Challenges remain when it comes our long-term care needs

 

NEW SCORECARD GIVES RHODE ISLAND IMPROVED MARKS
FOR SERVING OLDER ADULTS, PEOPLE WITH DISABILITIES

 Challenges remain to improve services to older adults, people with disabilities;
pace of change must accelerate to meet demographic demands

 

PROVIDENCE, RI – Rhode Island ranks 32 ^nd overall when it comes to meeting the long-term care needs of older residents and people with disabilities, but showed improvement in all but one Scorecard category.  AARP warns more must be done, at an accelerated pace, to meet changing demographic demands. Rhode Island ranks 22 ^nd nationally Support for Family Caregivers and 24 ^th in Quality of Life & Quality of Care. The state ranks 35 ^th in Effective Transitions – the only category in decline 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.

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 Rhode Islanders want to live independently, at home, as they age—most with the help of unpaid family caregivers,” says  Kathleen Connell, State Director of AARP Rhode Island, which serves more than 138,00 members age 50 and older in the state. “Even facing tight budgets, Rhode Island is making 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 Rhode Islanders in part because the cost of long-term care remains unaffordable for most middle income families.  In Rhode Island, more than 134,000 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 $1.78 billion.

AARP_RI_LTSS_RhodeIsland

“When it comes to helping older Rhode Islanders live in the setting of their choice, family caregivers take on big responsibilities,” explains Connell. “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 Medicaid. They have earned some basic support.”

That’s why AARP Rhode Island has fought for Caregiver, Advise, Record, Enable (CARE) Act; caregiver temporary leave insurance; and caregiver tax credits.

Rhode Island has made 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 Medicaid funding would threaten these advancements, likely resulting in our most vulnerable citizens losing the lifesaving supports that they count on,” says Connell.

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 fights to expand services provided at home and in the community, by shifting funds away from and more expensive nursing home care. While the percent of long-stay nursing home residents hospitalized within a six-month period has decreased, the Scorecard highlights additional serious issues related to institutional care in Rhode Island, such as residents with pressure sores and residents with low care needs].

While Rhode Island has improved its rank from 50 ^th to 44 ^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 Rhode Islanders prefer—the Scorecard spotlights areas that call for improvement, including choice of setting and provider; and effective transitions.

Specifically, the percent of

• Medicaid and state-funded LTSS going to HCBS;
• Medicaid LTSS users first receiving services in the community;
• People with 90+ day nursing home stays successfully transitioning back to the community;
• Nursing home stays lasting 100 days or more.

“This Scorecard gives us a snapshot of how well Rhode Island serves our older residents, those with disabilities, and family caregivers—and shows us where we must sharpen our focus to better assist hardworking Rhode Islanders,” concludes Connell. “We will continue to work with the governor, legislative leaders and policymakers to take the actions needed now to protect our expanding needs.”

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.