Among the many concerns currently facing America’s health care system, few are more significant, both medically and fiscally, than long-term care, or LTC. With the continuing rise in the population of U.S. citizens 65 and older—statistically, the demographic most in need of LTC—states need to begin preparing for the growing pressures that will be placed on their budgets as a result of the nation’s aging population.

CSG South

Among the many concerns currently facing America's healthcare system, few are more significant, both medically and fiscally, than long-term care (LTC). Broadly defined as a range of services that support individuals who are limited in their ability to care for themselves, long-term care stands to become one of America's foremost healthcare challenges in the years ahead. With the continuing rise of U.S citizens 65 and over — statistically, the demographic most in need of LTC — states need to begin preparing for the growing pressures that will be placed on their budgets by the nation's aging population. This SLC Special Series Report explores the challenges long-term care poses for states in the SLC region. Subsequent reports will examine possibilities for managing long-term care and highlight actions that states in the SLC region have taken to tackle this important issue.

By Pennsylvania state Rep. Pamela A. DeLissio
With a strong professional background in long-term care and working with older adults for more than 20 years before entering public service, I learned not to make assumptions about how people age. We all age differently. We live different lifestyles and make different choices at all points along life’s timeline, including through our 70s, 80s, 90s and beyond. It is imperative to recognize the individuality of our older constituents and not generalize or assume—you know the adage about when we assume—that their needs are the same or even similar. We can best serve our older constituents by recognizing that many are still working well into their 70s and 80s.

A generation ago, retirement meant slowing down for most older adults—spending hours on the front porch swing, working crossword puzzles and playing the occasional game of Bingo. That was then, this is now. “It’s one of the great success stories of not only our country, but around the world, that people can be expected to live 20 or 30 years beyond the age of 65,” said Nora Super, chief of programs and services at the National Association for Area Agencies on Aging, or n4a. “And with this new opportunity, people are rethinking what that means and how they want to spend their time.” Super, who previously served as executive director of the White House Conference on Aging, said a growing number of seniors are searching for, and finding, purpose in retirement through volunteerism.

As Americans age, they look to live in communities where they can remain active and have transportation options once they are no longer able to drive. That’s a big concern for a state like Connecticut, which is largely thought of as a car-centric state. “By 2025, 20 percent or more of almost every Connecticut town will be 65 and older,” said Christianne Kovel, senior policy analyst on aging at the Connecticut Commission on Women, Children and Seniors. “Connecticut, while it’s a small state, has areas that are very, very rural. … Public transportation is not an option.”

By Jenni Bergal, Stateline staff writer | Reprinted with permission from Stateline.org
Facing a wave of aging baby boomers, many states are trying to make it easier for frail seniors to stay in their homes—as many prefer—instead of moving into more costly nursing homes. States have a huge stake in where aging seniors and disabled people end up getting long-term care because many of them won’t be able to afford to pay for their care and will have to rely on Medicaid, the health care program for the poor and disabled. Each state has its own Medicaid program, funded jointly by the state and the federal government. Some states have been ahead of the pack in dealing with long-term care issues. In Minnesota, for example, nursing home beds have been cut more than a third as the state focuses on its home and community-based care system. In Hawaii, the state set up a program offering frail older adults in-home services at no charge.

The November-December issue of Capitol Ideas magazine features my article on how states and communities are working to improve transportation mobility for older Americans. One of the experts featured in the article is Beth Osborne, vice president for technical assistance at Transportation for America in Washington, D.C. Osborne, a veteran of both the U.S. Department of Transportation and Capitol Hill, in recent years has been working with states on the implementation of complete streets policies. Complete streets are streets designed for safe access by all users, including pedestrians, bicyclists, motorists and transit riders. In this extended excerpt of our conversation, Osborne talks about how complete streets can benefit seniors, how complete streets implementation processes have evolved, how the process differs from state to state, the promise of rideshare companies and autonomous vehicles for improving senior mobility and what kinds of policies state officials should consider during the 2017 legislative sessions. Osborne will be among the presenters next month at Transportation for America’s Capital Ideas II conference in Sacramento, for which CSG is a promotional partner.

In June, Alzheimer’s and Brain Awareness Month is celebrated around the world.

Four years after the Older Americans Act expired, the bill was reauthorized by Congress and on April 16, 2016, signed into law once again by President Obama.

CSG Midwest
In response to concerns raised by family members about the care and safety of their loved ones in nursing homes, Illinois has become one of the first U.S. states to allow the use of cameras in resident rooms. HB 2462, signed into law in 2015, took effect in January.
CSG Midwest
In 2015, more than 1 million people in the 11-state Midwest were living with Alzheimer’s disease — the sixth-leading cause of death among adults in the United States. And minus a cure, this common form of dementia will touch and take even more lives in the decades ahead.
In most of the region’s states, for example, the number of Alzheimer’s cases is expected to increase by close to 20 percent or more between now and 2025 due to rises in the number of people 65 or older (see table). By the middle of this century, the number of Americans with the disease could triple.

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