State's long-term care budget needs support

Oregon's population is aging, but our long-term care system is not keeping up with the needs of our residents.

Our community-based system that was created 32 years ago in Southern Oregon is a model for the nation. It was designed to honor the independence, choice and dignity of seniors and people with disabilities by supporting in-home care and community-based care alternatives such as adult foster homes, assisted living and residential care facilities.

The greatest need for LTC is among those ages 85 and up. Their numbers in Oregon will grow from 80,959 in 2010 to 121,741 in 2022. While the boomers born between 1946 and1964 are creating a dramatic shift in population, the major waves of significantly increased needs will hit around 2030. Investing now in maintaining and growing our LTC system makes sense and will prepare Oregon for our aging citizens.

A majority of our frail and elderly are cared for by a family member. But those whose spouses, children and friends are deceased, or live in another state or who need care themselves often have no choice but to rely on the state for help. The services that seniors and people with disabilities receive are to help with activities of daily living — such as getting dressed, bathing, preparing meals or eating. Services may be provided at home, in a community setting or in a nursing home.

Currently the nursing home occupancy rate in Oregon averages 61 percent annually, the lowest in the nation. Once we subtract what the federal government pays in matching funds, it costs Oregon's general fund an average $7,464 to care for someone in a community-based facility (adult foster home, assisted-living or residential-care facility) and only $5,676 annually to care for someone in our Medicaid in-home program. Oregon's Project Independence program costs the state general fund on average only $2,592 annually to help someone remain in their own home. Comparing these costs to the average $24,948 it costs Oregon to care for an individual in a nursing facility, it is easy to see why our LTC system is cost-effective and saves taxpayer dollars.

Oregon's LTC system, in which 84 percent of its approximately 28,000 Medicaid clients are served outside of nursing facilities, saves taxpayers more than $1 billion a biennium over what it costs the Connecticut LTC system, which serves almost the same number of clients but where only 43 percent are cared for in home- and community-based settings.

Gov. John Kitzhaber's recommended budget continues basic funding support for Oregon's LTC delivery system. In addition, the governor's budget contained an innovative $30 million spending package to improve the services and supports. Unfortunately, the governor's budget continues the underfunding of Oregon Project Independence at last biennium's $9.7 million. Funding it at $12.6 million of previous biennia could reduce the number of individuals on wait lists around the state and increase the number of individuals able to stay in their own homes and off of Medicaid-funded services.

The budget recently released by Oregon's Ways and Means co-chairmen Sen. Richard Devlin, D-Tualatin, and Rep. Peter Buckley, D-Ashland, calls for reductions in the governors' proposed LTC budget and removes the $30 million in investments contained in the governor's budget.

Oregonians of all ages should care, and be engaged in this issue. Just as investments in our schools are investments in our future, so are investments in our LTC system.

Most of us will need some type of long-term care during our lifetime. Rosalynn Carter once said, "There are only four kinds of people in the world — those who have been caregivers, those who currently are caregivers, those who will be caregivers, and those who will need caregivers."

Results of an AARP Oregon member survey ranks LTC services just below job creation/economic development and just above K-12 education as the most important issues legislators must address this session.

I urge you to call or write your legislators and ask them to invest in our LTC system so that it can meet both the current and future needs of some of Oregon's most vulnerable citizens.

Don Bruland of Medford retired last July as director of Senior and Disability Services after 37 years with the Rogue Valley Council of Governments.

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