Smart Policy Can Make Long-Term Care More Accessible for Older Adults

long-term care, older adults on benchMost older adultsabout 90 percent — want to remain in their own homes and communities as they age. To make this happen, many need extra support. This can take the form of transportation when a person can no longer drive, a personal care aide to help with dressing, or home modifications to make stairs safer. Unfortunately, many older adults find these types of services financially out of reach. While privately purchased long-term care insurance can pay for personal, in-home assistance,  only 11 percent of adults over 65 have these products. As a result, many people pay out of pocket for long-term care, rely on underfunded nonprofit safety net programs, or spend down savings until they become Medicaid eligible.

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States, including Colorado, increasingly recognize the value of ensuring access to affordable long-term supports to older adults, their families, and state coffers. In 2017, Washington legislators introduced a bill to fund long-term services for older adults through a new payroll tax. Recently, Hawaii created the Kapuna Caregivers Program to provide financial support for informal family caregivers.

Perhaps the boldest effort to fund long-term care for older adults comes from a current campaign in Maine. This November, Maine residents will have an opportunity to vote on a ballot measure to create a Home Care Universal Trust Fund. If passed, it will create a new tax on high-income earners and their employers to fund services and support for adults 65 and older and adults with disabilities who live in their own home or in the community and need help with at least one activity of daily living. These can include activities like dressing, bathing, eating, or walking. With this measure, these individuals can access a range of supports from professional medical services like nursing, physical and occupational assistance, to companion and attendant services, home repair, respite and hospice, and transportation assistance. The effort is spearheaded by Maine People’s Alliance, one of the groups behind the successful 2017 ballot measure to expand Medicaid.

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Maine’s ballot measure is also aimed at helping the direct care workers who provide the important supports needed by older adults and people with disabilities. If the measure passes, participating agency providers must spend at least 77 percent of the funding they receive from the Home Care Universal Trust Fund on direct service worker costs. Currently, many of these direct support workers receive low wages. When adjusted for inflation, Colorado’s personal care aides, one of the most in-demand long-term care workers, have only seen their wages grow by an abysmal $0.59 between 2006 and 2016.

While backers of the Home Universal Trust Fund submitted over 67,000 signatures to put the proposal on the ballot, its passage is anything but certain. Opponents cite concerns about the tax’s impact on businesses and how services will be allocated if the program doesn’t bring in enough funds. Regardless of the measure’s outcome, Maine’s effort is drawing important attention to the growing discrepancy between the needs and available resources for our aging community members. As Colorado experiences its own demographic changes, we too must face this challenge head on. To solve these problems, we must embrace a spirit of creativity and ingenuity to help our older adults live the lives of their choice.