Help seniors stay in their
homes
homes
The Register's editorial • October 31, 2010
Nursing homes are necessary, and many provide
good care. But you'd be hard-pressed to find a
senior who wants to live in one. Surveys show the
vast majority of older people want to stay in their
own homes as long as possible.
Despite this, Iowa ranks second in the country for
the number of nursing home residents per 1,000
people age 65 or older. Our Medicaid program
spends a smaller percentage of its long-term care
dollars on community-based services than the
national average.
The wave of the future in this state must be
cultivating home- and community-based services to
help aging Iowans stay in their homes. But the first
step toward creating the infrastructure to foster
independence isn't necessarily spending more
money. It's working to make better use of the public
money already being spent on senior care.
It's a lot of money - about $22,000 per year, per
senior, for everything from Medicare to food
programs, according to an analysis by the non-
profit Brookings Institution. In fiscal year 2008,
federal and state spending on long-term care for
Iowans age 60 and older was $533 million.
A few ideas to make better use of the money:
Spend Medicaid dollars wisely
Iowa spends two-thirds of its Medicaid dollars on
institutional care. Thousands of low-income seniors
- frequently those who first used up their own
resources on care - rely on taxpayer-funded
Medicaid to pay for a nursing home.
The Medicaid Elderly Waiver allows seniors with
certain intensive care needs to receive home-based
care. Seniors using the waivers cost taxpayers an
average $607 per month. Compare that to $3,687
for seniors in nursing homes. There is currently no
waiting list for these waivers. Families should look
into using them.
The government also should promote waivers as an
alternative to more expensive nursing home stays.
Keeping people in their homes should be the
standard, not the exception. Not something that
requires a waiver.
good care. But you'd be hard-pressed to find a
senior who wants to live in one. Surveys show the
vast majority of older people want to stay in their
own homes as long as possible.
Despite this, Iowa ranks second in the country for
the number of nursing home residents per 1,000
people age 65 or older. Our Medicaid program
spends a smaller percentage of its long-term care
dollars on community-based services than the
national average.
The wave of the future in this state must be
cultivating home- and community-based services to
help aging Iowans stay in their homes. But the first
step toward creating the infrastructure to foster
independence isn't necessarily spending more
money. It's working to make better use of the public
money already being spent on senior care.
It's a lot of money - about $22,000 per year, per
senior, for everything from Medicare to food
programs, according to an analysis by the non-
profit Brookings Institution. In fiscal year 2008,
federal and state spending on long-term care for
Iowans age 60 and older was $533 million.
A few ideas to make better use of the money:
Spend Medicaid dollars wisely
Iowa spends two-thirds of its Medicaid dollars on
institutional care. Thousands of low-income seniors
- frequently those who first used up their own
resources on care - rely on taxpayer-funded
Medicaid to pay for a nursing home.
The Medicaid Elderly Waiver allows seniors with
certain intensive care needs to receive home-based
care. Seniors using the waivers cost taxpayers an
average $607 per month. Compare that to $3,687
for seniors in nursing homes. There is currently no
waiting list for these waivers. Families should look
into using them.
The government also should promote waivers as an
alternative to more expensive nursing home stays.
Keeping people in their homes should be the
standard, not the exception. Not something that
requires a waiver.
Pay caregivers adequately
Keeping seniors in their homes means having a
good work force to make that possible. Experienced
caregivers who provide assistance to disabled
people and seniors are already in demand. As the
population ages, demand will grow.
These workers are undervalued and frequently
underpaid. There have been proposals for
government to make changes, such as setting a
higher minimum wage for these workers. But it's not
simple for the government to intervene in a private-
sector work force issue.
What really needs to happen: Private companies in
the senior care business should do more to
redistribute the millions of dollars in profits some
collect - paying those who push papers less and
those who actually provide care more. That will help
build a fairly compensated and experienced work
force.
A few years ago, the Register reported that Care
Initiatives, a "charity" that operates 56 homes in
Iowa, paid its CEO $2.1 million in one year and
members of its board of directors $412 an hour.
That was an example of money flowing to the top,
rather than to the people who directly care for
seniors.
Means test for some services
The federal Older Americans Act has funneled
billions of dollars to states over the past 45 years.
Title III of the law ensures seniors receive services
including home-based meals, day care, senior
Keeping seniors in their homes means having a
good work force to make that possible. Experienced
caregivers who provide assistance to disabled
people and seniors are already in demand. As the
population ages, demand will grow.
These workers are undervalued and frequently
underpaid. There have been proposals for
government to make changes, such as setting a
higher minimum wage for these workers. But it's not
simple for the government to intervene in a private-
sector work force issue.
What really needs to happen: Private companies in
the senior care business should do more to
redistribute the millions of dollars in profits some
collect - paying those who push papers less and
those who actually provide care more. That will help
build a fairly compensated and experienced work
force.
A few years ago, the Register reported that Care
Initiatives, a "charity" that operates 56 homes in
Iowa, paid its CEO $2.1 million in one year and
members of its board of directors $412 an hour.
That was an example of money flowing to the top,
rather than to the people who directly care for
seniors.
Means test for some services
The federal Older Americans Act has funneled
billions of dollars to states over the past 45 years.
Title III of the law ensures seniors receive services
including home-based meals, day care, senior
