Florida ranks near bottom nationally for long term services for elderly
By: Liz Freeman
Elder Law Associates Newsletter dated August 15, 2017
Florida may welcome seniors for their golden years, but there’s no gold star for the state for aging services, a new AARP report shows.
Florida ranks 46 among the states in a new scorecard that examines accessibility and quality of long-term care for the aging and disabled. It also looks at settings of care, support for family caregivers and transitions from different care settings.
Besides Florida ranking in the bottom quartile of states at 46, it was a drop from a rank of 43 in a 2014 scorecard. AARP officials caution against comparing a current ranking with three years ago due to changes in the study methodology.
Still, the scorecard sounded alarms that states must step up the pace of expanding long-term services for the aged and disabled, especially with the flood of baby boomers beginning to turn 80 in 2026, AARP said.
“Most states have made some progress, but it’s slow, uneven and incremental,” Susan Reinhold, senior vice president and director of the AARP Public Policy Institute, said.
It would take 36 years for states at the bottom of the ranking to make enough improvements to reach the middle states, and another 50 years for the bottom states to get to the performance level of the top states, she said.
The top five states for long-term services are Washington, Minnesota, Vermont, Oregon and Alaska, according to the report.
The five states at the bottom are Indiana, Kentucky, Alabama, Mississippi and Tennessee.
The analysis looked at 25 indicators in five categories of affordability and access: choice of setting, quality of care, support for family caregivers and the effectiveness of transitions from home to nursing homes or hospitals, and transition back to the home.
The study was funded by the AARP Foundation, The Commonwealth Fund and The Scan Foundation.
Florida ranked in the bottom quartile in four categories of affordability and access, choice of setting and provider, quality of life and care, and support for family caregivers.
The data for Florida show the median household income for people 65 and older is $39,896 while the annual cost of a private nursing home room is $100,375 and the cost of 30 hours of home care is $28,860.
Jaclynn Faffer, president and chief executive officer of the JFCS of Southwest Florida, which offers an array of services for seniors in Collier County, said she is disappointed that Florida is not making progress.
“I am particularly concerned about the decline in the ‘affordability and access dimension,’” she said. “Since opening the Naples Senior Center in 2014, we have had a bird’s eye view of the issues facing older adults in our community. We have seen formerly middle-class seniors, particularly women, struggle with homelessness when their resources become severely diminished because of the loss of a spouse and his or her income or simply outliving their savings among increases in the cost of living.”
Home care support for seniors living at home with conditions like dementia are scarce if someone cannot afford it privately or doesn’t have a long-term care policy, Faffer said.
JFCS offers a dementia respite program for those with Alzheimer’s disease or dementia, which helps their caregivers.
“The fact that our program has increased from two groups a year ago to six now and projected eight in the fall speaks to the depth of need and the dearth of services,” she said.
Faffer said the time may have come for county leaders to appoint an advisory board to analyze the issues locally and develop a comprehensive plan.
“We could become the lead county in helping our state improve our ranking,” she said.
On the other hand, the AARP report says Florida does better at transitioning elders back to their home or elsewhere in the community after a nursing home stay or hospitalization. The state ranks 21 in this category.
Two states that made the most progress across all categories are New York and Tennessee, the AARP's Reinhard said.
There has also been progress in many states to reduce the use of antipsychotic medications among nursing home residents in “off label” usage, she said, and many states have stepped up assistance to family caregivers.
Florida saw a decline since 2014 of its inappropriate use of antipsychotic medications for long-term nursing home residents from 22 percent to a current rate of 17.5 percent, according to the data.
What’s lagging is getting people back to their homes after a hospitalization or nursing home stay, and that needs to change, Reinhard said.
More than anything, proposals to cut Medicaid services to the disabled and for long-term assistance would be detrimental to millions of Americans, she said, and that message needs to be conveyed to state policymakers.
“The progress we are making is at risk,” Reinhard said.
If Florida improved its services and performance to the average of the top five states, there would be $1.8 billion more spent for home and community-based services, according to the AARP.
In addition, nearly 366,000 more people of all ages would be able to receive Medicaid-funded help with daily activities. Another 69,000 disabled residents with low or moderate income levels would have Medicaid coverage, the AARP said.