State lawmakers could save money by putting more funding and emphasis on prevention and less on treatment for those with serious health problems and disabilities.

During the last session of the Legislature, the Division of Aging and Adult Services requested $83,000 in state funds to provide services within the community for those who have been certified eligible for Medicaid placement in nursing homes.At the same time, the Division of Services to the Handicapped requested money for its attendant care program. About 22 Utahns with severe disabilities receive up to $500 a month to hire attendants so they can stay in their own homes.

Citing a lack of money, legislators passed over the aging program, which is now unfunded. Utah will end up paying far more to help the elderly as a result.

Matched with federal funds, the state money would have paid administrative costs for the Home and Community Based Waiver program.

This program would have provided services to allow approximately 50 people to remain in their homes for a six-month period.

The waiver was targeted to help those people who are so ill or frail that they could qualify for admission to a nursing home, yet - with help - could still get by at home.

Without the program, the individuals will be admitted to nursing homes - at the expense of state Medicaid dollars.

Either way, state funds are used. But the price tag is smaller when services are provided in the community, rather than in long-term care facilities. And most elderly people indicate a heartfelt preference for staying in their own homes within the community. It's a choice they ought to have - and besides, it's cheaper.

Lawmakers did allocate some money to continue attendant care services, and the division committed an additional $25,000 to expand the program - either by increasing the amount of money available to hire attendants (it's almost impossible to find people willing to work 24 hours a day seven days a week for a maximum of $500 a month) or by adding others from the 45-person waiting list. The latter would provide attendant service for no more than five of the 45 who are waiting.

Critics said that the attendant-care program was a less effective use of funding than some options because it does not draw down federal matching funds, but relies entirely on state dollars.

That's misleading, according to Sherry Repscher, who oversees the program for the Division of Services to the Handicapped. Although it doesn't draw in federal money, the $300-500 allocation is about the same as the state's portion of Medicaid placement in a nursing home.

"It doesn't cost the state any more than a nursing home would," she said, "it's about the same cost. But the attendant-care program speaks out about our commitment to the quality of life of those who have severe disabilities."

Utah - and its lawmakers - should consider not only cost when funding programs, but also quality-of-life factors and the importance of prevention. When dollar amounts are the same, the state should opt for the approach that provides independence and dignity.