Addressing the needs of our aging population will be one of the most complex policy challenges facing our state and nation in the 21st century. The number of people age 65 and older is projected to double over the next 40 years, and studies show two-thirds of Americans who reach age 65 will need long-term care at some point due to their age or disability.
Moving forward, we need solutions that will allow people to age in their homes. In Indiana, 75% of people over 50 want to age in their homes, but only 45% are able to do so because of financial limitations.
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Local agencies like New Hope of Indiana and Life Span Services do a commendable job of meeting the needs of those who need home care. However, local agencies like these are woefully underfunded by the state. In 2019, Indiana spent just 35% of its long-term services and supports funding on home- and community-based services, which is below the national average of 59%. Aging at home makes financial sense for the state. Nursing homes cost the state $4,700 per month per individual, while care through local agencies that provide services, like assistance with bathing, cooking and monitoring medication, only ring in at $230 per month.
Direct Service Providers, caregivers who makes aging in place possible, are historically underpaid and in short supply, especially considering the strain of the pandemic. Policy considerations must address this vital workforce and their value in health care models.
The Indiana Family and Social Services Administration has done an adequate job of administering programs in the past. Their recent push to fund long-term care through big insurance companies, while well meaning, comes with risks. Insurance companies are kept to their shareholders, not patients. During the pandemic, we saw ballooning CEO salaries and record profits, but this windfall of profits did nothing to help Hoosiers. Currently, the wait list to receive benefits that allow people to remain in their homes is over 6 weeks. For some state administered programs like Community and Home Options to Institutional Care for the Elderly and Disabled, the wait is over a year. This forces people to place their loved ones in nursing home facilities because they do not have the support to keep their loved ones at home while they wait for approval.
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This year, FSSA backed Indiana Senate Bill 407 in an effort to create a comprehensive plan for long-term care. While the proposal was not perfect, it opened the door to progress. The bill passed the Senate and the House of Representatives Public Health Committee but then died with no explanation. This sudden halt raises questions about why a bill with so much support failed to advance. It comes as no surprise that insurance companies have a strong influence on the political process — what role did they play?
How much money do insurance companies invest in swaying policy to pad their pocketbooks while Hoosiers wait for solutions? I have long resolved not to take donations from insurance companies. As a retired physician, I understand that people must come before profits. I only wish more legislators felt the same.
State Rep. Rita Fleming is a retired obstetrician.