Since December, the Indiana Family and Social Services Administration has been trying to sell a snow job regarding the costs and benefits associated with Indiana’s CHOICE home care program and the Medicaid aged and disabled waiver. Those two programs are publicly funded and provide vital home care services for senior citizens and people with disabilities.
Sad to say, the senior staff at FSSA cannot bring themselves to tell the Indiana General Assembly the truth about the CHOICE and the Medicaid aged and disabled waiver programs.
FSSA has been telling the General Assembly that CHOICE costs an average of more than $7,000 per person per year, that CHOICE clients are middle class, and CHOICE services are a luxury to many of those clients. FSSA has been telling the General Assembly the Medicaid aged and disabled waiver program costs on average $3,366 per person per year and Medicaid waiver clients are indigent.
Both of the above numbers are falsehoods, both populations are poor, and individuals on both programs must be at risk of losing their independence if they do not receive home care.
FSSA knows these things but is telling lawmakers a different story.
On Nov. 18, FSSA staff reported to the state’s CHOICE Advisory Board the cost of the CHOICE program was $3,994 on average per person per year. At that same meeting FSSA reported the equivalent cost of the Medicaid waiver to be $33,480. The waiver costs so much because everyone who goes on the waiver receives by law Medicaid state plan services, which include a wide variety of medical and related services.
FSSA produced the low waiver cost by omitting both the Medicaid state plan costs and the federal share of the waiver’s home care costs.
If FSSA wanted to truthfully identify the state tax-only cost of the waiver, those costs would still have exceeded more than $11,000 per year.
A recent update of the waiver shows the average per-person per-year costs now exceeding $36,800, and the state share of that total exceeding $12,000 per year. The cost of CHOICE is nowhere near those numbers.
CHOICE is important because it provides quality low-cost home care for people who need only home care.
The waiver is important because it provides home care and Medicaid state plan services for people who would not otherwise have access to medical care.
Here is the scariest part of the story.
HB 1001, the pending state budget bill, will allow FSSA to take up to $25.9 million per year in CHOICE funds to use as state match dollars for the waiver. That is expected to reduce CHOICE funding from $48.8 million to just $18.3 million in the first year of the new two-year budget period that starts July 1, and to just $23 million in the second year of the budget cycle.
These cuts are expected to cause one or more of the following things: the premature death of senior citizens and people with disabilities, broken families, and wrongly forcing seniors and Hoosiers with disabilities into nursing homes.
Because CHOICE clients are poor, once they are forced into nursing homes, they will go onto Medicaid at a far greater expense to taxpayers.
The nursing home expense will be more than $40,800 per person per year, if you can believe FSSA. The question must also be asked: Who is benefiting when people who only need home care are forced into nursing homes at 10 times the cost to taxpayers?
Yes, it is time FSSA told the truth to the General Assembly. HB 1001 passed the House with huge cuts in home care, and big increases in nursing home care, based on FSSA’s misrepresentation of its own numbers. The new budget needs to be based on the truth. If the truth is heard and acted upon in the new state budget, then senior citizens, people with disabilities, their families, and taxpayers will be taken out of harm’s way.