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Elders' advocates fight state program shift

Lawmakers also question proposal

By Kay Lazar
Globe Staff / January 22, 2009
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The Patrick administration wants to shift a wide range of services, such as home healthcare and adult day care programs, from an office that specializes in elderly affairs to one that oversees Medicaid, prompting an outcry from AARP and other advocates for the elderly.

Critics say the shift, outlined in an internal e-mail provided to the Globe, would risk letting elderly residents fall through the bureaucratic cracks.

The administration intends to finalize the proposal by the end of this week, according to the internal e-mail, sent by an administration representative to three lawmakers briefed last week on the plan. All three responded with a joint letter that said the reorganization should be shelved.

Kristina Barry, a spokeswoman for the Executive Office of Health and Human Services, said in a written statement yesterday that nothing has been decided. She did not say whether the governor would press ahead with the reorganization of elderly services, as outlined.

Barry said that when the governor announced sweeping budget cuts in October, he instructed top administrators to consider consolidations that would "improve government and make it more efficient in how we provide services."

But this particular reorganization, according to those briefed by top administration officials, would not save the state any money. That has raised questions about the impetus.

"This was presented to us at the 11th hour, with no discussion ahead of time," said Paul Lanzikos, director of the nonprofit North Shore Elder Services, who was among a handful of advocates briefed last week by Health and Human Services Secretary Dr. JudyAnn Bigby. "No one understands the implications ,and we have been around long enough to know there are unintended consequences if you don't think things out."

According to the state's written proposal given to the three lawmakers after their briefing, the reorganization is "primarily about administrative simplification" and aims to improve care and cost management.

"Consumers and providers will not experience any change in their access to services, payment, or direct program administration," the proposal states.

The governor must submit his overall reorganization plan to the Legislature, which must act on it within 60 days or it becomes law. By law, legislators must approve or reject the entire proposal as written, with no changes.

"I think it would be a mistake to ask the members to take a vote on something that would be disapproved of by their constituents, especially where there are already waiting lists for home care, when rates are being cut, and when people are facing higher" copayments for prescriptions, said Senator Patricia Jehlen, chairwoman of the Legislature's Joint Committee on Elder Affairs, who was briefed on the plan last week by Bigby.

"When people are being hurt substantively already, you have to have an awful good reason [for a change] that has no apparent benefit for them," she said.

A letter that strongly recommends that the proposal be shelved was sent to the administration late last week by Jehlen, Representative Kathi-Anne Reinstein, who cochairs the Committee on Elder Affairs, and Senator Richard T. Moore, who chairs the Legislature's Health Care Financing Committee.

Several years ago, state lawmakers consolidated under the Executive Office of Elder Affairs the programs that the Patrick administration now proposes to shift to Medicaid oversight.

Kay Lazar can be reached at klazar@globe.com.

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