There are additional administration factors that are hard to put a finger on, but on the face, the Independent Caregiver option saves the state 8.1% cash outlay over the identical hours of service from an agency home care provider.   Additionally, the competition introduced by the Independent Caregiver significantly helps keep in check the homecare charges by agencies.  Perhaps most importantly, (if the option was groomed with reasonable incentives), more workers could be attracted to help alleviate the impending caregiver shortage.

Here's an example of how employing Independent Caregivers could save Nevada hundreds of thousands of dollars each year...

We know:

· There are more than 6000 folks who are now using Medicaid funded home care in Nevada.
· The participants' average approximately 2.7 hours of homecare each day.
· Using agency homecare services, whether the ISO or other privately held homecare agencies, these services cost the state $17.02 per hour.
· The identical services, (or what some of us consider better services), using Independent Caregivers at current rates, cost the state $15.52 per hour.

Let's just suppose:

·  Medicaid officials would equally allow all eligible recipients access to the Independent Caregiver Option. Many of the participants (especially those, whose need for personal assistance is heavier), will take advantage of that option... let's just say one out of 10 of the total homecare participants, that is 600, choose this model.

Now, look at the math...
A $1.50 per hr. lower cost,   times the average 2.7 hours of daily use,   times 600 participants,   times 365 days of the year, =   $898,000

Perhaps saving a few hundred thousand dollars is not a big concern to Nevada Medicaid administrators. But, they should not neglect to pursue developing every practical resource that will allow Nevada’s elderly and disabled people a means to live in their own homes and to escape unnecessary institutionalization. The real bottom line question is, are we willing to make the effort necessary to effect the changes that will help these people?