Seventy-seven million baby boomers are rapidly approaching their Agolden years,@ according to statistics provided by Senator Breaux on June 28, 2001 at the Senate Special Committee on Aging Hearing: ALong-Term Care: Who Will Care for the Aging Baby Boomers?@ The panel members agreed that institutionalized care, such as nursing homes, is not necessarily the best way for every senior to spend his or her retired life. Therefore, options in long-term care must be established to satisfy the needs of every individual. Witnesses at the June 28^th hearing discussed the need for a selection of long-term care programs from which individuals may choose and the financing of such programs.

The hearing considered a range of long-term care options, from institutionalized care to family care with community-based support centers. Studies show that most elderly and disabled people would prefer to live with their families rather than move into nursing homes. However, many American families are unable to provide the appropriate level of care or afford such care. One proposal is to establish community-based programs that can aid home caregivers. Health and Human Services Secretary Tommy Thompson (former governor of Wisconsin) testified that Wisconsin has established Aging and Disability Resource Centers where citizens obtain information, advice, and access to a wide variety of services. The Centers also review medications, nutrition, and appropriate fitness programs, and make home safety evaluations for older people and people with disabilities.

Secretary Thompson also described the Program of All-Inclusive Care for the Elderly (PACE), which provides acute care and long-term care including personal and homemaker services to qualified individuals through Medicaid waivers. PACE programs provide services to individuals who: (1) are Medicaid eligible; (2) have a chronic illness or disability that, without the services of the waiver program, would require Medicaid institutional care services; and (3) live within the coverage area of a program. In response to questioning from Senator Breaux, Secretary Thompson also described the Community Options Program (COP), which provides home and community-based care as an alternative to institutionalized care for elderly and physically disabled people. COP services range from home modification to respite care, and are financed either by the individual or through the program via Medicaid waivers. The program both provides services and directs participants to other resources that the individual may privately hire.

All of the witnesses testified about the benefits and practicalities of private long-term care insurance, which may be used to pay for individuals= long-term care needs. Secretary Thompson testified that the government Amust take the steps today to encourage people to start saving for tomorrow.@ One proposal to encourage such saving is to provide an itemized tax deduction for the cost of long-term care insurance (Senate bill 627). Carol O=Shaughnessy, Specialist in Social Legislation, Congressional Research Service, cautioned that long-term care insurance may be a practical solution for those who can afford it, but that there must be provisions for lower income families.

In his written testimony, David Durenberger, Chairman of Citizens for Long Term Care, called for a public/private system where the Aacquisition of private insurance... [is] encouraged and supported through publicly supported tax incentives@ while the Medicaid program for the poor is maintained and improved. By inducing those who can, to purchase long-term care insurance, fewer people will go bankrupt as a consequence of a debilitating accident or age-induced need for long-term care. Therefore, some of the strain on the Medicaid program will be alleviated, thus allowing the program to better serve poor people.

Robert Blancato, former Executive Director of the 1995 White House Conference on Aging, testified that Americans must be willing to invest today and look for the savings tomorrow. Mr. Blancato discussed the savings to the government over the past 29 years that resulted from Senator Ted Kennedy=s nutrition program, which provides meals for the elderly at either the individual=s home or a local community setting. This program prevents seniors from entering nursing homes because of complications due to poor nutrition. Long-term care service systems such as the nutrition program cost less than nursing home care and satisfy some seniors= care needs. By keeping seniors in their homes with one prepared meal five times a week, the seniors are healthier, happier, and save Medicaid for those who need institutionalized care and cannot pay for it themselves. Preventive coverage such as this can be an investment for future savings.

In closing remarks, Senator Breaux declared that the issues of long-term care options and financing are an educational problem. He and the witnesses agreed that not enough Americans know that Medicare doesn=t pay for long-term care and that Medicaid only pays for poor people. Senator Breaux referred to the long-term care issues and debates as a Anational dialogue@ that must continue.

Testimony can be found on the Senate Special Committee on Aging=s website at http://www.senate.gov/comm/aging/general/.

Copyright © Center for Medicare Advocacy, Inc. 01/08/2010