Republicans want the family and not government to be the safety net for our frail ones

By Gema G. Hernández, D.P.A

As a person that was a caregiver for 18 years I fully acknowledge the important role families play in making sure their loved ones maintain quality of life in a secure and protected environment. It is therefore not my intention to provide family members with a ticket out of their difficult situation.

However, it is my belief that the solution to the long term care crises we are beginning to experience should not be resolved by placing the bulk of the responsibility on the family unit. This approach will give government at the state and federal level a way out of their social and human responsibility for the most vulnerable among us.

Not known to many caregivers plans are already underway to measure the success of a given program, not on the amount of people for whom they provide services, but on the number of caregivers that year after year keep caring for their family members regardless of decreasing government support. Plans to design a long term care system with state and federal funding are the exception to the rule, not the rule. This is going to permeate legislative and congressional actions this year.

This is the task Governor Bush is giving Carole Green, the task to change the long term care system so the system will be more privatized, more dependent on the family and if at all possible, not dependent on government at all. A task that includes the integration of elders and individuals with disabilities under one community based roof. A task that provides faith based organizations and non traditional long term care providers with incentives to get into the arena while offering them protection from liability claims in cases of client neglect, abuse or exploitation.

To achieve such a purpose, Ms. Green requires not only the expertise she has on playing the legislative game, but also on the plan’s lack of public knowledge. The less people know about what are the goals of the Office of Long Term Care Policy the better it will be for her because no objections will be presented to the state legislators. By the time the changes required to achieve shifting those responsibilities to the family's shoulders, it will be too late.

Ms. Green would have at her disposal the five legislative directors of the agencies that at this time are responsible for pieces of the long term care puzzle; a Long term Care puzzle that in my opinion should include the Nursing Homes to be equal partners in the integrative process. The army of legislative affairs employees she is going to command leads me to believe that behind the public Long Term Care agenda the office is going to have a much bigger agenda, that of reforming, modernizing and if need be dismantling Medicaid.

It is clear Medicaid is a 2.1 billion dollar item in the state budget and a much bigger item in the federal budget. If Ms. Green, with the help of a Republican-controlled House and Senate is able to achieve all the above mentioned tasks she will be the heroine of the Republican Party, one of the rising stars of the twenty first century and perhaps a true contender for the Governor's mansion.

The clear winners in this plan are the community based providers who are given reassurances that if they are not able to keep their Capitated costs under control, a safety net will be there for them in the form of a risk pool possibly funded by our taxes. It is really sad to see that while families are being left alone with no safety net to protect them, private providers, hospitals and other non government entities are offered the safety net that used to be the trademark of our American society.