Older Americans Month #2 - Long Term Care
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May 15, 2009 Posted by Adam Swope
Long Term Care is the forgotten crisis within the Health Care debate. 40% of adults who reach the age of 65 will need more than 2 years of Long Term Care – which includes nursing home care, or in-home care from an attendant who helps with every-day activities. However, 200 million adults in the United States have no Long Term Care insurance! We are a nation of 350 million people, many of whom are children. Therefore, virtually no one is prepared for Long Term Care that a great many of us will need. The result? People who have saved money all their lives, who expected to leave something to their children, their church or their favorite charity, are now forced to spend their assets into poverty so that Medicaid will pay for their Long Term Care. This leaves many seniors with no financial freedom at the end of their lives, and nothing to pass on to their loved ones.
Furthermore, choice in Long Term Care services is often limited. While some seniors have health issues severe enough to mandate nursing home care, most seniors would prefer to receive services in their own home, rather than move to a nursing home. This outcome is also desirable from a cost perspective. Home care in Pennsylvania has an average annual cost of $21,000, while nursing home care costs average at $60,000 per year. However, only 18% of Medicaid Long Term Care dollars are spent on home care, while 82% are spent on nursing homes. How can this be? Well, if a senior is forced to spend their assets down into poverty before Medicaid will pick up the bill for Long Term Care, then that senior no longer has the money to maintain their home, pay taxes on it, pay utility bills, etc. Furthermore, home care workers are scarce in Pennsylvania. Seniors are free to choose home care agencies. However, some seniors wish to have control over the selection of their home care worker. In those case, seniors do not have easy access to candidates. And many seniors cannot deal with having their caregiver miss a day of work or leave the position for a better-paying career. These seniors are forced to choose nursing home care to avoid these problems. As a result, cost goes up and quality of life declines.
Luckily, there are proposals at the Federal and State level that would dramatically improve Long Term Care.
First, the US Congress must pass the CLASS Act, or make its provisions part of a total health care overhaul. The CLASS Act, or Community Living Assistance Services and Supports Act of 2009 (S. 697 and H.R. 1721) would create a national Long Term Care insurance program through monthly payroll deductions such as fund Social Security and Medicare. The money would go into the “National Independence Fund”, administered by the Department of Health and Human Services. All workers over the age of 18 would be automatically enrolled, but would have the option to opt out of the program. Anyone with at least 60 months paid into the program would be eligible for benefits. Benefits through this act would not affect those who already receive Social Security Disability Insurance benefits.
The CLASS Act would create a very large risk pool, making the coverage far more affordable than it could ever be on the open market. Furthermore, it would reduce the burden on Medicaid, producing significant savings for State budgets and taxpayers. And, of course, seniors would not be forced into poverty by Long Term Care costs.
To learn more about the CLASS Act, click here:
Next, Pennsylvania must create a Consumer Workforce Council. The Consumer Workforce Council would provide a service to seniors who choose home care, and who choose consumer-directed home care over agency home care. In other words, it would help seniors who want to select their own health care worker, and have the ability to replace that worker if they choose. The Consumer Workforce Council would create a voluntary registry for these types of workers. Seniors could use this registry to interview several home care workers and make their choice. The registry would also allow them to find temporary replacements for their home care workers if they become ill, or so they could have time off. For seniors who need care every day, this flexibility would make home care a more viable option.
Furthermore, the Consumer Workforce Council would allow home care workers to collectively bargain for wages and benefits. Currently, many home care workers make so little money that they themselves qualify for state assistance like food stamps. They also have no health insurance benefits. Through the Consumer Workforce Council, workers who sign up for the registry could sign a contract for wages and benefits. This would not only be good for the workers, but it would also help reduce turnover and thereby improve care.
The Consumer Workforce Council is about improving choice for seniors. Agency care and nursing home care would not be affected. Nor would family members who choose to care for their loved ones be forced into any agreement or registry.
PARA is proud to stand with other organizations like AARP, Pennsylvania Council of Churches, labor groups and Independent Living Centers in support of the Consumer Workforce Council.
For more information, visit www.choosehomecare.org.
By supporting the CLASS Act and the Consumer Workforce Council, we can finally control costs and improve the quality of life for Long Term Care recipients.
Jean Friday
President, Pennsylvania Alliance for Retired Americans