Monday, December 11, 2017
Opinion

Column: What Hurricane Irma taught us about better care for older people in Florida

Irma cut a destructive path through Florida, leaving many people with damaged homes and businesses and communities without essential infrastructure and services. One of the saddest, most heart-wrenching and perhaps avoidable of all the terrible effects from Irma was the death of 10 residents in a Hollywood nursing home and the suffering of more than a hundred other residents. That these individuals suffered as a result of negligence on the part of the facility's operators seems clear and will ultimately be decided by regulators and the courts.

But that should not be the end of the scrutiny. In fact, it should open our eyes to an issue that has not received proper attention for several years — the state of publicly funded long-term care, or LTC, in Florida. We have good reason to fear that the state is not prepared to care properly for the great growth in LTC over the next 20 years. This growth will come with the unprecedented increase in Florida's 75- to 85-and-older population between now and 2040.

Florida does not have the foundation required to meet the future need for care provided through in-home, nursing home and assisted-living programs. AARP released a report in June that provides a well-designed comparative assessment of every state's LTC system using criteria such as ease of access to care and quality of care provided. Florida was ranked 46th in the overall quality of its publicly funded LTC system, far below states such as Washington, Oregon, Minnesota and Wisconsin, which are ranked the highest. Florida ranked 43rd in the 2013 AARP report.

Further illustrating the problems facing older Floridians needing LTC are the long and growing wait lists. The wait list for Medicaid-supported services alone is more than 47,000 people and grows each year by several thousand, a pace likely to increase if more funding is not made available soon. Closer analysis of these trends is needed, with an eye toward policies and funding increases that can address the gaps in care for older Floridians.

Policymakers also need to take a close look at the way Florida delivers publicly funded LTC services. In 2013, the state removed control of community-based LTC programs from the long-standing non-profit Aging Network by contracting for the delivery of these services with for-profit HMOs. This shift was made with very little public debate, in spite of the fact that the Aging Network organizations had built and very effectively administered the publicly supported community-based programs for over 25 years. It is time to take an in-depth, objective look at this arrangement and determine if it is best for the state and its citizens as we prepare for the future.

Florida has a long history of innovation in LTC stretching back to the creation of community care and home care programs for the elderly in the mid 1970s. The state also has a history of using governor- and Legislature-appointed commissions on aging to identify issues and concerns and generate innovative policy options to address them. Three commissions were appointed between 1984 and 2000. The 2000 commission, chaired by Lt. Gov. Frank Brogan, produced a comprehensive set of policy recommendations that were supported by Gov. Jeb Bush and largely passed into law by the 2001 Legislature. Unfortunately, some of the most progressive provisions of this legislation, including increased caregiving staff levels in nursing homes, have been undone since 2005 in order to reduce funding in the Florida Medicaid LTC budgets.

A lot has happened since 2000 as the population needing LTC has grown and programs have changed. It is now time for a new commission to be appointed with a comprehensive mandate to address the future of aging and LTC in Florida. The commission would be expected to inform the public and policymakers about what we are doing well in LTC, where we are failing, and what we must do to ensure the citizens of Florida that our LTC system will be able to provide the quality of care that people needing help deserve in the years ahead.

It does not take a commission, however, to know that the state should begin now to increase funding substantially for its LTC system in order to reduce the number who need care but aren't receiving it and to better prepare for the huge increase in need for LTC that is already under way.

Larry Polivka is director of the Claude Pepper Center at Florida State University.

Comments

Another voice: Privacy in the internet age

How much information about you is on your cellphone? Likely the most intimate details of your life: photographs, internet searches, text and email conversations with friends and colleagues. And though you might not know it, your phone is constantly c...
Updated: 5 hours ago
Editorial: Grand jury could force reforms of juvenile justice system

Editorial: Grand jury could force reforms of juvenile justice system

Confronted with documentation of sanctioned brutality and sexual abuse in Floridaís juvenile detention centers, the reaction from Gov. Rick Scottís administration was defensive and obtuse. So itís welcome news that Miami-Dade State Attorney Katherine...
Updated: 4 hours ago

Editorial: U.S. House sides with NRA over stateís rights on concealed weapons permits

With the horror of the mass shootings at a Las Vegas country music concert and a small Texas church still fresh, the U.S. House finally has taken action on guns. But the bill it passed last week wonít make Americans safer from gun violence. It is an ...
Published: 12/07/17
Editorial: Hillsborough cannot afford pay raises for teachers

Editorial: Hillsborough cannot afford pay raises for teachers

There is no satisfaction for anyone in the standoff over pay raises between the Hillsborough County School District and its teachers. Most teachers across the nation already are underpaid, but this district simply cannot afford the raises teachers ex...
Published: 12/07/17
Editorial: Impact of Water Street project extends beyond buildings

Editorial: Impact of Water Street project extends beyond buildings

With a buildout of $3 billion encompassing entire city blocks, itís obvious that Jeff Vinikís plans will change the look and feel of downtown Tampa. But the Tampa Bay Lightning owner unveiled a broader vision last week that reflects how far the impac...
Published: 12/06/17
Updated: 12/08/17
Editorial: Make texting while driving a primary offense

Editorial: Make texting while driving a primary offense

It is dangerous and illegal to text while driving in Florida, and police should be able to pull over and ticket those lawbreakers without witnessing another violation first. House Speaker Richard Corcoran has lent his powerful voice to legislation th...
Published: 12/06/17
Updated: 12/07/17

Editorial: Outsourcing common sense on St. Petersburg Pier naming rights

St. Petersburg officials predict that selling the naming rights to parts of the new Pier could generate $100,000 in annual revenue. But first the city wants to pay a consultant to tell it how and to whom to sell the rights. Why do city officials need...
Published: 12/06/17
Updated: 12/07/17

Another voice: Trumpís risky move

President Donald Trumpís decision to recognize Jerusalem as Israelís capital has a certain amount of common sense on its side. As a practical matter, West Jerusalem has been the seat of Israeli government since 1949, and no conceivable formula for Pa...
Published: 12/06/17
Updated: 12/07/17
Editorial: Tampaís MOSI reinvents itself

Editorial: Tampaís MOSI reinvents itself

A tactical retreat and regrouping seems to be paying off for Hillsborough Countyís Museum of Science and Industry. After paring back its operations, the museum posted a small profit over the past year, enabling the attraction to keep its doors open a...
Published: 12/05/17
Updated: 12/07/17
Times recommends: McClure for Florida House District 58

Times recommends: McClure for Florida House District 58

Voters in Temple Terrace, Plant City and Thonotosassa have an easy choice in the Dec. 19 special election to replace state Rep. Dan Raulerson, who resigned for health reasons. Republican Lawrence McClure is the only credible candidate.McClure, 30, ow...
Published: 12/05/17
Updated: 12/07/17