In the last few days, I have received more than 400 letters in support of the Nursing Home Litigation reform bill. I have also received several letters concerning the self-directed health care program.

The primary issue we are facing is availability of service. Currently, community and private owned nursing homes in Tennessee are being forced to pay high insurance premiums and expensive attorney's fees just to combat litigation.

The last thing we want is for nursing homes in Tennessee to close up because of fear of being sued. I realize there are problems in some nursing homes, but most nursing homes in Tennessee do a great job of caring for their patients, and I am confident that this great care will continue.

Other states such as Florida have taken steps to stop out of control litigation costs. Florida, however, waited too late to bring reform and over 100 of their local nursing homes were sold or closed. Tennessee does not need to make this same mistake.

This bipartisan bill house bill 4053 opens the debate on controlling the outrageous costs of litigation, similar to the discussion we have had in the State Legislature over the last several years on medical malpractice reform.

Again, the last thing we want to do is force Tennessee nursing homes to close or leave the state. If that happens, Tennesseans lose because their access to care will be eliminated. Another bill that affects the elderly is the self-directed health care program legislation that aims to help citizens "age in place."

This legislation calls for a pilot program for a "self-directed care program" where individual patients get the opportunity to choose services they need and who provides them. Consumers would receive a monthly budget based on their needs, and could use this money to hire personal assistant services, make home modifications, and more.

We must look at all of our laws to help give citizens more options regarding their health care so that they can age in place in their homes with dignity. This is one of several bills we hope to pass this year aimed at providing more choices and options to elderly and disabled Tennesseans to help them stay in their homes as long as they can. I believe it's important to ensure that seniors and the disabled have options, and that they are in control of those options. What fits for one person may not fit another.

Arkansas, Florida and New Jersey were the pioneers of this self-directed health care concept. Since that time, 12 other states have expanded their choices. In Arkansas, there was a 40% reduction in nursing home admissions in the second year of the program, and the total Medicaid cost per person under the self-directed car plan was about the same as that for the traditional agency model. Studies show that, by every measure, self-directed care is succeeding and that consumers with this option are reporting greater satisfaction, better quality of life, and fewer unmet needs.

Tennessee spent approximately $1.1 billion on long term care last year. Out of the 22,000 seniors on Medicaid in Tennessee, only a few thousand get home- and community-based care services.

Another proposal encourages responsibility by rewarding those who purchase long term care insurance. Currently, to receive state dollars for long term care, participants are required to "spend down" their assets-sometimes having to dispose of family heirlooms, land, or other things that do have monetary value, but also have sentimental value.

We debate many important things up here; however, healthcare takes up one-fourth of our budget. We need to make sure these funds are being spent that will truly assist our aging population. We need to give seniors this voice.

Rep. Eric Watson