A new report sheds light on the critical state of long-term care across the United States, with Arizona facing significant challenges in providing adequate support for its aging population and individuals with disabilities. The Long-Term Services and Supports (LTSS) Scorecard, released by AARP, reveals that even years after the onset of the COVID-19 pandemic, long-term care systems remain “painfully inadequate,” including within Arizona. This in-depth analysis underscores major gaps in various aspects of care, from adult day services to nursing home quality and accessibility of home care, signaling an urgent need for comprehensive reform and highlighting areas where focused efforts, like a detailed Scan Long Term Care Arizona initiative, could drive substantial improvements.
Arizona, ranking 22nd nationally according to the LTSS Scorecard, demonstrates only marginal progress in enhancing care options for older adults. While there have been slight advancements in assisted living availability and Medicaid LTSS spending balance, the state shows significant improvement in a mere 5 out of 50 indicators evaluated. This modest progress underscores the considerable work still required to meet the escalating needs of Arizona’s rapidly aging demographic. The report serves as a critical tool for stakeholders in Arizona to scan long term care Arizona services and identify areas for strategic intervention.
Dana Marie Kennedy, AARP Arizona State Director, emphasizes the urgency of the situation: “The pandemic reinforced the need to strengthen long-term care for countless loved ones across the country, including in Arizona. AARP’s Scorecard shows that there are many roads to meet the needs of all Arizonans who deserve the very best care, including the 850,000 family caregivers in our state. It’s time to accelerate our efforts, for the sake of saving more lives. Arizona’s current position on the LTSS Scorecard is concerning, especially considering quality of care with one key indicator ranked so poorly. We have unfortunately seen, very recently, times when things that may not be reported to CMS can result in negative resident outcomes.” This statement highlights the importance of initiatives to scan long term care Arizona facilities and practices to ensure quality and accountability.
Family Caregiving: A Cornerstone of Long-Term Care in Arizona
Family caregivers are the unsung heroes of long-term care, and in Arizona, their contributions are substantial. While only a handful of states offer tax credits for family caregivers’ out-of-pocket expenses, Arizona provides a valuable grant program. This initiative allows family caregivers to receive reimbursement for essential home modifications, such as installing grab bars or ramps, easing the financial strain of home adjustments necessary for care. Despite this support, the average family caregiver in Arizona still spends approximately $7,242 annually on out-of-pocket caregiving costs, highlighting the significant financial burden they bear.
Arizona is also among the 18 states with paid sick day laws that extend to caregiving. The state’s sick leave policy grants five days of sick leave per year, which can be used to care for family members. This provision is a crucial support for working caregivers, enabling them to balance employment responsibilities with their caregiving duties. However, the report points out a concerning trend: a decline in care choices supporting families. Arizona, along with 20 other states, has experienced a decline of 10% or more in adult day services since 2016. This reduction in adult day care options presents a challenge for families who rely on these services for respite and support, emphasizing the need to scan long term care Arizona service availability and accessibility.
Home and Community-Based Services (HCBS): Shifting Landscapes in Arizona
A significant shift is occurring in long-term care preferences, with more older adults opting for home and community-based services (HCBS) over institutional care. For the first time, over half (53%) of Medicaid LTSS spending for older people and adults with physical disabilities is directed towards HCBS. This marks a considerable increase from 37% in 2009 and reflects a growing demand for care in home-like settings. HCBS encompasses a range of supports, including home health aides, respite care, assistive technology, and home modifications. In 2021, the average annual cost of home care in the US was $42,000, making it a significant expense for many families in Arizona. As Arizona continues to develop its long-term care strategy, a thorough scan long term care Arizona HCBS options is crucial to ensure these services are robust, affordable, and accessible to those who need them.
Nursing Homes and Institutional Care: Addressing a Workforce Crisis in Arizona
Nursing homes and institutional care facilities are facing a severe workforce crisis nationwide, and Arizona is no exception. Direct care worker wages are consistently lower than wages in comparable entry-level occupations. In Arizona, the wage gap is $2.37 per hour, making it challenging to attract and retain qualified staff. This wage disparity contributes to a high turnover rate in nursing homes. Nationally, over half of nursing staff leave their positions within a year (53.9%). Arizona’s turnover rate is even higher, at 55%, exceeding the national average and indicating a particularly acute staffing challenge within the state. High turnover negatively impacts the quality of care residents receive, making workforce development a critical area to scan long term care Arizona nursing facilities and address.
Susan Reinhard, Senior Vice President, AARP Public Policy Institute, underscores the systemic failure revealed by the pandemic: “COVID-19 tested our long-term care systems, and they failed. Now is the time to take the lessons we’ve learned to fix them, for the sake of saving lives. AARP’s LTSS Scorecard shows some progress and innovation, but there’s still a long way to go before we have systems that allow people to age well and independently for as long as possible and support the nation’s 48 million family caregivers. It’s also clear some emerging issues deserve more attention – from whether nursing homes are prepared to confront natural disasters, to whether they have plans in place to maintain and grow their workforces.” This call to action emphasizes the need for proactive measures and comprehensive strategies to strengthen long-term care systems in Arizona and across the country.
Recommendations for Strengthening Long-Term Care in Arizona
The report and AARP offer several key recommendations to bolster long-term care support and promote aging at home, particularly relevant for Arizona:
- Prioritize and Support Family Caregivers: Recognizing family caregivers as the backbone of the long-term care system is paramount. Arizona can further enhance support through initiatives such as expanding financial assistance, promoting paid family leave, and providing respite care services. Holding facilities accountable for quality care is also crucial.
- Invest in Home and Community-Based Care Infrastructure: Arizona should increase investment in all aspects of HCBS, including expanding training and support for home health aides, improving access to medical devices and equipment, and modernizing Medicaid regulations and payment models to incentivize home-based care.
- Bolster the Nursing Home and In-Home Care Workforce: Addressing the workforce crisis requires a multi-pronged approach, including improved recruitment and training programs, increased wages for direct care workers, and expanding the roles of trained nurses, aides, and community health workers. Arizona can also enact and enforce robust staffing and care standards in nursing homes.
- Expand Innovative Nursing Home Models: Exploring and implementing innovative models, such as smaller, more person-centered facilities and private rooms, can enhance both the quality of care and the quality of life for nursing home residents in Arizona.
- Address Inequities in Access and Quality: Targeted investments are needed to close disparities in access to quality care and address staffing shortages, ensuring equitable long-term care services across all communities in Arizona.
- Develop Multisector Plans for Aging: Arizona should build multisector collaborations and age-friendly health systems to address the broader needs of older adults, including affordable housing, accessible transportation, and comprehensive emergency preparedness plans that specifically consider the long-term care population.
- Advance Innovation in Aging Services: Supporting comprehensive state and community-wide aging plans and piloting innovative programs can pave the way for scalable solutions that improve long-term care across Arizona.
- Ensure Emergency Preparedness in Nursing Homes: Every state, including Arizona, must have a robust emergency preparedness plan to protect nursing home residents during crises, including natural disasters, ensuring their safety and well-being.
The LTSS Scorecard, funded by organizations like The SCAN Foundation, The Commonwealth Fund, and The John A. Hartford Foundation, provides a valuable framework for states to scan long term care Arizona and identify areas needing improvement. Sarita A. Mohanty, MD, President and Chief Executive Officer of The SCAN Foundation, highlights the importance of home and community-based care: “Most older adults prefer home and community-based care that meets their needs, but it remains financially out of reach for many working-class families, particularly those who are part of the ‘forgotten middle’. TSF is committed to identifying, highlighting, and elevating innovative policies and programs to ensure all older adults can age well in home and community.”
The call to action is clear: Arizona needs to undertake a comprehensive scan long term care Arizona system, leveraging the insights from the LTSS Scorecard to implement targeted reforms and ensure that all Arizonans have access to high-quality, affordable, and person-centered long-term care services. This proactive approach is essential to address the current inadequacies and build a robust system that meets the evolving needs of the state’s aging population.
