From the June 1999 issue of: Capitol Woman, pp.18-19. Cutting costs of long-term health care By MH Sims

Ida Tonkan is 90 years old. And there is one thing that she is certain about. "I will not be warehoused. Why should I go into a nursing home when I can still be alive and do what I want to do," she said emphatically.

The East Haven resident still volunteers in a nursing home gift shop and makes sure she attends her "aqua-size" class regularly. While she is still spry and can take care of herself, Tonkan is faced with the threat of being institutionalized because of a small increase in her pension which exceeds the Home Care income gap and threatens the state assistance which currently allows her to be taken care of at home.

How much of an increase?
$2.18.

When it comes to the long term care of the elderly, the focus of state officials is allowing seniors a choice. If they want to continue to stay at home and not go to a nursing home, they should have that option, argues State Comptroller Nancy Wyman, who is one of the champions of the cause. According to Wyman, who used to be a state representative, there are a lot of people in nursing homes who wouldn't have to be there if long term health care insurance was more accessible and affordable.

My feeling is history will judge us by how we cared for the most vulnerable in our society, and our elderly rely on us to to coordinate their care and better ways to preserve their dignity. Nancy Wyman State Comptroller

"We should be doing something in this state to see what kind of program we could set up to keep our people at home; to look to see what we can do to make sure people start purchasing long term health care insurance. There should be tax credits to encourage [businesses] to have their employees buy it," she said.

Wyman, who as comptroller purchases health insurance for state employees, has proposed creation of a public-private task force to look into ways to control the cost of long term care and to encourage more people to purchase private long term care insurance. "We have to think about innovative ways to get this product [long-term health care insurance] sold to the people of this state because in the long run it is the best thing we can do for our seniors," said Wyman.

"What it [long-term insurance] provides will be a certain amount of money per day ... to pay for services coming into the house such as nursing or a physical therapist or whatever is needed to keep a person in the house," added Wyman.

Wyman would also like to see Connecticut replicate New York's Nursing Without Walls program. "It combines the services often associated with home care...and it adds many other services that today are only available in nursing homes," said Wyman. The best part: the services are offered at 75 percent of the cost of placing a person in a nursing home.

While New York has had some problems with the program because of poor management, she believes that "with good management, I think this is one of the alternatives we to have to keep our seniors at homes".

State Sen. Edith G. Prague (D- Columbia), co-chairwoman of the General Assembly's Select Committee on Aging and strong proponent of senior issues, agrees. 'We have to do everything we possibly can to keep people out of nursing homes. I'll tell you its a budget buster," Prague said.

One proposal being considered this legislative session would provide flexibility in income guidelines for the state's Home Care program, which would help people like Ida Tonkan. It would allow elderly persons who receive unexpected increases in income to continue to live in their homes and not be forced into nursing homes.

State Sen. Senator Mary Ann Handley (D-Manchester), who cared for her elderly mother who stayed at home until her death, also supports the state doing all it can to keep the elderly in their homes and out of nursing homes. "We in Connecticut have made some very unusual and costly decisions about the care of our elderly. The bill for nursing home care in the state runs ... anywhere, between $800 million and a billion. The governor budgeted this year $19 million for home care. It really doesn't make a whole lot of sense," said Handley.

"My feeling is history really will judge us by how we cared for the most vulnerable in our society, and our elderly rely on us to coordinate their care and better ways to preserve their dignity," said Wyman.

MH Sims writes monthly about the goings on at the State Capitol. He is also a veteran political correspondent for Connecticut Radio Network.

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