Hurricane Irma and the future of aging services in Florida
Hurricane 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 14 residents in a Hollywood nursing home and the suffering of over a hundred other residents. That these individuals suffered as a result of apparent 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 (LTC) in Florida.
Florida does not now have the foundation required to meet either its current or future need for care provided through in-home, nursing home and assisted living programs. AARP released a report in June 2017 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.
Further illustrating the problems facing older Floridians needing long-term care are the long and growing wait lists. The wait list for Medicaid-supported services alone is now over 47,000 persons and grows each year by several thousand, a pace likely to increase if more funding is not made available soon.
Policymakers also need to take a close look at the way Florida now delivers publicly funded LTC services. In 2013, the state removed control of community-based LTC programs from the long-standing nonprofit Aging Network by contracting for the delivery of these services with for-profit HMOs. This shift was made 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.
The state has a history of using governorand Legislature-appointed commissions on aging to identify issues and concerns and generate innovative policy options to address them. The last commission in 2000 produced a comprehensive set of policy recommendations that were supported by Gov. Bush and largely passed into law by the 2001 Legislature.
A lot has happened since 2000 as the population needing long-term care has grown and programs have changed. It is now time for a new commission with a comprehensive mandate to address the future of aging and LTC in Florida to be appointed. It does not take a commission, however, to know that the state should begin now to substantially increase funding for LTC in preparation for meeting the huge increase in need for care that is already underway.
Larry Polivka, Ph.D., is director of the Tallahassee-based Claude Pepper Center. Anne Barrett, Ph.D., is director of the Pepper Institute on Aging and Public Policy and professor of sociology at Florida State University.