Mary Kay cosmetics sales representative who lives in Topeka. Her mother “ended up having to go to a nursing home. We didn’t have a choice. She hated it.”

After 12 days at the nursing home, Hansen took her mother, Helen Johnson, to the hospital where Johnson died 13 days later of heart failure.

“I know people can look at this and say ‘Well, that’s just one person,’’ Hansen said. “But that’s not true, this affected my mother, it affected me, it affected my family. You do everything you can, and it’s not enough. This is going to be something that my family will be dealing with for the rest of our lives.”

Hansen said she’s angry at Gov. Mark Parkinson, who, last November, ordered a 10 percent cut in the state’s Medicaid rates, which led to the decision to reduce Hansen’s mother’s services.

“If he really cares about Kansans – like he says he does – then I’d say he needs to get his priorities straight,” she said.

Parkinson at the time said the decision was bad public policy but revenue shortfalls left no choice.

He proposed raising taxes to restore the Medicaid cuts and stave off more cuts to education and social service programs and has been waging a campaign to convince the public and legislators to go along.

Nursing home the only option

Carla Butler’s great aunt, Wilma Young, 76, moved to an Oskaloosa nursing home shortly after funding for her overnight services – called sleep cycle support - was eliminated.

“She’d fallen a couple times and she’d been in the hospital,” Butler said. “She couldn’t be alone at night because she’d get up half-asleep to go to the bathroom and fall again so I got her approved for sleep support. But two days later, she got an infection and had to go back to the hospital.

“In between that time and when she was ready to go back home is when they cut the funding,” said Butler, who helped care for Young. “After that, the nursing home was her only option.

“She’s doing OK, I go see her twice a week,” she said. “She’s made some friends, but she doesn’t like it there. She’s sharing a room with another person now and she really doesn’t like that.”

The services that allowed Young to live in a one-bedroom apartment in McLouth cost Medicaid about $2,000 a month. Her stay in the nursing home is costing the program around $4,000 a month.

“Raw deal”

“There’s a lot of this that doesn’t make sense to me,” Butler said. “We were doing fine then they cut the funding and now she’s in a nursing home which she doesn’t like and that costs more. I think it’s a raw deal.”

Within Medicaid, in-home services are considered optional and may be cut; nursing home services are an entitlement and must be provided.

Young, who has diabetes, high blood pressure and a weak heart, while living at home had been taking part in a telehealth pilot project that used a computer program to monitor her vital signs.

“Along with her caregiver, we kept her out of the nursing home for two years. But when the sleep cycle support was taken away nobody felt comfortable leaving her alone at night,” said Monte Coffman, who runs Windsor Place, the Coffeyville-based company that oversees the telehealth project.

Good value

“It’s sad,” he said. “Sleep cycle support costs like $25 a night. It’s one of the best values the Department on Aging had to offer. And now it’s gone.”

The department also suspended Medicaid-funded dental services, non-medical companion-type care, and assisted technology support for the frail elderly.

Annette Graham runs the Central Plains Area Agency on Agency in Wichita. She said Young’s move to a nursing home and Johnson’s death were not unique.

“We’ve had many, many families tell us that losing sleep support was the straw that broke the camel’s back,” Graham said. “They held on as long as they could but without sleep support there wasn’t anything they could do. A nursing home became the only option.”

The loss of assisted technology support also has been troubling, she said.

“If you get to the point where you need a lift chair to get up or you can’t get on or off the toilet or take a shower without some bathroom modifications or you can’t get out of the house to go to the doctor’s office because you can’t up or down the steps and you need a ramp – well, that assisted technology support isn’t available now,” Graham said.

“We’ve seen a lot of people have to go to a nursing home,” she said, “and we’ve had a lot of families say they’re holding on for as long as they can, but they’re also telling us they can’t hold on much longer if services don’t get restored in the next couple months.”