States Respond to Long Term Care Issues

Meanwhile, several states have moved to tackle the growing shortage of geriatricians and a number of other long term care challenges. A summary of their efforts appears below.

• Pennsylvania: A study conducted for the state's Intra-Governmental Council on Long Term Care, a panel of government and industry officials and consumers, found that more than 40% of the state's nursing homes and home-health agencies have a "serious problem" with recruitment or retention of employees. Between one-fourth and one-third of employees have less than a year's experience with their employers. The report also revealed that one in five home-health agencies and one in nine private nursing homes had a "severe staff shortage" last year. According to council Chair Richard Browdie, Pennsylvania's aging secretary, the panel will discuss the results in "coming months." Meanwhile, Gov. Tom Ridge (R) has proposed a $2.8 million program in the state's 2001-02 budget that will direct the Area Agencies on Aging to help home care providers recruit and retain employees (Rotstein, Pittsburgh Post-Gazette, 3/22);
• Arkansas: Advocates for seniors, "fear[ing]" that state lawmakers "aren't doing enough" to bolster programs to provide care for seniors, have backed a bill (HB 1898) that would help fund services for seniors. The legislation, sponsored by state Rep. Jay Bradford (D), would impose a 13% sales tax hike on tobacco products, raising $62 million annually, with $20 million earmarked for senior services, but Bradford predicted that the bill would receive a "rocky reception" in the Legislature. In addition, state Rep. David Rackley (R) has proposed a separate bill (HB 1694) that would require teams at several state universities to play in an annual basketball tournament, with proceeds used to fund the Meals on Wheels program (Osher, Arkansas Democrat-Gazette, 3/18);
• Texas: State Rep. Carl Isett (R) has proposed legislation (HB 2227) that would expand statewide the Program of All-Inclusive Care for the Elderly -- where an adult health care center serves as the "base of operations" for a team of health care professionals focusing on preventive care for seniors. Under the measure, which the state House Human Services Committee backed by a unanimous vote, officials could establish PACE programs across the state and eliminate "cost barriers" by removing a requirement that forces them to "be certified as [an] HMO." The bill, which has garnered bipartisan support, will move to the full House for a vote. State Sen. Eliot Shapleigh (D) has proposed a similar bill (SB 908) in the Senate (San Martin, Dallas Morning News, 3/14).
• Oregon: Nine Oregon state lawmakers, "worried" that proposed budget cuts would "jeopardize" the state's long term health care system, have formed a task force to help combat the problem. But Gov. John Kitzhaber's (D) proposed human services budget "falls about $60 million shy" of the funds required to finance the state's long term care programs. The governor has proposed cuts for in-home care, assisted living, nursing homes and transportation, as well as up to a 45% reduction in Medicaid reimbursement rates for assisted living facilities. State Rep. Bill Morrisette (D), a member of the task force, has co-sponsored a bill (HB 3212) that would earmark tobacco settlement funds to "reinstate" long term care cuts (Barnett, Portland Oregonian, 3/14);
• North Carolina: The Raleigh News & Observer reports that North Carolina's population of seniors will rise from 13% today to 21% in 2025, with almost two out of three seniors requiring long term care. While providers "are [not] ready for the coming surge" of seniors, "they could be," the News & Observer reports. Last week, a state task force outlined 47 recommendations to "refashio[n]" the state's long term care system. The task force advocated a more "user-friendly" system, urging the state to find "more money" to help "ease a staffing crisis" in nursing homes, promote "creative alternatives" for care and "encourage" baby boomers to plan for their future care. The recommendations would cost about $80 million for "big-ticket" programs next year and $129 million in 2003 (Wilson, Raleigh News & Observer, 3/15).