A number of bills in the Maryland legislature are looking to increase the quality and accountability of the state's nursing homes and assisted living facilities.

Advocates for seniors are supporting a bill that would require facilities to install video surveillance systems in common areas.

That way, there would be video evidence to monitor any neglect, abuse or exploitation of residents.
Another bill would increase the number of inspections of assisted living facilities.

Tammy Bresnahan the senior director of advocacy for AARP Maryland.

She said a lot of her focus this legislative session is on assisted living facilities, because of how many high-care individuals they take in.

"We've been looking at assisted living, because they're systematically taking more chronically health-needed individuals," said Bresnahan. "So they look a lot like what's in a nursing home, but people are privately paid for that."

Bresnahan explained that nursing homes have many layers of accountability, given the state and federal medicare dollars flowing into the facilities.

Assisted living centers, on the other hand, usually only receive funds from private customers - with little oversight.

Data from the Center for Medicare and Medicaid Services found Maryland has some of the longest wait times for nursing home inspections, at nearly three years.

Bresnahan added that it's important to have more inspections for assisted living facilities.

"The regulations really only require initially for the licensure to have the inspection - and if there's a problem, they have to go out," said Bresnahan. "So, they really want their assisted living to be inspected more often. "

Bresnahan said any Maryland senior considering a nursing home or assisted living facility should call the Maryland Office of Healthcare Quality.

That office can let seniors know if a facility has a history of issues.

Michigan is home to more than 470,000 veterans, yet many have never accessed the military benefits to which they are entitled. The gap in support prompted a local war veteran to take action.

During the COVID-19 pandemic, nearly 200 Michigan veterans died by suicide, well above the state's average, and the number is growing.

Joshua Parish, president of the nonprofit service organization VETLIFE and an Iraq War veteran, is working to change it. His organization, which started in 2018, provides veterans with sustainable resources, free events and community support to help them navigate civilian life. Parish said one of their flagship events called VetFest attracts more than 3,000 people at each event.

"We have 60 resource providers that help connect the dots," Parish explained. "What we're seeing is one month after the VetFest event, a 60% increase in veterans going down to their local resources, which is what we want."

Parish emphasized his main goal is to educate and empower veterans to be their own best advocate. He believes by doing so, it will decrease the veteran suicide rate.

More than 8 million U.S. veterans are 65 and older, nearly half of the veteran population. Many face isolation, depression and struggles transitioning to civilian life, even decades later. As a veteran, Parish has battled mental health challenges himself. He added many feel a loss of purpose and betrayed by the government they once served.

"If you can give these veterans or help cultivate the sense of purpose, the sense of identity, and just make them feel like a person again, I feel like that's going to drastically reduce the veterans' suicide rate," Parish contended.

Many veterans rely on VA pensions, Social Security or disability benefits, making it crucial for them to know and access the resources they have earned.

Oregon's population, along with the rest of the country, is getting older. Within 10 years there will be more Oregonians age 65 and older than children younger than 18.

New legislation would establish a task force to create a blueprint for the state to prepare for the massive change.

Bandana Shrestha, state director of AARP Oregon, said having an older population will affect every sector of the state including housing, transportation and health. She emphasized the task force would bring representatives from many of these sectors to the table.

"It's not just the needs that we're going to be responding to," Shrestha pointed out. "People talk about aging as a net deficit in some ways. Aging also can be very positive."

Shrestha noted older adults benefit the state by contributing billions of dollars in unpaid care to other adults and children, as well as volunteer hours to schools and nonprofits. Public testimony for the bill has been overwhelmingly positive.

Rep. Mari Watanabe, D-Bethany, a sponsor of the bill, said the shifting age demographics will also affect the state's workforce and older people who want or need to keep working will be able to help fill in gaps.

"They bring skills, they bring knowledge, they bring their acumen that they've learned all through the years," Watanabe outlined. "To keep them in the workplace would be great for Oregon."

Shrestha stressed the need for financial support as more families care for older adults at home. She also highlighted the rising homelessness among older adults and urges state investment in housing for aging in place. Despite all the work needing to be done, Shrestha is optimistic about the plan the legislation lays out.

"It's proactive," Shrestha acknowledged. "It's not waiting 'til there is an emergency. We still have a nice timeline to work towards it. And everybody should be invested because it's about our future."

The Montana governor's proposed budget includes cuts to funding for senior long-term care. Those in the already-struggling industry said as more Montanans enter their 80s, a wider community will feel the effects.

Within the last three years, 11 of Montana's nursing homes closed in a single 12-month period. It adds pressure to those providers left, like Big Sky Senior Services in Billings, which provides payee services for over 100 people and offers in-home care for seniors on a sliding-fee scale.

Tyler Amundsen, executive director of Big Sky Senior Services, said keeping seniors in their homes as long as possible is the goal but there is usually a point where outside care becomes necessary.

"Then they're in crisis because we don't have enough places to send them," Amundsen observed. "Or the places that are available to send them aren't getting funded well. And so the quality of care is going down."

Amundsen added reimbursement rates are not keeping up with the rise of inflation. Gov. Greg Gianforte has proposed $50 million in cuts over the next biennium to senior and long-term care services via the Department of Public Health and Human Services, amounting to nearly 6%.

As there are fewer services and increased need, more people will likely become caregivers for family, which Amundsen emphasized will affect the workforce. He is predicting a trend called the "sandwich generation."

"They'll be taking care of their parents as well as their kids at the same time," Amundsen explained. "It just puts more strain on our communities to be able to do all the things we hope we can do."

He advises people and groups in the state pay attention to this rising issue now, before it worsens. Nearly 100,000 Montanans will enter their 80s this decade, nearly 70% more than did between 2010 and 2019.


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