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Maintaining Long Term Care in Washington: Demographic and Economic Trends Threaten Access and Quality, Study notes of Nursing

University of Washington (UW) - TacomaNursing

The demographic and economic trends in Washington that threaten access and quality of long term care for the elderly. The retirement of the baby boom generation in ten years will more than double the number of Washington residents over the age of 65, leading to a substantial rise in demand for long term care. The document also discusses the limited government help available and the changing composition of long term care, with growing numbers utilizing home care instead of nursing homes.

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Public Affairs
The
Evans
School
of
Executive Summary
Maintaining Long Term Care:
Washington demographic and economic trends threaten access and quality
UNIVERSITY OF WASHINGTON OCTOBER 2001
Washington Residents over 65
2000-2030 Projection
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
1,800,000
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
85+
80-84
75-79
70-74
65-69
Source: Office of Financial Management projection.
Source: Evans School of Public Affairs projection.
Home Care Enrollment Projection, 2001-2031
Medicaid-funded Caseload, Washington State
-
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
FY 2001
FY 2003
FY 2005
FY 2007
FY 2009
FY 2011
FY 2013
FY 2015
FY 2017
FY 2019
FY 2021
FY 2023
FY 2025
FY 2027
FY 2029
FY 2031
Starting in ten years, retirement of the baby
boom generation will more than double the
number of Washington residents over the age
of 65. Coupled with rising life expectancies
and improved medical care, the demand for
long term care for the elderly is expected to
substantially rise.
Care is currently most often provided by
family members. More likely to be separated
from relatives by geography and limited by
work hours, over the next 30 years more
retirees will have to make do without family
help.
Long term care is expensive, and government
help is limited. Medicare only fully covers the
first three weeks of nursing home stays after
serious illness and traditional private health
insurance provides no coverage at all.
Medicaid coverage becomes available only
after elderly recipients have expended almost
all of their assets, consumed typically by long
term care costs. Medicaid is equally funded
by the state and the federal government. Long
term care Medicaid caseloads are more driven
by those who have exhausted Medicare
coverage or private resources than by those
living in poverty prior to retirement.
In recent years the composition of long term
care has changed, with growing numbers
utilizing home care instead of nursing homes.
Home care is less costly and preferred by the
elderly, particularly younger senior citizens.
Under current state policy, which encourages
home care and consumer choice, home care is
expected to continue to grow.
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Download Maintaining Long Term Care in Washington: Demographic and Economic Trends Threaten Access and Quality and more Study notes Nursing in PDF only on Docsity!

Public Affairs

The

Evans

of School

Executive Summary

Maintaining Long Term Care:

Washington demographic and economic trends threaten access and quality

U NIVERSITY OF WASHINGTON O CTOBER 2001

Washington Residents over 65 2000-2030 Projection

0

200,

400,

600,

800,

1,000,

1,200,

1,400,

1,600,

1,800,

2000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030

85+ 80- 75- 70- 65-

Source: Office of Financial Management projection.

Source: Evans School of Public Affairs projection.

Home Care Enrollment Projection, 2001- Medicaid-funded Caseload, Washington State

10,

20,

30,

40,

50,

60,

70,

80,

90,

FY 2001FY 2003FY 2005FY 2007FY 2009FY 2011FY 2013FY 2015FY 2017FY 2019FY 2021FY 2023FY 2025FY 2027FY 2029FY 2031

Starting in ten years, retirement of the baby boom generation will more than double the number of Washington residents over the age of 65. Coupled with rising life expectancies and improved medical care, the demand for long term care for the elderly is expected to substantially rise.

Care is currently most often provided by family members. More likely to be separated from relatives by geography and limited by work hours, over the next 30 years more retirees will have to make do without family help.

Long term care is expensive, and government help is limited. Medicare only fully covers the first three weeks of nursing home stays after serious illness and traditional private health insurance provides no coverage at all. Medicaid coverage becomes available only after elderly recipients have expended almost all of their assets, consumed typically by long term care costs. Medicaid is equally funded by the state and the federal government. Long term care Medicaid caseloads are more driven by those who have exhausted Medicare coverage or private resources than by those living in poverty prior to retirement.

In recent years the composition of long term care has changed, with growing numbers utilizing home care instead of nursing homes. Home care is less costly and preferred by the elderly, particularly younger senior citizens. Under current state policy, which encourages home care and consumer choice, home care is expected to continue to grow.

U NIVERSITY OF W ASHINGTON O CTOBER 2001

A caseload projection model was constructed for this study based on care preference by age and gender, flows from Medicare and private coverage, and generational wealth levels. While projecting little to no enrollment growth in nursing homes, the model predicts that Medicaid-funded home care enrollment will nearly quadruple over the next 30 years, rising from nearly 23,000 to over 88,000 by 2031.

Increased caseloads – and the likelihood of limited fiscal resources – will pose serious logistical challenges for state officials. A review of the gerontology literature suggests that, relative to other forms of long term care, home care quality is most sensitive to funding shortfalls. The state currently provides home care workers limited compensation

  • $7.68 per hour – and it has proven difficult to recruit and retain home care workers.

Assuming funding levels increase by Initiative 601’s fiscal growth factor and caseloads increase as projected, home care worker wages will stagnate, falling 38.3 percent behind the growth in personal income by 2031.

With demand for home care workers outstripping the supply estimated in the Bureau of Labor Statistics Industry- Occupation Employment Projection, the state will face even larger problems finding care workers without boosting compensation. Based on projected caseloads, and assuming care worker turnover equal to enrollment turnover, the data predict a peak waiting periods in 2018 of about seven months from program enrollment to the start of care.

Source: Evans School of Public Affairs projection.

Additional Home Care Placement Delay Washington State, 2007-

2007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031

Months