Will AT Save IHSS?

By Allan Friedman, CFILC's Technologies Manager

California made a BIG bet in March.  We (the disability community, caregivers and the legislature) bet that AT devices for a few at-risk individuals will save the state $140 million dollars in prevented hospitalizations.  And if we’re wrong? A cut to IHSS hours for all.

When SB 72 was signed into law March 24^th, the clock began ticking on an ambitious pilot project to see if California could reduce Medi-Cal hospital costs by ensuring that patients take their proper dosages of medications at the proper times.  More than a dozen states have succeeded in reducing hospitalizations due to medication mismanagement, so hopes are high.

The technology being piloted is called a Medication Dispensing Machine.  Loaded by the Medi-Cal recipient or caregiver with a month’s supply of medications, the machines are programmed to dispense the proper dosages at the proper times.  The user is alerted with both a visual (flashing light or sign) and auditory signal (a recorded voice, bell or other sound).  If the dispensed meds are not taken in a set amount of time, they are withdrawn into the machine and a text or audio message is sent by telephone to caregivers, doctors or other designated receivers. All dosages are recorded and can be monitored remotely.

But will California realize the savings from this use of assistive technology in time to prevent cuts to IHSS hours?  It's doubtful.  The Department of Healthcare Services has only just begun to work out the details of how they will identify those at risk and how they will deliver the service to them. Their most recent progress report (available on the pilot project webpage) shows that implementation will not start for several more months, most likely in 2012. 

Yet the bill calls for reporting to begin in October and that evidence of savings must be reported to the legislature by April 2012 or else the budget committees will begin planning a reduction in authorized hours for IHSS recipients beginning in October of 2012. This budgeting tactic is being called a "trigger."

The Medication Dispensing Machine Pilot Project has a lot of potential to reduce costs and help consumers stay healthy and out of hospitals.  It is likely that, even with delays to its implementation, it will be continued in the next budget cycle.  But it seems clear that the saving from this program probably will not come soon enough to avert cuts to IHSS services.