West Virginia must get ready for the tidal wave of Baby Boomers that will hit the state budget in the next 20 years, say 45 of the state's most knowledgeable experts on long-term care.
West Virginia must get ready for the tidal wave of Baby Boomers that will hit the state budget in the next 20 years, say 45 of the state's most knowledgeable experts on long-term care.
"The Baby Boomers give the state, at most, five more years," they warn, in the Vision Shared report on long-term care, to be released today.
In 2000, 276,000 West Virginians were age 65 or older, the U.S. Census reports. By 2030, that number will mushroom to 426,000, the Census predicts.
The number of working-age West Virginia taxpayers is predicted to drop simultaneously, the report said.
"This is indeed a frightening situation when you look at where we are, what's coming, and the fact that we are not prepared," said Sen. Dan Foster, D-Kanawha, one of the planners.
Delegate Don Perdue, chairman of the House Health and Human Resources Committee, said legislators "desperately need solid, apples-to-apples statistics" on almost every aspect of long-term care.
"Right now, I have little confidence that the statistics we have are accurate enough to plan in the long range," he said. Specifically, "we have a lot of numbers that are accurate, but can't be compared."
They do have these numbers:
Medicaid spends more than $800 million a year on long-term care.
The cost of hospital care is not included.
A year in a nursing home bed costs $63,000, according to state Health Care Authority statistics.
In 2005, Medicaid paid for more than 80 percent of state nursing home beds.
Medicaid pays about $13,700 to keep an elderly person on in-home care for a year, according to Medicaid grant applications.
Perdue wants regional information, as the study recommends. "We can't just assume that what it costs to live or be on a program in Charleston is what it costs in Wirt County."
"It's so fragmented right now," said Foster, who is also a CAMC physician. "We should have a system that is prepared for these numbers, within the level of resources the state has.
"Most of the Baby Boomers will stay here," he said, "and a lot of these folks' kids are not here. That's different from other states. We have a very high percentage of elderly people whose children have emigrated."
West Virginia can coordinate services and get ready. "But we've got to do it soon."
Charleston-based Vision Shared was created in 2000 in part to bring knowledgeable West Virginians together to wrestle with the state's quality-of-life problems, said Vision Shared president Julie Terry.
"This is an opportunity to manage a crisis before it hits," she said. "Because once it does hit, we're going to be scrambling."
To get ready, the planners said, West Virginia should:
Beef up public and private alternatives to nursing homes: in-home care, adult day care, respite care and so forth.
Coordinate long-term care programs now scattered among agencies.
Provide easy ways West Virginians can get information about all care choices, talk with a knowledgeable person, and arrange for screening and referral.
Develop an advertising campaign to encourage people to plan for their old age and their parents' old age.
Find ways to encourage those who can afford it to take out long-term care insurance.West Virginia must get ready for the tidal wave of Baby Boomers that will hit the state budget in the next 20 years, say 45 of the state's most knowledgeable experts on long-term care.
"The Baby Boomers give the state, at most, five more years," they warn, in the Vision Shared report on long-term care, to be released today.
In 2000, 276,000 West Virginians were age 65 or older, the U.S. Census reports. By 2030, that number will mushroom to 426,000, the Census predicts.
The number of working-age West Virginia taxpayers is predicted to drop simultaneously, the report said.
"This is indeed a frightening situation when you look at where we are, what's coming, and the fact that we are not prepared," said Sen. Dan Foster, D-Kanawha, one of the planners.
Delegate Don Perdue, chairman of the House Health and Human Resources Committee, said legislators "desperately need solid, apples-to-apples statistics" on almost every aspect of long-term care.
"Right now, I have little confidence that the statistics we have are accurate enough to plan in the long range," he said. Specifically, "we have a lot of numbers that are accurate, but can't be compared."
They do have these numbers:
Medicaid spends more than $800 million a year on long-term care. The cost of hospital care is not included. A year in a nursing home bed costs $63,000, according to state Health Care Authority statistics. In 2005, Medicaid paid for more than 80 percent of state nursing home beds. Medicaid pays about $13,700 to keep an elderly person on in-home care for a year, according to Medicaid grant applications.Perdue wants regional information, as the study recommends. "We can't just assume that what it costs to live or be on a program in Charleston is what it costs in Wirt County."
"It's so fragmented right now," said Foster, who is also a CAMC physician. "We should have a system that is prepared for these numbers, within the level of resources the state has.
"Most of the Baby Boomers will stay here," he said, "and a lot of these folks' kids are not here. That's different from other states. We have a very high percentage of elderly people whose children have emigrated."
West Virginia can coordinate services and get ready. "But we've got to do it soon."
Charleston-based Vision Shared was created in 2000 in part to bring knowledgeable West Virginians together to wrestle with the state's quality-of-life problems, said Vision Shared president Julie Terry.
"This is an opportunity to manage a crisis before it hits," she said. "Because once it does hit, we're going to be scrambling."
To get ready, the planners said, West Virginia should:
Beef up public and private alternatives to nursing homes: in-home care, adult day care, respite care and so forth. Coordinate long-term care programs now scattered among agencies. Provide easy ways West Virginians can get information about all care choices, talk with a knowledgeable person, and arrange for screening and referral. Develop an advertising campaign to encourage people to plan for their old age and their parents' old age. Find ways to encourage those who can afford it to take out long-term care insurance. Take steps to cure a serious shortage of health-care workers for the elderly."We're going to need all the nursing homes that we have, probably more as time goes on," Foster said, "but we want to not have to build them like we're building prisons now. First, we want to find other alternatives so we can keep more and more people in a setting they prefer and that will make the financial status of the state better. That's the challenge."
In January, House Speaker Rick Thompson created a new Select Committee to contend with senior citizen issues.
"We never have had a true comprehensive plan for long-term care," Perdue said. "To do what we need to do, we need cost statistics we can accurately compare."
Legislators must compare costs of nursing home care, in-home care, adult day care, personal care and so forth, he said, "and the apples-to-oranges problem too often gets in our way."
For example, a seemingly easy question: How much did Medicaid pay for nursing home care in fiscal year 2006? Three answers, all correct:
The state Health Care Authority says $425 million - the amount all state nursing homes say Medicaid paid or is obligated to pay that year. Medicaid reports to the Legislature say $403 million - the claims Medicaid paid that fiscal year, including claims for services from other years. Medicaid reports to the federal government say $385 million - the services rendered that year that Medicaid will have to pay for at some point.Another example: How much did Medicaid pay for one nursing home bed in 2006?
HCA statistics: $63,000 for a full year. Medicaid yearly average cost: $34,569.The $34,569 is an average, a partial-year cost. It includes everyone who occupied a Medicaid bed that year, whether they were in it for one day or 365 days.
But you'll come out with apples and oranges if you use yearly averages to compare, said Donna Folkemer, of the National Conference of State Legislatures. "Per member, per month - that's a standard way of figuring things out in Medicaid and acute care."
Delegate Sam Cann, D-Harrison, is eager for that kind of advice. The Vision Shared report was assigned to the subcommittee he chairs on the House Health and Human Resources Committee.
"It's a subject I'm not really familiar with," he said.
He asked Medicaid to create a matrix of all departments and programs for the elderly. "Once we understand the programs, funding sources, who gets what and so forth, then we can decide how you go forward to plan for the future," he said.
He worries that people assume the state must take care of all elderly people's needs. He likes cost-effective programs that provide essential help, but leave room for family to help: in-home care, chore services, respite care and so forth, he said.
It's no small job to think about all this, he said.
"The [Vision Shared] experts from these fields came up with how you plan, but they didn't come up with a lot of conclusions and methodologies or ways to solve it.
"If anybody thinks we can do something real quick and come up with a program to solve this, I don't think that's going to happen," he said. "But I'm glad we're starting the discussion now."
The full Vision Shared report is available at www.visionshared
.com.
To contact staff writer Kate Long, use e-mail or call 348-1798.
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