Sen. Black legislation to help elderly and disabled “age in place” moves through Senate

(NASHVILLE, TN), February 15, 2008 – Two bills sponsored by Senator Diane Black (R-Gallatin) moved through the State Senate this week aimed at helping elderly or disabled Tennesseans receive more options in their health care, including staying in their homes for as long as possible.  The long term care legislation is part of a series of bills sponsored by Black aiming to help citizens “age in place.”

“Our elderly and disabled citizens need more options regarding their health care so that they can ‘age in place’ in their homes,” said Black.  “We are focusing on passage of several bills that will give these citizens more choices and options to help them stay in their homes as long as they can.”

One bill, SB 1157, approved by the Senate General Welfare, Health and Human Services Committee, calls a “self-directed care program” where individual patients get the opportunity to choose services they think they need and who provides them.  Black has brought the bill to the legislature for the past two General Assemblies but feels the time is ripe for passage during this legislative session. 

Under the proposal, consumers would receive a monthly budget based on their needs, and could use this money to hire personal assistant services, make home modifications, and more.   The self-directed care program requires consumers to develop plans that show how they would use the allowance to meet their personal care needs.  It would provide counseling and financial assistance to help them plan and manage their responsibilities. Consumers who are unable to manage their care themselves may designate a representative, such as a family member, to help them or do it for them. These features make this program adaptable to consumers of all ages and with all types of impairments. Basically, it gives frail elders and adults with disabilities the option to manage a flexible budget and decide for themselves what mix of goods and services will best meet their personal care needs.

Black said Arkansas, Florida, and New Jersey were the pioneers of this self-directed health care concept.  Since that time, 12 other states have expanded their choices. In Arkansas, there was a 40% reduction in nursing home admissions in the second year of the program, and the total Medicaid cost per person under the self-directed car plan was about the same as that for the traditional agency model.  Studies show that, by every measure, self-directed care is succeeding and that consumers with this option are reporting greater satisfaction, better quality of life, and fewer unmet needs.

“This bill will help family members, who are the backbone of care-givers in this state hang in there longer so that elderly or disabled Tennessans can stay in their homes longer ,” Black added.  “It is unacceptable that Tennessee is last in the nation in providing options for home- and community-based health care services.” 

Tennessee spent approximately $1.1 billion on long term care last year.  Out of the 22,000 seniors on Medicaid in Tennessee, only a few thousand get home- and community-based care services. 

The second bill sponsored by Black, and approved this week, would help provide more options for elderly and disabled citizens receiving hospice care.  The legislation, SB 2614, was approved by the full Senate on final consideration.  Black said it broadens the definition of assisted living to include hospice services and make it clear that any assisted-care living facility resident who qualifies for hospice care under Medicare can continue those services and also receive reimbursement for assisted living services.

“These bills are positive steps towards making our laws friendlier to assisted-care living,” Black added.  “I am pleased the Senate and General Welfare Committee have passed this legislation and hopeful that the House of Representatives will take it up soon.”

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