State Legislative Actions Show Concern About Long-Term Care Staffing, Prescription Drugs

Alzheimer's Association
Monday, 18 September 2000

Improved nursing home care through better staffing ratios and training, expanded prescription drug coverage and respite care for family caregivers, were among the issues addressed by state legislatures during the year 2000, according to a new report by the Alzheimer's Association of 263 different pieces of state legislation.

The annual report, titled State Review 2000, reflects the work of the Alzheimer's Association's chapters nationwide and seeks to prepare for the next legislative session through the exchange of details of state actions.

The single most important determinant of quality care in any long term care setting is direct care staff, adequate numbers of well-trained workers available to meet residents' needs. According to the report, our nation is facing a workforce crisis. The booming economy and near full employment has improved job opportunities elsewhere, causing alarm about the extremely high turnover rate and low morale among low-paid nursing home staff.

This problem will only get worse as millions of babyboomers move into the age of high risk of Alzheimer¹s disease. Currently, four million Americans have the disease, but that figure could jump to 14 million by mid-century, heightening concern about the future of the national caregiving system.

As a result, the Alzheimer's Association has focused on legislation to improve current conditions, such as the implementation of wage pass-through legislation that earmarks a portion of Medicaid reimbursement increases to wages and benefits to nursing home aides; and provides for more dementia training in long-term care facilities.

Family caregivers provide the equivalent of $196 billion annually in direct care; without their valuable contribution, programs like Medicare and Medicaid would simply collapse, analysts warn. As a result, Alzheimer advocates are intensely interested in such issues as relief for caregivers, whether through caregiver support programs or through tax deductions and credits from both the federal and state governments.

In an election year, Alzheimer advocates welcome the added emphasis on health care issues like prescription drug coverage under Medicare, but warn of the consequences of ignoring long-term care issues.

The analysis addresses 10 legislative topics taken up by the states. In addition to the long term care workforce, prescription drugs and respite care, the report addresses adult day care, home and community based services, assisted living, special care unit disclosure, rural health issues, Alzheimer/dementia specific issues and long term care, including the creation in four states of long term care task forces or study commissions.

For more information, or to contact Alzheimer's Association, see their website at: www.alz.org