Reading Linda Herman's posting this am re: community based care for
disability ...grants available to some states to implement these programs in
the $5-8 million range set me to doing some figuring and thinking.
Using figures from various postings related to Ivan's situation in
Maine....PCA help during the night. I used Ivan's request/comments because
they have been discussed openly on the list...and it gave me a basis from
which to start....a "what if" scenario. ...I went to several Maine websites
re home care and found that PCA (personal care asst) was basically not a
skilled medical professional, but for the individual who requires "social
needs and individual can assume responsibility for his/her own care"....So I
interpret this as being.....not demented, no lifting of a patient, no IVs, no
catheters, no injections, no wound care....a situation that many individuals
cope with on a daily basis. (This is as opposed to skilled nursing care....at
a MUCH higher price tag).
The general figure being discussed seems to have been hopefully $8.50 per
hour for night time care...for reliable employee.....so I did the math....
$8.50/hr for 8 hrs.....$68.00 per night ......add benefits and the employer
(state?) pays a minimum of $85 per night for night time care for one
individual. extending that further......we go to $595 per
week........$30,940 per year PER patient for NIGHT time care at home.
Thinking in terms of the grants at $5-8 million.....per state............That
translates out to 32 individuals receiving night time PCA for each $1 million
per state. That is a bill for only night time care.......no daytime hours
are covered in my figures.
Quite honestly....I was shocked at this figure! I do think we really need to
look at the pricetags attached to the requests that we make. The above
figures do not cover expenses of managing a program for PCA's.....hiring,
supervising, scheduling....etc...I don't know what those expenses are...but
the service does not come free. If we extend that coverage to 16 hours per
day.....we are servicing only 16 persons for $1 million dollars......and they
still have 8 hours a day not covered with assistance.....and I still have no
figures included for someone to "manage the programs".
As Hilary commented, there is a lot of lobbying effort going on for the
disabled community....and we (PWP) are a very small segment of that
community......the disabled needing care do range from newborn to
centennarians......many requiring much more intense (medically necessary) or
constant (thinking Alzheimer's and profound dementia's).....care than PWP's.
It would be a great idea for us to present a joint effort in some of these
programs. But I do find it frightening when viewing the overall picture,
that nighttime coverage in the home could possibly cost $30,900 per
individual per year.....(If we drop to $6.50 per hour...we are at almost
$25,000/yr...and are covering 40 persons per year at night for $1,000,000.
Or we are covering 20 persons for 16 hours per day. How many people do you
estimate qualify for this type of care in your city? state?).
I would like to have care available to individuals so that we could remain in
our homes. Our family has had both negative and very positive nursing home
experiences in the past four years....I know that both exist.
Are our options better addressed with co habitation arrangement....where a
couple of people with similar/compatible needs share a residence? Group
homes?? If we irradicated the term "institutional care" would we be more
accepting?? College dorms are mass living experiences where people can
support/care.....isn't that what some of the assisted living experiences
provide? Should we be asking for more support for these communities?
I am asking myself questions out loud. I would appreciate comments. I don't
know where I would throw my support on these issues at this time. What are
the alternatives? How does the price tag compare???
Rita Weeks 56/11
