To the Point for 7/7/2005


THE STATE OF INDIANA has been undergoing some significant changes since Governor Mitch Daniels took office at the beginning of 2005; but a new plan announced by the administration this week could drastically change the care for thousands of Hoosiers — and indirectly, the lives of some Switzerland County residents — in the near future.

The plan is a course that will streamline the state’s health care plan in terms of how the state operates mental hospitals and nursing home facilities.

It is a plan that has been proposed by Mitch Roob, the head of the Family and Social Services Administration, and changes how the state will “do business” in the future in terms of providing care.

In his words, Mitch Roob said, “We’d like to get out of the business of making health care and into the business of buying health care.”

It all sounds good, but if we truly have a government founded on the responsibility of taking care of those who are unable to care for themselves, then everyone needs to take a very careful look at this program before it is implemented statewide.

It is a four year plan that at this stage is purely a proposal, but there are some interesting points in it that will impact people here:

— Under the plan, the state will turn over control of the state’s three mental hospitals, including the one in Madison, to non-profit groups in the private sector who would then run them and charge the state.

Under Secretary Roob’s plan, either Madison, Evansville, or Richmond would be under the control of one of these non-profit groups within one year.

Let’s just say that it’s Madison. What happens to the quality of care that those patients are receiving now? Granted, the state-run operations have had their problems; but isn’t the state only creating more bureaucracy by having to monitor what’s going on in the private facilities?

And what about the employees, many of whom have been state employees under state pension plans for their entire careers? Will they still have jobs under the new configuration? Since the operators will be non-profit, does that mean that the jobs will have lower pay? Are state retirement plans and health insurance plans still in force?

— Outside of the hospitals, the proposal calls for almost half of the state’s senior citizens who are in nursing homes to be moved into “apartment-like” settings. Private businesses would handle applications for Medicaid. How does this impact the elderly and the poor? Many people are in nursing homes solely through Medicaid benefits, and moving them into apartments might not be what’s best for their particular situation in the long run.

Once they are in those apartments, who’s going to make the decision that they are now no longer able to live in such a setting, and move them back to a nursing home facility?

— One of the most interesting items in the proposal, at least to me, is that Mitch Roob said that the state might ask people who are receiving community-based care because of mental or physical problems to give up living alone, and instead would live with at least one roommate — possibly more — who are also receiving similar Medicaid benefits.

There would be a freeze placed on the number of nursing home beds in the state, and would instead give tax incentives for businesses creating assisted-living facilities that have people living in apartment settings.

— Although Mitch Roob says that this isn’t entirely about money, I’m sure that he doesn’t mind the savings, either.

The point here is that these seniors have given a lot to this state during their lives, and as they grew older they came to rely on promises from the state that they would be taken care of.

Those who are struggling with mental problems have also received that same promise, and as a community of citizens within that government, those people have also been promised care and compassion.

Who makes that promise now?