I have no idea where – or if – I’ll be here in another twenty years, but, if I am, I hope I’m one of the kippy old ladies I see on Beacon Hill all the time, heading off to their book clubs or whatever.
And while I fully intend to be one of those fiercely independent oldsters, fully capable of opening my own can of soup and getting to my next doctor’s appointment, I certainly hope that there will be plenty of services available to the elderly who are not as fortunate as I hope (and expect) to be.
Thus, it was somewhat disheartening to read a recent article in The New York Times on the emergence of adult day care centers that provide government paid for services – to the tune or nearly $100 per day – to old folks who are capable of taking care of themselves.
That $3K a month is so attractive that all sorts of these centers are popping up all over New York City, luring the elderly in with goodies from the low-cost (and lower goodie) social centers for the elderly run by community organizations, churches, etc.
Even giving away free lunches (ordered off a takeout menu), bags of groceries, free transportation, grocery vouchers, and cash, these scabrous outfits are able to turn a profit. And, hey, who wouldn’t rather have a bunch of fully with-it, able-bodied old folks around – folks who are capable of playing ping-pong and getting themselves to and from the bathroom – rather than having to take care of those truly in need of adult day care services: those with dementia, those with mobility problems, suffering from impaired vision, recovering from strokes, etc.
All coming from the good intentions of providing the elderly-in-need with the ability to get out of the house, have a social life, keep them from having to fall into the maws of that point of no return, the nursing home system.
Such centers have mushroomed, from storefronts and basements to a new development in the Bronx that recently figured in a corruption scandal. With little regulation and less oversight, they grew in two years from eight tiny programs for people with dementia to at least 192 businesses across the city…
Beneficiaries are supposed to be impaired enough to need at least 120 days of help with tasks like walking, bathing or taking medication. But managed care companies, not government agencies, are now mainly in charge of determining eligibility, typically by using nurses to assess each potential member.
“It is being gamed,” said an executive at a managed care company, speaking on the condition of anonymity. “There are just plums in the payment system. And the state will choose to be blind about this until something happens, which is what they did with nursing homes.” (NYTimes.)
Anyway, these “social adult day care centers” don’t need to be licensed, and all they need to have are two people working there, one of whom can be a volunteer. There is supposed to be some vetting that the elders joining these new centers are in need, but this is apparently exceedingly vulnerable to gaming, given the mutual back-scratching arrangement between managed care providers and these social centers.
Because they’re bringing in the big bucks, the new for-profit day care centers can pay more for rent than city-run or non-profit organizations that operate on shoe-string budgets.
In one recent case, the private management of a federally subsidized senior housing development in Coney Island sent an eviction notice to the longstanding Ocean Parkway Senior Center on its ground floor, and moved to replace it with a social day care center company offering higher rent.
Anyway, with little by way of costs – rent and goodies, little by way of oversight, and lots by way of upside (50 old geezers x $3K per month), and you’ve got a no heavy-lifting, nearly all upside business bringing in nearly $2M per year.
When the marketing executive of one of the managed care providers who works with the adult care centers was asked to “denounce the inducements,” he instead said:
‘This could be kickbacks or this could be marketing.’
Sorry, but there really is a difference between kickbacks and marketing, and this sure looks like kickbacks to this marketer.
What a shame that kickbacks to the well elderly are draining resources that should be going to those truly in need – or staying in the pocket of the taxpayer.
No comments:
Post a Comment