January is a time of inaugurations. Today we witnessed the swearing in of President Barak Obama for his second term, and Washington’s new governor, Jay Inslee, took the oath of office in Olympia last week.
No matter what your own political leanings are, we all live in a representative democracy. We have the right to speak up, advocating for issues we hold dear. One of the issues relevant to readers of this website is a provision in the Affordable Care Act, specifically relating to home- based care.
There are many ways to pay for home based services. Veterans receive support for home care through the Aid and Attendance or Homebound programs. Persons who hold long-term care insurance may find their needs covered through these policies. Others rely on private pay or state-funded supports. The Affordable Care Act recognized three facts among the aging population:
*Most seniors express the strong desire to “age-in-place” rather than to be relocated to a nursing facility as their healthcare needs increase;
*Even persons needing skilled care can be very effectively served at home, often with better outcomes than in a long-term care facility;
*Providing care at home is more cost-effective than providing care in a nursing home setting.
In light of this, the Affordable Care Act contains incentives for states to make home care more affordable for more seniors. There is a Community First Choice Option, which offers an incentive to state funding if Washington takes action to provide home care attendant benefits to seniors and persons with disabilities. There is also a State Balancing Incentive Payments Program, which offers additional grants to states that achieve a balance of at least 50% of long-term care services delivered in home settings. Many families will be interested to know that the ACA also has a Spousal Impoverishment Protection clause, which is intended to limit the devastating effects of a Medicaid “spend-down” requirement before a spouse can be eligible for services.
Whether these provisions are good public policy is debatable. What is important and inarguable is that the needs of seniors and persons with disabilities are being actively discussed in the centers of power, and that the need for more access to home care is seen as an urgent public priority. This is the time for senior advocates, long-term care providers, seniors, concerned family members and governmental bodies to work together to ensure that every senior has access to the care they need. Won’t you join the discussion by contacting your legislator and expressing your concerns and recommendations on this important topic?
Resources for Further Reading:
AARP Health Care Reform Fact Sheet, http://assets.aarp.org/rgcenter/ppi/ltc/fs192-hcbs.pdf
National Academy for State Health Policy, http://www.nashp.org/node/2131