TV Program Is A Wake-Up Call On Aging and Long-Term Care
Monday, December 29, 2003 - Page updated at 12:00 A.M.

Dear readers:

Stop the presses! Shortly before deadline, I learned from a favorite news source — the Center for Long-Term Care
Financing at www.centerltc.org — about an extraordinary program that will air at 11:30 a.m. Sunday on KCTS-TV (Channel
9).

Called "Living Better: A National Conversation on Aging," the program is the brainchild of Idaho Gov. Dirk Kempthorne,
who, from personal experience with his aging parents, has made long-term care the focus of his chairmanship of the
National Governors Association this year.

The program features a panel of the nation's governors, plus former House Speaker Newt Gingrich and Alice Rivlin,
former White House budget director and Congressional Budget Office director — a motley group of policymakers who agree
that one of the most critical calamities facing this country is our burgeoning aging population.

"Just eight years from now," the program begins, "77 million people will begin to turn 65. The baby boomers — the
largest generation of Americans ever born — will head for retirement, threatening to overwhelm already financially-
stressed state governments. They are a generation unlike any other: more active, often more prosperous than their
parents — but not necessarily healthier."

The number of impoverished older people needing to rely on the government safety net will increase dramatically, the
program says. "Where will they go? Who will take care of them? And who will pay the bill?"

"We think it can never happen to us," says moderator Morton Kondracke, executive editor of the Capitol Hill newspaper
Roll Call and co-host of Fox News Channel's The Beltway Boys. Yet, he's experienced the problems firsthand, caring for
his wife who's suffered from Parkinson's for 16 years and is now bedridden.

"As hard as that's been, I'm fortunate," he says. "I can pay for excellent daily care, but others can't."

Some sobering statistics:

• In the next 20 years, 157 million people — more than half our nation's population today — are expected to experience
chronic diseases, such as heart disease, cancer, arthritis, and diabetes.

• We spend more than $1 trillion on health care each year in this country, of which three-quarters — $750 billion —
goes to chronic diseases.

• Long-term care consumes one-third of all state Medicaid funding, Medicaid accounts for 20-30 percent of all state
budgets, and both Medicaid and Medicare spending is expected to increase nearly $100 billion by 2011.

What are some ways we can dodge this bullet? The program offers a number of ideas — people making better lifestyle
choices such as exercising to avoid chronic illnesses, research to eliminate catastrophic diseases such as Alzheimer's,
preventive care to avoid disease, and the purchase of long-term care insurance by individuals to provide for their own
needs.

But the most important is culture change: individuals taking responsibility for their own futures rather than relying
on the government to take care of them. And, says Kempthorne, "We must begin to act now."

This is a wake-up call we can't afford to miss.

Q: My mother has the chance to move into an adult family home private-pay. If we gift her assets, which an elder-care
attorney says we can do, we can make her eligible for Medicaid in a matter of a few months. The operator says if we pay
him the difference between the private rate and Medicaid for at least two years, he'll keep her for three years, even
if we run out of money. What do you think?

A: Sounds like a neat trick, but it's illegal to supplement Medicaid services. Under federal law, says Mary Lou
Percival, Financial Program Manager with Aging and Disabilities Services Administration, of the state Department of
Social and Health Services, families can only supplement what Medicaid doesn't cover, such as a private telephone or a
TV. Because providers that contract with Medicaid agree to accept the Medicaid payment as "payment in full," it's
illegal to supplement it.

If you get caught, the adult-family-home operator could be investigated for fraud, fined, and possibly lose his
license. The older person could lose Medicaid eligibility if they transferred funds improperly and be required to pay
privately.

But other cautions are important as well. The most important is how long the adult family home will actually operate.
As much as I recommend adult family homes to care for frail older people, it's a tough job. Many go out of business
because they can't attract enough clients to pay the bills, while others give out in exhaustion. Promises to care for
someone in the future may be moot if circumstances cause the home to close.

This question also underscores the significant disparity between private-pay and Medicaid rates in eldercare. Among
adult family homes in King County, for example, private rates range between $3,200 and as much as $6,000 a month,
depending on the level of care, luxuriousness and location. For the same care, Medicaid — whose rates vary by county
and level of care — pays between $1,350 and $2,563 a month.

"Homes that accept Medicaid have substantially smaller operating budgets," says Marque Burbatt of Bellevue, director of
The Road Home, a private placement agency for adult family homes. "This means they may be unable to hire enough staff
and have outings or activities. Paying privately for care usually results in better care, quality food, and a nicer
atmosphere."

Liz Taylor's column runs Mondays in the Northwest Life section. As a specialist on aging and long-term care, she
consults with individuals and teaches workshops on how to plan for one's aging — and aging parents.

E-mail her at [log in to unmask] or write to P. O. Box 11601, Bainbridge Island, WA 98110. You can see all
of her columns at http://www.seattletimes.com/growingolder/

SOURCE: The Seattle Times
http://seattletimes.nwsource.com/html/health/2001823849_liztaylor29.html

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