Alert
Close

Think you know AARP? What you don't know about us may surprise you. Discover all the 'Real Possibilities'

HIGHLIGHTS

Open

REAL POSSIBILITIES

AARP Real Possibilities

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Dream Vacation Sweepstakes

10 weeks. 10 amazing trips. Seize your chance to win!
See official rules. 

CHECK OUT OUR
NEW IPAD APP!

ATM Mobile App for iPhone and Ipad

Enjoy the best of AARP’s award-winning publications

on the go with the new

AARP ePubs iPad App

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

AARP BOOKS

Planning for Long-Term Care for Dummies

Get expert advice on planning for your own or a relative’s future care needs.

Webinars

Learn From the Experts

Sign up now for an upcoming webinar or find materials from a past session.

Learning centers

Get smart strategies for managing health conditions.

 

Arthritis

Heart Disease

Diabetes

Most Popular

Viewed

share your thoughts

What does the health care law mean to you? Your story is important. We read and learn from every story and it helps us in our educational efforts. We may even use your comments (with permission) to brief legislators, inspire readers and more. Please share your story with us. Do

Oregon

State Slipping as Leader in Home- and Community-Based Care

Budget cuts are threatening those programs

Oregon State Page News April 2011

A home-care worker has helped Dorothy Willis, 85, stay in her Portland apartment. With two types of arthritis, Willis would like more help, but Oregon now has a waiting list for home-care services. — Robbie McClaran

Ten hours each month for six years, a care worker has dropped by Dorothy Willis' cozy Portland apartment to do laundry and clean, tasks the 85-year-old with two types of arthritis cannot manage.

The $200 worth of state-provided monthly care has kept Willis out of a nursing home and in her apartment, where she'd like to stay, she said, " 'til my toes curl up."

As she's become more prone to dangerous falls, Willis has requested five more hours of assistance from the care worker, but she's been put on a waiting list.

Her situation illustrates the challenges facing Oregon's long-term care system, which has been a national leader in caring for people in home- and community-based settings. Since 1981, the state has helped residents stay in their homes, but now the system is under pressure as the state grapples with a projected $3.5 billion two-year budget shortfall (PDF).

States are required to offer nursing home care by federal Medicaid regulations. But home- and community-based care is not mandated, so it's easier to cut.

Cutting payments to providers could cause home-care workers to leave the profession or refuse patients with complex needs, said James Toews, policy adviser for the Seniors and People with Disabilities Division. That could lead older people to "bump up to a higher level of care, which ends up costing more."

Nursing home care, at about $6,400 a month, costs the state two to three times more, on average, than home-based care.

As the population ages, the number of Oregonians who need long-term care is expected to double within 20 years.

A 2010 human services report (PDF) warned: "If Oregon's in-home and community care system falters, the migration into nursing facility settings at two to three times the cost cannot be stopped … without jeopardizing the operation of the entire state Medicaid program."

Oregon spends about $3.2 billion on long-term care, with $1 billion from the state general fund and most of the balance from federal funds, mainly Medicaid. In his proposed two-year budget, Gov. John Kitzhaber, D, has called for deep cuts in payments to nursing homes and home- and community-based services for long-term care.

"These cuts are disproportionate and hurt poor seniors, mostly women, while eliminating thousands of home-care workers' jobs," said Rick Bennett, director of government relations for AARP Oregon.

In 2003, Oregon's last major recession, the state cut long-term care spending by eliminating some prevention and outreach services, increasing caseloads, reducing payments to providers and tightening eligibility requirements. That last move cost 5,000 people their home and community care.

Next: Penny-wise and pound-foolish. >>

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Health blog

Discounts & Benefits

bring health To Life-Visual MD

AARP Bookstore

AARP Bookstore - woman reaches for book on bookshelf

VISIT THE HEALTH SECTION

Find titles on brain health, drug alternatives and losing weight. Do