Missouri’s Department of Health and Senior Services anticipated saving as much as $43 million through cuts it made to in-home care in 2017. However, while there was some savings, the actual amount fell far short of expectations. The cost for these services actually increased between 2014 and 2017, but that was due to an increase in the number of people relying on said services.
According to Missouri State Auditor Nicole Galloway, spending increased from $620 million in fiscal year $2014 to $816 million in fiscal year 2017. The number of people relying on these in-home care services increased from 61,101 to 66,332.
These in-home care services can range from basic support for mobility to direct medical attention from visiting nurses. Essentially, the Department of Health and Senior Services raised the required score from 21 to 24, making it more difficult for residents throughout the state to qualify for these services. By doing so, the expectation was that the state would save $43 million when, in fact, it saved $10 million based on fiscal year 2018 numbers.
According to the Missourian article, After cuts to in-home care, savings come up short, written by Natalie Macintosh:
“The Department of Health and Senior Services didn’t save as much as it predicted it would after making cuts to in-home care in 2017, a state audit has found.
On Wednesday, Missouri State Auditor Nicole Galloway released her review of the state’s home- and community-based services program. The audit found that costs of services for the program increased from $620 million in fiscal year 2014 to $816 million in fiscal year 2017 and that the number of participants grew from 61,101 to 66,332 over the same period.”
One of the key reasons for this failure to meet anticipated cost savings is a fact that the scoring system found residents’ dependability needs increased. In other words, residents were finding a greater need for in-home care than they had in the past.
The scoring system ranges from 0 to 81. There are a number of categories with scores ranging from 3, 6, to 9 in each category. The needed increase might only come from one category, but when it does, it increases the number of people eligible for these services.
Even though the state did not reach its savings estimates, it’s unclear how much it did save had people scoring 21 to 23 been eligible for these programs as well. In other words, had the state’s Department of Health and Senior Services not increased the eligibility score, thousands more people may have qualified for these very services, thus increasing the amount of spending at the state level. It is unclear whether the state would have been able to provide services to all who needed it during this recent fiscal year.