The Providence Journal had a great article on a government program ––called Shared Living–– which is part of Rhode Island’s effort to save nursing-home costs while allowing people to stay in their homes. States have been offering the Shared Living program for people with developmental disabilities and now is expanding the concept to frail elderly people and adults with disabilities who are eligible for Medicaid. The first participants are expected to be paired up in about four weeks.
Through two agencies selected by the state, the program provides caregivers with money ($13,000 to $18,000 a year, nontaxable), nurses, caseworkers, training and respite. The caregiver lives with the elderly or disabled client and helps with such tasks as bathing and dressing. Typically the caregiver and patient know each other, may be related and may already be living together.
Shared Living bolsters efforts to care for people at home so they are less likely to need a nursing home. “It’s not just the money, but the support behind it,” said Jane E. Korb, program director for the Homestead Group, one of the two companies that will run the program. The other is Caregiver Homes of Rhode Island.
In Rhode Island, the Shared Living program sprang from the state’s “global waiver” to its Medicaid program, which frees the state from Medicaid rules to allow innovative programs.
The state has focused its efforts on reducing nursing-home use in favor of community-based programs. Long-term care accounts for nearly a third of Medicaid spending, and more than half of that long-term care money pays for nursing homes, according to 2007 data from the Kaiser Family Foundation.
The agencies that will run the program are not licensed. The Health Department has no oversight, even though it regulates nursing homes, assisted living and home care. The state Department of Human Services plans to monitor client and caregiver satisfaction, length of stay in the program, caregiver retention rates and complaints.
The Homestead Group has been running the state’s Shared Living program for developmentally disabled people for years. Caregiver Homes is among the agencies that have been providing a similar service in Massachusetts. Its Rhode Island program director, David E. Bell, was formerly director of elder services at Child and Family Services of Newport County.
KEY POINTS: Shared Living
What it is: A caregiver lives with and cares for a disabled or elderly person who cannot live alone. The caregiver is often someone the client already knows, such as a relative, friend or neighbor (but cannot be a spouse). The state Medicaid program, through an agency, pays the caregiver $13,000 to $18,000 a year, nontaxable, depending on how sick the client is, and provides backup services.
Who runs the program: The state has chosen two agencies, Caregiver Homes of Rhode Island and the Homestead Group. The agencies “match” caregiver with client, ensure the safety of the home, train the caregiver, and provide backup services — a case manager, a nurse who visits at least monthly and someone to take over temporarily if the caregiver needs a break.
Who can be a client: Clients must be eligible for Medicaid and also frail enough to qualify for nursing-home care — that is, in need of 24-hour care and unable to manage on their own (although they must be able, with help, to leave if there’s a fire). Clients must be free of communicable diseases and not a danger to themselves or others.
What the caregiver does: The caregiver is responsible for assistance with daily living, such as dressing, bathing and using the bathroom; doing household chores; providing meals and transportation; being available around the clock; and providing socialization and a home-like environment.
How to enroll or get more information: Department of Human Services www.dhs.ri.gov
Caregiver Homes of Rhode Island. David E. Bell, program manager. (866) 797-6222, a toll-free call, or email@example.com.
The Homestead Group. Jane E. Korb, program manager. (401) 765-3700, ext. 293, firstname.lastname@example.org