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Opinion/Flynn: How will we care for baby boomers?
Providence Journal - 2/18/2021
Bill Flynn is the executive director of the Senior Agenda Coalition of Rhode Island.
This year, when we begin turning 75, marks a milestone for America’s baby boomer generation born between 1946 and 1964. We belong to a population “age wave” that will profoundly increase the demand for seniors’ long-term care. While we celebrate making it to 75, we acknowledge that the odds of our needing some long-term care in our remaining years are at least 1 in 2. Many of us have limited retirement savings and are likely to have to rely on Medicaid to pay for that care.
Medicaid is a state-federal cost-share program providing basic health-care coverage for low-income people. While Medicaid makes nursing home care an entitlement for seniors who need that level of care, it gives states leeway to serve them alternatively with home and community-based services when appropriate. Rhode Island lags behind many other states by investing only 27% of our Medicaid dollars in home and community-based care, the remainder goes to nursing home care.
For years the Senior Agenda Coalition has urged Rhode Island to “rebalance” that ratio to 50-50 by investing a larger share of Medicaid dollars in community-based care. We helped pass legislation establishing that goal, but progress toward it has been very slow.
We support two positions about seniors’ Medicaid long-term care that may seem contradictory, but both are necessary. We must invest more in expanding and improving our state’s Medicaid system by giving seniors more opportunities to access care in their own homes or community settings. But we also recognize and acknowledge that the older we get, the more likely it is that any one of us could end up needing nursing home level of care. To that end we have supported higher wages for nursing home workers and will continue to do so.
The coronavirus pandemic’s deadly impact on our nursing home residents has raised additional concerns about our reliance on nursing home care. It has reminded us of an inconvenient truth — congregate living at close quarters in a nursing home carries an increased risk of infection and disease spread due to rooms shared by two persons and bathrooms shared by two or more, typical in most of our nursing homes.
But now another risk has been exposed — some nursing homes lack sufficient staff coverage and are experiencing high staff turnover. For that reason we are supporting “Raise the Bar” legislation in the General Assembly mandating average hours of care for nursing home residents and a minimum wage of $15 per hour for workers caring for them.
Some states have been able to increase Medicaid home care investments and improve nursing home quality. Minnesota now invests 62% of Medicaid dollars in far less expensive home and community-based care, thus saving millions of dollars. It has used some of those savings to “buy back” nursing home beds, allowing some beds to be converted to assisted living. It also incentivized nursing homes to convert more Medicaid-funded beds to single occupancy. However, achieving those results took years of effort.
The pandemic has revealed that for many of us care in the community can be a better, less risky option. Our baby-boomer “age wave” is no longer on the horizon — it’s reached the shore. We must urge our elected leaders to take action to begin creating a better future for every Rhode Islander as we age.
This article originally appeared on The Providence Journal: Opinion/Flynn: How will we care for baby boomers?
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