------------------------------------------------------------------------------ NewsBank, inc. - The Commercial Appeal - 1998 - Article with Citation ------------------------------------------------------------------------------ Headline: Plan offers modest long-term care assistance Date: Dec. 18,1998 p. B 1 Section: Metro Page: B1 Edition: Final Dateline: NASHVILLE Length: 609 words Author: Paula Wade The Commercial Appeal\ Nashville Bureau Text: NASHVILLE - Tennessee's proposed $30 million statewide long-term care program will cover about 2,000 of the estimated 239,000 disabled and elderly people who need long-term care services to stay out of nursing homes. But it's a start, says Health Commissioner Nancy Menke, who led the state's Long Term Care Advisory Commission and Long Term Care Planning Council through the draft proposal of the groups' recommendations to the General Assembly on Thursday. For Tennessee, the proposed program will mark the first time the state has agreed to fund a statewide alternative to nursing home care for frail Tennesseans. Long-term care has become a major issue for Tennesseans. A recent statewide poll by the UT Social Science Research Institute found that 86 percent of Tennesseans want at-home alternatives to nursing home care, and that 69 percent would support higher taxes to get those services. Legislative Democrats have targeted long-term care as their No. 1 issue this year. In addition, the Tennessee Justice Center has sued the state in U.S. District Court over its lack of long-term care services for the disabled. Menke said she plans to submit a federal Medicaid waiver application in January to create the program, which would be limited to Medicaid-eligible and nursing-home-eligible Tennesseans on a first-come, first-served basis. About $10 million would come from state funds, and the rest would be from the federal government. The Commission and the Council were formed by the legislature last year to design a comprehensive plan for long-term care in Tennessee, which now is 49th in the United States in its funding of long-term care services. The draft proposal lists the Medicaid waiver program as its first step but has no firm recommendations for how to expand the program beyond that. Under the draft waiver proposal unveiled Thursday, participants could get government-funded help with chores, personal care such as bathing and dressing, minor home modifications such as wheelchair access ramps, medical equipment and electronic personal emergency systems, home-delivered meals, adult day care, transportation, assisted living and nursing services. But on Thursday, state officials came forward with estimates showing that the broad list of services could add up to be more expensive than nursing home care - $18,700 per year for each person, compared to $18,300 for nursing homes. Those estimates were quickly disputed by advocates for the elderly and disabled. "This list of services is like a menu, and nobody's going to order everything on the menu," said Anne Carr, lobbyist for the assisted living industry. "If you're in an assisted living facility and getting that package, you don't need the meals, the day care, or personal care services because that's part of the package." Deborah Cotney, president of Senior Services of Memphis, said her program of long-term care services costs only $10,230 per person per year. "But our program doesn't include some of the things they are talking about. And if anything, the cost would be higher to provide those services in a rural area." Menke and others have argued that narrowing the program to the less-expensive services would give the state a better bang for its buck. But advocates argue that it's unfair to deliberately design the program to exclude services that are clearly needed. "The council feels strongly that we need to offer the full array of services even if that means fewer people can be served initially," Menke said. Call reporter Paula Wade at 615-242-2018, or E-mail wade@gomemphis.com Copyright 1998 The Commercial Appeal, Memphis, TN Accession Number: 9811200113 ------------------------------------------------------------------------------