Washington performs well in a new report scoring states' long-term care systems.

The Evergreen State ranked second in AARP's Long-Term Services and Supports State Scorecard. Cathy MacCaul, advocacy director for AARP Washington, said this is an achievement for the state.

"Number two is a really positive indicator that all the challenges that the long-term care system experienced during COVID - Washington state did well," she said. "We have a lot of work ahead of us, though, to continue to improve the long-term care system."

AARP's last scorecard on long-term care services was released in 2020. In that report, Washington also ranked second. While the state performed well this year, the analysis noted there are major gaps in maintaining an adequate workforce in every state.

MacCaul said new indicators appeared in this report related to livable communities.

"There's a lot more work Washington state can do on housing and transportation to improve affordability and access for older adults and for their caregivers," she said.

MacCaul said the report also recognized that at-home care is key as the population ages rapidly.

"Home- and community-based services and supporting the 820,000 family caregivers that we have in the state are the two areas of probably the most importance when it comes to this scorecard," she said, "and recognizing the work that we need to do to improve our long-term care system in Washington state."

As of Jan. 1, insulin will become a lot more affordable for many Nebraskans, and those who have come to rely on telehealth visits are more likely to be able to continue receiving care this way.

The state senators who helped bring about these changes have received 2023 AARP "Champion Awards."

Sen. Eliot Bostar, D-Lincoln, was named a "Champion for Prescription Drug Affordability." His bill led to an out-of-pocket price cap of $35 for Tier 1 insulin.

Jina Ragland, associate state director of advocacy and outreach for AARP Nebraska, said it could make a big difference for people, some of whom might not have been able to take their medications as prescribed.

"They're rationing medications because they can't afford them, and they're trying to pay for groceries or utility bills or whatever," Ragland observed. "Which, for diabetes and insulin-dependent individuals, can be deadly."

Sen. Tom Brewer, R-Gordon, received a "Champion for Family Caregivers" award for his legislation to help ensure access to telehealth services. It requires insurance companies to pay in-state providers at least as much for telehealth visits as for in-person visits.

Ragland pointed out telehealth can make a huge difference, especially for those in rural parts of the state. She noted the telehealth option can spare some Nebraskans many hours of driving to appointments.

"How many people have a loved one that's an older parent that may have to take off a full day of work to drive from rural Nebraska," Ragland stressed. "Either into Grand Island, Lincoln, Omaha - or if they're going the other way, even into Denver or parts of Wyoming?"

Ragland expects telehealth will continue to grow in popularity, and believes it will help with the workforce shortage at Nebraska's rural clinics and hospitals.

"As people become more and more comfortable and have the connectivity, they're able to utilize this service," Ragland emphasized. "I think even for the provider side, it saves a lot of time for them, also, in meeting the needs of more people, I think, in a more time-efficient and effective model."

She added telehealth can contribute greatly to a person's ability to remain as independent as possible while "aging in place."

November is National Family Caregivers Month, and many of the 200,000 Nebraskans who help care for loved ones with a health issue or disability could use help.

Caregiving can take its toll. In one survey, almost three-fourths of caregivers said they were emotionally stressed, and over half reported financial strain.

Mike Osberg is coordinator of the Caregiver Support Program at the Eastern Nebraska Office on Aging, which provides respite, or relief, for caregivers. He said the person being cared for must be age 60 or older, unless they have a diagnosis of early dementia. And they must require help with at least two activities of daily living.

"That includes things like being able to take a bath or shower by themselves, dressing themselves, being able to manually feed themselves," Osberg outlined. "Then, do they have problems with walking and using the bathroom?"

Osberg pointed out the caregiver is actually the client and must be at least 18 years old. They can receive up to six hours a week of relief from an in-home respite provider, or they can have their loved one attend an adult day program for five full days per month.

The Eastern Nebraska Office on Aging serves Cass, Dodge, Douglas, Sarpy and Washington counties. Each of Nebraska's eight Area Agencies on Aging provide support for caregivers, although the services may vary.

Each month, they send the caregiver a "contribution request" to cover a suggested percentage of respite expenses. Osberg noted the amount is based on the care receiver's monthly income, or a couple's combined income, if the spouse is the caregiver.

"A lot of folks, their income is low, so we may only ask for them to consider 10% of what the total cost was for the month -- or 20%, or 30% or on up -- but it's strictly voluntary," Osberg emphasized.

He added no one is denied services based on income or inability to pay.

Those who choose an in-home respite provider can schedule how they use the six hours per week, and Osberg stressed the adult day program can benefit the care receiver as well as the caregiver.

"The caregiver gets a bigger chunk of time," Osberg observed. "But also, the care receiver gets to participate in activities, is going to probably eat their noon lunch and snacks there, participate maybe even in a little road trip, things like that."

He said the participating caregiving agencies are all bonded and insured, and conduct background checks on their employees.


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Idaho officials are holding an event in the capitol to recognize family caregivers during National Family Caregiver Month. Lieutenant Governor Scott Bedke is reading a proclamation signed by Governor Brad Little in the Capitol Rotunda today.

Francoise Cleveland, associate state director of advocacy, AARP Idaho, said family caregivers often don't recognize the vital role they play.

"They sacrifice their time, their health and their financial stability to provide that care and support, and often this is a labor of love," Cleveland said.

Cleveland added that family caregivers are crucial for ensuring people stay in their homes as they age, which is the option many prefer. There are about 210,000 caregivers in Idaho, according to data from AARP.

Deneice Anderson, a family caregiver in Idaho taking care of her 82 year old mother, said it can be difficult to balance the assistance her mom needs with her own needs.

"She had a gal hit her car one day and so I'm the one that's doing the insurance work for that. And I take her to her appointments - and I work full time," she explained.

Cleveland says AARP Idaho has legislative priorities for the 2024 session that could help improve caregivers' lives.

"We will be working on addressing the shortage of direct care workers in Idaho, protecting vulnerable adults from financial exploitation, ensuring health care is available through Medicaid and working to update the guardianship and conservatorship statutes," Anderson said.

The 2024 legislative session is scheduled to begin on January 8th.