Our Opinion: Caregiver bill needs structure to prevent abuse

A Missouri lawmaker has an idea to provide another option to care for the increasing population of elderly residents. Although the option is attractive in theory, potential problems abound.

Greater longevity has prompted an increase in in-home care services, assisted-living facilities, nursing homes, dementia units and more.

Legislation to establish a model called structured family caregiving has been filed this session by Rep. Kurt Bahr, R-St. Charles. The model provides for family members to receive stipends for providing 24/7 assistance to some of the poorest people in the state.

Bahr said the state could save money by eliminating the cost of paying for Medicaid patients in nursing homes.

Under the proposal, the state would hire a private company to oversee the family caregivers and ensure clients' needs are met. An official with one such company told lawmakers concerns about possible Medicaid fraud could be addressed by requiring the caregiver to submit daily electronic notes and by monthly visits.

Reverence and care for the elderly is the norm in some cultures, and also is practiced widely in the United States. We know of many elderly residents who are cared for by family members, who neither expect nor receive monetary compensation.

Sadly, we also publish news stories about cases of elderly abuse and neglect, and about Medicaid fraud.

Nikki Strong, executive vice president of the Missouri Health Care Association, said: "I don't see the mechanisms in place for keeping the fraud from happening."

Strong raised other questions including: "What will be the cost to the Medicaid program? Will it save the state money? How will it be regulated?"

We share those concerns.

Structured family caregiving would be a wonderful option if honesty and kindness prevailed.

In the real world, however, the model would require provisions to prevent fraud and, more importantly, to ensure Missouri's elderly residents receive the care, attention and compassion they deserve.