The Florida House will soon vote on proposed legislation that, if not amended, would severely harm our elderly citizens who are being cared for by a family member. A similar bill is in Senate committees.
Currently Personal Service Contracts (PSCs), allow family member caregivers to be paid by the ill person for their services. Since many family member caregivers must leave their jobs or reduce their work hours to devote the time necessary for caregiving, putting unreasonable limits on how much they can make would be a huge financial sacrifice. The Senate version even calls for minimum wage.
But let’s remember that many of these caregivers have families of their own to support. The proposed legislation, HB 1323 in the House and SB 1748 in the Senate, would also require these caregivers to accurately predict the time they will spend performing their services. That means knowing in advance when and how often the elderly loved one will have to be taken to the hospital and have vital errands run for them. These are impossible to accurately predict when it involves a frail, elderly adult, and our caregivers don’t have a crystal ball. The legislation would, in effect, get rid of the contracts That would mean discouraging at-home care and put more people in nursing homes. This is the opposite of what our new Medicaid Reform seeks to encourage. It is always better to have a senior citizen stay at home as long as they can do so with proper care.
The reason lawmakers are considering the changes is the concern by the Florida Department of Children and Families (DCF) that some people are using PSCs to cheat the system by 1) getting paid too much and 2) utilizing these over payments to make the elderly person in their family appear “poor enough” to qualify for Medicaid. DCF is the agency that determines Medicaid eligibility.
All of us want to get rid of fraud, but it’s important not to throw the baby out with the bathwater. That’s why Florida elder law attorneys, who advocate for senior citizens daily, AARP and the Alzheimer’s Association have worked with DCF to keep the PSC oversight in Florida reasonable and flexible. All of the organizations are proposing an amendment to the bill that, instead of creating an inflexible law, emphasizes that DCF will make rules governing PSCs. That way, Medicaid eligibility cases can be determined on an individual basis.
Creating a new law encourages more big government looking over our shoulders. This is something honest senior citizens don’t need. We would urge our lawmakers to vote in favor of the new amendment, recognizing that it will fight those who try to cheat the system, while still allowing family member caregivers, who already make huge sacrifices, to care for their deserving elderly family members without fear of financial ruin. It will also help ensure that deserving seniors and their family members aren’t punished for the sins of others.
Len Mondschein, past chair, Elder Law Section of The Florida Bar, Miami