But voters may curb union political donations
One of the region's more active labor unions is pushing a ballot measure that could expand in-home care for the elderly and disabled in Montana - and allow the union to organize a new pool of in-home care workers. Initiative 159, whose supporters are trying to qualify it for the November ballot, aims to direct state/federal health care money away from nursing-home care to in-home care, says Ted Dick, political coordinator for Service Employees International Union in Montana.
“People like being in their homes, they do better in their homes,” he says. “That's not to say there's no need for nursing homes, but the nursing home hey-day is behind us.”
Yet a consumer group representing the elderly and a lobby for nursing homes and in-home care businesses are not supporting I-159, saying it unnecessarily revamps how in-home workers are employed, could ring up huge bills for the state and may not improve care.
“It is mainly an effort to increase union membership in SEIU, disguised as an effort to improve in-home care in this state,” says Rose Hughes, executive director of the Montana Health Care Association.
AARP Montana, a consumer group with 162,000 members 50 and older, says
I-159 may hold a “false promise” to expand in-home services and could end up eroding the funding for other services to the elderly.
AARP and the Health Care Association say language in I-159 could require the state to provide in-home care to 1,000 people on waiting lists, thus imposing new annual costs for the state of $27 million by 2010 and $47 million by 2013.
Dick says the language merely makes serving “underserved” consumers a priority, including those on the waiting lists.
Using volunteers and paid workers, SEIU began gathering signatures about three weeks ago to attempt to place I-159 on the November ballot. The initiative needs the signatures of 22,308 registered voters statewide and at least
5 percent of voters in at least 34 state House districts.
Ballot-measure organizers have until June 20 to turn in their signatures to county election officials.
Dick says signature-gatherers for I-159 will be outside polling places on the primary election on Tuesday - along with signature-gatherers for other, unrelated measures trying to make it on the November ballot.
I-159 would add a significant new wrinkle to how Montana manages and provides in-home care for 8,100 elderly and disabled people, paid for by Medicaid, the state-federal program that pays medical bills for the poor.
Under current law, nearly 9,000 in-home care workers are employed by private companies, some of which are nonprofit. They provide care wherever the companies offer their services.
Under I-159, in-home workers can be independent, private contractors employed by the people for whom they provide care. They also can choose to be organized by SEIU, which already has organized about 500 in-home care workers employed by companies.
Medicaid would still pay the self-employed in-home workers, and the state would train and certify them.
Dick says this type of set-up has worked in several other states, including Washington, Oregon and California, and will lead to more in-home workers in under-served, rural areas.
Montana and the nation is facing a “tsunami” of aging babyboomers who will need health care assistance, and it's far better - and cheaper - to have this help in-home rather than in nursing homes, he says.
“It diverts money away from institutionalized care and puts more into home and community-based services,” he says. “Allowing people to stay in their home instead of institutionalized care saves the state money in the long run.”
The Montana Health Care Association, which represents nursing homes and businesses that employ in-home workers now, says it agrees that in-home care should be expanded in Montana.
But I-159 is not the way to do it, says Hughes, the association's executive director.
Montana already has a good in-home care system developed with collaboration from providers, advocates for the elderly and the state, and I-159 drastically changes the system, with unknown consequences, she says.
The “fiscal note” for the measure says it would cost the state $2.6 million during its first year in 2009 and increase to $7 million by 2013, as the state must train, certify and supervise more in-home workers.
Yet Hughes and AARP say the costs could be much higher, because of the language in I-159 that says people on in-home care waiting lists should be served.
“If this initiative is adopted by voters, we fear it will create a significant unfunded mandate that will jeopardize the department's funding of existing critical programs,” AARP said in a statement.
Voters will likely face signature-gatherers for 6 initiatives
HELENA - When voters go to the polls for Tuesday's primary election, they may see signature-gatherers for several initiatives attempting to qualify for the November ballot.
Here's a summary of the proposals you may be asked to sign:
Children's health care: Initiative 155 would expand two state-federal programs, Medicaid and the Children's Health Insurance Program, to provide health coverage for an additional 30,000 children in Montana.
Home health care: I-159 would create a potentially unionized work force of in-home care workers, who would be trained by the state but act as independent contractors who take care of the elderly and disabled who need assistance at home.
Property tax revision: Constitutional Initiative 99 would amend the state constitution to limit residential property-tax increases and allow an “acquisition value” system of appraising residential property for tax purposes. Such a system would reappraise property only when it's sold, at the sales price.
Abortion: C-I 100 would amend the state constitution to define a life and a legal “person” as beginning at the moment of fertilization of a human egg. Supporters hope its passage would lead to outlawing abortion.
Hunting/fishing access: CI-101 would amend the constitution to say the “opportunity” to harvest wild fish and game is a heritage that shall be preserved. I-157 would allow nonprofit corporations to conduct a lottery to raise money to acquire or enhance access to land or wildlife. I-158 would prohibit anyone from limiting public access to fish or game by trading or selling access to land.
Political contribution restrictions: I-156 would prohibit labor unions and other groups that have contracts with government from making any political contributions in Montana.