This blog post first appeared on HealthCetera, from the Center for Health, Media & Policy at Hunter College, where I’m a Senior Fellow.
The Federal Long Term Care Commission issued its final report last week –adopting 28 recommendations addressing home and community based care, increased support for family caregivers, better workforce training and compensation, and a push away from a knee-jerk adherence to “institutional first” transitional care. That’s good news for the millions of disabled and older adults requiring some level of long term services and support.
But there’s this one problem.
The Commission couldn’t agree on how to pay for it. Instead of reaching consensus on payment reform, a split committee proposed different approaches – one focused on private market solutions and the other on public programs to finance these recommendations. A little insurance, a little personal savings, a little government help, perhaps some changes in Medicare rules… it was difficult to determine what, if anything was really on the table.
To make matters worse, six commissioners voted against presenting this as the panel’s final report. They refused to whole-heartedly condone the document primarily because of the nebulous statements on financing.
The Commission was formed as part of last year’s fiscal cliff deal to address issues that the repealed CLASS Act, was supposed to take care of. The CLASS Act offered Americans some real options for long term care coverage and was part of the original Affordable Care Act. It was axed when the final numbers didn’t work out as proposed.
Commissioners only really began work on these issues in June and there was little optimism that anything substantive could be accomplished in the 100 or so days left in their mandate. Throughout the summer, they heard testimony from long term care experts and advocates. A final report was required by mid-September and they managed to meet the deadline. But once again, older adults and others who need ongoing services and support are left hanging.
It’s highly doubtful a fractured Congress will come to quick agreement on financing any — let alone all — of the Commission’s proposals. Several Commissioners plan to write their own reports, with more of their specific ideas on costs and coverage. Conceivably as many as a half-dozen different versions could end up on legislator’s desks.
The long term care crisis is real, and it’s only getting worse. 12 million Americans currently require some type of long term support. Aging baby boomers will swell the ranks of seniors to nearly one-fifth of the population by 2030, according to the Scan Foundation, while the availability of caregivers – both family members and paid workforce – are declining. Costs of care are increasing, strain on family caregivers, and strain on the system is nearly at the breaking point already.
The Commissioners recognize that the report falls short. They urged Congress to view the document as a jumping off point for more refined proposals, additional committees, and alternative financing approaches. If there’s movement at all on these recommendations, it will be incremental at best.
How do you tell an 85 year old who could remain in her own home with just a little help, to wait?
How do you tell the son or daughter of a parent with Alzheimer’s that respite care is being “negotiated?” What can prevent someone from spending down nearly all of their assets because it’s the only way they can qualify for Medicaid-financed nursing home care?
Real solutions to improve quality of life, and quality of care for a significant portion of our population are in the pages of the Commission’s report. Unfortunately, the missing piece of the puzzle leaves millions still grappling with the same issues, and no relief in sight.
Tagged: aging in place, linkedin, long term care, long term care commission
Many of us are at that point where just as our kids need us less, our parents need us more. We have moved away from the old “nuclear family” concept, when generations often lived together or near by. Now, juggling a job, home, kids, and parents becomes a tremendous exercise in stress. MetLife estimates that 10 million adult children over age 50 now care for an aging parent.
It’s overwhelming just to think about it, let alone do it. The National Institute on Aging offers a free booklet, Twenty Questions and Answers About Long-Distance Caregiving that helps caregivers deal with many of the issues that surround aging relatives – whether it’s helping them cope with declining physical abilities, to setting up a system for household finances. Another good source for some additional ideas on caregiving and older parents is this recent US News & World Report article.
When was the last time you thought about whether someone else was getting good healthcare? Despite the progress we have made as a country in developing high-tech equipment, state-of-the-art hospitals, and breakthrough research, there are still huge segments of the population that don’t have readily available, high-quality care, and as a result, suffer many avoidable health problems.
The recent CDC Report on Health Disparities in America took an in-depth look at how health inequities impact our citizens and potential solutions to address this national problem. To backtrack, health disparities refers to the ongoing imbalance between the health status of minorities and non-minorities in the United States. This report is the first of what will become a regular series of reports on healthcare in the U.S. It looked at health differences among groups in a number of categories, including income, race and ethnicity, education, gender, disability status and other socio-economic factors.
Most of us don’t like to think about the day when we can no longer work because of a disability, or might need some kind of help with the basics of living as we age. However, it was something the late Senator Ted Kennedy thought about a lot. He knew that many Americans would eventually need some kind of extended care, and he also knew that most people preferred to stay at home, in their community, rather than going to a nursing home. His legacy is the CLASS Act (Community Living Assistance Services and Supports), a provision of the new Patient Protection and Affordable Care Act, aka health reform.
What the CLASS Act means is that you, or any working adult, may voluntarily choose to pay into a special long-term care pool; after five years you become vested. Once vested, you can receive benefits, regardless of age, diagnosis, or pre-existing condition. The caveat is that you have to be working – if you are already retired you cannot join this Continue reading