A new report finds Virginia's long-term care facilities need improvement to better serve their residents.

AARP's Long-Term Care Services and Supports Scorecard ranks Virginia at 28th among states. While the state has ranked high in terms of affordability and access to long-term care, it scores lowest in safety and quality, as well as support for family caregivers.

Jared Calfee, state advocacy director for AARP Virginia, said nursing home financial transparency is one of several priorities the group will take up at the General Assembly next year.

"Our nursing facilities, they largely operate with a lot of taxpayer money coming from Medicaid," Calfee pointed out. "The public has a right to know how that money is being spent and what's being dedicated to staffing and providing quality care, versus what is going to profits and paying administrators."

Other areas on which he noted AARP Virginia would focus include providing aid to family caregivers, licensure, and enforcement of both state and federal rules on staffing. However, with many seats in both chambers of the General Assembly up for election, Calfee acknowledged it is too early to tell what kind of progress might be made.

The scorecard also reflects trends stemming from the COVID-19 pandemic. Calfee emphasized nursing homes have been and continue to face issues, particularly with staffing, which surfaced due to the pandemic.

"When you don't have adequate staffing, and you have staff coming and going -- who aren't able to stay in facilities and get to know people -- then that's what you end up with, is facilities that are not as high-quality as you would want," Calfee asserted. "And it's the residents who then end up suffering because of that."

He added stronger policymaking will be necessary to make progress. Bills on nursing home staffing requirements failed in previous years, but the General Assembly was able to pass a law this year. However, it does not go into effect until July 1, 2025.

AARP Iowa has released a series of videos asking congressional candidates how they would support Iowans who are unpaid caregivers.

The group traveled Iowa this summer on its "Cruisin' for Caregivers tour" to not only educate people about the issue but to hear from caregivers about what is important to them. Caregivers from each district sat down with Congressional candidates to discuss the challenges they face and potential solutions. AARP Iowa said unpaid family caregivers in the state provide what amounts to about $5 billion worth of services every year.

Paige Yontz, state advocacy manager for AARP Iowa, said unpaid family caregiving is a top issue for Iowa voters age 50 and older.

"The fact of the matter is, these voters are the driving force behind every election," Yontz pointed out. "In Iowa, voters accounted for 54% of the total electorate in 2020 and 62% in 2022, that's voters in the 50-plus category."

AARP polling shows voters in this age group are more likely to choose candidates who have a plan to support unpaid family caregivers. In the videos, Iowa's congressional candidates have 30 seconds to describe their approach.

Seniors have said aging at home has become increasingly important to them and Yontz argued having the help and care they need to do that is critical.

"In Iowa, there are over 330,000 unpaid family caregivers that assist their loved ones with needs that allow them to remain independent in their homes," Yontz explained. "That might be medical care and finances to chores, transportation, grocery shopping, you name it."

AARP said nationwide, unpaid family members provide at least $600 billion in care and services to loved ones and others who need support.

Drawing attention to a housing option that could make it easier for older Nebraskans to "age in place" is one of the goals of an AARP Community Challenge grant-funded contest.

Omaha by Design was awarded a nearly $24,000 AARP "Demonstration Grant" for its "Duplex by Design" contest. The contest is for duplex designs which "promote health and greater autonomy" with their accessibility and affordability.

Abe Lueders, director of urban design and affordable design fellow at Omaha by Design, explained duplexes are one type of badly needed "missing middle housing."

"When we say 'missing middle,' we're talking about basically small multifamily buildings," Lueders noted. "That includes duplexes but also up to quadplexes, townhomes; things that are bigger than a house but smaller than an apartment."

AARP maintains one reason small, affordable housing is missing in many communities is too little of it has been built since the 1940s. This causes some seniors to remain in larger homes than they need.

Empty-nest Baby Boomers in the United States currently own twice the number of large single-family homes as Millennials raising children.

Todd Stubbendieck, state director for AARP Nebraska, said not only is there a need for more "accessible" senior housing but also for more housing options that allow seniors to live independently for as long as they can.

"Duplexes provide that opportunity for a little smaller space, downsized, maybe less stairs and just more of an age-friendly design option for folks," Stubbendieck outlined. "This project is going to highlight and raise awareness of duplexes and create some buildable designs that folks in Omaha can work with."

Lueders stressed in addition to being more affordable and accessible, "missing middle housing" creates more housing on a single lot. He pointed out duplexes are "the next rung up" on the housing ladder, since they are built on the same scale, use the same construction methods and are subject to the same residential building codes as single-family homes.

"It seemed like a really fruitful housing type to explore because of how low the bar for entry is," Lueders emphasized. "Because part of the goal is that you want to create a design that smaller developers can build. Maybe people that are newer to development that have a small piece of land and want to create some housing."

Contest designs must all fit a specific lot, which Lueders added ensures every designer is working with the same real-world constraints.

Registration for "Duplex by Design" closes Sept. 16, after which designs will be accepted until Oct. 18. The first, second and third place winners will receive cash awards of $2,500, $1,500 and $1,000.

A new report found Connecticut residents will benefit from Medicare's new out-of-pocket cap.

An estimated 49,000 people in the state would see prescription costs reduced because out-of-pocket costs will be limited to $2,000 per person each year. The report estimated the number of residents using the cap will hit more than 62,000 by 2029.

John Erlingheuser, senior director of advocacy and outreach for AARP Connecticut, said unaffordable prescriptions are forcing people to take matters into their own hands.

"We continually hear from folks that cut back on the number of pills they're supposed to take," Erlingheuser reported. "Maybe they're taking them every other day as opposed to every day, or they're cutting pills in half and taking a partial dose every day as opposed to taking the dose that they're required to take."

This cap stems from the health care reforms in the Inflation Reduction Act. Other reports showed more than 11,000 Connecticut Medicare enrollees using insulin can save about $590 per year. The out-of-pocket cap goes into effect on Jan. 1.

However, state lawmakers are reviewing other options to reduce prescription prices such as establishing a prescription drug affordability board, an independent body tasked with evaluating drug prices to determine if a price increase is valid.

Erlingheuser explained it can help keep prescription drug costs from getting too high.

"What it'll do is really allow the state of Connecticut to monitor the cost of prescription drugs, compare it with other states, and really put a downward pressure on those manufacturers to bring down those costs," Erlingheuser outlined.

Connecticut's most recent bill to establish a prescription drug affordability board failed to pass due to last-minute hurdles during the shortened legislative session. Public hearing testimony was mixed with many praising the idea of saving people money. However, some opposed Connecticut's bill creating a board because its members would not be representative of people who need lower drug costs.