CHALLENGES OF LONG-TERM CARE

By Catherine L. Barrett

LONG-TERM CARE. IT IS PERHAPS ONE OF THE BIGGEST CHALLENGES WITHIN HEALTH CARE.

THE QUESTION FOR MANY CITIZENS AND LEGISLATORS IS HOW TO AFFORD GOOD CARE FOR LONG-TERM RESIDENTS IN NURSING HOMES, COMMUNITY SETTINGS AND IN THEIR OWN HOMES.

THE QUESTION FOR MANY CITIZENS AND LEGISLATORS IS HOW TO AFFORD GOOD CARE FOR LONG-TERM RESIDENTS IN NURSING HOMES, COMMUNITY SETTINGS AND IN THEIR OWN HOMES.

CENSUS BUREAU FIGURES HAVE THE AVERAGE PER PERSON NURSING HOME COST AT $51,000 A YEAR AND MORE THAN HALF OF THE U.S. POPULATION WILL EVENTUALLY NEED SOME KIND OF LONG-TERM CARE.

MANY PEOPLE BELIEVE THAT MEDICARE OR EMPLOYER-PROVIDED MEDICAL INSURANCE COVERS THE MAJORITY OF LONG-TERM CARE EXPENSES AND IN MOST CASES THEY DO NOT.

THE MEDICAID PROGRAM WHICH WAS DESIGNED AS A SAFETY-NET FOR LOW-INCOME WOMEN AND CHILDREN, AS WELL AS PEOPLE WITH DISABILITIES AND THE ELDERLY, HAS BECOME THE PRIMARY SOURCE OF PAYMENTS FOR LONG-TERM CARE.

PERHAPS ONE WAY TO REFORM LONG-TERM CARE, IS TO EXPAND HOME AND COMMUNITY BASED SERVICES. THIS MAY SERVE TO REBALANCE A SYSTEM SLANTED TOWARD NURSING HOMES.

BUT IN ORDER FOR STATES TO OFFER COMMUNITY AND HOME CARE OPTIONS THAT ARE PARTIALLY FUNDED BY THE FEDERAL GOVERNMENT, THEY NEED TO APPLY FOR WAIVERS TO PAY FOR THOSE SERVICES NOT COVERED BY MEDICAID.

FOR EXAMPLE, I WILL BE INTRODUCING LEGISLATION THAT WILL CREATE AN ASSISTED LIVING PROGRAM PURSUANT TO A HOME AND COMMUNITY-BASED WAIVER GRANTED BY THE UNITED STATES SECRETARY OF HEALTH AND HUMAN SERVICES.

THIS BILL WOULD REQUIRE THE DIRECTOR OF JOB & FAMILY SERVICES TO CONSULT WITH THE DIRECTOR OF AGING AND APPLY FOR THE WAIVER.

THE PROGRAM WOULD BE OPERATED SIMILARLY TO THE PASSPORT PROGRAM AND WILL PROVIDE HOME AND COMMUNITY-BASED SERVICES, OTHER THAN ROOM AND BOARD, TO RESIDENTS OF RESIDENTIAL CARE FACILITIES.

THERE ARE MANY ELDERLY PEOPLE WHO NEED ASSISTANCE WITH DAILY LIVING ACITIVITIES BUT WHO ALSO VALUE THEIR INDEPENDENCE.

THIS ASSISED LIVING PROGRAM WILL PROVIDE ASSISTANCE FOR THOSE WHO MAY NEED HELP WITH DAILY LIVING ACTIVITIES AND IT WILL PROVIDE THEM THE ABILITY TO LIVE INDEPENDENTLY FOR AS LONG AS POSSIBLE. IT ALSO CUTS THE COSTS OF PLACING INDIVIDUALS WITHIN NURSING HOMES.

MEANWHILE, LEGISLATORS MUST BALANCE PROTECTING THE ELDERLY AND DISABLED WITHOUT OVERREGULATING THE BUSINESSES THAT PROVIDE THEM WIH CARE...BUT SENIORS IN LONG-TERM CARE SETTINGS MUST BE PROTECTED.

THE KEY TO ENSURING PROVIDING QUALITY CARE IS ENTIRELY DEPENDENT ON TRAINED STAFF AND NURSING ASSISTANTS ARE CRITICAL IN THIS AREA.

HOWEVER, THERE IS A SEVERE SHORTAGE OF NURSING ASSISTANTS AND THE TURNOVER RATE IS EXTREMELY HIGH DUE TO LOW WAGES.

LEGISLATORS MUST FIND A WAY TO CONTINUE TO WORK ON CHANGING THE WAY STATES PAY FOR AND DELIVER LONG-TERM CARE.