By AMY MOORE
By Amy Moore
Ten years ago, on a beautiful spring day, Paul Scott was in his garden planting tomatoes with his wife. She called his name and when he turned to look at her, he collapsed, hit his chin on the ground and broke his neck in three places. After spending four months at Boston Medical Center, doctors determined that he had directional vertigo, most likely caused by a crystal in his ear coming loose. Chances of this happening were one in 3 million … Paul was that one.
Two years later, Paul’s 34-year marriage ended. “The divorce rate for someone with a catastrophic injury skyrockets … from that point on I’ve been alone.” Paul owned a successful antiques business for 45 years. “Being self-employed, you do everything on your own; it’s all on you … now I have to rely on people for everything, from washing my hair to putting me to bed.”
Paul has been able to remain at home with services through the Medicaid Choices for Independence program (CFI). It pays for personal care service providers to help him with bathing, transferring, meal prep and housekeeping. Over 3,000 Granite Staters depend on CFI. “I should be able to stay at home, I’m a taxpayer, and I’m contributing to the economy … this shouldn’t be called an ‘entitlement program’, I worked for 45 years.” It costs the State about $17,500 per year to provide care for a CFI client at home, compared to more than $56,000 for a nursing home.
Unfortunately, the CFI program has been underfunded for over a decade. The rate for personal care services has risen just 88 cents in twelve years. Home care agencies that provide CFI services lose money or struggle to break even. As a result, most CFI clients are not receiving the care they need and agencies turn away up to 50 cases a month. Paul has been going without a good portion of his care for many months because he can’t find help. Workers can go to Target, Walmart, McDonalds … pretty much anywhere and make a higher wage.
Our state has the second oldest population in the country, with low birth rates and few people moving into NH. With a 2.4% unemployment rate and staggering workforce shortage, legislators are struggling to figure out how we can attract people to NH. Issues such as affordable housing and education debt are major factors — but what about our long term care system, what do we have to offer? As Gandhi said, “the true measure of any society can be found in how it treats its most vulnerable members.”
Paul will spend the ten-year anniversary of his accident in Concord Hospital. He has been there for several weeks due to sores that have gone down to the bone. He will soon have his third surgery of this hospital stay. There are many more like Paul in NH; people ages 18 to 102 who just want to stay at home, but need some help.
The Legislature must confront this crisis. It should re-base the rates to stabilize the provider network, enabling home care agencies to invest in workforce. It should fully fund Senate Bill 308, which would increase Medicaid rates for all providers. Paul and the thousands of others that rely on CFI services need and deserve so much more.
Amy Moore is the Director of Ascentria In-Home Care in Concord, which serves over 460 CFI clients statewide. Paul Scott is a graduate of New England College and former business owner.
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