Indiana Long-Term Elderly Care

This editorial appeared in the Fort Wayne Journal Gazette on Tuesday, July 18, 2017. It speaks to the status of long term care in Indiana.

EDITORIAL

Steep uphill climb
Indiana last among states in long-term elderly care

It’s no secret that Indiana faces a litany of health care challenges.

One area that is deservedly getting more attention is long-term care for seniors and those with disabilities. The need for workers and resources for home-based and nursing-home care will rise as the baby-boom generation passes retirement age. In 2015, according to the Indiana Division of Aging, “Hoosiers 65 and older made up nearly14 percent of Indiana’s population, and that number is projected to grow to 20 percent by the year 2030.” The numbers will grow even faster in urban areas.

It would be nice to be able to say that Indiana is well positioned to cope with the needs those changing demographics will create.

But a recent study measuring five key areas of long-term care ranked Indiana dead last – 51st out of the 50 states and the District of Columbia.

In addition to its overall bottom ranking, Indiana ranked last in two of five areas of the study: affordability and access to care, and support for family caregivers.

The report is the third three-year survey conducted by the AARP Foundation, the Commonwealth Fund and the SCAN Foundation. In the two previous reports, in 2011 and 2014, Indiana ranked 47th.

It’s possible things aren’t quite as bad as the report indicates. Some of the data referenced in the AARP survey are several years old, Kristen LaEace, CEO of the Indiana Association of Area Agencies on Aging, noted Monday. “It’s not necessarily reflective of recent improvements Indiana has made,” she said.

But the report shows other states have been making improvements earlier and faster than Indiana, LaEace said. “We’re saying the state needs to pick up the pace.”

Responsibility for long-term care in Indiana is shared among the Indiana Department of Health, the Family and Social Services Administration and other agencies, LaEace said. Other states, she said, have a state commission or “czar” to oversee long-term health care policy, and such an approach could help Indiana focus on the issue.

“There’s not that comprehensive, overall view,” LaEace said. “I think that’s to our detriment.”

One crucial component of the services area agencies on aging provides is “options counseling” – to help those needing long-term care navigate the system. But, LaEace said, “the state doesn’t have a dedicated funding source for that.” The legislature’s reluctance to consider even voluntary family-leave programs has held the state back as well, she said.

Monday and today, the FSSA is holding a public hearing in Indianapolis on one aspect of the long-term care challenge: home and community-based services funded by the Medicaid program. The agency will forward findings to the legislature.

But the state’s efforts to catch up on long-term care may be undercut if proposals to drastically cut Medicaid funding are approved in Washington. “It really has the potential to have some disastrous consequences,” LaEace said.

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Medicare Part D Late Enrollment Penalty

Be careful when making initial enrollment elections for Medicare.  If you do not elect Part D (prescription drugs) when you initially enroll for Medicare there is a penalty when you do enroll.  According to Medicare.gov:

The late enrollment penalty is an amount that’s added to a person’s monthly Part D premium. A person enrolled in a Medicare drug plan may owe a late enrollment penalty if he or she goes without Part D or creditable prescription drug coverage for any continuous period of 63 days or more after the end of his or her Initial Enrollment Period for Part D coverage.

Further, the penalty does not go away and is applied monthly for the rest of the recipient’s life.  Go to medicare.gov for more information on this penalty to see how it applies to you.