SEATTLE - Washington tops the list for providing long-term care options for its residents in a report released today.

The report measures the care available in states based on accessibility, choice and quality. It also assesses their support for family caregivers and the transitions between health facilities and home.

Bea Rector, assistant secretary of aging and long-term support administration at the state Department of Social and Health Services, said Washington state provides a range of services for people as they age.

"We have created in Washington a very nice continuum of care that includes in-home options, licensed residential options, such as assisted-living facilities and adult family homes, as well as nursing homes for folks that need the 24/7 access to skilled nursing care," she said.

Even though the state ranks number one in this report, Rector said, there still is room to improve. She said her agency is rolling out initiatives this year for affordable-housing options and employment for people with disabilities.

Among the state's accomplishments is the CARE Act, which requires that hospitals notify and consult with caregivers before patients are discharged. Rector said Medicaid also is a critical part of the care system, especially as the number of older Washingtonians doubles in the next 20 years. Proposals by the Trump administration and in the U.S. House health-care bill would cut more than $1 trillion dollars from Medicaid - but Rector said that without the program, long-term care would be out of reach for many.

"Medicaid pays for about 60 percent of all nursing-home beds in Washington state," she said, "and Medicaid picks up all of the public payments associated with community-based care."

Rector added that family caregivers still are the backbone of the caregiving system. More than 820,000 Washingtonians provide care for loved ones.

The new AARP report, which was compiled jointly by AARP, the Commonwealth Fund and the SCAN Foundation, is online at longtermscorecard.org.


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Every Missourian knows property values and property taxes have risen dramatically in the past 15 years, as well as the cost of rent.

State lawmakers are now looking at increasing what's known as the "circuit breaker" as well. The Missouri Property Tax Credit has not changed since 2008. It was designed to help low-income seniors and Missourians with disabilities, both homeowners and renters, stay in their homes longer.

House Bill 1351 would raise both the amount of tax credit and the income eligibility limit.

Juli Jordan, director of marketing and community engagement/wellness for the SeniorAge Area Agency on Aging, says the update is long overdue.

"The very people that this credit was designed for are being left out now, with inflation and rates going up; housing rates and renters' rates going up," Jordan contended. "It's leaving out those people who need it the most."

The maximum tax credit has been $750 for renters and $1,100 for homeowners since 2008. The bill would raise the maximum tax credit for renters to $1,055, and for homeowners to $1,550 in 2024, and includes an annual adjustment based on inflation. The income eligibility level would also increase and be adjusted annually based on inflation.

Jordan noted in 2021, the average credit was $602, and only Missourians earning less than $14,300 a year qualified for the full credit. She pointed to the challenges many seniors and people living with disabilities are facing, especially in light of inflation.

"Some seniors, they have to decide, 'Can I buy groceries, or am I going to pay my utility bill?' " Jordan observed. "Or even having to decide, 'Can I get my life-altering medications this month?' "

Jordan stressed increasing the "circuit breaker" limits would not impact the amount of tax money available for schools or other tax-dependent services. The bill is not currently on the Missouri House legislative calendar. It was introduced by Rep. Marlene Terry, D-St. Louis County.

Many Nebraskans know how crucial a family caregiver is to one of their family members. Now AARP research has put a dollar value on that unpaid care - $2.8 billion dollars in 2021. Nearly 180,000 Nebraskans provided family caregiving that year. The organization has calculated the value on a state-by-state basis in the latest report of their "Valuing the Invaluable" series.

Todd Stubbendieck AARP Nebraska director said these caregivers are often making it possible for their family members to "age in place."

"Because without the support of those family caregivers, many people would be forced to go into a long-term care or an assisted-living situation," he said. "In addition, not being able to live more independently - which we know is what people want - many of the costs of that care would then get shifted to taxpayers. "

Stubbendieck added it is important for Nebraska family caregivers to learn about the support programs available to them, including the statewide Aging and Disability Resource Center. Since 2021, Nebraskans who leave work to care for a family member are eligible to collect unemployment insurance if they meet certain requirements.

This session, state Senator Machaela Cavanaugh (D-Omaha) introduced The Paid Family and Medical Leave Insurance Act, LB-57, which would provide paid leave to Nebraskans who must leave work to care for themselves or a family member.

Stubbendieck said often people do not consider themselves a family caregiver.

"They're supporting a grandparent or a parent or even a child because that's what we do. And because they don't know that they are a family caregiver, sometimes they don't access the support and help they need," he said.

AARP estimates the value of family caregivers nationwide in 2021 was more than $600-billion dollars - up more than $200 billion in just five years.

The report's recommendations include implementing more of the 350 actions in the U.S. Department of Health and Human Services' 2022 National Strategy to Support Family Caregivers.

It also highlights the need to strengthen the Family Medical Leave Act and make sick leave more widely available for workers who need to take family members to medical appointments and procedures.

A recent report finds nursing homes across New York are going without proper oversight.

AARP New York's report finds about 80% of New York City's almost 300 nursing homes, assisted-living and adult-care facilities didn't receive a single visit from the state's Long Term Care Ombudsman Program during a three-month period in 2022.

The reason for this is that the program has long been underfunded, a trend that's set to continue in Gov. Kathy Hochul's latest budget.

Richard Mollot, executive director of the Long Term Care Community Coalition, explained what would improve the ombudsman program and keep nursing homes accountable for patient care.

"The Department of Health needs to do a better job," said Mollot. "You know, these surveyors are inspectors. They need to be equipped and supported to ensure that residents are safe and that the facilities are not allowed to perpetuate poor care and demeaning conditions."

He added that what's critically needed is a professional ombudsman staff to meet the needs of nursing-home residents. This means regularly monitoring facilities, providing support to residents, and being a voice for residents too.

AARP New York is calling on a commitment of $15 million in state funding for the ombudsman program to ensure it has enough staff to follow through with serious complaints from nursing-home residents.

Trends for nursing homes across the state weren't much better. The report finds that more than half of facilities throughout New York failed to receive one visit from a Long Term Care Ombudsman.

But, outside of this program, there are challenges nursing homes have been facing for some time. Lindsay Heckler, supervising attorney at the Center for Elder Law & Justice, said one challenge that needs to be addressed is staffing.

"The rules and regulations that are in both federal and state law need to be fully enforced," said Heckler. "So, for example, New York State has the minimum staffing standards that are in effect. The state needs to make sure that nursing homes are doing their job and meeting those bare minimums."

Issues with staffing in nursing homes have been ongoing, but were exacerbated by the COVID-19 pandemic.

According to a report from the American Healthcare Association and the National Center for Assisted Living, from February 2020 to December 2022, nursing homes across the U.S. lost more than 210,000 workers.




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