Funding long-term care has far-reaching impact

    However, the two reports released separately by the American Health Care Association (AHCA) and the Rhode Island Department of Labor and Training (RIDLT) reveal that our legislators’ funding decisions go far beyond just the clientele served by the long-term care profession. They impact every facet of our economy and all of our citizens.
    The AHCA report indicates that long-term care facilities make up the sixth largest industry in Rhode Island, providing jobs for almost 18,000 people directly and for another 3,470 people indirectly. The RIDLT reports just over 18,000 people are directly employed in the industry.   Those employees generate more than $290 million dollars in federal and state taxes and account for an estimated $1.8 billion of the state’s economic activity.
    Despite being paid less than their counterparts in neighboring Massachusetts and Con-necticut in the majority of job categories, according to the RIDLT report, employment in Rhode Island’s nursing, residential mental health and community care facilities for the elderly grew 5.5 percent from 2002 to 2009, which is in stark contrast to a 4 percent drop in total private sector employment. Clearly, the demand is there and will continue because of the silver tsunami of aging baby boomers.
    Given the enormity of those figures it is clear that the decisions regarding the funding of long-term care have widespread impact. In the skilled nursing and rehabilitation sector, for example, more than 70 percent of care is paid for by Medicaid and changes in reimbursement levels can be the difference between quality care delivered by adequate staff and substandard care and increased unemployment. Whether one is a recipient of long-term care services or just a Rhode Island citizen, they will feel the impact of funding cuts in the care delivered or in the economic implications the cuts create.
    In evaluating the long-term care arena, it’s important to understand the inherent characteristics of Rhode Island’s population that play a large part in determining which long-term care settings are used most. For example, as a percent of the population, Rhode Island’s age 85-plus population is one of the largest in the country, and that age bracket is the most likely to need nursing home care. In states across the country, it’s not unusual for nursing homes to use the largest part of the state’s long-term Medicaid budget and given Rhode Island’s unusually large proportion of people 85 and older, it’s no surprise that our nursing home population requires the largest slice of the funding pie.
    What is also essential for policymakers to consider is that each part of the long-term care continuum serves a critical purpose and services are generally not interchangeable for the populations served. The acuity of the typical nursing home resident, for example, requires 24-hour skilled nursing care not found in other residential long-term care settings.
    The AHCA and RIDLT reports, which are available online at www.ri-hca.com, point out valuable information that deserves serious consideration when legislators make funding decisions.

    Joan M. Woods is chair of the Rhode Island Health Care Association (RIHCA), a non-profit association comprised of about two-thirds of the state’s skilled nursing and rehabilitation facilities. She is also executive administrator of the Genesis HealthCare Grand Islander Center in Middletown. She can be reached at 401.849.7100 or joan.woods@genesishcc.com.