How Tennessee can protect CHOICES program and continue support for older adults, people with disabilities | Opinion

Because Tennessee has never increased the reimbursement rate for home care providers since the program began over 11 years ago, the state’s CHOICES program is at great risk. 

Dawne Bunn, Rebecca Kelly and Maegan Martin – Guest Columnists

  • Dawne Bunn is Executive Director of the Tennessee Alzheimer’s Association.
  • Rebecca Kelly is State Director for AARP Tennessee.
  • Maegan Carr Martin is Executive Director of the Tennessee Association for Home Care.

Tennessee’s CHOICES Program helps eligible seniors and individuals with disabilities receive the personal care and support services needed to safely age at home.

TennCare, the state’s Medicaid program, had the vision to create the CHOICES program more than a decade ago to support the many Tennesseans who wanted to age in their homes.

CHOICES recognizes that with a little extra help from non-medical care – such as bathing, dressing, toileting, walking and eating assistance, meal preparation, Alzheimer’s and dementia care—many more individuals can safely age at home.

Our organizations continue to support the CHOICES program and support TennCare’s ongoing efforts to keep Tennesseans at home.

TennCare also saves the state tens of thousands of dollars each year for every person who remains in their home instead of entering an institutional care setting. These cost savings allow TennCare to provide more services to more Tennesseans.

But now, because Tennessee has never increased the reimbursement rate for home care providers since the program began over 11 years ago, the state’s CHOICES program is at great risk.

Concerns that add to the risk 

Rising administrative costs, staffing shortages, and low reimbursement rates are combining to drive CHOICES home health providers away from the program – and the health and well-being of those who depend on these services the most are being threatened. 

Due to the low reimbursement rate, fast food restaurants in many areas of the state can afford to pay higher wages for much less demanding work. 

Yet, adequately funding the CHOICES program would actually save state taxpayers hundreds of millions of dollars each year. 

This year, Tennessee will spend around $78,000 for each TennCare recipient placed in a nursing home. 

But the cost to provide the same personal support services to these citizens in their own homes would cost only 10-20% of that amount. 

This will be especially important as Tennessee’s population continues to age. 

With the aging baby boom generation, the Population Reference Bureau projects the number of Americans requiring nursing home-type care could see a 50%increase by 2030. 

In a 2018 survey conducted by AARP, 90% of senior citizens said they preferred to stay in their homes as they age versus entering an assisted-living facility. 

We believe Tennessee seniors and individuals with disabilities deserve to have a choice in where they live as they age.

Governor Lee and state policymakers can help protect and ensure that option by fully-funding the state’s CHOICES program. 

The program has proven to work. When the TennCare CHOICES program launched in 2010, 80% of eligible patients lived in nursing homes. Today, that number is around 60%. 

Please join us in letting Governor Lee and members of the Tennessee Legislature know that our seniors and individuals with disabilities deserve choices. 

Let’s work together to support the additional funding needed to save and sustain Tennessee’s CHOICES program. 

Dawne Bunn is Executive Director of the Tennessee Alzheimer’s Association.  Rebecca Kelly is State Director for AARP Tennessee. Maegan Carr Martin is Executive Director of the Tennessee Association for Home Care.