Early intervention is best for youthsI am...

THE BALTIMORE SUN

Early intervention is best for youths

I am writing to applaud Attorney General Joseph Curran's commitment to serving at-risk children and youth through prevention, early intervention and treatment. The Rand Corporation study cited in Mr. Curran's letter of July 11 ("Jail not preferred for juveniles") clearly demonstrates that prevention efforts targeted at vulnerable youths can divert them from crime and violence.

In these times of shrinking federal and state funds, utilizing cost-effective programs that turn kids away from crime seems to be a logical, positive alternative.

Providing treatment and early intervention for young people who have committed some crimes also needs to be considered. By providing treatment early, we will reduce the costs of future incarceration for these youths, along with the social costs of fearing to live and work in certain communities.

George L. Carlson

Baltimore

The writer is director of social services at Good Shepherd Center.

Article raises painful questions

I was deeply touched by the superbly written July 24 Opinion Commentary article, "Visiting mother."

What a sad commentary on our society that at a young age such a gifted writer chose the path that led to his own destruction. Why?

Nathan Johnson Jr. stated that his mother and father had taught their nine children the difference between right and wrong. His mother loved him. What is the answer?

J. E. Grumbach

Dundalk

Sexual harassment a matter of course

It sounds as if we have heard this song played out before: Drunken young man wearing naval uniform becomes sexual predator and then is defended by peers and line of authority.

It is no wonder that the Tailhook incident took place. It appears that they practice, drill and exercise such a procedure at the Naval Academy until proficiency is attained. I wonder if a course number is assigned yet?

W. W. Beydler

Laurel

Locked doors recommended

Seems to me that all the problems that they are having at the Naval Academy due to the changing of one rule (allowing women) could be solved easily by changing another: lock your doors.

Emily Johnston

Westminster

Know your Maryland shores

When was St. Mary's County moved to the Eastern Shore?

The obituary for Paul Hill, July 13, said he was "a native of Great Mills in St. Mary's County on the Eastern Shore." A geography lesson is in order.

I vacation frequently in Calvert County and am always surprised to realize how many Marylanders place that county, also, on the Eastern Shore.

For the information of the many local geography know-nothings, Calvert, Charles and St. Mary's counties are considered Southern Maryland, and are located on the Western Shore in -- guess what? -- Southern Maryland.

Incidentally, there are many wonderful places of interest in those three counties which I recommend for day trips. Maybe that way, Marylanders will realize what a jewel we have right here on the Western Shore.

Carol Chesney Meyers

Towson

Elderly still need homes and income

Recently, Maryland enacted legislation which requires the Office of Aging to license and regulate health care providers offering continuing home care to the elderly -- visiting nurses, for example. Although the legislation protects the rights of the elderly, it does not provide financial assistance to the elderly, nor does it limit the fees health care providers may charge for such care.

For those elderly who are disabled and lacking the resources to afford home care, the only viable type of long-term care may be a nursing home, and that is usually expensive. The monthly cost of even a modest facility can range anywhere between $4,000 and $5,000. This does not include the cost of any additional hospitalization. Many seniors will find nursing home care unaffordable unless they are able to rely on Medicaid.

To qualify for Medicaid coverage, an individual must be 65 years or older and disabled -- that is, in need of skilled or custodial nursing care or rehabilitative services on a daily basis. There is also a financial criterion for Medicaid which requires that a person's assets not exceed $2,500, unless the asset falls into a category of exemptions. Currently, Medicaid treats an individual's home as an exempt asset, assuming he or she can show an intent to return to that home at some point after being placed in a nursing home.

When a person entering a nursing home has a spouse, the spouse is entitled to a "spousal allowance," which allows the community spouse to retain a certain amount of money each month. Assuming one meets these requirements, then Medicaid will pay the difference between a senior's monthly income and the monthly nursing home bill, permitting the senior to retain only $40 a month from his or her income for personal use.

This imperfect method of delivering nursing home care to senior citizens is in need of reform. Not all seniors who are eligible for nursing home care necessarily need to be placed in a nursing home. Seniors who are not suffering from dementia and have a supportive family should be able to obtain financial assistance for continuing home care. At present, this care is not covered through Medicaid.

Seniors should have flexibility in exchanging exemptions that they do not need for those that they can use. Single seniors who enter a nursing home may not have need of their home, but will still need some income -- at least more than $40 per month. Therefore, seniors should have the option of selling their home and giving the proceeds to Medicaid in exchange for Medicaid paying a larger portion of the nursing home bill and thereby allowing the seniors to retain a greater portion of their income.

Despite the need for reform, Medicaid should not be eliminated or entrusted entirely to the states. Before the Medicaid law mandated that a senior's home had to be treated as an exempt asset, many states, including Maryland, required seniors to sell their homes and the community spouse to spend all of their assets before providing coverage for the institutionalized spouse.

If Congress eliminates the Medicaid program or gives the money through block grants to states, there there is no guarantee that Maryland will not return to this prior practice and require seniors to sell their homes in exchange for financial assistance in paying for nursing home care -- a scenario which is likely given Maryland's budget constraints.

Taras Andrew Vizzi

Baltimore

Pub Date: 8/01/96

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