When I was a kid, Florida and Arizona were the retirement states of choice. My parents and their friends decided that, after decades of Midwestern winters, the promise of warmth and sunshine, coupled with the notion of never picking up a snow shovel again proved too enticing to pass up. At their first opportunity, many of the “snowbirds” declared permanent residency in those sunshine states. Did they make the wrong move?
This week, AARP in conjunction with the Commonwealth Fund and the SCAN Foundation, released the 2014 State Long-Term Services and Supports (LTSS) Scorecard. In it, they rate states based on long-term services and support for the elderly, people with physical disabilities, and family caregivers. State performance was measured across five categories:
- affordability and access,
- choice of setting and provider,
- quality of life and quality of care,
- support for family caregivers, and
- effective transitions
The report shows that in terms of quality of long-term care, Florida ranks in the bottom quartile compared to other states, although it fares better than Kentucky, Alabama, Mississippi, and Tennessee in affordability and transitions from nursing home care back to the community. This interactive map shows each state’s ranking:
The top-ranking states for long-term care and services are Minnesota, Washington, Oregon, Colorado, and Alaska; perhaps it’s not quite time to put those snow shovels on eBay.
It’s a well-known fact that few of us prepare for long-term care, although about 70% of people age 65 and up will need some sort of assistance with the activities of daily living. While most people would prefer to age at home, Medicare doesn’t cover the cost of home care provided by a Home Care Agency. Few of those in their 40s, 50s and 60s carry long-term care insurance and Medicaid is available only for low-income seniors with few assets. And before we all decide to retire to Minnesota or Washington, it’s important to note that long-term care is unaffordable for most middle-income seniors in all states.
The authors of the study see the need for a guide at the federal level to establish minimum long-term care performance standards below which no state should fall. No one anywhere in the U.S. should fear that their state cannot provide the needed level of assistance. Susan Reinhard, one of the study’s authors and senior vice president of Public Policy at AARP told Forbes magazine that she is optimistic in the incremental improvements she’s seen since a similar study was published in 2011, but admits all states can do better.
Caregiverlist® champions the need for change in the long-term care arena and urges you to contact your state legislature or your state’s Department on Aging and let them know how important it is to improve services in providing high-quality, well-coordinated, affordable long-term care.
The Senate passed the Community Living Assistance and Support Services (CLASS) Act on Friday, December 4th, making this act an approved portion of the healthcare reform bill. The word on the street is the healthcare bill will pass, in some form, and this portion of the bill has now been approved.
What is it?
The CLASS Act allows Americans to contribute, through payroll deductions, to this long-term care insurance program. After 5 years of paying into the program, benefits may be paid, if assistance is needed for a minimum of 2 Activities of Daily Living.
The purpose of the program is to provide an alternative to nursing home care for people with disabilities and seniors. It will also allow family members to be able to continue to work and pay for a caregiver.
Average policy premium? About $50 per month.
Average amount of daily benefit? About $75 per month.
How will the benefit be paid for? Through the insurance policy premiums - - this was fashioned to follow how private insurance is operated - which can be extremely profitable when managed well. The government did have actuaries crunch the numbers for this insurance program (yep, there is a reason why Warren Buffett, one of the wealthiest guys in the U.S.A., likes to buy insurance companies - - many more people pay into premiums than collect on them and interest can be earned on the money in the meantime). The premiums will be age-adjusted and contributions must be made for 5 years before someone can file a benefit claim. And, the government can't "borrow" from this money to pay for other programs.
By delaying and preventing nursing home admissions, the CLASS Act will also decrease costs for Medicaid, which only provides for care in a nursing home.
The risk? It will be important for participation rates to be high.
Learn more about the CLASS Act and read the statement prepared for the Senate by Massachusett's Senator Kirk, who filled former Senator Edward Kennedy's seat - - Senator Kennedy had been a proponet of the CLASS Act as a way to allow seniors and the disabled to remain in their homes and afford at least part-time care.
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