Jan292019

My turn: California has a broken system of long-term care. Here’s what’s needed

Posted by Kassy Perry

By Nancy McPherson and April Verrett
CALmatters
January 29, 2019

In his inauguration speech, Gov. Gavin Newsom pledged that “every senior should be able to retire with security.” That’s a significant commitment to address challenges facing older adults, families and caregivers who struggle in a dysfunctional system.

California has an insufficient system of long-term services and supports for older people and people with disabilities, as detailed in a 2015 report by the California Senate’s Select Committee on Aging and Long-Term Care.

The report painted an alarming picture of the shortcomings of the current system, but offered real solutions: California can build a better system to serve all who have long-term care needs.

Since the Senate issued its report, the problem is only becoming more critical. By 2030, the California Department of Finance projects 24 percent of the population will be at least 65. And, in the next 20 years, the number of adults with disabilities could grow by 20 percent.

This added pressure on the system is creating a crisis for the middle class and generational poverty as each generation spends more of its savings caring for family members.

According to an AARP study, the annual cost of nursing homes is more than double the $50,000 median income of older households in California. Although Medi-Cal is a major public payer for the system of long-term services and supports, the high cost of nursing homes and long-term services is causing an increase in the number of unpaid family caregivers. The study also showed that in 2013, 4.5 million family caregivers provided care valued at roughly $58 billion.

Fortunately, there are innovative ways to address the long-term care crisis to achieve the intended results without putting additional pressure on the state’s general fund.

While some people can afford private long-term care insurance, the market for those policies is disappearing. As premiums rise, insurance companies are dropping coverage for long-term care.

And, as most people find out when it is too late, Medicare does not adequately cover long-term care services, which are far too expensive for most to pay out of pocket.

What is desperately needed is a solution that fits the diverse long-term care needs of the Golden State. We need an affordable and accessible system of long-term care for all Californians, regardless of their income or ZIP code.

To come up with that solution 20 organizations representing long-term care stakeholders have come together to form the California Aging and Disability Alliance. This alliance is working on an innovative and cost-effective approach to the long-term services and supports challenges we face.

We believe the public would embrace funding a limited but meaningful range of services for those with long-term services and supports needs. This would have many positive effects, including providing some relief to the state in its Medi-Cal long-term services and supports costs.

In the next few months, California Aging and Disability Alliance will develop our proposal based on that principle and seek the active involvement of the Legislature. At the same time, we look forward to working closely with Gov. Newsom to support his ideas and plans on this issue.

As Gov. Newsom said: “I have never been a fan of pretense or procrastination. After all, our state is defined by its independent, outspoken spirit.”

We agree. California can do this, but only if we work together.


Nancy McPherson is state director for AARP California, nmcpherson@aarp.org. April Verrett, aprilv@seiu2015.org, is President of SEIU Local 2015, both are CADA members. They wrote this commentary for CALmatters.