Fall 2009 Action Messages

Re-Balancing Long Term Care

The core mission of The Generations Project since it was founded has been the re-balancing of Indiana's system of long term care (LTC). This means investing far more human talent and resources in the provision of affordable and quality home and community based services (HCBS). Regardless of age, disability or income level, no Hoosiers should be forced into inappropriate institutional care. No Hoosier should be deprived of his or her rights simply for the lack of in-home and support services in the community. To achieve the implementation of this mission, The Generations Project engages in a wide variety of education activities involving senior citizens, persons with disabilities, their families, advocacy organizations, HCBS professionals, members of the media, businesses, and others. Presently, the Project is working with the Indiana Home Care Task Force to urge the state's Family and Social Services Administration, and that agency's Division of Aging, to increase their LTC re-balancing activities. Below are recommended action messages and activities for the fall of 2009.

Readers wanting more information before acting on the recommendations presented below can examine several publications and articles on this website. The publications include two reports from The Generations Project that provide a comprehensive overview of LTC re-balancing initiatives and policy recommendations. Those reports are: Lessons from Home (February 2008) and Moving Forward (presented in November 2004 and published in January 2005).

Ask the Indiana Family and Social Services Administration (FSSA) and its Division of Aging to SUPPORT the full re-balancing of publicly financed long term health care in Indiana by doing the following:

1. Use all the dollars appropriated by the Indiana General Assembly for the CHOICE home care program to provide the home care services for senior citizens and persons with disabilities that are defined in the CHOICE statute (Indiana Code 12-10-10) and in the 2009 state budge act, House Enrolled Act 1001(ss). This includes any CHOICE funds not spent in the previous budget year. Why? 1) It is the law.2) Nearly 2,400 Hoosiers remain on waiting lists for CHOICE home care services. Tell the Division of Aging and FSSA, people who are on waiting lists cannot afford to have their access to vital home care services delayed. Go to the Resources page on this website to get the contact information for FSSA and its Division of Aging.

2. Take every opportunity to implement the provisions of SEA 493, the historic 2003 law that gives FSSA and its Division of Aging the legal authority that is needed to re-balance long term care. No Hoosier should ever have to reside in an institution who does not want and does not need that care. That means Indiana must do far more than it has to utilize both Medicaid waivers and the CHOICE program to provide HCBS in a wide variety of settings. SEA 493 provides the needed legal framework. That law must be vigorously applied and used on an unprecedented scale.

3. Thank the Division of Aging for its positive dialogue with advocates for senior citizens and persons with disabilities, for establishing a better framework for growing home and community based services (HCBS) through Medicaid waivers and the CHOICE home care program, and for positive changes in the administrative rules governing the financing of nursing homes. Tell the Division NOW is the time to act on the opportunities to dramatically expand the access to HCBS for Hoosiers.

Stopping the Medicaid, Food Stamps and Family Assistance Crisis

Help impoverished Hoosiers who must use Medicaid, nutrition and family assistance services provided through the Medicaid, SNAP (Supplemental Nutrition Assistance Program), and TANF (Temporary Assistance for Needy Families Program). These services have been privatized and the new privatized system is not working. Under privatization the administration of these services has been given to a group of private contractors known as the IBM business coalition. IBM and its fellow private business partners have proven to be incompetent in the administration of these public benefits for senior citizens and persons with disabilities of all ages. (You can learn more about this crisis by going to the Home page of this website and clicking on the Editorial link shown in the middle of the page. Also visit the Publications page of this website.)

Here's what you can do.

1. Ask any individual or family that has been unfairly denied Medicaid, SNAP (food stamps) or TANF services to contact The Generations Project or call 317.441.3812. Volunteers for The Generations Project will help identify public and private agencies that can provide assistance in getting their services restored.

2. If you want to file a complaint with the federal government because you believe the Indiana Division of Family Resources or one of its private contractors has unfairly denied Medicaid, SNAP, or TANF services click on the Complaint box on the lower left side of the Home page on this website. That will take you to The Generations Project privatization website where all the information you need for filing a complaint is available.

3. To advocate change in the state's public policy that allowed Indiana's Medicaid, SNAP and TANF services to be privatized, contact your State Representative and State Senator in the Indiana General Assembly or Governor Daniels. Go to the Resources page on this website and click on Access Indiana. There you will find a link to the Indiana General Assembly and to the Governor's office.

4. To advocate change at the federal level, contact any member of the U.S. Congress from Indiana. Those members include U.S. Senator Richard Lugar, U.S. Senator Evan Bayh, and the nine Indiana members of the U.S. House of Representatives.

5. Review the Model Welfare Reform Proposal that is being developed by The Generations Project for the Indiana Home Care Task Force, a voluntary alliance of organizations and individuals representing senior citizens, persons with disabilities, and professionals concerned with long term care services. The Generations Project reform model is expected to be available in September or October 2009 on this website.

6. Talk to your friends, neighbors and community organizations. Ask them to get involved by speaking out at public meetings, calling and writing members of the General Assembly, the Congress, and Governor Daniels. You can also ask The Generations Project to do a presentation to any group or organization in your community.

Health Care Insurance, Health Care Reform: The Crisis

Presently, health care reform or health care insurance reform, depending on your point of view, is being considered by the U.S. Congress and intensely debated throughout the nation. President Barack Obama has made change in the American health care system a center piece of his administration. Not since the passage of Medicare and Medicaid in the 1960s has the possibility of sweeping health care reform seemed so imminent. The driver behind the debate in Washington is the health care costs and access crisis that is having profound effects on the U.S. economy and the health and well being of most Americans.

The Generations Project sees the impact on Hoosiers every day who cannot get medical and health care services due to several factors. These include individuals that have no health care insurance or insurance that provides very limited coverage because of pre-existing medical conditions. Other Hoosiers lack insurance because they cannot afford it due to low incomes or unemployment. For persons with employer provided insurance the coverage may be limited. Persons who have their own insurance often discover their insurance companies will refuse to pay large claims. For other individuals, their out-of-pocket expenses and co-pays are not affordable.

Health care services and health insurance coverage are also rapidly rising in costs. This makes the provision of health insurance by employers increasingly difficult and the purchase of affordable health insurance that provides adequate coverage impossible for many individuals. The cost of health care and health insurance has been a direct contributor to the demise of the auto industry, and other businesses and manufactures in the United States. The results have included the loss of market share and profitability by American business and industry, and the disappearance of millions of jobs throughout the nation. Health care costs are commonly seen as the leading driver of personal bankruptcies.

The uncontrolled growth in health care costs threatens the viability and affordability of public and private services for many Americans. The future of publicly funded, comprehensive and quality home and community based services (HCBS), and other long term care services, may be at risk if health care costs are not effectively addressed. This possibility deeply concerns The Generations Project.

What can you do?

The Generations Project recommends contacting the following organizations that give a variety of perspectives on the issue of national health care and insurance reform: Families USA, the Indiana Alliance for Retired Americans, Hoosiers for a Commonsense Health Plan, the AFL-CIO, and AARP. You can compare what these organizations have to say. They can be reached by going to the Resources page on this website.

Please get involved in the public discussion. Members of Congress need to hear from informed citizens who are genuinely speaking from their own point of view.