Armed with a constellation of proposals, a coalition of advocacy groups will urge state lawmakers Monday to support initiatives they say will bolster the independence of older adults and ultimately save Massachusetts millions of dollars.
Some of the proposals would expand existing programs, so more frail patients discharged from hospitals would receive services, such as help with grocery shopping or taking medications, to avoid ending up back in the emergency room or in nursing homes.
Other proposals are new, such as one that would require Massachusetts hospitals to demonstrate often complex nursing tasks, such as administering intravenous medications, when a patient is sent home to be cared for by family.
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The State House gathering comes as lawmakers brace for what are expected to be painful cuts as Massachusetts faces a $1.5 billion gap in the upcoming fiscal year. Coalition leaders, led by the state’s largest advocacy organization for older adults, AARP Massachusetts, say they are keenly aware of the state’s precarious finances.
“We could make significant cost savings by shifting more care to the community,” said coalition member Al Norman, executive director of Mass Home Care, a network of nonprofit agencies focused on home-based care.
By Norman’s accounting, the rise in community care over the past decade has helped reduce the number of patient days in nursing homes by about a third. That, he said, will save taxpayers roughly $853 million just this year in the Medicaid program.
To continue that trend, Norman said, lawmakers should expand the home-care services program, which would help about 9,000 more “lower middle class” frail elders avoid nursing homes. The program limits eligibility to those with an annual income of $27,000, but the coalition is urging that be raised to $35,000, a level consistent with eligibility rules for other Medicaid programs.
Norman said the estimated $16 million price tag for expansion could be paid for by federal money already earmarked for Massachusetts.
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AARP Massachusetts is championing new legislation, called the CARE Act, which the organization says recognizes the critical role that family caregivers play in keeping patients out of costly institutions.
“Probably 70 percent of all care is being done at no charge to the Commonwealth because it is done by family and close friends,” said AARP state director Mike Festa. The organization estimates that more than 1.2 million state residents are caring for an aging parent or loved one at home.
But many of these caregivers are overwhelmed by complex nursing tasks, according to a national AARP survey. It found that roughly half of those queried reported difficulties in operating a family member’s mechanical equipment such as breathing machines and feeding tubes. More than a third had problems using monitors to measure blood pressure, and sugar and oxygen levels.
The survey also found that many family caregivers said they had multiple interactions with hospitals and physicians’ offices while taking care of their loved ones, yet rarely received coaching or training in how to perform some of the more difficult tasks at home, such as dealing with wounds, giving medication, and operating the medical equipment.
The CARE Act would require hospitals to instruct caregivers on the medical tasks — such as medication management, injections, and wound care — that would be performed at home. It is modeled on laws passed last year in New Jersey and Oklahoma.
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Festa said the caregiver training would help avoid complications that typically land patients back in the hospital shortly after discharge.
“We don’t think the law will create any additional cost or bureaucracy,” Festa said.
The Massachusetts Hospital Association said in a statement that it had not yet had an opportunity to review the new legislation.
“We have an excellent working relationship with AARP MA and we look forward to discussing the CARE Act with them,” the statement said. “We do know that the issue is complex and should involve a variety of providers and stakeholders to address this in a sensible and sustainable manner.”
Kay Lazar can be reached at Kay.Lazar@globe.com.