The Health Care Association of Michigan (HCAM) has been following with great interest the LSJ series on aging and is appreciative of your efforts to shine a spotlight on the numerous issues relating to senior care. HCAM is a statewide organization representing residents, families, owners and employees of nursing and rehabilitation facilities.
Although HCAM supports the conclusion of your editorial “Aging’s price” (8/19/07), we do have several concerns. We agree the state needs a better way to consistently fund long-term care.
One concern was the inference made in the editorial that nursing facility care is the reason for the large increase in Michigan’s Medicaid costs. Medicaid pays for many services and long-term care is just one portion. The Medicaid budget for long-term care has stayed relatively consistent while other Medicaid costs have ballooned due to Michigan’s ailing economy.
The editorial also infers that Michigan has a high nursing facility bed rate in comparison to other states. According to AARP, in 2005 Michigan ranked 38th in the number of nursing facility beds per 1,000 people aged 65 and above. Michigan is very judicious in its use of nursing facility beds with high acuity standards needed for admittance.
The MI Choice Waiver Program is designed to provide services at home for people with less acute illnesses. HCAM supports the Waiver Program but not at the expense of funding nursing facility care. Adequate funding is needed for the entire health care continuum. As people age they are more likely to endure illnesses such as, heart disease, strokes, cancer and dementia. These illnesses cause limitations in daily living including; bathing, dressing and eating. For elderly living in a community setting incidences of these limitations are very low, in contrast, these incidences are very high for residents of nursing facilities. Those with Alzheimer’s or other acute illnesses need 24-hour nursing care/supervision. In those cases skilled nursing care is not only the best option; it is sometimes the only option to ensure health and safety. Home health or home and community based wavier services are not legitimate substitutes for nursing facility care. They serve a different population based on a more limited need for medical or personal care assistance—more importantly they assume a social support structure is in place, i.e. family and friends to supply the balance of a 24-hour period of care.
People working in and managing nursing facilities take on the hard and sometimes thankless task of providing medical care and compassion to the most ill among us. They deserve our gratitude and support.
The high cost of long-term medical care is an issue that will not go away. It is estimated that by 2015 those 85 years and older will increase by 40 percent and aging baby boomers will swell the 65 and older population by 26 percent. This crisis will continue - unless something is done now to prepare for the future. The state needs to make long-term care a priority and find a way to pay for it.
Dan Gustafson is the President/CEO of the Health Care Association of Michigan which works to promote excellence in senior care.