State ranks No. 2 in long-term care

Report shows room for improvement in specific areas

By Paris Achen, Columbian courts reporter



Who did the study?

The State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities and Family Caregivers is a two-year study by AARP Public Policy Institute, The Commonwealth Fund and The SCAN Foundation.

The report and interactive map where users can compare states are available at:

Long-term care scorecard.

Washington has long held the reputation of doing a good job of caring for its elderly population, but a new report Thursday has quantified that distinction.

The state ranked second in the nation for providing quality long-term care to seniors and people with disabilities, according to a national report by AARP. Washington trailed only Minnesota.

“It’s not really a surprise to see that,” said Klaus Micheel, planning and advocacy manager at the Southwest Washington Agency on Aging and Disabilities in Vancouver. “Washington has been known for many years for providing quality long-term care and having a system that allows the frail senior population to receive care in their own homes instead of being locked up in a nursing home.”

The study ranks states by measuring 25 indicators of quality in long-term care. The authors said they plan to update the study every two years to show where states have improved or regressed. Some of the indicators had never been measured before in a national study, said Enid Kassner, AARP’s director of independent living and long-term care. Among the new indicators were programs that facilitate more consumer choices for long-term care, legal and other supports for family caregivers, and how many tasks family caregivers are able to delegate to paid caregivers, Kassner said.

On specific indicators, Washington ranked second in the percent of Medicaid spending going toward home and community-based care, third in providing consumers with choices for long-term care and second in support for family caregivers. However, the state lagged behind about half of other states in the cost of home-based and nursing home care and nursing home staffing. Both nursing home care and home-based care remain unaffordable for Washington’s middle-income residents, the study showed.

Eric Erickson, executive director of Vancouver’s CDM Long-Term Care Services and a member of Washington Eldercare Alliance, said one reason for the state’s high costs could be employees who have unionized and hence, achieved higher pay. The home caregivers at his company are unionized.

The state was 44th in nursing home staff turnover and 29th in highest number of high-risk nursing home patients with pressure sores from not being turned over enough, a likely sign of inadequate staffing.

While the study may provide a guide for consumers, it’s particularly relevant to policymakers who face the dilemma of skyrocketing health and long-term care costs related to a senior population expected to double by 2030, the authors said. About 77 percent of people need long-term care at some point in their lives, said Bruce Chernof, president of SCAN Foundation.

In order to balance the state budget, the Legislature for the past two years has cut one of the programs that helped the state rank second-highest in the nation. Caregiver hours in the state’s In-Home Care program were cut by 10 percent in the past legislative session. The program uses Medicaid money to pay for patients to receive time with a caregiver at home instead of going to a nursing home.

“Our best-in-the nation status is at risk,” said Ingrid McDonald, Washington AARP advocacy director. “We are in danger of eroding our services and, in the long run, spending more on long-term care and leaving nursing home care as the only option.”

On the other hand, state lawmakers last session augmented the allocation for the state’s Family Caregiver Support Program. The program assesses family caregivers’ needs and provides training and services to support them. The program is meant to reduce caregivers’ risk of burnout and stress-induced health problems so they can go on caring for their loved one and reduce or eliminate the need to send the patient to a more costly and, often less desirable, nursing home.

“We argued that by putting money in that program, the state would save money by supporting people who are doing caregiving for free,” said Erickson of the Eldercare Alliance.

Long-term care includes assisted living centers, nursing homes, adult homes, home- and community-based care, respite and other services that provide assistance to the elderly, people with physical disabilities and their caregivers.

However, the study’s authors were unable to measure quality of respite and home- and community-based care because states don’t collect enough information on those programs, said Susan Reinhard, AARP senior vice president for public policy and one of the study’s authors.

Paris Achen: 360-735-4551;;;