States Moving in the Right Direction on Long-Term Care Services
A new state scorecard on long-term care services from AARP Foundation, the SCAN Foundation and the Commonwealth Fund paints a distressing picture of uneven, slow progress in providing the care older adults and people with disabilities want and need.
Yes, Jen, it is a slow process for states for a number of reasons.
We don't have enough qualified caregivers.
We don't have enough community based homes for care. There is always all those local, state and federal regulation that have to be complied for personal care community based homes.
Olmstead vs L.C. actually legislated de-institutionalizing for many of the disabled back in the 90's and even some states now are still trying to catch up.
Yes, for those elderly that can, staying in their home or in a community based setting is better cost wise and probably quality of life wise too, but it does require the manpower and the appropriate settings to be available and those take a while for a state to pull together.
Would paying family caregivers make them more apt to take on the task?
How much should they be paid since this is coming out of the taxpayers pocket (Medicaid)
Wouldn't they still have to monitored by the state? Or does the state side-step this oversite by paying the elderly person and having them direct the payment?
In theory it sounds good but there is lots to think about and plan.
All I know for sure is as the baby boomers age, many of them have not made any plans - financial or otherwise - for what is a normal course of life.
According to the report, CA is #9 in ranking. The proposed Medicaid cuts will hurt its ranking; 1 in 5 Californians uses Medi-Cal, our state's program.
If one lives in the coastal urban areas, community and care programs are available but the best care, of course, costs proportionately more here, due to high RE and the usual population density issues.
Many retiree homeowners sell and move to areas of lower cost (turn those blue states red, or at least purple, LOL!). That's not a recent phenomenom, btw; we've seen it going on for at least 35 yrs. People are more mobile in the West; the majority come from somewhere else to begin with, and when you've moved across the country once, it's easier to do the next time.
Most people don't know how to even begin doing financial and retirement planning. So they put it off, until it's too late. We find most people we know don't even take the idea seriously until about 6 mos. before their planned retirement date.
Also, LTCi is expensive. It has been expensive for over a decade. Our policies are 19 yrs old and they were grossly underpriced in the beginning. I suspected this and told my DH we had to plan for sizable premium increases in the future.
We now pay 4x the premium we started with - market rates, except the market no longer offers policies as good as ours.
We have friends who are getting LTCi, with the highest limits available. They will pay a little less than half what we pay - but their policies are nowhere near as generous as ours.
Most people also grossly underestimate what home health care and convalescent/skilled nursing care actually costs. In 2013 one of the largest full service seniorcare facilities quoted us a price of over $10K/monthly for skilled nursing/Memory Care. As there have been four price increases since, I would expect that cost is now over $12K/monthly.
It is also a common misapprehension that people "only need care for two years on average" before dying. Actuarial statistics are pointing very definitively towards a generation of elderly who become slowly sicker and disabled, but whose longevity continues to improve as medical technology advances.
My thinking is that people that can afford to buy LTC do not because they think they will never need LTC and our politicians give the impression ...do not worry it's up to your government to take care of you.
We do have LTC insurance because we were brought up with "if you can take care of your needs you should do so". That is not the way it is today.
@KidBoy2 - Some people who can afford LTC insurance don't get it because they:
- Don't like the restrictions in the fine print, on LTC payouts, - Don't like that they're insurance policies on which you may not collect, - Have the income to pay for exactly what they want, if & when they actually need long term care.
=============================================== I agree with your first reason.
When you buy insurance on your car or home you may not collect...that is the way insurance works...but it's a weak excuse as to not buy LTC insurance.
There are not many that could pay for their care. For most, like us, it would wipe out what we have worked for and our children would get nothing.
What's really scary, when you look at the map of the United States, on their Long Term Care Scorecard, is that the states in the southeast - which have been developed as a draw for retirees - are in the worst quartile for services!
Happy to see that NJ is in the 2nd Quartile, coming in at #17 .. not as bad as I thought!