According to a new scorecard measuring state-by-state performance on long-term care services and supports (LTSS), Florida ranks in the bottom half on all measures. The report was released last week by The AARP's Public Policy Institute, The Commonwealth Fund and The SCAN Foundation.
The scorecard examines state performance across four key dimensions of LTSS system performance: (1) affordability and access; (2) choice of setting and provider; (3) quality of life and quality of care; and (4) support for family caregivers.
Florida ranks 44th overall when compared to other states while Minnesota, Washington and Oregon have the most efficient LTSS.
The report's goal is to help states identify areas in need of improvement. For example, with better LTSS, 8000 unnecessary hospitalizations of people in nursing homes in Florida could be avoided. Almost 12,000 new users of Medicaid LTSS would first receive services at home or community based settings instead of more costly nursing homes. More than 63,000 additional low or moderate-income disabled adults over age 21 would be covered by Medicaid.
The average cost of nursing home care in the country is 241 percent of the average annual household income of older adults. Even in the five most affordable states the cost averages 171 percent of income, and in the least affordable states like Florida it averages 374 percent.
The result of this situation is that many people with LTSS needs will exhaust their life savings and eventually turn to the public safety net for assistance.
Even home health care services, which average 88 percent of household income for older adults nationally, have become unaffordable for an increasing number of Americans. Those who receive home care services must add these costs to all their other living expenses. If they can't afford the home care services they need, they may place added burdens on family caregivers who most likely already are providing services.
This new scoreboard couldn't come at a worse time in terms of our overall economy. The Census Bureau has just reported that the number of Americans in poverty jumped to 15.1 percent in 2010, a 27-year high. About 46.2 million people, or nearly 1 in 6, are in poverty. That’s up from 43.6 million, or 14.3 percent, in 2009. It was the highest level since 1983.
The number of people without any health insurance increased to 49.9 million, a new high after revisions were made to 2009 figures. Losses were due mostly to working-age Americans who lost employer-provided insurance in the weak economy.
The good news is that Americans are living longer. Centenarians (those over 100) are the fastest growing group in the US. The not so good news is that many of those elderly individuals have significant LTSS needs. In addition, the number of younger Americans with disabilities requiring LTSS is increasing. At some point, every state, including Florida will have to face the growing demands of all of these individuals with long-term care needs. Hopefully, those in leadership positions will stop kicking this can down the road.
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