A Clere view of the Statehouse

Older Hoosiers in need deserve CHOICE

STATEHOUSE (Sept. 15, 2009) — Seniors who have trouble caring for themselves at home face tough — and, it would seem, few — choices.

            In Indiana, however, they have CHOICE.

            The Community and Home Options to Institutional Care for the Elderly and Disabled program started as a pilot program in 1988 and expanded statewide in 1992. Funded exclusively by the state, the program is available to individuals who are at least 60 years old or who have a disability.

            I have been appointed to the CHOICE Board, which includes four legislators among its 15 members,  and I will attend my first meeting Thursday. I requested the appointment, and I am looking forward to learning more about CHOICE.

            I want to gain a better understanding of what Indiana is doing — and what else we could be doing — to promote independent living.

            It’s an important subject, especially in light of current demographic trends. Baby Boomers started turning 60 a few years ago, and as they age, they threaten to overwhelm our long-term care system.

            Finding alternatives to institutional care makes sense. It makes sense for individuals, who should have every reasonable chance to live independently. It also makes sense for government, which can save money.

            Medicaid — jointly funded by state and federal government — picks up the tab when an individual needs institutional care but can’t afford to pay for it. Medicaid also provides for a waiver program that allows Medicaid dollars to be used to provide home and community-based services.

            To become eligible for Medicaid, though, an individual must first run out of money and other assets. That means people of modest means can’t get home care through Medicaid. CHOICE bridges the gap, allowing Hoosiers with up to $500,000 in assets to receive the many available services. A cost share exists for anyone with income greater than 150 percent of the federal poverty level.

            Of course, I’m concerned about the cost to the state — almost $50 million a year — and I want to make sure we’re spending our CHOICE dollars wisely.

            Under the CHOICE program, dozens of services are available. They include adult day care, attendant care, home modifications, meals, therapy and transportation, to name just a few.            

            Almost anything that could help keep someone at home is included. Pest control, not necessarily something that would come to mind at the mention of home care, a good example of how the program has the potential to address a wide range of issues that might make it difficult for someone to remain at home.

            Not everyone can remain at home. Institutional care is appropriate for many individuals, and we are fortunate to have good facilities that are well equipped to meet their needs. Other individuals, however, benefit from Medicaid waivers and CHOICE.

            Whenever possible, when it comes to receiving care at home, people should have choices.

            Disaster assistance update: The water rushed in quickly on Aug. 4, but in the weeks that followed, damage reports came in at a trickle, delaying any possible aid. Now, six weeks after disaster struck, we appear to be close to finding out what, if any, help will be available from the federal government.

            Last Thursday, Gov. Mitch Daniels sent a letter to President Barack Obama requesting federal disaster assistance. I have stayed in touch with local and state emergency management officials since soon after the storms and flooding. They expect a response to the governor’s letter within about two weeks, possibly sooner.

            I also have stayed in touch with individuals who were flooded. This was a very localized disaster. Many people were unaffected or sustained minimal damage. For those who suffered major damage, however, the wait for word on help has been hard, especially as they have watched folks across the river receive almost immediate assistance.

            The difference was reporting. Because reports were slow to come in, state officials didn’t have enough to work with until late August. After that, it took about a week for officials to view the damage and prepare a report.

            Gov. Daniels requested various types of assistance for more than a dozen counties, including Floyd and Clark. In addition to a three-page, single-spaced letter, the governor provided 14 pages of supporting documentation.

            According to the documentation, officials surveyed 76 homes in Floyd County. Of those, three were destroyed, 16 sustained major damage and 20 had minor damage. In Clark County, officials surveyed 264 homes and found one was destroyed and 31 suffered major damage and 138 had minor damage. In addition, local governments incurred hundreds of thousands of dollars in cleanup and repair expenses.

            After learning that damage was not being reported, I held a public meeting the week after the disaster. That prompted a wave of damage reporting, but I’m still hearing from people who had damage and didn’t report it.

            From what I’ve seen, the folks who need disaster assistance really need it, and they needed it more than a month ago. Let’s hope we hear soon.

(Rep. Clere's column also appears in each Tuesday’s New Albany News and Tribune.)