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Editorial: Legislature supports elder care by overriding vetoes

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Tuesday, August 07, 2018

In a state budget that contains $41.7 billion, you would think that $4 million would seem like a reasonably slim payout for poor, sick, elderly residents who benefit from getting care at home.

Yes, yes: $4 million here and $4 million there. Pretty soon it adds up. But at the expense of sick senior citizens?

Gov. Charlie Baker, a generally moderate Republican who gets along reasonably well with the Democratic Legislature, apparently saw higher priorities for the $4 million as he reviewed state spending for the year that began July 1, and so he cut rate increases in the senior care programs.

The elder care vetoes, $2 million for adult foster care and $2 million for adult day care programs, were among $49 million Baker slashed last month from the Legislature’s budget.

Happily, the Legislature last week restored that money for elder care by overriding the governor’s vetoes.

Baker noted in his veto document that the two MassCare senior health budget items were “consistent” with his earlier budget recommendation. Consistent or not, the raises were greatly needed, according to advocates for the region’s elders.

“We haven’t had rate increases since 2012, and those increases were based on costs in 2009, so we are a little behind,” said Elaine T. Fluet, president and chief executive officer of GVNA HealthCare Inc., which has an office in Greenfield.

The $2 million that was included in the Legislature’s budget “is not even getting us where we need to be, but it’s something,” said Fluet, explaining that the program operators had been asking for more than that for years. “The costs of delivering services has increased and increased, and changes to regulations have increased our staffing requirements. A lot of the programs have closed over the last couple of years because their agencies can’t take the loss.”

The Greenfield adult day program, which provides nursing, nutrition and activities for seniors and respite for at-home caregivers, serves about 30 people.

Al Norman of Greenfield, former executive director of the advocacy group Mass Home Care, criticized Baker’s cuts, which he said run counter to Massachusetts helping keep seniors in their homes and out of institutions.

“I’m amazed the governor would veto them, and that they weren’t in his original budget,” said Norman. “We hear rhetoric about Massachusetts being an age-friendly state, where we’re shifting more people from institutions into the community. So this is totally inconsistent, and shortsighted.”

Similar to adult day care programs, adult family care programs — like those run by LifePath in Hampshire and Franklin counties — have not seen increases for years, Norman said.

The family care programs pay caregivers to look after participants — both seniors and those with disabilities — round-the-clock in the home, allowing them to remain in the community with a host family rather than in a nursing home or other institutional setting.

LifePath’s adult family care services, which helps about 150 people, “is one of the more cost-effective programs out there,” said Barbara Bodzin, the agency’s executive director. But without the raise, she said, what the state has been paying has made the service “cost-prohibitive to providers.”

It is encouraging that while the governor may not quite understand the wealth of support these programs provide our needy, ailing senior citizens, at least the Legislature does.