Change On Tap For Long-term Care In Oregon

East Oregonian | Oct. 28, 2012 1:50 p.m. | Updated: Oct. 28, 2012 8:50 p.m.

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Daily Astorian

Traditionally, the trajectory was clear.

In the journey of life, the nursing home was often the final destination for Oregonians who relied on publicly funded long-term care. That changed some 30 years ago when the federal government gave Oregon permission to use Medicaid dollars to pay for care in homes and community-based facilities.

Still, the nursing home is perceived as the customary last stop of the old, poor and infirm.

That perception and others may change soon, depending on feedback from the public and legislators.

During a statewide tour, representatives of the state’s Aging & People with Disabilities division are pitching ideas for transforming Oregon’s long-term care system. Tuesday at the Pendleton City Hall Community Room, policy analysts Naomi Sacks and Max Brown described a possible model.

Sacks said most Oregonians don’t want to live out their final days in a nursing facility.

“Eighty-two percent will choose community-based care over institutional care,” she said.

Brown concurred, saying “When I ask people, ‘Do you want to live your entire life in your own home,’ most of the time, the answer is yes.”

Sacks said they envision a system that enshrines that reality and removes barriers to home or community-based care for seniors or individuals with disabilities.

The state is facing, if not a silver tsunami, at least a rising number of seniors. Brown said 20 percent of Oregon’s population will be 65 or older by 2030, compared with 13 percent in 2010. Umatilla and Morrow counties are graying at a slightly slower clip.

“It’s a bit of a younger demographic than we see statewide,” Brown said.

The Office of Economic Analysis projects Umatilla County’s 65-plus population at 17 percent and Morrow County at 16 percent in 2030, compared with 13 and 11 in 2010. The number of seniors receiving Medicaid-funded long-term care and other Medicaid assistance would likely rise from about 1,450 to 2,500 in Umatilla County.

“Oregon’s population is growing,” Brown said, adding, “This isn’t to say the sky is falling … people are living longer and healthier lives.”

Currently, only 2.3 percent of all Oregonians have long-term care insurance.

Another challenge is the escalating cost of healthcare. He compared medical inflation to food costs.

“If you were to apply the medical inflation rate since 1930, a carton of eggs would cost $80.20,” Brown said. A roll of toilet paper would cost about $24 and a dozen oranges almost $105.

The department is scoping out cost-effective new choices that could include prevention planning and early intervention and technology, including smart phone applications, to bring independence at home.

Sacks said people are often propelled into the state long-term care system by a major health event. Early intervention could prevent falls, strokes and the like “before there is irreversible harm — before a catastrophic event that becomes a downward spiral.”

The Pendleton crowd wasn’t large at eight, but all offered input, worrying about such things as the lack of housing in the area and the gap between those who can afford long-term care and those who qualify for Medicaid.

The agency will continue gathering input through November. Legislators will consider the new concept (dubbed LTC 3.0) in February.

Contact Kathy Aney at kaney@eastoregonian.com or 541-966-0810.

This story originally appeared in East Oregonian.


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