Alter aging care strategy
For years, those of us who work in the field of senior services have been warning about the influx of aging baby boomers that will increase the demand for long-term care services. Well, the age wave has arrived, both in our state and the nation.
Currently in our state, there are about 1.8 million people between ages 45 and 64, including nearly 100,000 within the five-county Aging & Long Term Care of Eastern Washington, which serves Spokane and four adjacent counties. Nationally, almost one in six Americans will be 65 or older by 2020, and the size of the age 85-plus population will have doubled.
Washington state’s Aging and Disability Services Administration is seeing the following combination of factors: the aging boomer phenomenon; the growing number of people age 85 and older; the increase of younger adults with disabilities; and individuals with developmental disabilities who are living longer while their family caregivers are growing older. It’s clear that our current national long-term care strategy will leave states and the federal government with a bill it cannot afford.
What can we do about it? Right now, as Congress negotiates a health care plan, we have the opportunity to fix the problem.
U.S. Sen. Maria Cantwell, D-Wash., has introduced legislation, S. 1257: “Project 2020: Building on the Promise of Home and Community Based Services Act of 2009.” The House companion bill is H.R. 2852. This legislation is a bipartisan, long-term care plan that will change the way the nation spends public dollars on our aging population.
With passage of this legislation, we will, finally, focus on providing consumer-centered information that will help people take care of themselves, cost-effective and proven health and wellness programs, and community supports to keep people out of nursing homes except as a last resort. Most importantly, people will not be forced to wait until their health has deteriorated and they have spent down to the poverty level in order to be eligible for support.
This is important because financing home and community-based services can save health care dollars, improve health status and contribute to economic growth. Project 2020 is expected to produce $1.1 billion in federal savings over 10 years.
Additionally, this bill ties into the health care reform goals of keeping Americans healthier, reducing overuse of clinical services and nursing home care and cutting costs in Medicare and Medicaid.
For example, it would provide comprehensive information for all Americans about privately and publicly funded long-term care options, including home- and community-based services, so they can plan appropriately for themselves or loved ones. Federal outlays for this section are $600 million. Net federal savings are $1.1 billion over 10 years.
It would also stress evidence-based health promotion and disease prevention by educating older adults in community settings about chronic disease management and interventions that enhance health and wellness. Net federal savings are $665.8 million over 10 years.
And the legislation would assist low-income elderly adults who can and want to remain in their homes, but who do not qualify for Medicaid and are functionally at risk of nursing home placement. Without these services and supports, such individuals are often left with virtually no choice but to move into a nursing home, which will deplete their resources, rendering them Medicaid eligible. The program allows them to remain at home at a much lower cost and avoid or delay Medicaid dependency. Net federal savings are $618 million over 10 years.
Not only is this what consumers want but it saves taxpayers money. The proof is right here in our state. We started in the mid-1990s to shift our dollars in helping senior citizens and adults with disabilities stay in their own homes or a community-based setting. Over that time we have saved millions in federal and state dollars because the cost of providing care for people at home is about one-third of the cost of care in a nursing home.
Aging & Long Term Care of Eastern Washington already is incorporating many of these concepts through its “bundled model” of services. Passage of the Project 2020 legislation would expand and streamline these services.
We have the opportunity to weigh in with Congress now. Please contact your member of Congress. Visit the Web sites of the National Association of State Units on Aging ( www.nasua.org) and the National Association of Area Agencies on Aging ( www.n4a.org) for more information.
Let’s change the outdated way we look at long-term care. It’s not about the “end of life” setting – it’s about the way we want to live as we age.