little older, you don't realize how important the quality of home care is, and that is not something that you can stand on the Senate floor and say, "Hey, hey, hey, it's the best place to be." As we're older, we don't want to look for more help. We don't want to take advantage of the system. We have spent our lives paying into the system and we only want to get what is the best for us. The "woodwork" effect, I think, is a cloud that people are trying to put over it to kind of take you away from the fact that home care and keeping people at home, adult day care, and respite care for the caregivers are important benefits. When I think of one of our caregivers who managed to get out to Hawaii to see her first grandchild, just because we had a short respite program for her—— Senator BRADLEY. You endorsed the aspect of one of the bills that I introduced that would change the definition of "intermittent" so that it is very clear that this could be 7 days a week. MS. BOER. That has been a problem for the providers. Senator BRADLEY. Right. Now, the question is, do you think that this would result in less institutionalization, since a lot of people are now being institutionalized for short periods of time, if they could get 7-day-a-week care in the home? Ms. BOER. I'm sure it would. I testified before a Federal administrative law judge for a patient that we kept at home, and we provided 7 days a week, and we were denied 7 days a week coverage. As an agency it was an extremely costly thing for us, but that man, because of our 7 days, died at home. The cost of it-I don't have the figures, but the cost was so much less than if he had gone into a nursing home. I'm just as sure as I'm sitting here that this would really prevent nursing home placement. Senator BRADLEY. Well, let me thank all three of you for your testimony, and also for your endorsement of the bills, and also for your willingness to continue to work with me as the process moves forward. We have hopes that we will be able to get an extension for the New Jersey Respite Care Pilot Project. We hope for another 2 years. We also hope that we will pass the Home Benefits Improvement Act, which has the respite care provision and increases home health benefits, IV benefits, and the hospice benefits. Then we also have as our goal to pass the adult day care bill. Those packages, while they are not long-term care in the broad sense and as the Pepper Commission envisioned, are nonetheless actions that, as we heard from today's witnesses, can make a real difference in the lives of many, many New Jersey families and many families across the country. I want to thank you for not only your appearance at today's hearing, but for your continued willingness to offer your counsel and advice. I would like to thank the first panel today because it is their personal stories that carry the strongest impact on the lives even of Senators and Congressmen. I would like to thank the second panel, who gave moving testimony that those who provide do so because they care. I would like to thank this panel for letting us see the quality that is in the New Jersey health care governmental and interest group area, all the way from the Commissioner to one of the most well-respected interest groups. Let me thank all of you for your willingness to testify. I think that this is a record that will help the Senate Aging Committee and that will also, frankly, help me in the Finance Committee to make the case that needs to be made to get these bills passed and into law as soon as possible. So let me thank you for your testimony, and particularly the Commissioner for taking time for this hearing. I know, as I said at the beginning, that it was not the easiest thing to do, to come to Leisure Village from Trenton, but I know that everyone here appreciated it, and I did very much. So with that, the Senate Special Committee on Aging is adjourned. [Whereupon, at 1:05 p.m., the committee was adjourned, to reconvene at the call of the Chair.] I am writing to submit written testimony regarding the Statewide testimony along with the verbal presentations at the field hearings on Written Testimony for the Field Hearings on Respite and Home Care Services in New Jersey Senior Citizens United Community Services is a nonprofit social service agency whose primary goal is to improve service offered to the senior citizens of Camden County to enhance the quality of their lives, with an emphasis on those with the greatest socioeconomic need. As one of the sponsor agencies for the Statewide Respite Care Program we are acutely aware of the positive impact it has had on the target population of aged, ill or severely disabled. This written document is being entered in addition to verbal testimony presented on April 16, 1990. We are anxious to support your efforts in securing continued funding for the New Jersey Statewide Respite Care Program (SRCP), currently funded as a federal demonstration project. Hopefully this will convey to you the ongoing need that exists for this vital program. From its beginning in April 1988 to the present time, the Respite program has grown tremendously. With minimal initial outreach efforts, the program was able to serve 195 clients by the end of 1989. This demonstrates a critical need for this service existed prior to the inception of the SRCP. For the first quarter of 1990 we have already assisted 72 families. Many of the families we service have been struggling on their own to provide 24 hour care for their aged, ill or severely disabled family members. This is not a group who seeks help easily. It usually takes a crisis for them to pursue outside help. SCRP is the only state or federally funded program that does not require personal care service in order to qualify. This is a critical issue for families who are often reluctant to accept this type of service (or may not qualify) but still desperately need a "break". We are easily able to provide a wide range of services including companion or medical or social day care. Many of our clients are also excluded from eligibility for other county programs due to the more stringent liquid asset limits. For many of our families, SRCP is their first and only social service connection. This then serves as a vital link in helping to direct them to the right area and any possible entitlement program. Referrals to caregiver support groups is another means of helping families to decrease the loneliness of the situation, while at the same time offering support and education. The average age of our caregivers is 59 year old with 50% older than 70. Many of them could also benefit from some assistance. Through careful revenue allocation of the SRCP funding, we are able to serve the maximum number of clients. We can then target those people who might otherwise fall through the cracks. Twenty-five percent of our total caseload is the Alzheimer or dimentia population. For the caregivers supporting this group, there is an acute need for respite. Not only are they faced with their loved one's physical deterioration, but also the ravages of mental decline, and for many the need for constant supervision. This places a tremendous strain on the caregiver. As part of our yearly agency self-evaluation, all SRCP families are sent a survey regarding the services provided and satisfaction levels. Sixty-nine percent responded they were very satisfied. Seventy-six percent of the caregivers responded that respite services were helpful in preventing nursing home placement. This satisfies our primary goal of avoiding unnecessary institutionalization. In actuality the cost and amount of service provided by the SRCP is minimal when compared to providing the more costly 24-hour nursing home care. The savings for the government is significant. The SRCP serves a critical need in our community. There is a demonstrated need for even additional home care service. Further cuts would be a great detriment to those in need. We would be more than happy to provide you with any additional information you could use. |