- Person and family-centered care
- Subsidized housing opportunities (place-based and vouchers)
- Percent of new Medicaid aged/disabled long-term services and supports first receiving services in the community
Specific areas of concern in Mississippi include rate of employment for adults with ADL disabilities age 18–64 relative to rate of employment for adults without ADL disabilities ages 18–64. This is 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.
Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers –the third in a series of reports—ranks each state overall and on 25 specific indicators in 5 key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and, effective transitions between nursing homes, hospitals and homes.
“The vast majority of older Mississippians want to live independently, at home, as they age—most with the help of unpaid family caregivers,” says Kimberly L. Campbell, Esq., State Director of AARP Mississippi, which serves more than 285,000 members age 50 and older in Mississippi. “Even facing tight budgets, Mississippi is making some progress to help our older residents achieve that goal. However, this Scorecard shows we have more to do, and we need to pick up the pace.”
Today, unpaid family caregivers provide the bulk of care for older Mississippians, in part because the cost of long-term care remains unaffordable for most middle income families. In Mississippi, more than 500,000 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 $5.3 billion.
“When it comes to helping older Mississippians live in the setting of their choice, family caregivers take on big responsibilities,” explains Campbell. “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 the Mississippi Division of Medicaid. They have earned some basic support.”
According to the state Scorecard, Mississippi has taken action. But, more must be done.
That’s why AARP Mississippi fought for The Caregiver Act, which requires hospitals to:
- Provide your loved one the opportunity to designate a family caregiver.
- Notify you when your loved one is to be discharged or transferred.
- Discuss your loved one’s discharge plan with you.
- Provide an opportunity for you and your loved one to ask questions about aftercare medical and nursing tasks.
Medicaid/Home and Community-Based Services (HCBS)
“Mississippi has made some progress to improve long-term services and supports for older adults and people with disabilities, as highlighted in this Scorecard. But, proposals in Washington, D.C. to drastically cut federal funding for Mississippi’s Medicaid program would threaten these advancements, likely resulting in our most vulnerable citizens losing the lifesaving supports that they count on,” says Campbell.
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 also fought to expand services provided at home and in the community, by shifting funds away from less desirable, and more expensive nursing home care. While the inappropriate use of antipsychotic medication in nursing homes has slightly decreased, the Scorecard highlights additional issues related to institutional care in Mississippi.
Some of those issues are:
- Percent of high-risk nursing home residents with pressure sores.
- Percent of long-stay nursing home residents hospitalized within a six-month period.
While Mississippi does rank 39 th in the percentage of Medicaid long-term care dollars for older adults and people with physical disabilities that support care provided at home and in the community—the care setting that most Mississippians 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.
- 21.7% of new nursing home stays lasting 100 days or more.
- 25.3% of Medicaid and state-funded long-term services and supports spending going to HCBS for older people and adults with physical disabilities.
- 28.3% of nursing home residents with one or more potentially burdensome transitions at end of life.
“This Scorecard gives us a snapshot of how well Mississippi serves our older residents, those with disabilities, and family caregivers—and shows us where we must sharpen our focus to better assist hardworking Mississippians,” concludes Campbell. “Now is the time for policymakers to act.”
Of the 25 Scorecard indicators, many may be improved through state policy changes, pointing to the importance of AARP’s multi-state advocacy campaign, launched in 2014, to help older Americans live independently, at home, and the family caregivers that support them.
The Scorecard reveals that in less than 10 years, Boomers will begin to turn 80, placing new expectations and 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.