But more must be done to improve long-term services and supports, especially in the area of quality care

Topeka, Kansas – Kansas ranks 17th when it comes to meeting the long-term care needs of older residents, and AARP warns more must be done, at an accelerated pace, to improve quality of care and effective transitions from nursing homes to community settings. This, according to a new, comprehensive state-by-state Scorecard from AARP with support of the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation.

Raising Expectations 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers – an update of the inaugural 2011 Scorecard – ranks each state overall and within 26 performance indicators along five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and, effective transitions. New indicators this year include length of stay in nursing homes and use of anti-psychotic drugs by nursing homes, raising serious concerns about the quality of institutional care.

“The vast majority of older Kansans want to live independently, at home, as they age – most with the help of family caregivers,” says Maren Turner, director of AARP Kansas, which serves more than 326,000 members age 50 and older in Kansas. “Even facing tight budgets following the Great Recession, Kansas is making some progress to help our older residents achieve that goal. However, this Scorecard shows we have more to do – and we don’t have time to stand idle.”

Today, unpaid family caregivers provide the bulk of care for older Kansans, in part because the cost of long-term care remains unaffordable for most middle income families. In Kansas, more than 414,000 residents help their aging parents, spouses and other loved ones stay at home by providing assistance with bathing and dressing, transportation, finances, complex medical tasks like wound care and injections, and more. The value of this unpaid care totals about $4.1 million.

“When it comes to helping older Kansans live in the setting of their choice, this silent army of family caregivers assumes the lion’s share of responsibility,” explains Turner. “Many juggle full-time jobs with their caregiving duties; others provide 24/7 care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes – most often paid for by Medicaid. They have earned some basic support.”

According to the state Scorecard, a number of family caregivers, 38 percent, face a degree of stress and worry. Kansas needs to take action to improve legal and systems supports for this group.

That’s why AARP Kansas will fight for passage of the Caregiver, Advise, Record, Enable (CARE) Act. The Caregiver, Advise, Record, Enable (CARE) Act will help family caregivers when their loved ones go into the hospital – and as they return home. Specifically, the CARE Act will require hospitals to:

• Record the name of the family caregiver when their loved one is admitted.
• Notify the family caregiver when their loved one is to be moved or discharged.
• Give instructions of the tasks the family caregiver will need to perform while caring for their loved one at home.

The single strongest predictor of a state’s long-term care system is the reach of its Medicaid long-term care safety net. That’s why AARP is also fighting to expand services provided at home and in the community, by shifting funds away from low quality and more expensive nursing home care. The Scorecard highlights concerns about institutional care in Kansas: including nurse staffing, resident health and safety, chemical restraints, and the transition of nursing home residents to home and community based care.

While Kansas does rank 22 in increasing the percentage of Medicaid long-term care dollars that support care provided at home and in the community – the care setting that most Kansans prefer – the Scorecard spotlights areas that call for improvement, including choice of setting and provider; quality of life and quality of care; and effective transitions. Specifically concerning are Kansans rankings in nursing home settings:

• 18th in the percent of high risk nursing home residents with pressure sores;
• 27th in the percent of nursing home residents with dementia with one or more potentially burdensome transitions at the end of life
• 39th in the percent of long-stay nursing home residents receiving antipsychotic medication;
• 46th in nursing home staff turnover;
• 35th in the percent of long-stay nursing home residents hospitalized within a six month period;
• 44th in the percentage of nursing home residents with low care needs who could be better served in community settings; and,
• 46th in the percent of people with 90+ day nursing home stays successfully transitioning back to the community.

“This Scorecard gives us a snapshot of how well Kansas serves our older residents, those with disabilities, and family caregivers – and shows us where we must sharpen our focus to better assist hardworking Kansans,” concludes Turner. “Now is the time for policymakers to act.”

Of the 26 Scorecard indicators, 13 may be improved through state policy changes, pointing to the importance of AARP’s multi-state advocacy campaign, launched this year, to help older Americans live independently, at home, and the family caregivers that support them. Currently, 42 states are advocating as part of the campaign, including Kansas.

The Scorecard reveals, “In just 12 years, the leading edge of the Baby Boom Generation will enter its 80s, placing new demands on a still imperfect long-term care system. Further, this generation will have far fewer potential family caregivers to provide unpaid help.

Long-term care (also called long-term services and supports) is a diverse set of services designed to help older people and those with disabilities; services can be provided in a person’s home, in a community setting such as an adult day center, or in a group residential facility like a nursing home.

The full state Scorecard, along with an interactive map of state rankings and information, is available at www.longtermscorecard.org.

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About AARP: AARP is a nonprofit, nonpartisan organization, with a membership of nearly 38 million, that helps people turn their goals and dreams into real possibilities, strengthens communities and fights for the issues that matter most to families such as healthcare, employment and income security, retirement planning, affordable utilities and protection from financial abuse. We advocate for individuals in the marketplace by selecting products and services of high quality and value to carry the AARP name as well as help our members obtain discounts on a wide range of products, travel, and services. Learn more at www.aarp.org.