By the year 2025 more than 1.6 million Georgians will be over the age of 64. If eligibility requirements stay the same, Georgia's Medicaid system could be picking up the tab for long term care for more than 250, 000 of those seniors with one or more chronic health conditions.
With so much money at stake, states are moving away from health care delivery systems centered on hospitalization and long-term nursing home care, and toward care coordination programs designed to keep the frail elderly, the blind and the disabled in their homes and in their communities for as long as possible.Georgia's innovative source care management system is considered one of the best home-and-community-based- services programs in the nation.
A Visit With Miss Carrie
Miss Carrie Tillman is 104 years old. She still lives in her own apartment in Wrightsville. She gets regular visits from Sharon Jones.
"Miss Carrie" is legally blind, and she's outlived practically everyone she once knew, including her two husbands and three of her four children. She's even outlived the battery in her pacemaker. She looks forward to Jones' visits. Jones is a care manager for SOURCE, which is the acronym for Service Options Utilizing Resources in Community Environments.
"Sometimes the case manager and maybe the personal support aide are the only people these people see. They look forward to them coming in - people need a little human touch every now and then. In the frail elderly population, often it's the simple things that allow someone to stay home."
Keeping Seniors Out of the Hospital
SOURCE is a fee-for-service program. It was designed to keep elderly and disabled Medicaid recipients out of hospitals and nursing homes by providing them with a wide range of home and community based services.
Only the very poorest Georgians – those with incomes of 66-hundred dollars or less – financially qualify.
Dr. Jean Sumner is the medical director of SOURCE and a primary care physician in Wrightsville.
"It's the ability to have a bath, 3 meals a day, someone that makes sure to check on you, make sure you're safe or have an emergency number to call."
What makes SOURCE unique is the active role of a physician who as a member of the care team. When Miss Carrie first enrolled in source her team created what they call a carepath for her. It lists specific goals or outcomes that Miss Carrie is expected to meet, and it holds the entire team responsible for her success. That's why she still lives in her apartment.
Miss Carrie: "I just love it here. I told the rent lady I wanted to stay here until I die."
This level of care and physician involvement and medical oversight is costly.
Saving Money At Home
The Federal government and the State of Georgia spend roughly 28,000 dollars a year to keep Miss Carrie healthy and independent. But that still beats the 66,000 dollars a year it would cost to put her in a nursing home.
Those savings are not lost on Georgia's leadership. Governor Purdue recently expanded SOURCE to make it available statewide. That's a good start, says Dr Sumner who'd like to see the SOURCE's enrollment criteria expanded as well.
"Because we feel there's a large number of people that make a little too much money to qualify for the services but may tremendously benefit from our services."
Sumners says she sees people in nursing homes every day who could live independently with the help of SOURCE, but they just aren't poor enough.
Miss Carrie Tillman is 104 years old. She still lives in her own apartment in Wrightsville. She gets regular visits from Sharon Jones.
"Sometimes the case manager and maybe the personal support aide are the only people these people see. They look forward to them coming in - people need a little human touch every now and then. In the frail elderly population, often it's the simple things that allow someone to stay home."
"Because we feel there's a large number of people that make a little too much money to qualify for the services but may tremendously benefit from our services."
