Testimony to
The Commission on Affordable Housing and Health Facility
Needs for Seniors in the 21st Century
September 24, 2001
by
Betty Verlie, Chair
and
Norman Myers, Steering Committee Member
The AOPHA Resident Forums

Madam Co-Chairs and members and staff of the Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century: Thank you for this opportunity to address you today regarding health care and housing issues confronting Seniors in the next century. I am Betty Verlie, Chair of the The AOPHA Resident Forum. Accompanying me is Norman Myers, a member of the Forum Steering Committee.

The AOPHA Resident Forum is an organization of residents and clients of not-for-profit aging services providers who are members of AOPHA, the Association of Ohio Philanthropic Homes, Housing and Services for the Aging. Working together with AOPHA, the Forum provides each of us an opportunity to bring our lifetime of experience to try and make a difference for seniors.

Demographically, our country is aging. As seniors, each day we experience the infrastructure failures and funding shortages in a country that has not yet comprehensively addressed the issues of aging. In August, the Forum conducted seven Senior Focus Groups around the state to identify the issues we feel are most important along with recommendations regarding them.

We heard about the following:

• Issue- Medicare and Medicaid, the healthcare programs on which we rely most heavily, are predominately focused on acute care. They rarely address the wellness, prevention and chronic care issues we face daily. Sadly, a missing prescription drug benefit often undermines our attempts at health maintenance.
  
  Recommendation- Call upon geriatric experts to assist in redesigning the programs to focus on wellness and prevention in a way that is practical and cost effective. Broaden the program to include prescription drug coverage; or, begin a dialogue regarding the pharmaceutical industry and the profit making that our current market system allows.



• Issue- Public transportation, particularly in rural areas, is often unavailable forcing many to go without transportation for needed appointments or use our own car long after it is cost efficient or wise to do so.
  
  Recommendations- Increase appropriation levels for transportation in both urban and rural areas.



• Issue- All ranges of long term care should be accessible regardless of income level. It is estimated that 1 million people live in assisted living; yet, with monthly rates ranging from $2,000 to $4,000, it remains a completely unaffordable option for the poor and near poor. Non-skilled nursing home care is beyond the reach of almost everyone unless they are Medicaid eligible. Home and community based services are fragmented and under funded; and it is often difficult to locate trustworthy individuals and programs for those of us who can afford to pay when such assistance would enable us to remain in our own homes longer.
  
  Recommendations: Encourage the growth of private long-term care insurance. Make it more affordable through tax deductions, tax credits, or direct subsidies. Maintain flexibility in regulations at the state level to promote expansion and growth of more assisted living units, promote affordable assisted living through HUD, and support Medicaid waivers for assisted living.
  
  Expand existing Area Agency on Aging programs to provide information, referral and assessment services to all senior citizens regardless of income level to assist in finding credentialed individuals and programs. Encourage provider infrastructure growth of all kinds by increasing Medicare and Medicaid payment levels to cover the cost of services delivered. Require states to offer home and community based services through Medicaid. Develop programs to educate the public about long-term care of all kinds, its costs, and the importance of planning to cover these costs.

In addition, demonstrating the wealth of expertise and insight our seniors bring, the following "behind the scenes" issues were identified:

• Overly burdensome regulations that exhaust system dollars. Recommendations included establishing a long- term care industry task force to make practical recommendations to streamline regulations safely.



• The staffing crisis. A tight labor market, non-competitive wage and benefit levels under current Medicare and Medicaid payment guidelines, negative public perceptions, and limited career advancement opportunities prevent staff recruitment and retention of all types. Our recommendations include: federal training and education grants for new long-term care workers, enacting immigration reform, broadening visa eligibility for long term care non-skilled workers, and passing "single-task" legislation allowing employers to better shift existing staff when needed and safe to do so.

It quickly became apparent to those of us with a lifetime of experience that we need a complete, comphrensive and systematic strategic plan for the future, and that there is no structure or entity as yet charged with meeting this goal.

Accordingly, we make the following recommendation:

• That a national, bi-partisan, "Task Force on Aging" be established comprised of experts in the field of aging from both the public and private sectors to identify a comprehensive plan for the future.
  
  The plan should be visionary in nature and should identify step-by-step recommendations to Congress for a new infrastructure that best utilizes all resources at the federal, state and local levels.
  
  And, further, that we form a new "Federal Department of Aging Services" under the direction of a new Cabinet level post specifically charged to champion, coordinate, and implement the recommendations of the Task Force.

In conclusion, as Senior Citizens, we appreciate the existing programs and services that are already available to us and which provide a minimum standard of support for many while living out their later years.

We appreciate being included in the planning process of this Commission and wish you success in sorting through the tangle of senior issues compounded daily by our growing numbers.

We are available to answer any questions you may have.

Thank you and good luck.